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USA Gymnastics needs a "complete cultural change" to better protect athletes from sexual abuse, according to an independent review of the embattled organization's practices.

The report released Tuesday by former federal prosecutor Deborah Daniels recommends that all USA Gymnastics members be required to immediately report suspected sexual misconduct to legal authorities and the U.S. Center for SafeSport. Daniels also suggested that USA Gymnastics prohibit adults from being alone with minor gymnasts "at all times" and bar unrelated adults from sharing or being alone in a sleeping room with gymnasts. She also recommended preventing adult members from having "out of program" contact with gymnasts through email, text or social media.

USA Gymnastics ordered the review last fall following a series of civil lawsuits filed against the organization and a former team doctor by a pair of gymnasts who claim the physician sexually abused them during their time on the U.S. national team. USA Gymnastics has denied wrongdoing. The organization stated it went to authorities quickly in the summer of 2015 after hearing claims of abuse against Dr. Larry Nassar but later amended the timeline following a Wall Street Journal report, saying it conducted a five-week internal review before going to the FBI.

"A delay is impermissible," Daniels said.

A Michigan judge on Friday ordered Nassar to stand trial on charges of sexually assaulting six young gymnasts who said he molested them while they were seeking treatment for various injuries. It is one of four criminal cases against Nassar in the state.

Daniels said USA Gymnastics "inadvertently suppressed" reporting of abuse because of several factors, including that athletes are taught to follow instructions and obey coaches and trainers.

"Athletes sometimes aren't aware of where the boundaries are, so they're not trained in that regard," Daniels said. "Parents aren't real sure (either)."

Daniels said the organization needs to more closely monitor member clubs to make sure its bylaws are followed. She suggested stripping membership from clubs that fail to report claims of child abuse, plus periodic random audits to see if updated policies are being obeyed.

"USA Gymnastics has never felt it had the ability to exert influence over the club," Daniels said. "You can use membership to enforce the policies."

The USA Gymnastics Board of Directors unanimously voted to develop a plan to implement many of Daniels' 70 recommendations.

"We're confident it will make us a better organization to develop a culture that had safe sport as a top priority," said chief operating officer Ron Galimore.

Daniels said the process USA Gymnastics had for investigating claims of abuse was "cumbersome" and "somewhat mysterious." She suggested a more proactive approach.

"There needs to be a very clear protocol for how these reviews are conducted, there needs to be a clear timeline," she said. "Frankly they need to be kept in a database. We've recommended that the board have oversight of that entire process."

While also taking the role of the USA Gymnastics president out of the equation. Former president Steve Penny resigned in March under intensifying pressure for the way the organization handled charges of sexual abuse. Daniels wants USA Gymnastics to remove the president from determining the disposition of allegations. USA Gymnastics is in the process of finding Penny's replacement and hopes to have a successor in place by September.

Whoever is hired will have plenty of work to do.

Many of the recommendations fall in line with policies put forward by the U.S. Center for Safesport. The organization operates independently from the U.S. Olympic Committee and organizations governing Olympic sports. The USOC and the 47 national governing bodies (including USA Gymnastics) help fund the center — about $13.3 million over five years — but do not have any say over how it operates or the cases it investigates.

Paul Parilla, chairman of the USA Gymnastics Board of Directors, said the organization needs to "clearly articulate" that the safety of the athletes is "paramount."

Galimore said it is a priority to make sure "everyone is aware and educated on everything from bullying to anything that would take away from having a safe environment."

Daniels spoke to more than 160 people at all levels of USA Gymnastics over six months, attended five competitions and visited the national team's training center at the Karolyi Ranch in Huntsville, Texas, to produce the 144 page report. She said the number of gymnasts abused nationwide over the years is "far higher" than what has been reported based on her experience as a federal prosecutor but stressed "my recommendations are forward looking and not in relation to anything that may have happened in the past."

She also believes third parties should be allowed to report suspected abuse. The previous method of looking into alleged wrongdoing — a "grievance process" which required a written complaint from the aggrieved party or the parents of the aggrieved party if the athlete was a minor — was not well suited for reporting abuse, the report said.

"Young athletes (in their teens or younger) and their parents are highly unlikely to report ongoing abuse to the authority that has so much power over the athlete's success in the sport," Daniels wrote.