Adult Protective Services in Massachusetts

Massachusetts Adult Protective Services (APS), administered by the Executive Office of Aging & Independence, investigates reports of abuse, neglect, exploitation, and self-neglect affecting adults aged 60 and older who live in the community. Massachusetts APS is specifically designed for community-dwelling elders — adults living at home or in unlicensed settings, not in nursing homes or licensed assisted living. If you suspect an elder is being harmed, call the 24/7 APS hotline at (800) 922-2275 or report online at mass.gov/report-elder-abuse.

How to Report Elder Abuse in Massachusetts

Massachusetts offers two primary ways to report suspected elder abuse: by phone through the 24/7 hotline and through the state's online reporting portal.

Report by Phone

Call (800) 922-2275 to reach the Massachusetts elder abuse reporting hotline. This number functions as both a voice and TTY line. The hotline is staffed 24 hours a day, 7 days a week. Reports are routed to the appropriate local Protective Services Agency (PSA), which conducts the investigation. When you call, a trained intake worker will document your report and determine the appropriate priority level and response time.

Report Online

Massachusetts offers online reporting. The online portal is available for non-emergency situations. Emergency reports — where an elder faces immediate danger — should be made by calling (800) 922-2275 or 911, as phone reports allow intake workers to assess and escalate urgency more quickly.

Emergency Situations

If an elder in Massachusetts is in immediate physical danger — a medical emergency, active abuse, or life-threatening neglect — call 911 first. APS investigators are social service professionals, not emergency responders. After emergency services have been summoned, call (800) 922-2275 to initiate an APS investigation and ensure ongoing support for the elder.

What Information to Have Ready Before You Call

Gathering the following information before calling will help the intake worker process your report efficiently. Provide what you can — you do not need all of this information to file a report:

• Full name, age, and address of the elder you are concerned about
• A specific description of what you observed — type of abuse or neglect, dates, frequency, and circumstances
• Name and relationship of the suspected abuser or neglectful caregiver
• Information about the elder's physical, cognitive, or mental health conditions
• Names of any witnesses or other people with relevant information
• Your own contact information (you may report anonymously, but contact details assist with follow-up)
• Any other information about the person's living situation or immediate safety needs

Types of Elder Abuse APS Investigates in Massachusetts

Under MGL c.19A and 651 CMR 5.00, Massachusetts APS investigates the following categories of elder mistreatment:

• Physical abuse — intentional acts causing bodily injury, pain, or impairment, including improper physical restraint or inappropriate use of medication
• Sexual abuse — any non-consensual sexual contact or sexual exploitation
• Emotional/psychological abuse — verbal threats, humiliation, intimidation, isolation, or psychological manipulation
• Neglect by caretaker — a caregiver's failure to provide adequate food, medical care, shelter, clothing, or supervision
• Financial exploitation — unauthorized use of money, property, or assets; misuse of power of attorney; coerced changes to estate planning documents
• Self-neglect — an elder's inability or unwillingness to provide for their own essential needs, posing a serious risk to health or safety

Warning Signs of Elder Abuse

Elder abuse is often underreported because victims fear retaliation or feel ashamed. Knowing the warning signs can help you recognize when an elder needs help.

Physical Signs

• Unexplained injuries — bruises, cuts, burns, or fractures — especially in unusual locations or varying stages of healing
• Bedsores, poor hygiene, unwashed clothing, or untreated medical conditions
• Dehydration, malnutrition, or unexplained weight loss
• Physical evidence inconsistent with the caregiver's explanation
• Visible distress or flinching in the presence of a particular caregiver

Behavioral Signs

• Sudden changes in personality, increased anxiety, withdrawal, or depression
• Reluctance to speak freely, especially when a caregiver or family member is present
• Fear, trembling, or evasive answers when asked about their home situation
• Reports — direct or indirect — of being threatened, screamed at, or isolated
• Confusion or disorientation greater than the elder's baseline cognitive status

Financial Signs

• Unexplained withdrawals from bank accounts or missing funds
• Sudden changes to wills, trusts, powers of attorney, or account beneficiaries
• Unpaid bills, eviction notices, or utilities shut off despite apparent financial resources
• An elder who seems unaware of or confused about their own financial situation
• A caregiver who controls all access to money or financial documents

Who Can (and Must) Report Abuse in Massachusetts

Any person who suspects an elder is being abused, neglected, or exploited may report to APS in Massachusetts. Reports may be made anonymously via phone.

Massachusetts law under MGL c.19A designates two categories of mandated reporters. Category 1 mandated reporters — who are subject to a fine for failure to report — include physicians, nurses, dentists, physician assistants, social workers, family counselors, probation officers, police officers, firefighters, EMTs, licensed psychologists, physical and occupational therapists, and coroners. Category 2 mandated reporters — not subject to a fine — include home health aides, homemakers, case managers, and other home care program staff who are not licensed clinicians.

Category 1 reporters who knowingly fail to report may be fined up to $1,000 under MGL c.19A §15–16. All good faith reporters are immune from civil and criminal liability under 651 CMR 5.07(6), and employees who report cannot be retaliated against by their employer.

What Happens After You Report to APS in Massachusetts

Massachusetts APS follows a structured multi-step response process after receiving a report:

Step 1 — Intake Screening

The hotline routes the report to the local Protective Services Agency (PSA) serving the elder's area. A screener reviews the report to determine whether the person meets the definition of an elder under Massachusetts law (age 60 or older, community-dwelling) and whether the reported conduct constitutes one of the six types of abuse under 651 CMR 5.02. Reports involving nursing home or assisted living residents are referred to the appropriate oversight agency.

Step 2 — Response Timeline

Massachusetts uses a three-tier response system under 651 CMR 5.09–5.10. Emergency reports — where the elder faces immediate danger — require an assessment within 24 hours and an in-home or alternative response within 5 hours. Rapid Response reports — where serious harm is likely but not immediate — require an assessment within 72 hours and an in-home response within 24 hours. Routine reports require first contact within 5 business days. All investigations must be completed within 30 days.

Step 3 — Investigation

A local PSA caseworker conducts a face-to-face assessment with the elder. The worker interviews the elder privately, observes the living environment, reviews medical and financial records as needed, and interviews caregivers, family members, neighbors, and other relevant parties. If criminal activity is suspected, the investigation is coordinated with law enforcement and may be referred to the District Attorney.

Step 4 — Service Plan and Outcome

If abuse, neglect, or exploitation is substantiated, the PSA develops a service plan in collaboration with the elder. Services may include emergency placement, meal delivery, home health aides, medical and mental health referrals, legal services, and financial management assistance. Elders with decision-making capacity have the right to refuse services. If capacity is in question, the PSA may pursue a formal evaluation and, if necessary, seek court-authorized intervention.

APS vs. Long-Term Care Ombudsman — Who Handles Nursing Home Abuse in Massachusetts?

Massachusetts APS serves only community-dwelling elders — adults 60 and older living in private homes or unlicensed settings. APS does not investigate abuse or neglect that occurs within licensed long-term care facilities, including nursing homes, rest homes, and licensed assisted living residences.

For concerns about a resident of a licensed long-term care facility in Massachusetts, contact the Massachusetts Long-Term Care Ombudsman Program at 1-800-243-4636. The Ombudsman investigates complaints about care quality, staff conduct, and residents' rights in licensed facilities. The Department of Public Health (DPH) oversees licensing and conducts inspections of nursing homes and other regulated facilities.

For a complete guide to filing a nursing home complaint in Massachusetts, including contact information for the survey agency, see our Massachusetts Nursing Home Complaint Guide.

Additional Resources in Massachusetts

• Massachusetts APS Hotline: (800) 922-2275 (Voice/TTY, 24/7)
• Massachusetts Long-Term Care Ombudsman: 1-800-243-4636
• Executive Office of Aging & Independence: mass.gov/orgs/executive-office-of-aging-independence-age
• Eldercare Locator: 1-800-677-1116
• National Elder Fraud Hotline: 1-833-FRAUD-11 (1-833-372-8311)
• National Center on Elder Abuse

All reports to Massachusetts APS are confidential. Anonymous reports are accepted by phone. If you are concerned about an elder in Massachusetts, call (800) 922-2275 or report online at mass.gov/report-elder-abuse.