How to Report Elder Abuse in Missouri: Filing and What Happens Next

To report elder abuse in Missouri, call the Adult Abuse and Neglect Hotline at 1-800-392-0210 between 7 a.m. and 8 p.m., any day of the year, or file a report online through the Department of Health and Senior Services at any hour.¹ If someone is in immediate danger, call 911 first. You do not need proof. A reasonable suspicion is enough, and Adult Protective Services (APS) will investigate from there.

The Three Ways to File a Report

Hotline — 1-800-392-0210. Staffed 7 a.m. to 8 p.m., 365 days a year. This is the primary channel. Intake staff will ask what you saw, when, and where.¹
Online reporting. Available around the clock through the DHSS site. Reports submitted outside hotline hours are reviewed the next business morning. Useful for non-emergency situations where you want your concerns in writing.¹
911. Use if the person is in immediate physical danger. Report to APS after they are safe.

Hotline staff may ask questions you can’t answer. Say what you know, say what you don’t, and let the investigator fill in the rest. An incomplete report is far better than no report.

What to Have Ready Before You Call

Don’t delay the call to gather information you don’t have. But the more you can provide, the faster APS can move.

The older person’s full name, home address, approximate age, and any known disabilities or medical conditions.
The suspected abuser’s name, relationship to the person, and address if you know it.
What you observed or were told: what happened, when and where, how often, and whether anyone else witnessed it.
Immediate risk factors: whether the person is in a dangerous situation right now, whether weapons are present, and whether the suspected abuser lives with them.

For suspected financial exploitation, note anything you have seen or heard rather than trying to collect documents yourself. Unusual withdrawals, unfamiliar people handling the person’s money, a new power of attorney the older adult doesn’t seem to understand, checks written as “loans” or “gifts” to strangers, missing statements — any of it helps investigators establish a paper trail. Bank records, canceled checks, deeds, and tax returns can all matter later, but the reporter’s job is to flag the concern, not build the case.

What Counts as Elder Abuse Under Missouri Law

Missouri’s adult abuse statutes protect two groups: people aged 60 or older who cannot adequately protect their own interests, and adults with disabilities between 18 and 59 who face the same vulnerability. The law calls both groups “eligible adults.”² Enforcement sits with DHSS and its Adult Protective Services division under Chapter 660.³

“Abuse” is defined broadly as the infliction of physical, sexual, or emotional injury or harm, including financial exploitation.³ In practice that covers:

Physical abuse. Bodily injury from hitting, restraining, or rough handling — unexplained bruises, burns, or fractures.
Emotional abuse. A pattern of insults, threats, humiliation, or deliberate isolation causing serious emotional distress.
Sexual abuse. Any non-consensual sexual contact, including forcing someone to view explicit material.
Neglect. A caregiver’s failure to provide necessary food, medication, hygiene, medical care, or a safe living environment when that caregiver has a legal or contractual duty and the failure creates imminent danger or a substantial risk of serious harm. Self-neglect, where the person cannot meet their own essential needs, also triggers APS involvement.³
Financial exploitation. Using deception, intimidation, or force to gain control over an older person’s money, property, or assets with the intent to permanently take them.

Warning Signs That Justify a Call

Physical injuries are the most obvious signal, but financial exploitation is the most common form of elder abuse and the hardest to spot. Watch for unusual bank activity: large or frequent unexplained withdrawals, ATM use by someone who never previously used a debit card, new joint accounts opened without clear reason, sudden credit card balances, or checks written as loans or gifts to people the family doesn’t recognize. If bank and credit card statements stop arriving at the older person’s home, or a new power of attorney appears that the person doesn’t seem to understand, those are strong red flags.

Neglect often shows as poor hygiene, untreated medical conditions, weight loss, dehydration, or unsanitary living conditions. Emotional abuse is harder to see from outside, but sudden withdrawal from social activities, fearfulness around a particular caregiver, or a dramatic change in mood or behavior can signal something is wrong. You don’t need to diagnose the problem. If something feels off, that’s enough.

What Happens After You Report

APS first screens the report to decide whether there is enough information to open an investigation. If the threshold is met, an investigator is assigned and visits the alleged victim in person, assessing safety, physical health, and mental well-being. The investigator also contacts the alleged abuser and interviews family members, caregivers, and others in regular contact with the older adult.⁴

Possible outcomes include:

Protective services. APS arranges medical care, in-home assistance, relocation to a safer environment, or help with finances.
Referrals. Connections to community agencies for housing, legal aid, counseling, or other social services.
Law enforcement involvement. In serious cases, APS refers the matter to police or prosecutors for criminal investigation.

One point that frustrates many reporters: APS cannot force a competent adult to accept help. If the older person is mentally capable and declines services, the case may close even when the situation looks bad from outside. APS can only override that refusal in extraordinary circumstances, such as when the person lacks the capacity to make informed decisions.

Protections for the Person Making the Report

Immunity From Lawsuits

Anyone who reports suspected abuse or testifies in a related proceeding is immune from civil and criminal liability, as long as they acted in good faith and without malicious intent.⁵ The exceptions are perjury and reports made negligently, recklessly, or in bad faith. Immunity does not protect someone who actually committed the abuse.

A separate federal law provides immunity for employees of banks, credit unions, brokerage firms, and insurance companies who disclose suspected financial exploitation of someone aged 65 or older to a covered agency such as APS, provided the employee received training and acted in good faith with reasonable care.⁶

Confidentiality

Your identity as a reporter is kept confidential under Missouri law. DHSS can only disclose the reporter’s name in narrow circumstances, primarily when a court orders it or when the department determines disclosure is necessary to prevent further harm to the eligible adult.⁷ In practice, the alleged abuser will not be told who called.

Reporting Abuse in a Nursing Home or Care Facility

If the abuse is happening in a nursing home, assisted living facility, or other residential care setting, you have an additional route: the Missouri Long-Term Care Ombudsman Program. Ombudsmen advocate specifically for residents of these facilities and investigate complaints about care quality, resident rights violations, and abuse or neglect.⁸

You can reach the program at (800) 309-3282 or by emailing LTCOmbudsman@health.mo.gov. Ombudsmen make regular facility visits and work at the resident’s direction; they will not take action or begin an investigation without the resident’s express consent, except in extraordinary circumstances.⁸ That makes the program particularly useful when a resident wants help but fears retaliation from staff.

Contacting the ombudsman does not replace an APS or law enforcement report. It is an added layer of advocacy. In serious cases, file with APS and the ombudsman at the same time.

If You Are a Mandatory Reporter

Missouri requires certain professionals to report suspected abuse of an eligible adult whenever they have reasonable cause to believe it has occurred. The list is long and includes physicians, nurses, nurse practitioners, dentists, pharmacists, optometrists, chiropractors, psychologists, social workers, mental health professionals, law enforcement officers, probation and parole officers, coroners, medical examiners, funeral directors, long-term care facility employees, home health agency workers, in-home service providers, ministers, hospital and clinic staff involved in patient care, and employees of the departments of social services, mental health, and health and senior services. If your work brings you into regular contact with older or vulnerable adults, you are almost certainly on the list. Failure to report is a Class A misdemeanor, carrying up to one year in jail.⁹

Everyone else — neighbors, friends, family, bank tellers, mail carriers — can and should report if they suspect abuse. You do not need to be on the mandatory list to use the hotline, and your report will be taken just as seriously.

1
Missouri Department of Health and Senior Services. Missouri Adult Abuse and Neglect Hotline Online Reporting System
2
Missouri Revisor of Statutes. Missouri Revised Statutes RSMo 192.2400
3
Missouri Revisor of Statutes. Missouri Revised Statutes RSMo 660.250
4
Missouri Department of Health & Senior Services. Adult Protective Services
5
Missouri Revisor of Statutes. Missouri Revised Statutes RSMo 198.070
6
Office of the Law Revision Counsel. 12 USC 3423 – Immunity From Suit for Disclosure of Financial Exploitation of Senior Citizens
7
Missouri Revisor of Statutes. Missouri Revised Statutes RSMo 660.263
8
Missouri Department of Health and Senior Services. Ombudsman Program
9
Missouri Revisor of Statutes. Missouri Code 198.070