South Carolina Adult Protective Services Report — Vulnerable Adult Abuse, Neglect, or Exploitation
SOUTH CAROLINA ADULT PROTECTIVE SERVICES REPORT — VULNERABLE ADULT ABUSE, NEGLECT, OR EXPLOITATION
TABLE OF CONTENTS
- Receiving Agency Selection
- Emergency Triage
- Reporter Information
- Vulnerable Adult Information
- Alleged Perpetrator(s)
- Nature of Alleged Abuse, Neglect, or Exploitation
- Detailed Narrative of Concerns
- Witnesses, Evidence, and Documentation
- Risk Assessment
- Mandated-Reporter Certification and Immunity Statement
- Confidentiality Acknowledgment
- Signature Block
- South Carolina Practice Notes
- Sources and References
1. RECEIVING AGENCY SELECTION
Select the SINGLE receiving agency based on the SETTING where the alleged abuse, neglect, or exploitation occurred.
☐ Adult Protective Services (DSS APS) — community/home setting (private residence, assisted living NOT licensed as facility, family caregiver context).
- Hotline: 1-888-CARE4US (1-888-227-3487)
- Online: dss.sc.gov/adult-protection/adult-protective-services/how-to-report-abuse-neglect/
- Statutory routing: S.C. Code § 43-35-25(A)(3)
☐ South Carolina Long Term Care Ombudsman Program — incidents in licensed long-term-care facilities (nursing homes, community residential care facilities (CRCFs), assisted living, DDSN/DMH residential, etc.) NOT operated by the Office of Mental Health or Office of Intellectual and Developmental Disabilities.
- Hotline: 1-800-868-9095
- Statutory routing: S.C. Code § 43-35-25(A)(2)
☐ South Carolina Law Enforcement Division (SLED) Vulnerable Adults Investigations Unit — incidents in facilities operated or contracted for operation by the Department of Mental Health (DMH) or the Department of Disabilities and Special Needs (DDSN).
- Phone: (803) 896-7901 (verify current number with SLED)
- Statutory routing: S.C. Code § 43-35-25(A)(1)
☐ Local Law Enforcement / 911 — emergency, suspected sexual assault, serious injury, criminal exploitation in progress, or imminent risk of harm.
☐ Concurrent Report — mark all that apply if multiple agencies have jurisdiction or if cross-reporting is appropriate (e.g., financial exploitation involving facility staff may go to BOTH Ombudsman and SLED/local law enforcement).
2. EMERGENCY TRIAGE
Is the vulnerable adult in IMMEDIATE danger?
☐ YES — STOP. Call 911 NOW, then complete this report.
☐ No — proceed with report.
Has medical care been requested or provided?
☐ Yes — Provider: [________________________________] Date: [__/__/____]
☐ No
Has law enforcement been notified?
☐ Yes — Agency: [________________________________] Case #: [________]
☐ No
3. REPORTER INFORMATION
| Field | Entry |
|---|---|
| Reporter Full Name | [________________________________] |
| Title / Role | [________________________________] |
| Employer / Agency | [________________________________] |
| Address | [________________________________] |
| Phone (daytime) | [________________________________] |
| Phone (after hours) | [________________________________] |
| [________________________________] | |
| Mandated Reporter? | ☐ Yes — category: [__________] ☐ No (permissive reporter) |
| Anonymous? | ☐ Yes ☐ No (identifying yourself helps investigators) |
| Date of report | [__/__/____] |
| Time of report | [____ : ____ AM/PM] |
| Method of report | ☐ Telephone ☐ Online ☐ Fax ☐ Mail ☐ In person ☐ Email |
Mandated-Reporter Categories under S.C. Code § 43-35-25(A): physician, nurse, dentist, optometrist, medical examiner, coroner, other medical or allied health professional, mental health or intellectual disability professional, Christian Science practitioner or religious healer, school teacher, counselor, psychologist, social or public-assistance worker, caregiver, staff or volunteer of an adult day care center or facility, law enforcement officer.
4. VULNERABLE ADULT INFORMATION
| Field | Entry |
|---|---|
| Full Name | [________________________________] |
| Date of Birth / Age | [__/__/____] / [____] |
| Sex | ☐ M ☐ F ☐ Other / [________] |
| Race / Ethnicity (optional) | [________________________________] |
| Current Address | [________________________________] |
| Setting | ☐ Private home ☐ Family member's home ☐ Nursing facility ☐ CRCF ☐ Assisted living ☐ DDSN/DMH facility ☐ Hospital ☐ Other: [________] |
| Facility Name (if applicable) | [________________________________] |
| Facility License # | [________________________________] |
| Phone | [________________________________] |
| Primary Language | [________________________________] |
| Communication needs | ☐ None ☐ Hearing ☐ Vision ☐ Cognitive ☐ Other |
| Medical conditions / disabilities | [________________________________] |
| Cognitive status (dementia, etc.) | [________________________________] |
| Primary physician | [________________________________] |
| Health insurance / Medicaid ID | [________________________________] |
| Legal representative (POA / guardian / conservator) | ☐ Yes — name: [________] ☐ No ☐ Unknown |
Vulnerable Adult definition (S.C. Code § 43-35-10(11)): a person 18 years of age or older who has a physical or mental condition that substantially impairs the person from adequately providing for their own care or protection. Residents of facilities are deemed vulnerable adults.
5. ALLEGED PERPETRATOR(S)
| Field | Alleged Perpetrator 1 | Alleged Perpetrator 2 |
|---|---|---|
| Full Name | [________] | [________] |
| Relationship to Adult | [________] | [________] |
| Address | [________] | [________] |
| Phone | [________] | [________] |
| Date of Birth (if known) | [__/__/____] | [__/__/____] |
| Employer / Facility role | [________] | [________] |
| Access to victim | ☐ Lives with ☐ Caregiver ☐ Staff ☐ Visitor ☐ Family ☐ Other | ☐ Lives with ☐ Caregiver ☐ Staff ☐ Visitor ☐ Family ☐ Other |
| Known weapons / drugs / threats | ☐ Yes ☐ No | ☐ Yes ☐ No |
6. NATURE OF ALLEGED ABUSE, NEGLECT, OR EXPLOITATION
(Check all that apply.)
☐ Physical Abuse — hitting, pushing, restraining, rough handling, unexplained injuries, bruises, fractures, burns
☐ Sexual Abuse — non-consensual touching or contact; signs include genital injury, STI, behavioral change
☐ Psychological / Emotional Abuse — verbal abuse, threats, intimidation, humiliation, isolation
☐ Neglect (Active) — withholding food, fluids, hygiene, medication, medical care
☐ Neglect (Passive) — caregiver inability or failure to provide necessary care
☐ Self-Neglect — adult unable to meet own basic needs (note: APS investigates; SLED does not unless other criminal conduct suspected)
☐ Financial Exploitation — unauthorized use of funds, forged checks, ATM withdrawals, deed transfers, beneficiary changes, predatory lending, undue influence over wills or POAs
☐ Abandonment — caregiver desertion of person dependent on care
☐ Medication Misuse / Diversion — over- or under-medication, theft of controlled substances
☐ Unlawful Restraint — chemical or physical restraints not justified medically and not authorized
☐ Other: [________________________________]
Date(s) of incident(s): [________________________________]
Frequency: ☐ One-time ☐ Ongoing ☐ Recurring pattern — describe: [________]
7. DETAILED NARRATIVE OF CONCERNS
Provide a chronological, fact-based narrative. Use first-hand observation where possible. Distinguish what you SAW from what you were TOLD. Quote the vulnerable adult verbatim where possible.
[____________________________________________________________]
[____________________________________________________________]
[____________________________________________________________]
[____________________________________________________________]
[____________________________________________________________]
[____________________________________________________________]
[____________________________________________________________]
(Attach additional pages as needed; mark each page with reporter name and date.)
8. WITNESSES, EVIDENCE, AND DOCUMENTATION
Witnesses:
| Name | Relationship | Phone | What They Observed |
|---|---|---|---|
| [________] | [________] | [________] | [________] |
| [________] | [________] | [________] | [________] |
| [________] | [________] | [________] | [________] |
Documents / Evidence Attached or Available:
☐ Photographs of injuries / conditions (date-stamped)
☐ Medical records / discharge summaries
☐ Bank statements / canceled checks / account printouts (financial exploitation)
☐ Power of attorney / will / deed / beneficiary designation copies
☐ Text messages, emails, voicemails
☐ Facility incident reports / nurse notes / MAR
☐ Surveillance video
☐ Police report / incident number
☐ Other: [________________________________]
9. RISK ASSESSMENT
☐ Adult is currently in IMMEDIATE physical danger (call 911 now)
☐ Adult lacks safe shelter, food, water, medication
☐ Adult has been threatened with retaliation for reporting
☐ Alleged perpetrator has unfettered access to adult and adult's finances
☐ Adult lacks decision-making capacity and has no guardian/conservator
☐ Adult is geographically isolated and unable to seek help independently
☐ History of prior reports / prior law-enforcement involvement
Recommended Protective Steps Already Taken: [________________________________]
10. MANDATED-REPORTER CERTIFICATION AND IMMUNITY STATEMENT
I am submitting this report in good faith based on information I have observed, received, or reasonably believe to be true. I understand that:
- Under S.C. Code Ann. § 43-35-25, I am required (if a mandated reporter) to report within 24 hours or the next working day.
- Under S.C. Code Ann. § 43-35-75(A), a person making a report in good faith is immune from civil and criminal liability that might otherwise result from making the report. Good faith is presumed, and the burden of rebutting that presumption is on the party challenging it.
- Under S.C. Code Ann. § 43-35-85(A), knowingly failing to report as required is a misdemeanor punishable by up to a $2,500 fine and/or imprisonment of up to one year.
- Under S.C. Code Ann. § 43-35-85, a person who knowingly and willfully makes a false report may be prosecuted.
- Under S.C. Code Ann. § 43-35-85(C)–(F), criminal abuse, neglect, or exploitation of a vulnerable adult carries felony penalties (up to 5 years; up to 15 years if great bodily injury results; up to 30 years if death results; up to 5 years and $5,000 fine for exploitation, plus restitution).
11. CONFIDENTIALITY ACKNOWLEDGMENT
I understand that records of this report are confidential under S.C. Code Ann. § 43-35-60 and may not be disclosed except to authorized persons engaged in the investigation, prosecution, or care of the vulnerable adult, or as otherwise authorized by law.
12. SIGNATURE BLOCK
[________________________________]
[REPORTER FULL NAME]
Title: [________________________________]
Date: [__/__/____] Time: [____ : ____ AM/PM]
Telephone: [________________________________]
Email: [________________________________]
Routing copy retained by reporter? ☐ Yes (recommended — keep date-stamped copy in your records for at least 7 years)
13. SOUTH CAROLINA PRACTICE NOTES
- Tri-routed reporting. S.C. Code § 43-35-25(A) splits jurisdiction:
- APS (DSS) — vulnerable adults living in the community, in private homes, or with family caregivers.
- Long Term Care Ombudsman — vulnerable adults in licensed nursing facilities, community residential care facilities, and most other long-term care facilities.
- SLED Vulnerable Adults Investigations Unit — vulnerable adults in facilities operated or contracted by the Department of Mental Health or DDSN.
- 24-hour rule. Reporting must occur within 24 hours or the next working day after the reporter has reason to believe abuse, neglect, or exploitation has occurred or is likely (S.C. Code § 43-35-25(B)).
- Emergency override. In emergencies, suspected sexual assault, or risk of imminent harm, contact local law enforcement / 911 IMMEDIATELY without waiting for APS / Ombudsman intake (§ 43-35-25(C)).
- Good-faith immunity. § 43-35-75 provides civil and criminal immunity for good-faith reporters and presumes good faith. Anti-retaliation: § 43-35-75(B) prohibits retaliation against reporters by employers.
- Anonymous reports allowed. Reports may be made anonymously, but mandated reporters retain personal liability for failure to report and benefit from documenting that they reported.
- Financial-institution reporting. S.C. Code § 43-35-555 allows financial institutions and their employees to report suspected financial exploitation of a vulnerable adult and to delay or refuse transactions, with statutory immunity. Cross-report to APS and SLED where appropriate.
- Health-care providers and HIPAA. Mandatory reporting under § 43-35-25 is a permitted disclosure under 45 C.F.R. § 164.512(c) (victims of abuse, neglect, or domestic violence) and § 164.512(b) (public-health activities). Document in the medical record.
- Confidentiality. § 43-35-60 keeps APS/Ombudsman/SLED records confidential. Do not share with media, family members, or others not authorized by statute.
- APS investigation timelines. APS will generally screen the report and initiate an investigation, with priority based on the level of risk (verify current DSS APS policy). Emergency cases require an in-person response within hours; routine cases within statutory windows.
- Petition for protective custody. If the adult lacks capacity and is in danger, APS or law enforcement may petition the probate court for emergency protective custody under S.C. Code § 43-35-55.
14. SOURCES AND REFERENCES
- S.C. Code Ann. Title 43, Chapter 35 (Omnibus Adult Protection Act) — https://www.scstatehouse.gov/code/t43c035.php
- South Carolina Department of Social Services, Adult Protective Services — https://dss.sc.gov/adult-protection/adult-protective-services/
- DSS APS Hotline: 1-888-CARE4US (1-888-227-3487)
- SC Long Term Care Ombudsman Program (SCDOA) — https://aging.sc.gov/programs-initiatives/long-term-care-ombudsman-program
- SC Long Term Care Ombudsman Hotline: 1-800-868-9095
- South Carolina Law Enforcement Division (SLED) — https://www.sled.sc.gov
- South Carolina Department on Aging (SCDOA) — https://aging.sc.gov
- Probate Court (emergency protective custody) — venue: county where vulnerable adult resides
- 45 C.F.R. § 164.512(c) (HIPAA permitted disclosure for abuse reporting)
Disclaimer: This template is provided for informational purposes only and does not constitute legal advice. South Carolina mandatory-reporter obligations are time-sensitive. When in doubt, REPORT — good-faith reporters are immune from liability under S.C. Code § 43-35-75. Verify current hotline numbers and reporting forms against the SCDSS, SCDOA, and SLED websites before reliance.
About This Template
Elder law covers the legal needs that come with aging: planning for long-term care costs, protecting assets from being wiped out by a nursing home stay, handling incapacity, and responding to elder abuse or financial exploitation. The paperwork often has to coordinate with Medicaid rules, tax treatment, and state guardianship requirements, which is why small mistakes can cost a family a great deal of money or control over decisions.
Important Notice
This template is provided for informational purposes. It is not legal advice. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Last updated: May 2026