Abuse, neglect, and mistreatment in the nursing facility are difficult topics, particularly because there is an expectation that dedicated care is being given to vulnerable frail older adults and those with disabilities. Elder abuse is a deliberate act or failure to act that initiates or creates a risk of harm to an older adult. Abuse can be divided into physical abuse, sexual abuse, domestic abuse, psychological abuse, financial abuse, and neglect. The abuse often occurs at the hands of a caregiver or a person whom the elder trusts. All social workers, along with all other members of the nursing facility team, are generally considered mandated reporters. In all states, licensed social workers are required to report suspected or actual abuse, neglect, or mistreatment. Reporting abuse does not mean that the social worker is liable for its occurrence nor true verification of its occurrence. It is valuable for the social worker to be familiar with the definitions of abuse and to carefully review their facility’s policy defining abuse, neglect, and mistreatment and their particular policy of the mandatory reporting law. Policies can vary from facility to facility, and the social worker should not assume that every facility, even in the same state or region, handles these issues in the same manner.