Title 42, The Public Health and WelfareRelease 119-110

§1320b–25 Reporting to Law Enforcement of Crimes Occurring in Federally Funded Long-term Care Facilities

Title 42 › CHAPTER 7 — SOCIAL SECURITY › SUBCHAPTER XI — GENERAL PROVISIONS, PEER REVIEW, AND ADMINISTRATIVE SIMPLIFICATION › Part A — General Provisions › § 1320b–25

Last updated Sep 22, 2026|Official source

Summary

Owners and operators of long-term care facilities that get federal money must each year check if the facility received at least $10,000 in federal funds the year before. If it did, they must tell every covered individual that those people must report suspected crimes involving residents or people getting care. Covered individual — anyone who owns, runs, works for, manages, represents, or contracts with the facility. Elder justice, long-term care facility, and law enforcement — have the meanings used in section 1397j. Underserved population — areas or groups with a shortage of elder justice programs, including isolated rural areas, racial and ethnic minorities, or groups with special needs (for example, language barriers, disabilities, immigration status, or age). Anyone who is a covered individual must report any reasonable suspicion of a crime against a resident or someone getting care to the Secretary and to one or more law enforcement agencies where the facility is located. If the suspected event caused serious bodily injury, the report must be made immediately and no later than 2 hours after the suspicion forms. For other suspicions, the report must be made within 24 hours. If a covered individual fails to report, they can face a civil money penalty up to $200,000 and may be excluded from federal health care programs. If the failure makes harm worse or causes harm to someone else, the penalty can be up to $300,000 and exclusion may also apply. While excluded, the facility that employs that person cannot get federal funds. The Secretary may reduce penalties for providers serving underserved populations. Facilities may not retaliate against employees who make reports; retaliation can bring up to $200,000 in fines and possible 2-year exclusion. Facilities must post a notice telling employees their rights and how to file a complaint with the Secretary. Procedures for penalties and exclusions follow existing federal rules.

Full Legal Text

Title 42, §1320b–25

The Public Health and Welfare, Source: USLM XML via OLRC

(a)Determination and notification

(1)Determination

The owner or operator of each long-term care facility that receives Federal funds under this chapter shall annually determine whether the facility received at least $10,000 in such Federal funds during the preceding year.

(2)Notification

If the owner or operator determines under paragraph (1) that the facility received at least $10,000 in such Federal funds during the preceding year, such owner or operator shall annually notify each covered individual (as defined in paragraph (3)) of that individual’s obligation to comply with the reporting requirements described in subsection (b).

(3)Covered individual defined

In this section, the term “covered individual” means each individual who is an owner, operator, employee, manager, agent, or contractor of a long-term care facility that is the subject of a determination described in paragraph (1).

(b)Reporting requirements

(1)In general

Each covered individual shall report to the Secretary and 1 or more law enforcement entities for the political subdivision in which the facility is located any reasonable suspicion of a crime (as defined by the law of the applicable political subdivision) against any individual who is a resident of, or is receiving care from, the facility.

(2)Timing

If the events that cause the suspicion—

(A)result in serious bodily injury, the individual shall report the suspicion immediately, but not later than 2 hours after forming the suspicion; and

(B)do not result in serious bodily injury, the individual shall report the suspicion not later than 24 hours after forming the suspicion.

(c)Penalties

(1)In general

If a covered individual violates subsection (b)—

(A)the covered individual shall be subject to a civil money penalty of not more than $200,000; and

(B)the Secretary may make a determination in the same proceeding to exclude the covered individual from participation in any Federal health care program (as defined in section 1320a–7b(f) of this title).

(2)Increased harm

If a covered individual violates subsection (b) and the violation exacerbates the harm to the victim of the crime or results in harm to another individual—

(A)the covered individual shall be subject to a civil money penalty of not more than $300,000; and

(3)Excluded individual

During any period for which a covered individual is classified as an excluded individual under paragraph (1)(B) or (2)(B), a long-term care facility that employs such individual shall be ineligible to receive Federal funds under this chapter.

(4)Extenuating circumstances

(A)In general

The Secretary may take into account the financial burden on providers with underserved populations in determining any penalty to be imposed under this subsection.

(B)Underserved population defined

In this paragraph, the term “underserved population” means the population of an area designated by the Secretary as an area with a shortage of elder justice programs or a population group designated by the Secretary as having a shortage of such programs. Such areas or groups designated by the Secretary may include—

(i)areas or groups that are geographically isolated (such as isolated in a rural area);

(ii)racial and ethnic minority populations; and

(iii)populations underserved because of special needs (such as language barriers, disabilities, alien status, or age).

(d)Additional penalties for retaliation

(1)In general

A long-term care facility may not—

(A)discharge, demote, suspend, threaten, harass, or deny a promotion or other employment-related benefit to an employee, or in any other manner discriminate against an employee in the terms and conditions of employment because of lawful acts done by the employee; or

(B)file a complaint or a report against a nurse or other employee with the appropriate State professional disciplinary agency because of lawful acts done by the nurse or employee,

for making a report, causing a report to be made, or for taking steps in furtherance of making a report pursuant to subsection (b)(1).

(2)Penalties for retaliation

If a long-term care facility violates subparagraph (A) or (B) of paragraph (1) the facility shall be subject to a civil money penalty of not more than $200,000 or the Secretary may classify the entity as an excluded entity for a period of 2 years pursuant to section 1320a–7(b) of this title, or both.

(3)Requirement to post notice

Each long-term care facility shall post conspicuously in an appropriate location a sign (in a form specified by the Secretary) specifying the rights of employees under this section. Such sign shall include a statement that an employee may file a complaint with the Secretary against a long-term care facility that violates the provisions of this subsection and information with respect to the manner of filing such a complaint.

(e)Procedure

The provisions of section 1320a–7a of this title (other than subsections (a) and (b) and the second sentence of subsection (f)) shall apply to a civil money penalty or exclusion under this section in the same manner as such provisions apply to a penalty or proceeding under section 1320a–7a(a) of this title.

(f)Definitions

In this section, the terms “elder justice”, “long-term care facility”, and “law enforcement” have the meanings given those terms in section 1397j of this title.

Reference

Citations & Metadata

Citation

42 U.S.C. § 1320b–25

Title 42, The Public Health and Welfare

Last Updated

Sep 22, 2026

Release point: 119-110