Mandatory Reporting: Nursing Training Guide for Facilities

Nurses play a vital role in protecting the health, safety, and wellbeing of their patients. As part of their commitment to providing quality care, they’re required to report on certain events that endanger their patients or the public — a process more formally known as mandatory reporting. Nursing professionals are one of many types of public service/healthcare personnel that are usually considered mandated reporters by law.

The failure to report on mandatory events is considered a punishable offense in most states, so it’s important for facility leaders to equip their staff with the tools and knowledge needed to comply with relevant regulations. In this guide, we’ll discuss what mandatory reporting guidelines are and how you can train your nursing staff to better adhere to state and federal requirements.

What Is Mandatory Reporting in Healthcare?

Mandatory reporting refers to the legal requirement of healthcare staff to report suspected cases of mistreatment, abuse, or neglect of patients to relevant authorities. Unlike other public service personnel, healthcare professionals are also responsible for reporting public health hazards, such as infectious disease outbreaks, to public health agencies. This helps prevent the spread of communicable conditions and protects the community at large.

Mandatory reporting is an important way to prevent harm to vulnerable patient populations and ensures that public health threats are addressed in a timely manner. The exact situations that are required to be reported by healthcare facilities vary from state to state. However, the most commonly reported cases of mistreatment involve:

• Child abuse
• Elder abuse
• Intimate partner violence

Are Nurses Mandated Reporters? Roles and Responsibilities

All healthcare professionals play a role in mandatory reporting. Nursing professionals are included in this mandate — holding distinct responsibilities based on their clinical duties. In general, nurses must understand how to:

• Look out for signs of abuse and neglect.
• Maintain patient confidentiality as appropriate.
• Relay information to leadership based on facility protocols.

In some cases, nurses may also be responsible for conducting a more targeted assessment if there are reasons to suspect mistreatment of a patient. Nurses must be able to remain objective in their assessments and collect information that’s necessary to make a determination of suspected abuse or file a report.

Mandatory Reporting for Nurses: 3 Training Tips

Laws on mandatory reporting vary by state, but it often falls on the facility to set protocols for how reporting should be coordinated within the healthcare team. Below are three tips to help you streamline your training process and ensure that your nurses are prepared to identify and report on required situations.

1. Deliver Regular Nurse Assessment Trainings

While nurses learn the fundamentals of screening for signs of abuse and neglect in school, it’s important to provide regular assessment training for events that fall under mandatory reporting requirements. This should be done during orientation and every two to three years afterward.

Local guidelines on what events nurses should report are often outlined by your state’s board of nursing or health agency. However, the following table provides general resources to help you train your staff on the screening and assessment of common reportable events.

2. Establish Clear Protocols on Documentation and Reporting

Every professional on the healthcare team has a role in facilitating mandatory reporting. Nursing professionals require clear policies from their leaders to understand what they should do when encountering suspected abuse cases. At baseline, your protocols should establish the following information.

How Cases Should Be Relayed Up the Chain of Command

Since there are multiple different healthcare professionals caring for each patient, it’s important to establish who is responsible for facility- and state-level reporting. If your nurses are the first to notice a suspected case of abuse, they should know when to take the following steps:

• Reporting this to their manager or overseeing provider
• Documenting it in the patient’s medical records
• Directly filing a report with the appropriate state agency

Establishing clear steps and roles ensures that suspected abuse cases don’t go overlooked. Additionally, this ensures that different members of the healthcare team are not duplicating steps in the reporting process.

Facility-Level Documentation Procedures

Your facility may require assessments to be documented in the patient’s medical chart as part of your process for mandatory reporting. Nursing professionals responsible for screening patients should receive clear guidelines on how to document their findings. This may involve filling out a few additional screening questions during a patient’s intake assessment or a more specific assessment tool.

For example, the U.S. Preventive Services Task Force (USPSTF) recommends screening all female patients of childbearing age for IPV. If your facility primarily works with this patient population, you may consider requiring your nurses to routinely conduct and fill out a Danger Assessment.

State-Level Documentation Procedures

If your nurses are responsible for filing state-level reports, they should be trained and educated accordingly. This process varies greatly from state-to-state, so it’s important to check your respective state agencies on what forms are required for what types of events.

For example, in Illinois, suspected cases of child abuse should be reported on the CANTS 5 form and submitted to the Department of Children and Family Services. Conversely, individuals should report suspected elder abuse by calling the Department of Aging directly.

Procedures for Reporting on Infectious Diseases

You should also reference your local health department and the Centers for Disease Control (CDC) to find a list of health conditions that fall under mandatory reporting. Nursing staff should be trained on how to use relevant reporting systems — such as electronic case reporting (eCR) — implemented at your facility.

3. Educate Nurses About HIPAA and its Exceptions

Nurses are trained to be both mandatory reporters and protectors of patient confidentiality, so it can sometimes be confusing to differentiate which information should and shouldn’t be shared. The Health Information Portability and Accountability Act (HIPAA) requires most patient health information to be kept confidential. However, HIPAA outlines exceptions to accommodate each state’s mandatory reporting laws. It’s crucial to clearly define and educate nurses on:

• Which types of mandatory reporting events are permissible by HIPAA.
• How information should be communicated with other staff, the patient, and their family.
• The minimum amount of protected health information (PHI) needed to file a report.
• Which authorities relevant PHI, documents, and reports should be sent to.

What Should Facility Leaders Do After a Report is Filed?

Once a formal report is filed, it’s important that facility leaders take steps to protect the health, safety, and wellbeing of everyone involved. Follow these tips to support both your patients and staff after an event.

• Ensure the Safety of the Patient: Once a report has been filed, it’s important to ensure that the affected patient remains safe. Many agencies have an emergency hotline that facilities can use if the patient is in immediate danger. If relevant authorities are on their way to the facility, it’s important to keep the patient supervised at all times.

• Extend Support: It’s important to make sure support is extended to patients and staff involved in mandatory reporting. Nursing professionals should be referred to employee assistance programs or counseling services as needed. For patients, provide ongoing emotional support by involving appropriate team members at your facility (e.g., social workers, psychologists) and maintain confidentiality as necessary.

• Keep Everyone Informed: Throughout the reporting process, clearly communicate with the patient, their guardians or caregivers (if applicable), and the healthcare team to ensure all relevant parties know that a report has been filed. Keep in mind that suspected perpetrators may be in the room with the patient. So, in some cases, the respective agency you filed a report with may recommend withholding information from family/visitors to keep the patient safe.

Help Your Staff Maintain Care and Safety Standards

Want to provide your nurses with compliance training that goes beyond mandatory reporting? Nursing leaders can start here. Stay informed on the latest tips and regulatory updates impacting your healthcare facility through IntelyCare’s free, expert-written newsletter.

Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current, as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.