Elder Justice Act

Elder Justice Act Compliance Guidance

The Elder Justice Act, which became effective Mar. 10, 2010, requires facility owners and operators to determine on an annual basis whether the facility received more than $10,000 or more in federal funds the previous year, and then notify each “covered” individual of his or her obligation to comply with the crime reporting requirements. “Covered” individuals are owners, operators, employees, managers, agents, and contractors of facilities that received at least $10,000 in federal funds the previous year as determined by the owner or operator.

Medicare and Medicaid participating long-term care provider types that are collectively referred to as “facilities” or “LTC facilities” are:

  • Nursing facilities (NFs),
  • Skilled nursing facilities (SNFs),
  • Hospices that provide services in LTC facilities, and
  • Intermediate Care Facilities for the Mentally Retarded (ICFs/MR)

Covered Individual Reporting

Multiple covered individuals, each of whom has a reporting responsibility, may file a single report that includes information about the suspected crime from each covered person. It remains the responsibility of each covered individual to ensure their individual reporting responsibility is fulfilled, so it is advisable for any multiple-person report to include identification of all individuals making the report.

If, after a report is made regarding a particular incident or suspicion of a crime, additional covered individuals become aware of the same incident or form a similar suspicion based on the same reported events, the original report may be supplemented with additional information including the names of the additional covered individuals along with the date and time of their awareness of such incident or suspicion.

However, in no way will a single or multiple-person report preclude a covered individual from making an individual report separately, in his or her own words, to the State Agency and at least one law enforcement entity. While facilities may establish an efficient process for avoiding unnecessary duplication and easing administrative burdens, they cannot prohibit individual reporting directly by a covered individual.

Time Period for Individual Reporting

Section 1150B establishes two time limits for the reporting of reasonable suspicion of a crime, depending on the seriousness of the event that leads to the reasonable suspicion.

1. Serious Bodily Injury – Two (2) Hour Limit: If the events that cause the reasonable suspicion result in serious bodily injury to a resident, the covered individual shall report the suspicion immediately, but not later than two (2) hours after forming the suspicion;

2. All Others – Within 24 Hours: If the events that cause the reasonable suspicion do not result in serious bodily injury to a resident, the covered individual shall report the suspicion not later than 24 hours after forming the suspicion.

Resources

Below are documents and tools available provided as a benefit to NNFA/NALA members in support of your efforts to comply with these requirements. These tools were developed in partnership with the American Health Care Association (AHCA).

DHHS memorandum, issued on Aug. 29, 2011, “Reporting Reasonable Suspicion of a Crime in a Long-Term Care Facility (LTC): Section 1150B of the Social Security Act”

View the Survey and Certification Memo (revised Jan. 20, 2012, to include a Q & A section developed by CMS in response to questions they received about the original memo).

Crime Reporting Form Template
A form entitled “Facility Suspected Crime Report Under Elder Justice Act.” This form was prepared by AHCA and is only a suggestion. Your facility may draft its own form for submission to local law enforcement and the state survey agency.

Policy and Procedure Template
Policy and Procedure for reporting suspected crimes under the federal Elder Justice Act. Please review this draft template very carefully. This template was drafted by the American Health Care Association and has been modified with Nebraska specific definitions. Do not use this template without reading and understanding all of the provisions contained in the document. You may choose to add your own policies and procedures and delete some of these, or reword some of the requirements to best fit your organization.

Notice for Employees (Poster) Template
A notice for employees under the federal Elder Justice Act. Please note that the Elder Justice Act requires you to post conspicuously in an appropriate location, the sign specifying the rights of employees under the Elder Justice Act. The sign is to include both the reporting requirements for each staff member and a statement that the employee may file a complaint with the state survey agency against a long-term care facility that retaliates against an employee for filing, and information on how to file such a complaint with the state survey agency. The notice is to be posted in the same area where the facility posts other required employee signs such as wage, hour, and OSHA postings.

Notification Template for agents, contractors, and vendors.

Template Letter to Local Law Enforcement Regarding Reporting of Crimes to Long-Term Care Facilities
This letter is an outline to send to your local law enforcement officer alerting them to the federal requirement.