submitting an anonymous neglect report

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In addition to my hospital job I work a couple of nights a week of home care, which I'm pretty sure is not a licensed agency - one of my coworkers at the hospital runs it with her sister and it's all cash. My concern is with the family of one of my clients. She's 99 with an MD son and two MD granddaughters (so they know better). There is never any food in the house - the family is very cheap and won't ever go grocery shopping, so often there is nothing there and my boss has to go buy something. Once she spent part of my pay because she didn't have extra and has forgotten to pay me back. I had to ask for a month to get soap for my client's showers. I always check the charting for the last week or so when I come in, and I noticed that 2 or 3 times she's become unresponsive at night. The aid on duty called my boss, who comes over because the son forbids them from calling an ambulance because of the cost. If it happens with me, I'm certainly calling 911 which I fear may get me fired.

My question is this - I want to quit working for this client because I think it's only a matter of time before something goes very wrong and I'll be blamed (I take a lot of heat from my boss when the client's family is irresponsible). I'm wondering if, since I'm a mandatory reporter, I should make a neglect report? I don't have a lot of specifics to report, but I'm quitting because I'm pretty sure this situation will end badly which I feel means I shouldn't just walk away from it. Should I make some kind of neglect report, and to whom? Is there something to report when nothing major has happened but I feel it will? I don't know exactly what details I would actually report to justify a neglect report. Since the agency isn't licensed, who do I make the report to?

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Specializes in Med-Surg.

You are in a strange situation with this non legitimate home health agency or whatever it is.

You make a report of abuse with adult protective services. If the patient doesn't have food or basic hygiene items in the home provided by the family or the "agency", then there is neglect. The whole thing is really weird to me.

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Run away. It sounds dodgy and you wouldn't want to be caught in the middle of it if the xxxx does hit the fan. I am sure the extra dollars are not worth it.

Make a anonymous report with social services or whatever they are called.

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Specializes in Family Nurse Practitioner.

It absolutely needs to be done now to APS. I would call, fax and keep copies of it. It isn't up for you to determine whether it is abuse or neglect but if you have any suspicions you are mandated by law to report and allow them to investigate or not.

Please reconsider putting your license in jeopardy with a shady "agency".

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Specializes in HH, Peds, Rehab, Clinical.

My question is why haven't you already run?

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There is so much of this that is wrong. "I have to give notice because I can no longer work 2 jobs" And get the heck out of there.

And your unethical friend who is running this gig.....if she is a nurse, report her to the board of nursing. That she is delegating CNA's to do or not do in the case of not calling for an ambulance-- is putting her license at risk to begin with. That she is ok with the kind of treatment that this patient is getting is scary.

What is putting your license at risk is that you are in a home where an elder is being neglected. You are being paid (or not) cash for under the table shady stuff. And if there are no adequate food/supplies for even basic care of this patient, then it is an issue. That is where I would call APS. Not only because you are mandated to do so, but it is the right thing to do.

When all this comes crashing down, the signatures on the "charting" are those of you, of other licensed nurses who may also work there, and some CNA's who are delegated to.

Interestingly, I am sure that you all work for the "family" and not for your co-worker and her sister. They are some sort of "employment placement agency" and that you are paid for "by the family" and it is "none of their business" how you all are paid. Cause when the chips come tumbling down there is absolutely no way to prove that your co-worker et al has one thing to do with anything....all cash, no charting by them, and quicker than you can say "I just find employees. She is an RN, so I have NO IDEA what she was thinking, I had NOT A CLUE there was no food in the house..." etc etc. You are in a heck of a lawsuit because everyone has amnesia, and you are the licensed nurse holding the bag.

Your license is not worth it. If you have , call them. If you have to work with this person in a charge nurse kind of a way, you may want to let your union or manager in on it. Because the last thing you need is grief at work due to this mess.

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Specializes in Care Coordination, Care Management.

Question - Is the 99 y/o client within her right mind? I've had problems with APS not opening a case, because the person in the situation is "competent".

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Specializes in Critical Care, Education.

As nurses, we are 'mandatory reporters' for child, domestic & geriatric abuse. Legally, if we fail to report we could be considered to be complicit in the abusive behavior. PP is correct. Because this is apparently focused on a single (victim) individual, contact your state's agency for Adult Protective Services. I believe that if it was a systemic thing (affecting many patients) in a nursing home, it may also be in the purview of an Ombudsman as well as the agency that licenses nursing homes.

An anonymous report may not be in your best interests because if there is any fall-out, you want to be on record as one of the 'good guys' and you may also need evidence that you were compliant with your state's Nurse Practice Act.

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Thank you for your responses - I found the APS information for my state. I'm actually a CNA, there aren't any nurses involved. I wanted to make sure my motives aren't influenced by my being angry at the family but I can see from your responses there is a legitimate concern. And thank you for pointing out that anonymity might be a bad idea, but (un)fortunately there have been HIPAA violations in the form of all the texts my boss uses to communicate with me, that nevertheless prove she knows what's going on.

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