Do PTs, OTs, SLPs and Nurses Have to Report Abuse? The Law in Every State

Yes, almost everywhere, and the duty is yours, not your agency's. In every state whose law I could read, nurses must report suspected child abuse, and 17 states require every person to. Most states also make reporting the abuse of an older or vulnerable adult mandatory for health professionals, but the lists differ. Some leave out occupational therapists or speech-language pathologists, a few cover only adults over 60 or 65, and New York leaves adult reporting voluntary.

These rules mostly aren't in the practice acts. They sit in each state's child protection law and its adult protective services (APS) or elder abuse law, so that is what this article quotes. It goes through every state for PTs, OTs, SLPs and nurses: whether you must report, to whom, how fast, and the exact words, with a link to the official text. I'm an occupational therapist, not a lawyer or a nurse, so I've stayed with what the laws say.

This isn't legal advice. I checked every rule on November 9, 2026, on the state's own legislature, code or board site. Your board's current rule is the one that counts.

The Short Answer

• Child abuse, everyone must report in 17 states: Delaware, Florida, Idaho, Indiana, Kentucky, Maryland, Nebraska, New Hampshire, New Jersey, New Mexico, North Carolina, Oklahoma, Rhode Island, Tennessee, Texas, Utah and Wyoming.
• 31 more list who must report. Nurses are covered on every list (New York names registered nurses only). PTs, OTs and SLPs are reached in 21 of them, by name or as health care providers.
• Therapist gaps for child abuse: Colorado and Connecticut leave out OTs and SLPs, Michigan leaves out SLPs, and Iowa, Massachusetts, New York and South Dakota leave out all three outside hospitals or schools. Kansas's list is unclear for therapists. Arizona and Alabama reach some therapists only for a child in their care.
• Adult abuse, mandatory in 43 states: 14 require every person to report, and 29 require health professionals to.
• Mandatory only in some cases in 4: Colorado (70 and older, or with intellectual and developmental disabilities), Illinois (adults who can't seek help), Pennsylvania (agency staff, about agency patients) and Wisconsin (serious cases).
• Voluntary in 1: New York.
• To whom: the state child protection agency or hotline (or the police) for children, and adult protective services (or the police) for adults.
• How fast: usually immediately. The firmest deadlines run from 12 hours (Connecticut, children) to two business days (Vermont, adults).
• Couldn't verify: Arkansas, Georgia and Mississippi publish their codes only through LexisNexis's viewer, which I couldn't open.

What Medicare Requires of Home Health Staff

This part is federal and applies to every Medicare-certified home health agency, whatever the state. It is not a reporting law for the public, and it doesn't replace your state's law. It sits in the home health conditions of participation, 42 CFR 484.50 (opens in a new tab), and it binds the agency and its staff.

Every patient has the right to "Be free from verbal, mental, sexual, and physical abuse, including injuries of unknown source, neglect and misappropriation of property" (§ 484.50(c)(2)). The agency must investigate complaints about "Mistreatment, neglect, or verbal, mental, sexual, and physical abuse, including injuries of unknown source, and/or misappropriation of patient property by anyone furnishing services on behalf of the HHA," document them, and "Take action to prevent further potential violations, including retaliation, while the complaint is being investigated" (§ 484.50(e)(1)). And staff must report:

(2) Any HHA staff (whether employed directly or under arrangements) in the normal course of providing services to patients, who identifies, notices, or recognizes incidences or circumstances of mistreatment, neglect, verbal, mental, sexual, and/or physical abuse, including injuries of unknown source, or misappropriation of patient property, must report these findings immediately to the HHA and other appropriate authorities in accordance with state law.

Three things follow. It covers contract therapists too ("under arrangements"). It asks for two reports, one to the agency and one to the authorities. And "in accordance with state law" sends you to the table below to find out who those authorities are. Note that it speaks of patients. A child in the home who isn't your patient is a matter for state law only. For what patients are told about these rights, see home health patient rights and how to complain.

Every State at a Glance

Yes, everyone means the state requires every person to report, so you are covered whatever your license. Not named means the list of required reporters doesn't include that profession, and the rest of the cell says who is. Couldn't verify means I couldn't open an official copy of the code. Each citation links to the official text I read.

Where the Child Abuse Lists Leave Therapists Out

In the 31 states that list who must report, nurses are always on it. Therapists are less certain. These are the states where at least one of PT, OT and SLP falls outside the list.

• Colorado. The list names "(i) Registered nurse or licensed practical nurse;" and "(q) Physical therapist;" but not occupational therapists or speech-language pathologists. They are covered only as "(j) Hospital personnel engaged in the admission, care, or treatment of patients;" which doesn't reach a home visit. (C.R.S. § 19-3-304(2) (opens in a new tab), 2024 edition from the Office of Legislative Legal Services)
• Connecticut. "(20) any physical therapist" is on the list of 41, and so are nurses. OTs and SLPs aren't. (C.G.S. § 17a-101(b) (opens in a new tab))
• Michigan. "physical therapist, physical therapist assistant, occupational therapist" and "audiologist" are on the list. Speech-language pathologists aren't. (MCL 722.623(1)(a) (opens in a new tab))
• Iowa. Mandatory reporting rests on "Every health practitioner who in the scope of professional practice, examines, attends, or treats a child," and a health practitioner "includes a licensed physician and surgeon, osteopathic physician and surgeon, dentist, optometrist, podiatric physician, or chiropractor; a resident or intern in any of such professions; a licensed dental hygienist, a registered nurse or licensed practical nurse; a physician assistant; and an emergency medical care provider certified under section 147A.6." Therapists come in only through listed settings, such as school employees. For everyone else: "Any other person who believes that a child has been abused may make a report." (Iowa Code § 232.69 (opens in a new tab), § 232.68 (opens in a new tab))
• Massachusetts. The definition of mandated reporter starts with "a physician, medical intern, hospital personnel engaged in the examination, care or treatment of persons, medical examiner, psychologist, emergency medical technician, dentist, nurse," and never names a therapist. (M.G.L. c. 119, § 21 (opens in a new tab))
• New York. The list includes "registered nurse" and "hospital personnel engaged in the admission, examination, care or treatment of persons," plus school staff who hold a teaching or administrative license. It doesn't name LPNs, PTs, OTs or SLPs. (Soc. Serv. Law § 413(1)(a) (opens in a new tab))
• South Dakota. The list names nurses and stops there for health care. "Any person who knows or has reason to suspect that a child has been abused or neglected as defined in § 26-8A-2 may report that information as provided in § 26-8A-8." (SDCL 26-8A-3 (opens in a new tab))
• Kansas, unclear. The list covers "Persons licensed to practice the healing arts, dentistry and optometry" and "licensed professional or practical nurses." Kansas defines the healing arts as including "specifically, but not by way of limitation, the practice of medicine and surgery; the practice of osteopathic medicine and surgery; and the practice of chiropractic." Whether a PT, OT or SLP license counts isn't spelled out. (K.S.A. 38-2223(a)(1)(A) (opens in a new tab), K.S.A. 65-2802(a) (opens in a new tab))

Two more reach therapists only for a child in their care. Arizona names nurses, and everyone else only as "Any other person who has responsibility for the care or treatment of the minor" (A.R.S. § 13-3620(A) (opens in a new tab)). Alabama names "A physical therapist" and "A nurse," and reaches OTs and SLPs as "Any other person called upon to render aid or medical assistance to any child" (Ala. Code § 26-14-3(a)(2) (opens in a new tab)).

At the other end, three states name all four professions outright. Alaska's definition of practitioner of the healing arts lists "occupational therapists, occupational therapy assistants," "physical therapists, physical therapist assistants," and "audiologists and speech-language pathologists licensed under AS 08.11" (AS 47.17.290 (opens in a new tab)). Oregon lists "(t) Physical, speech or occupational therapist." and "(v) Speech-language pathologist." alongside nurses and "employee of an in-home health service" (ORS 419B.005 (opens in a new tab)). Wisconsin lists "22. A physical therapist. 22m. A physical therapist assistant. 23. An occupational therapist. 24. A dietitian. 25. A speech-language pathologist." (Wis. Stat. § 48.981(2)(a) (opens in a new tab)).

The Child in the Home Who Isn't Your Patient

Home health puts you in a family's living room, and the child you're worried about may be a grandchild, not the patient. Whether the law reaches that child depends on how your state words the trigger.

• Universal states don't care how you learned it. In the 17 states where every person must report, you report as a person, not as a clinician.
• Pennsylvania says outright that the child doesn't have to be your patient: "Nothing in this section shall require a child to come before the mandated reporter in order for the mandated reporter to make a report of suspected child abuse." The trigger includes contact "in the course of employment, occupation and practice of a profession." (23 Pa.C.S. § 6311(b) (opens in a new tab))
• Louisiana covers a health practitioner "who diagnoses, examines, or treats a child or his family." Treating the grandmother counts. (Ch.C. art. 603 (opens in a new tab))
• Oregon covers "any child with whom the official comes in contact," and makes the duty "personal to the public or private official alone." (ORS 419B.010 (opens in a new tab))
• Narrower wording in some states ties the duty to children you see professionally: New York's "a child coming before them in their professional or official capacity" (SSL § 413 (opens in a new tab)) and Wisconsin's "a child seen by the person in the course of professional duties" (§ 48.981 (opens in a new tab)). A child you see in the home during a visit is seen in the course of your work.

Adult Abuse: Who Counts, and Where It's Optional

Adult protective services laws protect two overlapping groups: older adults, at an age the state picks, and adults of any age who can't protect themselves. Most states cover both under one word, vulnerable adult. Some cover only older adults in the statute I've quoted: Connecticut and Ohio (60 and older), Rhode Island (60 and older), Massachusetts (60 and older, with a separate law for ages 18 to 59) and Oregon (65 and older).

Three states put home health patients inside the definition:

• Minnesota: a vulnerable adult includes anyone 18 or older who "receives services from a home care provider required to be licensed under sections 144A.43 to 144A.482." (Minn. Stat. § 626.5572, subd. 21 (opens in a new tab))
• Washington: a vulnerable adult includes a person "Receiving services from home health, hospice, or home care agencies licensed or required to be licensed under chapter 70.127 RCW." (RCW 74.34.020 (opens in a new tab))
• Vermont: a vulnerable adult includes someone who "was receiving assistance with personal care services for more than one month from a designated home health agency." (33 V.S.A. § 6902 (opens in a new tab))

Five states make adult reporting optional for most clinicians, or mandatory only in some cases:

• New York has no duty to report for clinicians in the community. Its law protects those who do: a person who reports in good faith "shall have immunity from any civil liability that might otherwise result by reason of the act of making such report or referral." (Soc. Serv. Law § 473-b (opens in a new tab))
• Wisconsin requires a report from a health care provider who has seen an adult at risk in the course of their duties only "if the elder adult at risk has requested the person to make the report, or if the person has reasonable cause to believe that any of the following situations exist: 1. The elder adult at risk is at imminent risk of serious bodily harm, death, sexual assault, or significant property loss and is unable to make an informed judgment about whether to report the risk." (Wis. Stat. § 46.90(4)(ad) (opens in a new tab); the same rule for ages 18 to 59 is in § 55.043 (opens in a new tab))
• Pennsylvania makes it mandatory through your employer. "An employee or an administrator who has reasonable cause to suspect that a recipient is a victim of abuse shall immediately make an oral report to the agency," and a facility includes "A home health care agency." Anyone else "may report." (Older Adults Protective Services Act §§ 103, 302, 701 (opens in a new tab); the Adult Protective Services Act sets the same rule for ages 18 to 59, Act 70 of 2010 (opens in a new tab))
• Illinois makes it mandatory when the adult "because of a disability or other condition or impairment is unable to seek assistance for himself or herself." Otherwise any person "may report." (320 ILCS 20/4 (opens in a new tab))
• Colorado makes it mandatory for an at-risk elder, "any person who is seventy years of age or older," and adults with intellectual and developmental disabilities. For other at-risk adults, clinicians are "urged to report." (C.R.S. § 18-6.5-102 (opens in a new tab), § 26-3.1-102 (opens in a new tab))

Texas adds a home health rule on top of its universal duty. At a licensed home and community support services agency, "a person, including an officer, employee, agent, contractor, or subcontractor of a facility or provider subject to this subsection, having cause to believe that an individual receiving services from the facility or provider is in the state of abuse, neglect, or exploitation shall immediately report to the commission" (the Health and Human Services Commission). (Tex. Hum. Res. Code § 48.051(b-1) (opens in a new tab))

Telling Your Supervisor Isn't Enough

Most of these laws put the duty on you personally. Some say so in as many words:

• District of Columbia: "notifying the person in charge of the institution or their designated agent shall not relieve the mandatory reporter who was originally required to report from their duty under subsection (b) of this section." (D.C. Code § 4-1321.02(b)(4) (opens in a new tab))
• South Carolina: a mandated reporter "who reports child abuse or neglect to a supervisor or person in charge of an institution, school, facility, or agency is not relieved of his individual duty to report in accordance with this section." (S.C. Code § 63-7-310(D) (opens in a new tab))
• Texas: "A professional may not delegate to or rely on another person to make the report." (Tex. Fam. Code § 261.101(b) (opens in a new tab))
• Oregon: "The duty to report under this section exists regardless of whether the entity or organization that employs the public or private official or uses the official as a volunteer has its own procedures or policies for reporting abuse internally within the entity or organization." (ORS 419B.010(4) (opens in a new tab))

A few states let a facility report on staff's behalf, such as Massachusetts for child abuse: a mandated reporter on a facility's staff "may instead notify the person or designated agent in charge of such institution, school or facility who shall become responsible for notifying the department" (M.G.L. c. 119, § 51A (opens in a new tab)). In home health you rarely have a person in charge on site, so the safe habit is the one Medicare asks for anyway: report to the state yourself, then tell your agency.

Failing to report can be a crime. Alabama makes it "a Class C misdemeanor" for adult abuse (Ala. Code § 38-9-8(e) (opens in a new tab)), South Dakota "a Class 1 misdemeanor" for child abuse (SDCL 26-8A-3 (opens in a new tab)), and New Mexico adds a civil penalty "not to exceed ten thousand dollars ($10,000) per violation" for adult abuse (NMSA § 27-7-30(D) (opens in a new tab)).

If You Suspect Abuse on a Visit

None of this is legal advice. It is what the laws above have in common, put as steps.

1. If someone is in danger now, call 911. The reporting laws come second to safety.
2. Report to the state yourself. Use the child protection hotline for a child and APS for an adult. In most states the police are an alternative. You don't need proof, only the reasonable suspicion your state's law describes.
3. Then tell your agency. Medicare requires home health staff to report to the agency and the authorities. Your agency may also have its own form.
4. Don't investigate. Don't question the suspected abuser or confront the family. Write down what you saw and heard, in the person's own words where you can.
5. Send the written follow-up if your state asks for one, often within 36 to 72 hours.
6. Know the deadline. "Immediately" is the rule in most states. Connecticut gives 12 hours for children; several states give 24.
7. Check where the patient is. If you work across a state line, on a compact privilege or by telehealth, look at the law where the child or adult lives too. Our licensure compact tool shows which states you can practice in.

Key Takeaways

• Child abuse: every state whose law I could read requires nurses to report, and 17 states require everyone to.
• PTs, OTs and SLPs are covered in most states, but not named in Colorado and Connecticut (OTs, SLPs), Michigan (SLPs), and Iowa, Massachusetts, New York and South Dakota (all three outside hospitals or schools).
• Adult abuse: mandatory for clinicians in 43 states, conditional in Colorado, Illinois, Pennsylvania and Wisconsin, and voluntary in New York.
• Report to the state agency or police yourself. Telling your supervisor usually doesn't count.
• Medicare requires home health staff to report abuse of a patient both to the agency and to the authorities.
• This isn't legal advice. I checked these rules on November 9, 2026, and your board's current rule is the one that counts.

Frequently asked questions

Are physical therapists, OTs and SLPs mandated reporters of child abuse?

In most states, yes. In 17 states every person must report suspected child abuse, so therapists are covered by default. Of the 31 states that list who must report, 21 reach PTs, OTs and SLPs by name or through a category such as health care provider. The gaps: Colorado and Connecticut don't list OTs or SLPs, Michigan doesn't list SLPs, and Iowa, Massachusetts, New York and South Dakota don't list PTs, OTs or SLPs outside settings such as hospitals or schools. Kansas lists healing-arts licensees, and it's unclear whether that reaches therapists. Arizona and Alabama reach some therapists only for a child in their care. I couldn't verify Arkansas, Georgia or Mississippi.

Do I have to report elder abuse as a home health clinician?

Almost everywhere, yes. Fourteen states require every person to report abuse of a vulnerable or older adult, and 29 more require health professionals to, though a few lists leave out some therapists. Four states make it mandatory only in some cases: Colorado (adults 70 and older, and adults with intellectual and developmental disabilities), Illinois (adults who can't seek help themselves), Pennsylvania (agency staff reporting on agency patients) and Wisconsin (serious cases). In New York it is voluntary. Separately, Medicare requires home health staff to report abuse of a patient to the agency and to the authorities state law names.

Does telling my supervisor or agency count as reporting?

Usually not. The duty is yours. Several states say so in plain words, including the District of Columbia, Oregon, South Carolina and Texas. Medicare's home health rule asks for both: a report to the agency and a report to the appropriate authorities under state law. Tell your agency after you have made the state report, not instead of it.

How fast do I have to report suspected abuse?

Usually immediately. Where a state sets hours for child abuse, the deadline runs from 12 hours in Connecticut to 48 hours in Washington, with 24 hours the most common. For adults, 24 hours is common, and Vermont allows two business days. Many states want a phone report first and a written report within 36 to 72 hours.

Sources

Every state's rule is linked in the table, to the state's legislature or official code publisher, and was read on November 9, 2026. Where a legislature's site blocks scripts (California, New York, Alabama's code browser), the text was read through the legislature's own data feed or a browser and is cited at the official address.

• Centers for Medicare & Medicaid Services, home health conditions of participation, 42 CFR 484.50 (opens in a new tab) (eCFR): patient rights (c)(2) and investigation of complaints (e).
• Arkansas, Georgia and Mississippi: the reporting statutes named in the table were not read, because their official codes are published only through LexisNexis's public viewer. Check with the state agency linked in each row.