6.2 Mandatory Reporting in Colorado

6.2 Mandatory Reporting in Colorado

Quick Answer: Colorado reporting is two layers, not one phone number. 3 CCR 716-1.10 I.2.f.(7) says report any suspicion of abuse, mistreatment, and neglect immediately to the supervisor or licensed nurse and follow facility policy. C.R.S. 18-6.5-108 (Colorado Department of Human Services / CDHS) says health-care providers and long-term-care or home-health staff must also report mistreatment of an at-risk elder (age 70 or older) or an at-risk adult with intellectual or developmental disability (IDD) to the law enforcement agency where the mistreatment occurred within 24 hours. Adult Protective Services (APS) investigates. Calling only APS does not meet that statutory duty.

Why two layers exist

The Board rule protects the person in front of you right now. The nurse can separate staff, protect the resident, and start the facility’s required internal process. The criminal-code rule protects the same person outside the building. Law enforcement receives the mandatory report so the event is not buried as an “in-house personnel matter.” NNAAP items will describe a bruise, a grab, a stolen card, or a skipped meal and ask what the nurse aide should do. The Colorado-correct answer is almost always both: tell the nurse immediately and complete the outside report the statute requires.

/practice/co-cnaPractice questions with detailed explanations

Layer A — Board rule, immediately

3 CCR 716-1.10 I.2.f.(7) sits inside basic CNA scope, next to clients’ rights. The CNA’s job includes freedom from abuse, mistreatment, and neglect and reporting any suspicion of abuse, mistreatment, and neglect immediately.

Immediate means now — not at the end of the shift, not at the next care conference, and not after you “watch for a few more days.” Tell the licensed nurse or the supervisor who has the assignment. Follow the facility’s written policy for internal documentation and any second call the policy names (administrator, abuse coordinator). Stay with the client if the person is unsafe. Do not leave the person alone with the alleged abuser while you “think it over.”

This layer applies to every client in your care, not only people older than 70. A 45-year-old rehabilitation patient, a 9-year-old on a pediatric unit, and an 81-year-old long-term-care resident all get the immediate nurse report if you suspect abuse, mistreatment, or neglect.

Layer B — C.R.S. 18-6.5-108, law enforcement within 24 hours

CDHS explains the second layer in plain language. Certain professionals — including any person providing health care or health-care-related services and staff of hospitals, long-term care facilities, home-care agencies, and home-health providers — must report mistreatment of two populations:

1. An at-risk elder: any person 70 years of age or older.
2. An at-risk adult with IDD: a person 18 or older whose intellectual or developmental disability had onset before age 22, with an IQ of 70 or below and/or significant limits in the ability to socialize, provide self-care, or communicate. CDHS notes that IDD includes conditions such as autism spectrum disorders, epilepsy, cerebral palsy, developmental delays, Down syndrome, and fetal alcohol syndrome.

Mistreatment in this statute is physical abuse, sexual abuse, caretaker neglect, and exploitation. Observation is enough. So is reasonable cause to believe mistreatment happened or is imminent.

The statutory report is to the law enforcement agency where the mistreatment occurred, not more than 24 hours after you observe or discover it. That is a clock, not a suggestion. If the grab happened on your unit in Pueblo, you report to the law-enforcement agency that covers that address — not to a department in another county because that is where the family lives.

CDHS tells reporters to bring what they have:

• Name and address of the at-risk elder or at-risk adult with IDD
• A description of what you saw or what the person said
• The nature and extent of any injury
• The alleged perpetrator’s name and contact information if you have it

Helpful extras include when you last saw the person, medical or memory problems that affect self-care, and which family or services are already involved. Missing a detail is not a reason to wait. Report with what you know.

APS investigates — APS is not the statutory substitute

County Adult Protective Services (APS) exists in Colorado. APS investigates adult mistreatment and can open services. Facilities often have a policy that also notifies APS or the state survey line. Follow that policy after you have told the nurse and made the law-enforcement report the statute requires.

Do not tell yourself — and do not pick an exam option that says — that calling only APS satisfies C.R.S. 18-6.5-108 for an at-risk elder or an at-risk adult with IDD. The mandatory reporter’s statutory duty for those two populations is law enforcement within 24 hours. APS work continues beside that report. It does not erase it.

Children and the 844-CO-4-KIDS line

If the suspected victim is a child, the Board-rule immediate nurse report still happens. Colorado also requires a child-abuse or neglect report when you are a mandated reporter. Use 844-CO-4-KIDS (the statewide child-abuse and neglect hotline) within 24 hours when required, or follow the facility policy that routes the same report to the county department or local law enforcement. Do not confront the parent in the hallway to “confirm the story.” Do not wait for photographs that look more convincing.

What you report — and what you never do

You do not need proof. A resident statement, a patterned bruise, a sudden fear of one aide, an empty wallet that was full yesterday, or a wet brief that has clearly been ignored for hours is enough to start both layers.

You do not investigate. Do not interview other residents “to build a case.” Do not pull badge swipe times. Do not ask the alleged perpetrator to explain. Confrontation contaminates the report, can intimidate the victim, and can put you in danger. Separate the person from harm if you can do it safely, call for the nurse, and report.

Good faith means you are reporting what you honestly suspect, not scoring a workplace fight. The law expects that report. A knowing false report — inventing abuse to punish a coworker — is a crime. Those two sentences travel together on the exam.

Colorado scenario

You work days in a skilled-nursing facility in Colorado Springs. Mr. Ellis is 81. While you dress him, you see new fingertip bruises on both upper arms. He looks at the door and whispers, “The night person gets mad and grabs me if I use the light.” Your charge nurse is in a stand-up meeting. A second CNA says, “Don’t start something. Call county APS on your lunch break if you still feel weird — that counts as reporting. Whatever you do, don’t bother the nurse, and don’t call the police. Corporate will handle it.”

Layer A is already late if you wait for lunch. 3 CCR 716-1.10 I.2.f.(7) requires you to report this suspicion immediately to the licensed nurse or supervisor. Get the nurse out of the meeting. Stay with Mr. Ellis if he is afraid. Do not go find the night aide to ask whether the bruises are from a transfer.

Layer B is not optional because someone said “corporate will handle it.” Mr. Ellis is an at-risk elder. C.R.S. 18-6.5-108 requires a report to the law enforcement agency where the mistreatment occurred within 24 hours. Follow facility policy for who places that call and how it is documented — and if policy is slow or someone tells you to stay quiet, you still have a personal mandatory-reporter duty. Calling only APS does not replace the law-enforcement report.

If this morning’s assignment had instead been 29-year-old Maya in a group home, with onset of IDD in childhood and new unexplained injuries, the same two layers apply: immediate supervisor report, and law enforcement within 24 hours because she is an at-risk adult with IDD.

Exam traps

• Waiting for proof, photographs, or a second witness.
• Confronting the alleged perpetrator “to be fair.”
• Treating “tell the nurse” as the only duty when the person is 70+ or an adult with IDD.
• Believing a call to county APS alone satisfies C.R.S. 18-6.5-108.
• Using 72 hours, “next business day,” or “the administrator will decide next week” as the outside clock — the statute is 24 hours to law enforcement.
• Filing a fake report to punish a coworker.