In a home-care visit you notice an older adult has unexplained bruises in various healing stages, appears fearful around a caregiver, misses meals, and has poor hygiene with a pressure injury. The caregiver asks you not to tell anyone. Which abuse-and-neglect action should the PCT take under mandated reporting duties?

Mandated reporter duty applies when multiple red flags suggest possible physical abuse and neglect: unexplained bruises in various healing stages, fear around the caregiver, missed meals, poor hygiene and a pressure injury. Promptly report objective findings to the nurse supervisor and state agency per policy, without confronting the caregiver; this supports safety and protects the integrity of the investigation. Providing gentle hygiene care, pressure-injury attention, documentation and continued monitoring is supportive care, but does not fulfill the duty to report promptly and may leave the person at risk while waiting for changes. Reporting to the nurse supervisor and observing closely without notifying the state agency fails the external-reporting requirement: internal follow-up cannot replace state notification needed to trigger a protective assessment. Waiting to report until after speaking privately with the caregiver to clarify events also fails the safety and role requirement. A PCT reports observed facts rather than investigating intent; confronting the caregiver may risk retaliation, coaching, evidence loss or delay. Exam caveat: do not make reporting conditional on certainty, proof, permission or family agreement; suspicion alone triggers the duty. Practical check: know your facility policy, reporting timeframe and state agency contact, use objective language with dates, descriptions and quotes without labeling abuse as confirmed, and hand off promptly while maintaining safety and privacy.