The study found significant challenges in implementing effective detection, investigation, and resolution of elder abuse in RCFs. The major barrier in all States and all agencies was the lack of sufficient resources to perform their responsibilities. Underreporting of elder abuse in RCFs was found; and in many instances, intake workers screened-out many cases that may have warranted further investigation or referral to other agencies. In addition, investigative procedures were flawed due to the lack of forensic training and the timely completion of investigations. Significant barriers to case resolution were also found, including policies that require \“intent\” for an act to be \“abuse.\” The involvement of police in elder abuse cases was uneven across jurisdictions. Further, prosecutors and judges were often unprepared or unwilling to deal with elder abuse cases. Moreover, unlicensed homes were a serious problem in some States. The study concludes that without some Federal standards and financial support for the investigation, detection, resolution, and prevention of elder abuse in RCFs, little progress will be made in addressing this crime. The study conducted a national survey of all State mandatory reporting laws, a telephone survey of all agencies identified as the \“first responder\” agency to which complaints about elder abuse should be made, and it reviewed all State RCF licensing laws. Focus groups were conducted with 22 long-term care ombudsmen from around the country. Intensive case studies were conducted in six States because of their special procedural features for dealing with elder abuse or the regulation of RCFs.