105-20 Definition of Serious Incident

Level II 2. An individual who is missing for any period of time…does this mean while in our care as in residential or day programs. Does this apply to all services such as outpatient services? Please define “time”. This should be a more focused reporting for residential and day services.

 Level II 4. If a client comes to the CSB to see a nurse and it is recommended to go to the doctor how would we know if the ER was being used in lieu of a primary care visit? Is this reportable? Does this include urgent care visit in lieu of seeing the PCP, even when the PCP offices are closed? How do we handle voluntary hospitalizations, are they considered unplanned? Are they reportable? We would only report hospitalizations we help with in level II? Considerations should be made to remove psychiatric hospitalizations as a reportable requirement.

 Level II. 7. a-b.  How will we know if a decubitus ulcer or a bowel obstruction occurred or originated on our premises or during provision of services for all licensed services such as outpatient services? Should be focused just for residential services.                    

Level III. For level III reporting, does the individual have the right to know what is being reporting to the state regarding what is shared with the provider?

Level III. 2. Sexual assault of an individual. In an outpatient service this has serious impacts on the therapeutic relationship as the individual may feel additionally victimized by the reporting and questioning from a root cause analysis completed. Shouldn’t the individual provide authorization to report, what about their right to privacy? This should not be a level III reporting and should be moved to level II.

Level III. 3. If a client was in a car accident, would this be reportable in Level III?   How does one assess, at the time, if something is “likely” to result in permanent physical or psychological (especially psychological) impairment?  What is your definition of psychological impairment?  To report to DBHDS when not occurring during service delivery, creates an undue burden for providers.  Individuals do not have to tell providers about situations that occur outside of service provision.

Level III. 4. Suicide Attempt.– What constitutes a suicide attempt? If a person talks about suicide and has a voluntary admission is that behavioral or suicidal?Is this reportable?

Level III.  How will we do a root cause analysis for events that happen not on our premises, as many Level III situations will occur that way?