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VA Nebraska-Western Iowa Health Care System

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** Reporting Abuse and Neglect

Abuse and neglect are serious detriments to the health and safety of patients. By law, suspected abuse or neglect must be reported, although the procedures to report abuse are different in all US states and territories. The differing regulations may cause confusion or delays in reporting suspected abuse or neglect. VA facility policies regarding reporting such cases should reflect state law and may slightly differ between VA Medical Centers. Regardless, in all VA Medical Centers, all instances of suspected abuse and neglect must be reported to your local VA Social Work Service. Involve your supervisor in all suspected cases of abuse or neglect. They will evaluate the situation and gather the pertinent information and documentation to present to Social Work Service for follow–up.


Most cases of abuse or neglect are discovered in outpatients who are visiting a clinic, patients arriving in emergency departments, or in newly admitted inpatients. Signs and symptoms of abuse or neglect include:

  • vague or inconsistent explanations of injuries (which may be the result of shame or fear of retaliation);
  • acute or past chronic injuries such as bruising or broken bones;
  • delayed medical care for injuries or illness;
  • chronic abdominal pain;
  • chronic depression and fatigue;
  • poor nutritional status;
  • bed sores;
  • neglected oral health or dentition;
  • inappropriate or soiled clothing; and/or
  • poor hygiene.

Because the suspicion or discovery of patient abuse or neglect is a serious matter and may cause embarrassment to the patient or caregiver or may cause further harm to the patient by a caregiver, do not confront the patient or caregiver. Confronting a guilty caregiver may escalate into a dangerous situation. In all circumstances of suspected or overt signs of patient abuse and neglect, notify your supervisor as soon as possible. The observation and reporting of suspected abuse or neglect is very important. You may be responsible for saving a life or preventing continued avoidable pain and suffering by being alert to the signs of possible patient abuse and neglect.

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