Home Health Mandatory Reporting Requirements

CMS Baseline Overview (Applies in All 50 States + DC)

Introduction

All Medicare-certified Home Health Agencies (HHAs) are federally regulated by the Centers for Medicare & Medicaid Services (CMS) under the Conditions of Participation set forth in 42 CFR Part 484. These federal requirements establish mandatory reporting, documentation, and compliance obligations that apply nationwide, regardless of state licensure frameworks or accreditation status.

CMS requires HHAs to identify, document, and report specific events that impact patient safety, quality of care, abuse prevention, and regulatory oversight. These duties exist independently of civil litigation and are enforceable through surveys, deficiencies, corrective action plans, civil monetary penalties, and termination from the Medicare program.

The table below establishes the federal CMS baseline for mandatory reporting in home health care. State-specific laws may impose additional or more restrictive obligations, which are addressed in the state-by-state rows that follow.

These resources are used by plaintiff and defense counsel nationwide for early case assessment, regulatory analysis, and litigation strategy in medically complex matters.

How to Use This Table

This table outlines the federal CMS baseline requirements for mandatory reporting by Medicare-certified Home Health Agencies (HHAs). These requirements apply nationwide and establish the minimum compliance standard regardless of state licensure rules or accreditation status.

Use this table to identify:

Events that trigger mandatory reporting under the CMS Conditions of Participation
Who within the Home Health Agency is responsible for reporting and documentation
Required reporting timeframes following an incident, allegation, or adverse event
Regulatory or enforcement bodies that must be notified
Where state law or accreditation standards impose stricter obligations

CMS requirements function as a regulatory floor. When state law or accrediting bodies impose more restrictive standards, HHAs are required to comply with the stricter rule. Failures in CMS-required reporting or documentation may result in survey deficiencies, enforcement actions, civil monetary penalties, or termination from the Medicare program—independent of any civil litigation.

Jurisdiction
Reportable Event / Trigger
Who Must Report
Reporting Timeframe
Reporting Destination
Documentation Requirements
Enforcement / Oversight
Accreditation Alignment
More Restrictive Than CMS?


CMS Baseline
(All States + DC)
Abuse, neglect, mistreatment, injuries of unknown source, or misappropriation of patient property.
Any HHA staff member (employee or contractor).
Immediately
HHA administration and appropriate authorities per state law.
Investigation, findings, resolution, corrective action, and anti-retaliation safeguards.
CMS via State Survey Agencies.
ACHC / CHAP / The Joint Commission Home Care.
N/A (Baseline)

Alabama
Abuse, neglect, exploitation of adults or children receiving home health services.
Any person with reasonable cause, including HHA staff.
Immediately
Alabama Department of Human Resources or law enforcement.
Written report with patient details, nature of abuse, and reporter information.
Alabama Department of Public Health & DHR.
Aligns; state reporting duties exceed CMS minimum.
Yes

Alaska
Suspected abuse, neglect, or exploitation of a vulnerable adult or minor.
Mandatory reporters including healthcare providers and HHAs.
Immediately
Alaska Adult Protective Services or Office of Children’s Services.
Immediate oral report followed by written documentation if requested.
Alaska Department of Health.
Aligns; broader mandatory reporter scope.
Yes

Arizona
Abuse, neglect, or exploitation of a vulnerable adult or child.
Any person responsible for care, including home health personnel.
Immediately
Arizona Department of Economic Security or local law enforcement.
Oral report with supporting written documentation maintained by the HHA.
Arizona Department of Health Services.
Aligns; explicit statutory reporting timelines.
Yes

Arkansas
Suspected maltreatment, abuse, or neglect of an adult or child patient.
Mandatory reporters including healthcare providers and HHAs.
Immediately
Arkansas Adult Maltreatment Hotline or Child Abuse Hotline.
Immediate report with detailed incident documentation retained.
Arkansas Department of Health.
Aligns; centralized hotline reporting exceeds CMS baseline.
Yes

California
Abuse, neglect, abandonment, isolation, or financial exploitation.
Mandated reporters, including home health clinicians and aides.
Immediately (or within statutory window)
Adult Protective Services or local law enforcement.
Immediate phone report plus written report within required timeframe.
California Department of Public Health.
Aligns; strict written follow-up requirements.
Yes




Delaware
Suspected abuse, neglect, exploitation, or mistreatment of an adult or child receiving home health services.
Any person with reasonable cause, including home health personnel.
Immediately
Delaware Adult Protective Services or Child Protective Services.
Oral report followed by written documentation as required; HHA must retain investigation records.
Delaware Department of Health and Social Services.
Aligns; mandatory reporter scope broader than CMS baseline.
Yes

Florida
Abuse, neglect, exploitation, or abandonment of a vulnerable adult or child.
Mandatory reporters, including all healthcare providers and home health staff.
Immediately
Florida Abuse Hotline (DCF) or local law enforcement.
Immediate report with detailed incident documentation; written records retained by the HHA.
Florida Agency for Health Care Administration (AHCA).
Aligns; strict statutory reporting and hotline requirements.
Yes

Georgia
Suspected abuse, neglect, or exploitation of a disabled adult or child.
Mandatory reporters, including home health clinicians and aides.
Immediately
Georgia Adult Protective Services or Division of Family & Children Services.
Oral report required; written follow-up documentation maintained by the HHA.
Georgia Department of Community Health.
Aligns; explicit mandatory reporter enforcement.
Yes

Hawaii
Abuse, neglect, or exploitation of a vulnerable adult or child in home care.
Mandatory reporters, including healthcare providers and HHAs.
Immediately
Hawaii Adult Protective Services or Child Welfare Services.
Immediate reporting with supporting documentation retained for survey review.
Hawaii Department of Health.
Aligns; state reporting statutes exceed CMS baseline.
Yes

Idaho
Suspected abuse, neglect, or exploitation of a vulnerable adult or child.
Mandatory reporters, including home health staff and providers.
Immediately
Idaho Adult Protective Services or law enforcement.
Immediate report with written documentation upon request; HHA investigation required.
Idaho Department of Health and Welfare.
Aligns; mandatory reporting statutes more explicit than CMS.
Yes

Illinois
Suspected abuse, neglect, exploitation, or financial exploitation of an elderly person or adult with disabilities.
Mandatory reporters, including healthcare professionals and home health personnel.
Immediately
Illinois Adult Protective Services or local law enforcement.
Immediate report required; written documentation and internal investigation records retained by the HHA.
Illinois Department of Public Health.
Aligns; detailed mandatory reporter statutes exceed CMS baseline.
Yes

Indiana
Suspected abuse, neglect, or exploitation of an endangered adult or child receiving home health services.
Mandatory reporters, including home health clinicians, aides, and administrators.
Immediately
Indiana Adult Protective Services or local law enforcement.
Oral report required; HHA must document findings, actions taken, and resolution.
Indiana Department of Health.
Aligns; state reporting duties more prescriptive than CMS.
Yes

Iowa
Suspected dependent adult abuse or child abuse.
Mandatory reporters, including healthcare providers and home health staff.
Within 24 hours
Iowa Department of Health and Human Services or law enforcement.
Report must include identifying information and nature of abuse; written documentation retained.
Iowa Department of Inspections, Appeals, and Licensing.
Aligns; defined statutory timeframe stricter than CMS.
Yes

Kansas
Suspected abuse, neglect, or exploitation of a child or adult in need of care.
Mandatory reporters, including home health professionals and aides.
Immediately
Kansas Department for Children and Families or law enforcement.
Immediate report required; HHA must maintain investigation and corrective-action records.
Kansas Department of Health and Environment.
Aligns; mandatory reporting obligations exceed CMS minimum.
Yes

Kentucky
Suspected abuse, neglect, or exploitation of an adult or child receiving home health care.
Mandatory reporters, including healthcare providers and home health staff.
Immediately
Kentucky Adult Protective Services or local law enforcement.
Immediate report with written documentation upon request; HHA investigation required.
Kentucky Cabinet for Health and Family Services.
Aligns; statutory reporting duties are more explicit than CMS.
Yes

Louisiana
Suspected abuse, neglect, exploitation, or extortion of a vulnerable adult or child receiving home health services.
Mandatory reporters, including healthcare providers and home health personnel.
Immediately
Louisiana Adult Protective Services or Child Protection Services; law enforcement when indicated.
Immediate report required; HHA must document the allegation, investigative actions, findings, and corrective measures.
Louisiana Department of Health.
Aligns; centralized reporting duties exceed CMS baseline.
Yes

Maine
Suspected abuse, neglect, or exploitation of an incapacitated or dependent adult or child.
Mandatory reporters, including home health clinicians and aides.
Immediately
Maine Adult Protective Services or Child Protective Services.
Oral report required; written documentation maintained by the HHA and produced upon request.
Maine Department of Health and Human Services.
Aligns; statutory mandatory reporting requirements are broader than CMS.
Yes

Maryland
Suspected abuse, neglect, self-neglect, or exploitation of a vulnerable adult or child.
Mandatory reporters, including health practitioners and home health staff.
Immediately
Maryland Adult Protective Services or local law enforcement.
Immediate report with detailed documentation of observations, actions taken, and outcomes.
Maryland Department of Health.
Aligns; expanded definitions and reporting scope exceed CMS baseline.
Yes

Massachusetts
Suspected abuse, neglect, or financial exploitation of an elder or vulnerable adult.
Mandatory reporters, including home health aides, nurses, and clinicians.
Immediately
Massachusetts Elder Protective Services or appropriate state agency.
Immediate oral report followed by written report within statutory timeframe; HHA records retained.
Massachusetts Department of Public Health.
Aligns; written follow-up requirements stricter than CMS.
Yes

Michigan
Suspected abuse, neglect, or exploitation of a vulnerable adult or child receiving home health care.
Mandatory reporters, including healthcare providers and home health personnel.
Immediately
Michigan Adult Protective Services or Child Protective Services.
Immediate report required; documentation of findings and corrective action maintained by the HHA.
Michigan Department of Health and Human Services.
Aligns; statutory reporting framework exceeds CMS baseline.
Yes

Minnesota
Suspected maltreatment, abuse, neglect, or exploitation of a vulnerable adult or child.
Mandatory reporters, including healthcare professionals and home health personnel.
Immediately
Minnesota Adult Protective Services or local law enforcement.
Immediate oral report required; written documentation and internal investigation records retained by the HHA.
Minnesota Department of Health.
Aligns; statutory reporting definitions and timelines exceed CMS baseline.
Yes

Mississippi
Suspected abuse, neglect, or exploitation of a vulnerable adult or child receiving home health services.
Mandatory reporters, including healthcare providers and home health staff.
Immediately
Mississippi Adult Protective Services or local law enforcement.
Immediate report required; HHA must document observations, actions taken, and outcomes.
Mississippi State Department of Health.
Aligns; explicit statutory reporting obligations exceed CMS minimum.
Yes

Missouri
Suspected abuse, neglect, or exploitation of an elder, disabled adult, or child.
Mandatory reporters, including healthcare providers and home health personnel.
Immediately
Missouri Adult Abuse & Neglect Hotline or Child Abuse Hotline.
Immediate oral report required; written documentation maintained by the HHA.
Missouri Department of Health and Senior Services.
Aligns; centralized hotline reporting stricter than CMS baseline.
Yes

Montana
Suspected abuse, neglect, or exploitation of a vulnerable adult or child.
Mandatory reporters, including healthcare providers and home health staff.
Immediately
Montana Adult Protective Services or local law enforcement.
Immediate report with documentation of findings and corrective action retained.
Montana Department of Public Health and Human Services.
Aligns; statutory reporting framework exceeds CMS baseline.
Yes

Nebraska
Suspected abuse, neglect, or exploitation of a vulnerable adult or child receiving home health care.
Mandatory reporters, including healthcare professionals and home health personnel.
Immediately
Nebraska Adult Protective Services or Child Protective Services.
Immediate report required; written documentation maintained by the HHA.
Nebraska Department of Health and Human Services.
Aligns; mandatory reporting statutes more prescriptive than CMS.
Yes

Nevada
Suspected abuse, neglect, exploitation, isolation, or abandonment of a vulnerable adult or child.
Mandatory reporters, including healthcare providers and home health personnel.
Immediately
Nevada Adult Protective Services or local law enforcement.
Immediate report required; HHA must document observations, investigation, findings, and corrective actions.
Nevada Department of Health and Human Services.
Aligns; statutory definitions and reporting duties exceed CMS baseline.
Yes

New Hampshire
Suspected abuse, neglect, or exploitation of an elderly adult or child receiving home health services.
Mandatory reporters, including healthcare professionals and home health staff.
Immediately
New Hampshire Bureau of Elderly and Adult Services or Child Protection Services.
Immediate report with supporting documentation retained by the HHA for survey review.
New Hampshire Department of Health and Human Services.
Aligns; mandatory reporting statutes are broader than CMS.
Yes

New Jersey
Suspected abuse, neglect, or exploitation of a vulnerable adult or child in home care.
Mandatory reporters, including healthcare practitioners and home health aides.
Immediately
New Jersey Adult Protective Services or law enforcement.
Immediate oral report required; written follow-up documentation maintained by the HHA.
New Jersey Department of Health.
Aligns; explicit reporting and documentation standards exceed CMS.
Yes

New Mexico
Suspected abuse, neglect, or exploitation of a vulnerable adult or child receiving home health care.
Mandatory reporters, including healthcare providers and home health personnel.
Immediately
New Mexico Adult Protective Services or Children, Youth & Families Department.
Immediate report with detailed documentation of findings and actions taken.
New Mexico Department of Health.
Aligns; statutory reporting obligations exceed CMS baseline.
Yes

New York
Suspected abuse, neglect, mistreatment, or exploitation of a vulnerable adult or child receiving home health services.
Mandatory reporters, including home health clinicians and aides.
Immediately
New York Adult Protective Services or Statewide Central Register (child abuse).
Immediate oral report required; written documentation and internal investigation records retained.
New York State Department of Health.
Aligns; comprehensive reporting and documentation requirements exceed CMS baseline.
Yes

North Carolina
Suspected abuse, neglect, or exploitation of a disabled adult or child receiving home health services.
Mandatory reporters, including healthcare providers and home health personnel.
Immediately
North Carolina Adult Protective Services or local Department of Social Services.
Immediate report required; HHA must document observations, investigation, findings, and corrective actions.
North Carolina Department of Health and Human Services.
Aligns; statutory mandatory reporting duties exceed CMS baseline.
Yes

North Dakota
Suspected abuse, neglect, or exploitation of a vulnerable adult or child.
Mandatory reporters, including healthcare professionals and home health staff.
Immediately
North Dakota Adult Protective Services or law enforcement.
Immediate report with documentation of findings and internal investigation retained by the HHA.
North Dakota Department of Health and Human Services.
Aligns; reporting scope broader than CMS baseline.
Yes

Ohio
Suspected abuse, neglect, or exploitation of an elderly person, vulnerable adult, or child.
Mandatory reporters, including healthcare providers and home health personnel.
Immediately
Ohio Adult Protective Services or local law enforcement.
Immediate oral report required; written documentation and corrective-action records retained.
Ohio Department of Health.
Aligns; explicit statutory reporting requirements exceed CMS minimum.
Yes

Oklahoma
Suspected abuse, neglect, or exploitation of a vulnerable adult or child receiving home health care.
Mandatory reporters, including home health clinicians, aides, and administrators.
Immediately
Oklahoma Adult Protective Services or local law enforcement.
Immediate report required; HHA must document findings, actions taken, and outcomes.
Oklahoma State Department of Health.
Aligns; mandatory reporting statutes are more prescriptive than CMS.
Yes

Oregon
Suspected abuse, neglect, or exploitation of a vulnerable adult or child in home health services.
Mandatory reporters, including healthcare providers and home health staff.
Immediately
Oregon Adult Protective Services or local law enforcement.
Immediate oral report required; written documentation maintained by the HHA for survey review.
Oregon Health Authority.
Aligns; statutory reporting obligations exceed CMS baseline.
Yes

Pennsylvania
Suspected abuse, neglect, exploitation, or abandonment of an older adult or child receiving home health services.
Mandatory reporters, including healthcare providers and home health personnel.
Immediately
Pennsylvania Adult Protective Services or ChildLine (child abuse); law enforcement when indicated.
Immediate report required; HHA must document observations, investigation steps, findings, and corrective actions.
Pennsylvania Department of Health.
Aligns; comprehensive mandatory reporting statutes exceed CMS baseline.
Yes

Rhode Island
Suspected abuse, neglect, or exploitation of an elderly person or child receiving home health care.
Mandatory reporters, including home health clinicians and aides.
Immediately
Rhode Island Elder Protective Services or Department of Children, Youth & Families.
Immediate oral report required; written documentation retained by the HHA for survey review.
Rhode Island Department of Health.
Aligns; statutory reporting duties are broader than CMS.
Yes

South Carolina
Suspected abuse, neglect, or exploitation of a vulnerable adult or child receiving home health services.
Mandatory reporters, including healthcare providers and home health staff.
Immediately
South Carolina Adult Protective Services or Child Protective Services.
Immediate report required; HHA must document findings, actions taken, and outcomes.
South Carolina Department of Health and Environmental Control.
Aligns; mandatory reporting statutes exceed CMS baseline.
Yes

South Dakota
Suspected abuse, neglect, or exploitation of an elder, vulnerable adult, or child.
Mandatory reporters, including healthcare professionals and home health personnel.
Immediately
South Dakota Adult Protective Services or law enforcement.
Immediate oral report required; written documentation maintained by the HHA.
South Dakota Department of Health.
Aligns; statutory reporting framework is more explicit than CMS.
Yes

Tennessee
Suspected abuse, neglect, or exploitation of an adult or child receiving home health care.
Mandatory reporters, including healthcare providers and home health staff.
Immediately
Tennessee Adult Protective Services or Child Abuse Hotline.
Immediate report required; documentation of investigation and corrective action retained.
Tennessee Department of Health.
Aligns; centralized hotline reporting exceeds CMS baseline.
Yes

Texas
Suspected abuse, neglect, or exploitation of an elderly or disabled person or child receiving home health services.
Mandatory reporters, including healthcare providers and home health personnel.
Immediately
Texas Adult Protective Services or Child Abuse Hotline; law enforcement when indicated.
Immediate report required; HHA must document observations, investigation, findings, and corrective actions.
Texas Health and Human Services Commission.
Aligns; detailed statutory reporting and hotline requirements exceed CMS baseline.
Yes

Utah
Suspected abuse, neglect, or exploitation of a vulnerable adult or child in home health care.
Mandatory reporters, including healthcare professionals and home health staff.
Immediately
Utah Adult Protective Services or Child & Family Services.
Immediate report required; written documentation and internal investigation records retained.
Utah Department of Health and Human Services.
Aligns; mandatory reporting scope and timelines exceed CMS baseline.
Yes

Vermont
Suspected abuse, neglect, or exploitation of a vulnerable adult or child receiving home health services.
Mandatory reporters, including healthcare providers and home health personnel.
Immediately
Vermont Adult Protective Services or Child Protection Services.
Immediate oral report required; written documentation maintained by the HHA.
Vermont Department of Health.
Aligns; statutory reporting duties exceed CMS baseline.
Yes

Virginia
Suspected abuse, neglect, or exploitation of an incapacitated adult or child receiving home health care.
Mandatory reporters, including healthcare professionals and home health staff.
Immediately
Virginia Adult Protective Services or local Department of Social Services.
Immediate report required; HHA must document findings, actions taken, and outcomes.
Virginia Department of Health.
Aligns; mandatory reporting statutes are more prescriptive than CMS.
Yes

Washington
Suspected abuse, neglect, abandonment, or exploitation of a vulnerable adult or child in home health services.
Mandatory reporters, including healthcare providers and home health personnel.
Immediately
Washington Adult Protective Services or Child Protective Services.
Immediate report required; documentation of investigation and corrective action retained.
Washington State Department of Health.
Aligns; comprehensive statutory reporting framework exceeds CMS baseline.
Yes

West Virginia
Suspected abuse, neglect, or exploitation of an incapacitated adult or child receiving home health services.
Mandatory reporters, including healthcare providers and home health personnel.
Immediately
West Virginia Adult Protective Services or Child Protective Services.
Immediate report required; HHA must document observations, investigation, findings, and corrective actions.
West Virginia Department of Health and Human Resources.
Aligns; statutory mandatory reporting requirements exceed CMS baseline.
Yes

Wisconsin
Suspected abuse, neglect, self-neglect, or financial exploitation of an elder adult or child.
Mandatory reporters, including healthcare professionals and home health staff.
Immediately
Wisconsin Adult Protective Services or local law enforcement.
Immediate oral report required; written documentation and internal investigation records retained.
Wisconsin Department of Health Services.
Aligns; detailed statutory definitions and reporting duties exceed CMS.
Yes

Wyoming
Suspected abuse, neglect, or exploitation of a vulnerable adult or child receiving home health care.
Mandatory reporters, including healthcare providers and home health personnel.
Immediately
Wyoming Adult Protective Services or local law enforcement.
Immediate report required; documentation of findings and corrective action maintained by the HHA.
Wyoming Department of Health.
Aligns; mandatory reporting statutes are more explicit than CMS.
Yes

District of Columbia
Suspected abuse, neglect, or exploitation of a vulnerable adult or child receiving home health services.
Mandatory reporters, including healthcare providers and home health personnel.
Immediately
DC Adult Protective Services or Child and Family Services Agency.
Immediate report required; HHA must document investigation steps, findings, and outcomes.
DC Department of Health.
Aligns; statutory reporting framework exceeds CMS baseline.
Yes

  

Mandatory Reporting Failures in Home Health Carry High Risk

Home health providers are subject to a variety of mandatory reporting requirements, including abuse/neglect, controlled substances, unexpected deaths, and patient safety incidents. Missing or delayed reports, failure to follow appropriate protocols, and improper documentation of these incidents can expose providers to regulatory penalties, civil liability, and adverse legal outcomes. Our team helps identify gaps in compliance and align your strategy with regulatory obligations.

Submit Records for Mandatory Reporting Review

HIPAA-secure intake • State-specific reporting compliance • Standard 7-day delivery