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Incident Reporting, Investigation, and Adverse Events

Requires every incident, adverse event, and injury of unknown source to be reported the same day, recorded on an Incident Report, investigated in proportion to its seriousness within Agency time frames (Georgia’s home health rules set none), and used by QAPI to prevent a repeat. Covers notifying the physician and family, protecting the patient during an investigation, Board of Nursing employer reports, and the link to abuse reporting.

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About this policy
Policy number
GA-HH-QA-03
Version
1.0
Main rule
42 CFR §484.65(c)(2)
Library
Georgia home health · 56 policies
Category
Quality
Sections
17

In short

  • If something goes wrong on a visit, make the patient safe first. Call 911 if needed.
  • If you suspect abuse, neglect, or exploitation, report it to the authorities right away. Do not wait to fill out a form.
  • Call the office before you leave the home if the patient was hurt, and fill out the Incident Report the same day.
  • Write facts only. Chart the patient’s condition and care in your note, but do not mention the Incident Report in the record.
  • Tell the truth and keep investigations confidential. No one is punished for reporting in good faith.

What's inside

17 sections. The full text comes with the One-time Policy Pack.

Full text with a package
  • Terms of Reference
  • 1. Purpose
  • 2. Scope
  • 3. Definitions
  • 4. Policy Statement (42 CFR §484.65(c)(2); 42 CFR §484.50(e))
  • 5. Time Frames
  • 6. Reporting an Incident
  • 7. Investigation Procedure
  • 8. Outside Reports After an Investigation
  • 9. Fairness to Staff
  • 10. Responsibilities
  • 11. Records and Compliance Monitoring
  • 12. Staff Training
  • 13. References
  • 14. Related Policies and Forms
  • 15. Approval
  • 16. Revision History

An inspector may ask

  • Show me your incident log for the last quarter and the investigation file for a fall with injury.
  • How do you investigate an injury of unknown source?

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