KATIE ADULT DAY CENTER POLICIES AND PROCEDURES

Abuse, Neglect and Financial Exploitation as Defined by the Vulnerable Adult Act

Definition of Vulnerable Adult

Under MN Statute 626.5572, subd. 21, any person 18 years of age or older who is a home care client is categorically defined as a
vulnerable adult. This section of law includes a functional definition of a vulnerable adult: a person who regardless of residence or
whether any type of service is received, possesses a physical or mental infirmity or other physical, mental, or emotional dysfunction:
(i) that impairs the individual's ability to provide adequately for the individual's own care without assistance, including the
provision of food, shelter, clothing, health care, or supervision; and
(ii) because of the dysfunction or infirmity and the need for care or services, the individual has an impaired ability to protect the
individual's self from maltreatment.
In this definition, "care or services" means care or services for the health, safety, welfare, or maintenance of an individual.

Definition of Mandated Reporter

MN Statute 626.5572, Subd. 16 defined a mandated reporter under the Vulnerable Adult Act as: "Mandated reporter" means a
professional or professional's delegate while engaged in: (1) social services; (2) law enforcement; (3) education; (4) the care of
vulnerable adults; [this language would appear to include staff in a senior housing setting as well as home care staff] (5) any of the
occupations referred to in section 214.01, subdivision 2; [this section includes those licensed by the Board of Nursing and the Board
of Social Work, among others] (6) an employee of a rehabilitation facility certified by the commissioner of jobs and training for
vocational rehabilitation; (7) an employee or person providing services in a facility as defined in subdivision 6; or (8) a person that
performs the duties of the medical examiner or coroner.

Following is a summary of important provisions in the Vulnerable Adult Act related to mandated reporters responsibility to report
maltreatment of a vulnerable adult under the law. Examples and the reference to the exact statutory language are included. A copy
of the VAA law is found in Section 9 of this manual.

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ABUSE -- Abuse of a Vulnerable Adult includes the YES
following actions, whether completed or attempted and
includes aiding and abetting a person who commits or
attempts to commit one of the following actions:

1. Criminal acts: YES Spouse beats client or resident

a) Assault. Non-consensual sexual contact between two
b) Use of drugs to injure or facilitate crime. residents/rape
c) Solicitation, inducement and promotion of
prostitution
d) Criminal sexual conduct.
(MN Statutes 626.5572, subd. 2 (a))

2. Conduct which is not an accident1 or therapeutic
conduct2 which produces or could be expected to
produce physical pain or injury or emotional distress,
such as:
a) hitting, slapping, kicking, pinching, biting, or
corporal punishment of a vulnerable adult;
YES Residents son visits and is seen slapping his
mother.
Staff person or relative of a VA is overheard
making oral threats to a VA.
Staff person uses a restraint to keep the VA
immobile (e.g., chair restraint, recliner) as a

1
Accident means a sudden, unforeseen, and unexpected occurrence or event which:1) is not likely to occur and which could not have been prevented by exercise
of due care; and 2) if occurring while a VA is receiving home care services, happens when the agency and the person providing services is in compliance with
relevant laws and rules.
2
Therapeutic conduct means the provision of program services, health care or other personal care services done in good faith in the interests of the VA by: 1) and
individual, facility [facility includes licensed home care provider] or employee or person providing services in the facility, including caregivers, providing
services in our program under our home care license.

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b) Use of repeated or malicious oral, written, or
gestured language towards a vulnerable adult or
the treatment of a vulnerable adult which would
be considered by a reasonable person to be
disparaging, derogatory, humiliating, harassing,
or threatening
c) Use of any aversive or deprivation procedure,
unreasonable confinement or involuntary
seclusion of a vulnerable adult from other
persons against the will of the vulnerable adult or
the legal representative of the vulnerable adult.
(MN Statutes 626.5572, subd. 2 (b))
3. Sexual contact between a staff person or person
providing services and the Vulnerable Adult (VA).
(MN Statutes 626.5572, subd. 2 (c))
4. Forcing, compelling, coercing or enticing a Vulnerable YES
Adult to perform services for the advantage of
another.
(MN Statutes 626.5572, subd. 2 (d))
5. A VA is not abused for the sole reason that the VA or
a person authorized to make health care decisions
for the VA refuses consent or withdraws consent to
any therapeutic conduct, care, service or procedures
to diagnose, maintain, or treat the physical or mental
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punishment or to make the staffs job easier,
and there is no physician order and nursing
assessment related to the use of restraints for
the VA.
Staff yells insults and curses at resident.
Staff physically restrains residents wrists to the
wheelchair arms while another staff member
forcefully administers medications while
resident resists.
Staff taunts and teases confused resident by
tapping her on the back and running away.
Resident becomes agitated and fearful.
YES Sexual contact between a staff person and a
resident
No report It is not abuse if the VA or the VAs health care
required agent refuses any treatment or care or service
and there are no other circumstances that
suggest abuse (e.g., the VA is competent and
the refusal of services is consistent with the
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condition of the vulnerable adult or, where VAs health care directive). Providers should
permitted under law, to provide nutrition and document the refusal and their efforts to
hydration parenterally or through intubation explain the consequences of the refusal. You
(including refusal to provide nutrition and hydration can always consult with MAARC or
parenterally or through intubation where permitted Ombudsman if you have questions.
by law).
(MN Statutes 626.5572, subd. 2 (e))

6. A VA is not abused for the sole reason that the VA or No report

a person authorized to make health care decisions or required
a caregiver in good faith selects and depends upon
spiritual means or prayer for treatment or care in lieu
of medical care, provided this is consistent with the
prior practice or belief of the VA.
(MN Statutes 626.5572, subd. 2 (f))

7. A VA who is not impaired in judgment or capacity by No report A staff member develops a personal
mental or emotional dysfunction or undue influence, required if the relationship with a new resident. If there was
engages in consensual sexual contact with a) a VA is competent no relationship between the staff person and
person, including a staff member, when a consensual and a prior the client prior to the client attending adult
sexual personal relationship existed prior to the consensual day, the adult day director should warn the
caregiving relationship or b) a personal care sexual staff person about maintaining appropriate
attendant, regardless of whether the consensual relationship boundaries and warn that any sexual contact
sexual personal relationship existed prior to the existed prior to will be reported as abuse and will be grounds
caregiving relationship. the caregiver for dismissal. If it appears that the relationship
(MN Statutes 626.5572, subd. 2 (g)) relationship. No

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report required is or is becoming a sexual relationship, this
if competent VA should be reported as abuse.
has a sexual
relationship with
a PCA.
8. Verbal or physical aggression occurring between Not reportable if Incidents of verbal or physical aggression
residents or clients, or self-abusive behavior by these no serious harm between residents may be reported to MAARC,
persons does not constitute abuse unless the depending on severity. Incidents of aggression
behavior causes serious harm. Incidents of should be documented on incident report
aggression between clients/residents or self-abusive form, investigated, and interventions
behavior must be recorded for review by surveyors, implemented to minimize the likelihood of
etc. (MN Statutes 626.557, subd. 3a (2)) recurrence. If resident to resident aggression
causes serious harm, it should be reported to
MAARC.

9. A report is not required if the event is an accident, Not reportable if

a sudden, unforeseen and unexpected occurrence or both conditions
event which: are met
a) is not likely to occur and which could not have
been prevented by exercise of due care AND
b) if occurring while a VA is receiving services,
happens when the provider and the person
providing services are in compliance with the
relevant laws and rules.
(MN Statutes 626.5572, Subd. 3)

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10. If the VA is a new client/resident and a staff member YES
has reason to believe that the VA was abused by the
VAs previous provider, a report is required unless
the current provider has reason to believe that that a
VA report was previously files.
(MN Statutes 626.557, Subd. 3 (a))

NEGLECT YES

1. The failure or omission by a caregiver to supply care or
services, such as food, clothing, shelter, health care,
or supervision, which is not the result of an accident
or therapeutic conduct and which is reasonable and
is necessary to maintain the vulnerable adults
physical or mental health or safety.
(MN Statutes 626.5572, subd. 17 (a))
Yes, report and Resident elopes from memory care unit that
conduct internal was supposed to be secure.
investigation Home care staff person fails to give a resident
the prescribed medications or treatment as
specified on the clients service plan

2. Neglect also includes the absence or likelihood of
absence of these types of care or services essential to
maintain the vulnerable adults physical and mental
health, safety or comfort, considering the vulnerable
adults physical and mental capacity or dysfunction
(such as food, clothing, shelter, health care or
YES Family refuses to use clients resources to pay
for additional services or meals for resident
that staff believes are necessary for the clients
health/safety
Family fails to purchase for client necessary
clothing, groceries, or supplies using clients
resources.

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supervision necessary to maintain physical and
mental health).
(MN Statutes 626.5572, subd. 17 (b))

3. A VA is not neglected for the sole reason that the VA
or the VAs authorized health care agent refuses
consent or withdraws consent, consistent with that
authority and within the boundary of reasonable
medical practice, to any therapeutic conduct,
including care, service or procedures to diagnose,
maintain or treat the physical or mental condition of
the VA, or, where permitted under law, to provide
nutrition and hydration parenterally or through
intubation.
(MN Statutes 626.5572, subd. 17 (c), (1))
4. A VA is not neglected for the sole reason that the VA,
the VAs authorized health care agent or a caregiver
in good faith selects and depends upon spiritual
means or prayer for treatment or care, provided this
is consistent with the prior practice or belief of the
VA or with the expressed intentions of the VA.
(MN Statutes 626.5572, subd. 17 (c), (2))
5. A VA is not neglected for the sole reason that the VA,
who is not impaired in judgment or capacity by
mental or emotional dysfunction or undue influence
engages in sexual contact with a) a person, including
staff, when a consensual sexual personal relationship
NO It is not neglect if the VA or the VAs health
care agent refuses any treatment or care or
service and there are no other circumstances
that suggest neglect or self-neglect (e.g., the
VA is competent and the refusal of services is
consistent with the VAs health care directive).
Providers should document the refusal and
their efforts to explain the consequences of the
refusal. Providers can consult with MAARC or
Ombudsman if they have questions or
concerns.
NO
No report
required if VA is
competent and
other condition
is met

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existed prior to the caregiving relationship or b) a
personal care attendant, regardless of whether the
consensual sexual personal relationship existed prior
to the caregiving relationship.
(MN Statutes 626.5572, subd. 17 (c), (3))
6. A VA is not neglected for the sole reason that an No report
individual makes an error in the provision of required;
therapeutic conduct to a VA which does not result in conduct internal
injury or harm which reasonably requires medical or investigation and
mental health care put in place
(MN Statutes 626.5572, subd. 17 (c), (4)) measure to
prevent future
errors

7. A VA is not neglected for the sole reason an individual MUST BE The following incidents or injuries are examples of
makes an error in the provision of therapeutic REPORTED, BUT those that may require medical care and from
conduct that results in injury or harm to a VA which IS NOT NEGLECT which the client may completely recover:
reasonably requires the care of a physician and IF ALL REQUIRED Medication error
a) the necessary care is provided in a timely fashion FACTORS ARE Minor burn
as dictated by the VAs condition AND MET Minor fracture
b) if after receiving care, the health status of the VA Bruise
can be reasonably expected, as determined by the Skin tear or laceration
physician, to be restored to the VAs preexisting
condition AND
c) the error is not a part of a pattern of errors by the
individual, AND

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d) if in a facility [includes home care], the error is
immediately reported to the CEP and is recorded in
the providers internal process; AND
e) if the provider identifies and takes corrective
action and implements corrective actions and
measures designed to reduce the risk of further
occurrences of this error and similar errors AND
f) the provider documents for review and evaluation
by the facility and any applicable licensing,
certification, and ombudsman agency.
(MN Statutes 626.5572, subd. 17 (c), (5))

8. Regulated caregivers are not required by the laws

provisions of neglect to provide services in excess
of those required by the caregivers license,
certification, registration or other regulation.
[However, if a VA is refusing to obtain additional
needed services beyond the regulated caregivers
license, the self-neglect may need to be reported, but
see #3 above regarding the right to refuse services.]
(MN Statutes 626.5572, subd. 17 (d))

9. If the VA is a new client/resident and a staff member YES

has reason to believe that the VA was neglected by
the VAs previous provider, a report is required.
(MN Statutes 626.557, Subd. 3 (a))

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FINANCIAL EXPLOITATION
1. In a breach of fiduciary obligation, a person a)
engages in unauthorized expenditure of funds which
is likely to be detrimental to the VA or b) fails to use
the VAs financial resources to provide food, clothing,
shelter, health care, therapeutic conduct or
supervision of the VA and the failure results or is
likely to result in detriment to the VA.
(MN Statutes 626.5572, subd. 9 (a))
2. Without legal authority, a person
a) willfully uses, withholds or disposes of funds or
property of a VA
b) obtains services by a third party for wrongful
profit or personal advantage to the detriment of
the VA
c) acquires possession or control of, or an interest
in, funds or property of a VA through the use of
undue influence, harassment, duress, deception
or fraud
d) forces, compels, coerces, or entices a VA against
the VAs will to perform services for the profit or
advantage of another.
(MN Statutes 626.5572, subd. 9 (b))
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YES
YES Son has power of attorney and access to a
residents checking account. The son uses
money in the checking account for his personal
use, rather than for services needed by the
client.
Daughter is the power of attorney/responsible
person for the residents bills. The resident has
adequate resources but the daughter does not
pay bills after repeated notices.
YES Daughter gets a confused parent to sign over
investments to the daughter who intends to
use the funds for things other than the VAs
care and services.
Staff uses clients phone for long distance calls.
Staff uses clients ATM or credit card for
personal purchases.
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3. If the VA is a new client/resident and a staff member YES
has reason to believe that the VA was financially
exploited by the VAs previous provider, a report is
required unless the current provider has reason to
believe a VA report was previously filed
(MN Statutes 626.557, Subd. 3 (a))

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