Key Takeaways
- CNAs are mandatory reporters—legally required to report suspected abuse
- Types of abuse: physical, sexual, emotional, financial exploitation, neglect, abandonment
- Report suspicion immediately—you do not need proof
- Document objectively: what you saw, heard, and who you reported to
- You are protected by law: immunity, confidentiality, and protection from retaliation
Last updated: January 2026
Abuse Recognition and Reporting
CNAs are legally required to recognize and report abuse, neglect, and exploitation of vulnerable adults. Understanding the types of abuse and reporting requirements is essential for protecting residents.
Types of Abuse
| Type | Definition | Examples |
|---|---|---|
| Physical Abuse | Intentional bodily harm | Hitting, pushing, pinching, slapping, inappropriate restraints, forced feeding |
| Sexual Abuse | Non-consensual sexual contact or behavior | Unwanted touching, sexual assault, exposure, forcing to watch sexual content |
| Emotional/Psychological Abuse | Verbal or nonverbal actions causing mental anguish | Yelling, threats, humiliation, intimidation, isolation, ignoring |
| Financial Exploitation | Illegal use of person's money or property | Stealing money/items, forging signatures, coercion for inheritance changes |
| Neglect | Failure to provide necessary care | Not providing food, water, hygiene, medications, supervision |
| Self-Neglect | Person's inability to care for self | Not addressed through reporting (requires intervention) |
| Abandonment | Desertion by caregiver | Leaving resident alone without care, not showing for shift without coverage |
Signs of Abuse
Physical Abuse Signs:
- Unexplained bruises, welts, burns
- Injuries in various stages of healing
- Injuries inconsistent with explanation
- Fear of caregivers
- Injuries in unusual locations (inner arms, inner thighs)
- Signs of restraint (wrist/ankle marks)
Sexual Abuse Signs:
- Bruising around genitals or breasts
- Unexplained STDs or genital infections
- Torn, stained, or bloody undergarments
- Difficulty walking or sitting
- Fear of being alone with certain people
Emotional/Psychological Abuse Signs:
- Withdrawal, depression, fearfulness
- Unusual behavior changes
- Resident seems fearful of certain staff
- Low self-esteem
- Anxiety, agitation
- Sleep disturbances
Financial Exploitation Signs:
- Missing personal belongings or money
- Unpaid bills despite adequate funds
- Changes in banking or documents
- "New best friends" with interest in finances
- Resident doesn't know where money went
Neglect Signs:
- Poor hygiene, body odor
- Pressure injuries, unchanged dressings
- Dehydration, malnutrition
- Unchanged soiled clothing or linens
- Unsafe living conditions
- Lack of needed medical care
- Medication errors or non-administration
Who Can Be an Abuser?
Anyone with access to vulnerable adults can be an abuser:
- Family members
- Caregivers (CNAs, nurses, others)
- Other residents
- Visitors
- Friends
- Strangers
Risk Factors for Abuse:
- Caregiver stress or burnout
- Substance abuse
- History of violence
- Financial problems
- Social isolation of victim
- Cognitive impairment of victim
Mandatory Reporting
CNAs are mandatory reporters. This means you are legally required to report suspected abuse.
What to Report:
- Any suspected abuse, neglect, or exploitation
- You do NOT need proof—reasonable suspicion is enough
- Report even if you only suspect—investigation will determine facts
How to Report:
| Step | Action |
|---|---|
| 1 | Ensure resident's immediate safety |
| 2 | Report to your supervisor/nurse IMMEDIATELY |
| 3 | Document objectively (what you saw, heard, or were told) |
| 4 | If supervisor doesn't act, report up chain of command |
| 5 | You may also report to state agency (Adult Protective Services) |
What to Document:
- Date, time, and location
- What you observed (objective facts)
- What the resident said (use exact quotes)
- Resident's condition and behavior
- Who you reported to and when
What NOT to Do:
- DON'T investigate yourself
- DON'T confront the suspected abuser
- DON'T promise to keep it secret
- DON'T delay reporting
- DON'T discuss with other staff (except as needed for care)
Protection for Reporters
You are protected by law:
- Immunity - Cannot be sued for good-faith reporting
- Confidentiality - Your identity as reporter is protected
- Retaliation protection - Illegal to punish you for reporting
Failure to Report:
- Legal consequences (fines, criminal charges)
- Loss of certification
- Civil liability
- Moral responsibility for continued harm
Test Your Knowledge
A CNA suspects a resident is being abused but isn't sure. What should they do?
A
B
C
D
Test Your Knowledge
Which of the following is a sign of possible financial exploitation?
A
B
C
D
Test Your Knowledge
What legal protection do CNAs have when reporting suspected abuse?
A
B
C
D