---
kind: "section"
citation: "42 U.S.C. § 1397j"
title: "42"
title_heading: "The Public Health and Welfare"
number: "1397j"
heading: "Definitions"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/1397j"
units:
  - "Chapter 7 — Social Security"
  - "Subchapter XX — Block Grants and Programs for Social Services and Elder Justice"
  - "Division B — Elder Justice"
---

# §1397j. Definitions


In this division:

- (1) **Abuse—** The term “abuse” means the knowing infliction of physical or psychological harm or the knowing deprivation of goods or services that are necessary to meet essential needs or to avoid physical or psychological harm.
- (2) **Adult protective services—** The term “adult protective services” means such services provided to [adults](/usc/42/619.md?p=1) as the [Secretary](/usc/42/1301.md?p=a-6) may specify and [includes](/usc/42/1301.md?p=b) services such as—
  - (A) receiving reports of [adult](/usc/42/619.md?p=1) [abuse](#1), [neglect](#16), or [exploitation](#8);
  - (B) investigating the reports described in [subparagraph (A)](#2-A);
  - (C) case planning, monitoring, evaluation, and other case work and services; and
  - (D) providing, arranging for, or facilitating the provision of medical, [social](#20) service, economic, legal, housing, [law enforcement](#13), or other protective, emergency, or support services.
- (3) **Caregiver—** The term “caregiver” means an individual who has the responsibility for the care of an [elder](#5), either voluntarily, by contract, by receipt of payment for care, or as a result of the operation of law, and means a family member or other individual who provides (on behalf of such individual or of a public or private [agency](/usc/42/1397n–12.md?p=1), organization, or institution) compensated or uncompensated care to an [elder](#5) who needs supportive services in any setting.
- (4) **Direct care—** The term “direct care” means care by an employee or contractor who provides assistance or [long-term care](#14-A) services to a recipient.
- (5) **Elder—** The term “elder” means an individual age 60 or older.
- (6) **Elder justice—** The term “elder justice” means—
  - (A) from a societal perspective, efforts to—
    - (i) prevent, detect, treat, intervene in, and prosecute [elder](#5) [abuse](#1), [neglect](#16), and [exploitation](#8); and
    - (ii) protect [elders](#5) with diminished capacity while maximizing their autonomy; and
  - (B) from an individual perspective, the recognition of an [elder](#5)’s rights, [including](/usc/42/1301.md?p=b) the right to be free of [abuse](#1), [neglect](#16), and [exploitation](#8).
- (7) **Eligible entity—** The term “eligible entity” means a [State](/usc/42/619.md?p=5) or local government [agency](/usc/42/1397n–12.md?p=1), [Indian tribe](/usc/42/619.md?p=4-A) or [tribal organization](/usc/42/619.md?p=4-A), or any other public or private entity that is engaged in and has expertise in issues relating to [elder justice](#6) or in a field necessary to promote [elder justice](#6) efforts.
- (8) **Exploitation—** The term “exploitation” means the fraudulent or otherwise illegal, unauthorized, or improper act or process of an individual, [including](/usc/42/1301.md?p=b) a [caregiver](#3) or [fiduciary](#9), that uses the resources of an [elder](#5) for monetary or personal benefit, profit, or gain, or that results in depriving an [elder](#5) of rightful access to, or use of, benefits, resources, belongings, or assets.
- (9) **Fiduciary—** The term “fiduciary”—
  - (A) means a [person](/usc/42/1301.md?p=a-3) or entity with the legal responsibility—
    - (i) to make decisions on behalf of and for the benefit of another [person](/usc/42/1301.md?p=a-3); and
    - (ii) to act in good faith and with fairness; and
  - (B) [includes](/usc/42/1301.md?p=b) a trustee, a guardian, a conservator, an executor, an agent under a financial power of attorney or health care power of attorney, or a representative payee.
- (10) **Grant—** The term “grant” [includes](/usc/42/1301.md?p=b) a contract, cooperative agreement, or other mechanism for providing financial assistance.
- (11) **Guardianship—** The term “guardianship” means—
  - (A) the process by which a [State](/usc/42/619.md?p=5) court determines that an [adult](/usc/42/619.md?p=1) individual lacks capacity to make decisions about self-care or property, and appoints another individual or entity known as a guardian, as a conservator, or by a similar term, as a surrogate decisionmaker;
  - (B) the manner in which the court-appointed surrogate decisionmaker carries out duties to the individual and the court; or
  - (C) the manner in which the court exercises oversight of the surrogate decisionmaker.
- (12) **Indian tribe—**
  - (A) **In general—** The term “[Indian tribe](/usc/42/619.md?p=4-A)” has the meaning given such term in [section 5304 of title 25](/usc/25/5304.md).
  - (B) **Inclusion of Pueblo and Rancheria—** The term “[Indian tribe](/usc/42/619.md?p=4-A)” [includes](/usc/42/1301.md?p=b) any Pueblo or Rancheria.
- (13) **Law enforcement—** The term “law enforcement” means the full range of potential responders to [elder](#5) [abuse](#1), [neglect](#16), and [exploitation](#8) [including](/usc/42/1301.md?p=b)—
  - (A) police, sheriffs, detectives, public safety officers, and corrections personnel;
  - (B) prosecutors;
  - (C) medical examiners;
  - (D) investigators; and
  - (E) coroners.
- (14) **Long-term care—**
  - (A) **In general—** The term “long-term care” means supportive and health services specified by the [Secretary](/usc/42/1301.md?p=a-6) for individuals who need assistance because the individuals have a [loss of capacity for self-care](#14-B) due to illness, disability, or vulnerability.
  - (B) **Loss of capacity for self-care—** For purposes of [subparagraph (A)](#14-A), the term “loss of capacity for self-care” means an inability to engage in 1 or more activities of daily living, [including](/usc/42/1301.md?p=b) eating, dressing, bathing, management of one’s financial affairs, and other activities the [Secretary](/usc/42/1301.md?p=a-6) determines appropriate.
- (15) **Long-term care facility—** The term “long-term care facility” means a residential care provider that arranges for, or directly provides, [long-term care](#14-A).
- (16) **Neglect—** The term “neglect” means—
  - (A) the failure of a [caregiver](#3) or [fiduciary](#9) to provide the goods or services that are necessary to maintain the health or safety of an [elder](#5); or
  - (B) [self-neglect](#18).
- (17) **Nursing facility—**
  - (A) **In general—** The term “nursing facility” has the meaning given such term under [section 1396r(a) of this title](/usc/42/1396r.md?p=a).
  - (B) **Inclusion of skilled nursing facility—** The term “[nursing facility](#17-A)” [includes](/usc/42/1301.md?p=b) a skilled [nursing facility](#17-A) (as defined in [section 1395i–3(a) of this title](/usc/42/1395i–3.md?p=a)).
- (18) **Self-neglect—** The term “self-neglect” means an [adult](/usc/42/619.md?p=1)’s inability, due to physical or mental impairment or diminished capacity, to perform essential self-care tasks [including](/usc/42/1301.md?p=b)—
  - (A) obtaining essential food, clothing, shelter, and [medical care](/usc/42/1301.md?p=a-7);
  - (B) obtaining goods and services necessary to maintain physical health, mental health, or general safety; or
  - (C) managing one’s own financial affairs.
- (19) **Serious bodily injury—**
  - (A) **In general—** The term “serious bodily injury” means an injury—
    - (i) involving extreme physical pain;
    - (ii) involving substantial risk of death;
    - (iii) involving protracted loss or impairment of the function of a bodily member, organ, or mental faculty; or
    - (iv) requiring medical [intervention](/usc/42/1397n–12.md?p=2) such as surgery, [hospitalization](/usc/42/1301.md?p=a-7), or physical rehabilitation.
  - (B) **Criminal sexual abuse—** [Serious bodily injury](#19-A) shall be considered to have occurred if the conduct causing the injury is conduct described in [section 2241](/usc/42/2241.md) (relating to aggravated sexual [abuse](#1)) or 2242 (relating to sexual [abuse](#1)) of [title 18](/usc/18.md) or any similar offense under [State](/usc/42/619.md?p=5) law.
- (20) **Social—** The term “social”, when used with respect to a service, [includes](/usc/42/1301.md?p=b) [adult protective services](#2).
- (21) **State legal assistance developer—** The term “State legal assistance developer” means an individual described in [section 3058j of this title](/usc/42/3058j.md).
- (22) **State Long-Term Care Ombudsman—** The term “State Long-Term Care Ombudsman” means the State Long-Term Care Ombudsman described in [section 3058g(a)(2) of this title](/usc/42/3058g.md?p=a-2).

## Source credit

(Aug. 14, 1935, ch. 531, title XX, § 2011, as added Pub. L. 111–148, title VI, § 6703(a)(1)(C), Mar. 23, 2010, 124 Stat. 782.)