Mandatory Reporting Requirements: The Elderly
Maryland

• Vulnerable adult: Any health practitioner, police officer, or human service worker who contacts, examines, attends, or treats an alleged vulnerable adult.
• Developmental Disabled: Any person.
• Mentally Ill Resident in Facility: Any person.
• Resident of Related Institution: Any person.

When is a report required?

• Vulnerable adult: Reason to believe that the alleged vulnerable adult has been subjected to abuse, neglect, self-neglect, or exploitation.
• Developmental Disabled: Belief that an individual with a developmental disability has been abused.
• Mentally Ill Resident in Facility: Receives a complaint of abuse, or observes or has reason to believe that abuse has occurred.
• Resident of Related Institution: Belief that a resident of a related institution has been abused.

Where does it go?

• Vulnerable adult:
• To the local department of social services (which is the department that has jurisdiction in the county where the vulnerable adult lives, or where the abuse is alleged to have taken place); and
• If acting as a staff member of a hospital or public health agency, to the head of the institution or the designee of the head.
• Reports may be made by calling the adult abuse hotline at 1-800-91-PREVENT (1-800-332-6347) or to the local department of social service office in the reporter’s location (http://dhs.maryland.gov/local-offices/).
• Developmental Disabled:
• The executive officer or administrative head of the licensee and the executive officer or administrative head must report the abuse to the appropriate law enforcement agency.
• Mentally Ill Resident in Facility:
• An appropriate law enforcement agency or the administrative head of the facility.
• Resident of Related Institution:
  • An appropriate law enforcement agency and the Office of Health Care Quality in the Department of Aging.

• Vulnerable adult:
• “Abuse” means the sustaining of any physical injury by a vulnerable adult as a result of cruel or inhumane treatment or as a result of a malicious act by any person.
• “Exploitation” means any action which involves the misuse of a vulnerable adult’s funds, property or person.
• “Human service worker” means any professional employee of any public or private health or social services agency or provider, and which specifically includes any social worker or caseworker).
• “Neglect” means the willful deprivation of a vulnerable adult of adequate food, clothing, essential medical treatment or habilitative therapy, shelter or supervision. “Neglect” does not include the providing of nonmedical remedial care and treatment for the healing of injury or disease, with the consent of the vulnerable adult, recognized by state law instead of medical treatment.
• “Self-neglect” means the inability of a vulnerable adult to provide the vulnerable adult with services (i) that are necessary for his or her physical and mental health; and (ii) the absence of which impairs or threatens his or her well-being.
• “Vulnerable adult” means an adult who lacks the physical or mental capacity to provide for the adult’s daily needs.
• Developmentally Disabled:
• “Abuse” means:
• Any physical injury that is inflicted willfully or with gross recklessness;
• Inhumane treatment; or
• Sexual abuse, including a sexual act, sexual contact and vaginal intercourse (see definitions below under “Mentally Ill Resident in a Facility”).
• “Developmental disability” means a severe chronic disability of an individual that:
• Is attributable to a physical or mental impairment, other than the sole diagnosis of mental illness, or to a combination of mental and physical impairments;
• Is manifested before the individual attains the age of 22;
• Is likely to continue indefinitely;
• Results in an inability to live independently without external support or continuing and regular assistance; and
• Reflects the need for a combination and sequence of special, interdisciplinary, or generic care, treatment, or other services that are individually planned and coordinated for the individual.
• “Licensee” means (1) A person who is licensed by the Administration to provide services; and (2) A State residential center.
• Mentally Ill Resident in Facility:

• “Abuse” means cruel or inhuman treatment that causes (i) any physical injury, or (ii) sexual abuse, including a sexual act, sexual contact and vaginal intercourse (in each case as defined in the MD criminal code and described below). Abuse does not include the performance of an accepted medical procedure ordered by a physician; or an action taken by an employee that complies with applicable State and federal laws and applicable Department policies on the use of physical intervention.
• “Sexual act” means any of the following acts, regardless of whether semen is emitted:
• (i) analingus;
• (ii) cunnilingus;
• (iii) fellatio;
• (iv) anal intercourse (including penetration, however slight, of the anus); or
• (v) an act in which object or part of an individual’s body penetrates, however slightly, into another individual’s genital opening or anus that can reasonably be construed to be for sexual arousal or gratification, or for the abuse of either party.
• “Sexual act” does not include vaginal intercourse or act in which an object or part of an individual’s body penetrates an individual’s genital opening or anus for an accepted medical purpose.
• “Sexual contact” means an intentional touching of the victim’s or actor’s genital, anal, or other intimate area for sexual arousal or gratification, or for the abuse of either party.
• “Sexual contact” does not include common expression of familial or friendly affection or an act for an accepted medical purpose.
• “Vaginal intercourse” means genital copulation, whether or not semen is emitted. “Vaginal intercourse” includes penetration, however slight, of the vagina.
• Resident of Related Institution:
• “Abuse” means the non-therapeutic infliction of physical pain or injury, or any persistent course of conduct intended to produce or resulting in mental or emotional distress. Abuse does not include the performance of an accepted medical procedure that a physician orders.
• “Related institution” means an organized institution, environment, or home that: (i) Maintains conditions or facilities and equipment to provide domiciliary, personal, or nursing care for 2 or more unrelated individuals who are dependent on the administrator, operator, or proprietor for nursing care or the subsistence of daily living in a safe, sanitary, and healthful environment; and (ii) Admits or retains the individuals for overnight care.
  • “Related institution” does not include a nursing facility or visiting nurse service that is conducted only by or for adherents of a bona fide church or religious organization, in accordance with tenets and practices that include reliance on treatment by spiritual means alone for healing.

Reports should be made immediately. See https://dhs.maryland.gov/documents/Brochures/Adult%20Services%20Flyers/SSA-AdultProtectiveAbuse_dg.pdf

• Vulnerable adult:
• The report must be made by telephone, direct communication, or in writing as soon as possible.
• Developmental Disabled:
• Reports may be oral or written, and must be made “promptly.”
• Mentally Ill Resident in Facility:
• Reports may be oral or written, and must be made “promptly.”    
• Resident of Related Institution:
  • Reports may be oral or written, and must be made “promptly.”

• Vulnerable adult: Insofar as is reasonably possible, the report shall include the following:
• Name, age, and home address of the alleged vulnerable adult;
• Name and home address of the person responsible for the care of the alleged vulnerable adult;
• Whereabouts of the alleged vulnerable adult;
• Nature of the alleged vulnerable adult’s incapacity;
• Nature and extent of the abuse, neglect, self-neglect, or exploitation of the alleged vulnerable adult, including evidence or information available to the reporter concerning previous injury possibly resulting from abuse, neglect, self-neglect, or exploitation; and
• Any other information that would help to determine the cause of the suspected abuse, neglect, self-neglect, or exploitation and the identity of any individual responsible for the abuse, neglect, self-neglect, or exploitation.
• Developmental Disabled:
• As much information as the reporter is able to provide.
• Mentally Ill Resident in Facility:
• As much information as the reporter is able to provide.
• Resident of Related Institution:
  • As much information as the reporter is able to provide.

• Vulnerable adult:
• Any individual other than a health practitioner, human service worker, or police officer who has reason to believe that an alleged vulnerable adult has been subjected to abuse, neglect, self-neglect, or exploitation may file an oral or written report with the local department.
• Any person, including a fiduciary institution, who in good faith makes or participates in making a report is immune from civil liability that would otherwise result.
• Developmental Disabled:
• A person, including a fiduciary institution, shall have immunity for making a report, participating in an investigation or judicial proceeding arising out of this section.
• A person who acts in good faith is not civilly liable for making a report.
• Mentally Ill Resident in Facility:
• A person who acts in good faith is not civilly liable for making a report, participating in an investigation or judicial proceeding arising out of making a report, or for participating in transferring, suspending, or terminating the employment of any individual who is believed to have abused or aided in abusing a resident.
• Resident of Related Institution:
• A person who acts in good faith is not civilly liable for making a report, or participating in an investigation or judicial proceeding resulting from a report.
• Any employee of a related institution who is required to report alleged abuse, and who fails to report the alleged abuse within 3 days after learning of the alleged abuse, is liable for a civil penalty of not more than $1,000.

• MD Code, Criminal Law, § 3-301
• Vulnerable adult: Md. Code Ann., Fam. Law §§ 14-101, 14-302, 14-309; Md. Code Ann., Courts and Judicial Proceedings § 5-622.
• Developmental Disabled: Md. Code Ann., Health-Gen. §§ 7-101, 7-1001, 7-1005; Md. Code Ann., Courts and Judicial Proceedings § 5-625.
• Mentally Ill Resident in Facility: Md. Code Ann., Health-Gen. §§ 10-705; Md. Code Ann., Courts and Judicial Proceedings § 5-626.
• Resident of Related Institution: Md. Code Ann., Health-Gen. §§ 19-301, 19-347, Md. Code Ann., Courts and Judicial Proceedings § 5-631.