Your role as a mandated reporter (~12 Minutes)

Unfortunately, there may be times when what you observe or suspect leads you to believe a vulnerable adult is being harmed.

We all share a moral responsibility to help protect others who are:

Less likely to be able to protect themselves.
At the risk of getting harmed physically, mentally, and/or emotionally.

By Washington State law, your responsibility as an LTC worker goes beyond a moral obligation. It is also the law. You are a mandated reporter if you suspect (meaning you have reasonable cause to believe) any vulnerable adult is being abused, abandoned, neglected, or exploited. This is true whether you are on or off your job. (RCW 74.34)

Washington State Law also requires all mandatory reporters to report suspected child abuse and neglect (RCW 26.44).

To make sure these state and federal laws are followed, the facility or company where you work has written rules and policies to protect each client from harm. These rules and policies are covered here and again during basic training.

Understand your role as a mandated reporter.

Some helpful definitions

Abandonment is when someone responsible for the care of a vulnerable adult leaves the person without the means or ability to get necessary food, clothing, shelter, or health care.
Abuse is willfully inflicting injury, unreasonable confinement, intimidation, or punishment on a vulnerable adult. Abuse includes sexual abuse, mental abuse, physical abuse, and exploitation of a vulnerable adult.
Sexual abuse means any form of nonconsensual sexual conduct, including but not limited to unwanted or inappropriate touching, rape, sodomy, sexual coercion, sexually explicit photographing, and sexual harassment. Sexual abuse also includes any sexual conduct between a staff person, who is not also a resident or client, of a facility or a staff person of a program authorized under chapter 71A.12 RCW, and a vulnerable adult living in that facility or receiving service from a program authorized under chapter 71A.12 RCW, whether or not it is consensual.
Physical abuse means the willful action of inflicting bodily injury or physical mistreatment. Physical abuse includes but is not limited to, striking with or without an object, slapping, pinching, choking, kicking, shoving, or prodding.
Mental abuse means a willful verbal or nonverbal action that threatens, humiliates, harasses, coerces, intimidates, isolates, unreasonably confines or punishes a vulnerable adult. Mental abuse may include ridiculing, yelling, or swearing.
Personal Exploitation means an act of forcing, compelling, or exerting undue influence over a vulnerable adult causing the vulnerable adult to act in a way that is inconsistent with relevant past behavior, or causing the vulnerable adult to perform services for the benefit of another.

Financial exploitation means the illegal or improper use, control over, or withholding of the property, income, resources, or trust funds of the vulnerable adult by any person or entity for any person’s or entity’s profit or advantage other than for the vulnerable adult’s profit or advantage.

Neglect means (a) a pattern of conduct or inaction by a person or entity with a duty of care that fails to provide the goods and services that maintain the physical or mental health of a vulnerable adult, or that fails to avoid or prevent physical or mental harm or pain to a vulnerable adult; or (b) an act or omission by a person or entity with a duty of care that demonstrates a serious disregard of consequences of such a magnitude as to constitute a clear and present danger to the vulnerable adult’s health, welfare, or safety, including but not limited to conduct prohibited under RCW 9A.42.100.

Reporting abuse to DSHS

You MUST report immediately to the Department of Social and Health Services (DSHS) if you have reasonable cause to believe a client or any vulnerable adult is being abused, neglected, abandoned, or exploited.

Where to report abuse

To report suspected abuse to DSHS for a vulnerable adult living in:

An adult family home or assisted living facility: call

1-800-562-6078

His or her own home, call

1-866-363-4276 or 1-866-End Harm.

In addition, you must report to DSHS and:

Law enforcement if you suspect physical or sexual assault.
The coroner or medical examiner and law enforcement if you suspect the death was caused by abuse, neglect, or abandonment.

Failure to report as a mandated reporter is a gross misdemeanor.

Who to Call

Where you report abuse depends on where the person lives.

If the person lives in:

An assisted living facility or adult family home:

Call the DSHS Complaint Resolution Unit (CRU) at 1-800-562-6078.

His or her own home:

Call the DSHS End Harm hotline number at

1-866-363-4276.

You may feel nervous or unsure about reporting. These are normal feelings. Don’t let them keep you from reporting. You must report. You are a mandated reporter in Washington State.

You do not need proof to call. You need reasonable cause to believe a vulnerable adult is being harmed.
You do not need the client’s or supervisor’s permission to call.
If you report in good faith and it turns out there was no abuse, you cannot be held liable.
Your name will be kept confidential unless there is a legal proceeding.

If you think a client may be in immediate danger or needs urgent help, call 911.

Self Neglect

There are some situations where a vulnerable adult living in his or her home is not providing for his or her own physical and/or mental well-being to the point of harm.

Although you are not a mandated reporter of self-neglect, you are encouraged to report it to DSHS if you have reason to believe a vulnerable adult is neglecting his or her needs to the point of harm. Call 1-866-363-4276.

Working with your supervisor and reporting

If you have reasonable cause to believe that abandonment, abuse, financial exploitation, or neglect of a vulnerable adult has occurred, alert your supervisor immediately.

There are documented policies and procedures for how your facility or company wants you to handle this situation so that the law is followed and the client is protected. It is your responsibility to know what they are, where these policies are documented, and to follow them.

Keep in mind that alerting your supervisor does not release you from your responsibilities as a mandated reporter. If you have reasonable cause to believe that abandonment, abuse, financial exploitation, or neglect of a vulnerable adult has occurred, you are mandated to report it.

Incident Log

All AFHs are required to keep an incident log of any alleged or suspected incidents of abuse, abandonment, neglect or exploitation. This incident log is also required to document any:

Accidents or incidents affecting a client’s welfare.
Injury to a client.

Although an incident log is not required in ALFs, ALFs must document what was done to investigate any allegations of suspected abuse, abandonment, neglect or exploitation, accident, or incident jeopardizing or affecting a client’s health or life. It is your responsibility to know what you must do and document if you work in an ALF.

It is your responsibility to know where the log is and how to fill it out.

The use of restraints

Three types of restraints were used in the past before it was widely known that most restraints do not keep a client safe. In almost all cases, the following types of restraints cannot be used. Restraints can NEVER be used to discipline a client or for staff convenience.

Physical restraints – anything used to prevent or limit movement or access to one’s body. This could be a belt, bed rails, or a chair a person cannot get out of.

Chemical restraints – drugs not required to treat medical symptoms that are used for the convenience of staff or without appropriate or enough monitoring.

Environmental restraints – locked rooms or barriers confining a person to a specific space.

Restraints put a client at risk.

There are very specific situations where a restraint may be used with an individual client in an AFH only. In an AFH, restraints may never be used for discipline or convenience and must be applied and supervised on-site by a licensed nurse or physician. These and other important guidelines must be followed. See WAC 388-76-10655 and WAC 388-76-10660. Talk with your supervisor and know exactly what you can and can’t do in these individual cases if you work in an AFH.

Restraints may never be used at any time in an ALF or an in-home setting.