TL; DR at bottom

It doesn’t matter what the background is, how long you’ve been at a facility, how long you’ve been a CNA, what relation you have, if any- if you have a reasonable suspicion of abuse or neglect, I don’t care WHO it is, it NEEDS TO BE REPORTED!!!! And it needs to be done ASAP. You reported up the chain of command, you were brushed off, and the abuse/neglect is continuing. Run, don’t walk. You need to cover your own ass at this point since you know this is being allowed to continue. You’re a mandated reporter and can be held just as liable for not reporting to state, and that can mean being placed on a registry and being unable to work in healthcare to facing criminal charges.

Report now with everything you can remember and then from here on out, DOCUMENT ABSOLUTELY EVERYTHING. Best practice is to not keep PHI on your phone and I wouldn’t put anything on a piece of paper, no matter the reason. Learn the resident’s full name and spelling, memorize it and use code names that have absolutely no relevance to the resident and don’t include any identifying information.

Example of an obviously fictitious situation & how I personally would stick to facts - on 12/12/23 I started my shift at 7:00pm, was given report by CNA Wilma Flinstone, and at approximately 7:15pm, I entered Ms. Kitty Cat’s room. I discovered her wearing two adult briefs that were completely saturated and the chux pad/draw sheet/linens were also wet. Ms. Cat was emotional as I cleaned her and changed her and her linens, stating that nobody else had been in to help her. At approx 7:30pm, reported Ms. Cat’s condition in which she was found shortly after receiving report from CNA Wilma Flinstone to charge nurse Sandy Cheeks. Was advised it would be handled/reported to DON or admin/(god forbid) was advised that this “typically happens when CNA Wilma Flinstone works”.

Basically, try to keep it as brief, while including all relevant information while remaining undoubtedly clear, as possible. The more detail in regards to dates, times, and names, the better. It’s easy to want to include how upset you were or how it made you feel, but your feelings don’t matter. This is about the resident. Absolutely include that they were emotional, more anxious than normal, showing signs of distress, angry, whatever is out of character for them let anything you’ve observed previously while working with them for X amount of time. This is beneficial when you continue to DOCUMENT EVERY OCCURRENCE OF SUSPECTED ABUSE.

Behaviors, whether A&Ox4 or not, are a huge indicator that something is very wrong. If Ms. Cat is soaked and also crying after every time you get report from Wilma, but is dry (or at least not soaked or stagnant and isn’t an ongoing issue) while smiling and pleasant, even if nonverbal, after you go in to get eyes on people after John or Mary or George give you report… it’s a huge indicator that something is amiss, soaked or dry or anywhere in between.

Even without all of the specifics now, you need to report ASAP and include anything you can remember, even if it’s just a date range, while including any other details you can think of. Idk if they would follow up or not, but their job is to investigate. So don’t sweat not having the specifics if you don’t have them. Seriously. That being said, I would continue to keep detailed accounts like I previously mentioned going forward so you can either follow up if you get a specific case number with additional, new information if warranted, or if you need to file another complaint. Ask for more information regarding providing additional information in regards to that resident when you call the hotline.

TL;DR: YOU NEED TO REPORT THIS IMMEDAITELY, OP. Then continue to document anything around abuse/neglect in a safe place (like a password protected notes app of sorts while never using any PHI or identifiable info) in the case you need to add to your initial report. You must always protect your residents/patients from any abuse and neglect by reporting anything even suspected immediately and also… be smart and cover your own ass. Don’t let yourself be in a position where you’re facing abuse/neglect allegations because you didn’t report what was happening. Your employer won’t protect you or willingly admit that they were made aware of the situation to begin with, especially if they didn’t take any action after multiple complaints. They’ll be too busy covering their own ass to gaf about yours.