Reporting alleged violations promptly is crucial for maintaining safety and compliance in long-term care facilities. Among the most frequently cited issues at the Immediate Jeopardy (IJ) level are those related to Abuse and Neglect. This article focuses on F609, one of the nine specific F tags, and provides practical tips to ensure timely and accurate reporting of alleged violations.

Understanding F609: Reporting of Alleged Violations

Common Issues with F609 Reporting

Many facilities struggle with the requirements of F609 Reporting of Alleged Violations because they lose focus on the timeframe requirements. The State Operations Manual (SOM) in Appendix PP provides specific guidance on the timeframes within which reportable events must be reported, depending on the circumstances of the event and whether serious bodily injury has occurred.

Reporting Timeframes and Requirements

The facility team members responsible for reporting must fully comply with Appendix PP guidance and report these events within the specified time requirements.

For all alleged violations of abuse, neglect, exploitation, or mistreatment, including injuries of unknown source and misappropriation of resident property:

      • Immediately but not later than 2 hours: If the alleged violation involves abuse or results in serious bodily injury.
      • Not later than 24 hours: If the alleged violation involves neglect, exploitation, mistreatment, or misappropriation of resident property; and does not result in serious bodily injury.

For reasonable suspicion of a crime against a resident, any covered individual (owner, operator, employee, manager, agent, or contractor of the facility) must report to the State Survey Agency (SA) and one or more law enforcement entities:

      • Serious bodily injury: Immediately but not later than 2 hours after forming the suspicion.
      • No serious bodily injury: Not later than 24 hours.

Facilities should consult with their local law enforcement to determine what actions would be considered a crime in their local jurisdiction and establish clear guidelines to staff on procedures to follow to report reasonable suspicion of crime and/or allegations of abuse or neglect.

Examples of Reportable Crimes:

      • Murder
      • Manslaughter
      • Rape
      • Assault and battery
      • Sexual abuse
      • Theft/Robbery
      • Drug diversion for personal use or gain
      • Identity theft
      • Fraud and forgery

Critical Elements for Compliance

To comply with these reporting timeframes, it is imperative that the facility has the following critical elements in place:

      1. Staff Training:
        • Train staff on the reporting requirements.
        • Provide clear instructions on reporting responsibilities and processes.
      2. Establishing a Reporting Team:
        • Create a dedicated team to handle reporting.
        • Ensure team members can quickly initiate initial investigations to meet reporting deadlines.
      3. Monitoring and Oversight:
        • Regularly monitor reportable events.
        • Ensure adherence to reporting timeframes.

Follow-up Reporting Requirements

Another crucial element is that the facility must also report the findings of their investigations into abuse, neglect, exploitation, mistreatment, and injuries of unknown origin within 5 working days of the incident. Maintaining focus on both the initial and final reporting regulatory requirements is imperative.


Ensuring timely and accurate reporting of alleged violations is essential for compliance and resident safety in long-term care facilities. By understanding F609 requirements, training staff, establishing a dedicated reporting team, and monitoring compliance, facilities can effectively manage reportable events.

For a Reporting Decision Tool and other helpful tips and strategies for completing a review of your facility’s Abuse and Neglect Prevention and Response Program, make plans to join Proactive for the Abuse & Neglect Program Checkup webinar series beginning August 7, 2024.


Written by Janine Lehman, RN, RAC-CT, CLNC
Director of Legal Nurse Consulting

Was this article helpful? Access weekly insights when you sign up for our weekly newsletter!