Incident Reporting, Investigation, and Ohio Medicaid Waiver Incident Management
Requires every incident, adverse event and near miss to be reported inside the Agency the same day on Form OH-HH-QA-02-A, investigated, and analyzed through QAPI. Lists the outside reports that may be required, and for patients on an Ohio Medicaid waiver or in a Medicaid managed care plan sets out the incident management rule: immediate action, and a report to the case management agency or plan immediately and no later than one business day after discovery.
About this policy
- Policy number
- OH-HH-QA-02
- Version
- 1.0
- Main rule
- 42 CFR §484.65(c)(2)
- Library
- Ohio home health · 59 policies
- Category
- Quality
- Sections
- 20
In short
- If something goes wrong, make the patient safe first and call 911 in an emergency.
- Call the clinical manager or on-call nurse at once, and complete the incident report before the end of your shift.
- Suspected abuse, neglect or exploitation must be reported outside the Agency immediately. Do not wait for a supervisor.
- For Medicaid waiver and managed care patients, the incident must reach the case manager or plan no later than one business day after it is discovered.
- Write only the facts in the patient’s record, and keep any evidence.
What's inside
20 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (42 CFR §484.65(c)(2))
- 5. What Staff Report
- 6. Immediate Response
- 7. Internal Reporting Time Frames
- 8. Outside Reports
- 9. Waiver and Managed Care Patients
- 10. Investigation
- 11. Analysis and QAPI
- 12. Documentation
- 13. Responsibilities
- 14. Records and Compliance Monitoring
- 15. Staff Training
- 16. References
- 17. Related Policies and Forms
- 18. Approval
- 19. Revision History
An inspector may ask
- Show me your incident reports for the last quarter and what you learned from them.
- A waiver patient falls and is taken to the emergency room. Who do you report to, and how fast?
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