The requirement that all serious incidents be reported within 24 hours of the incident for providers who are offering 24 hour care is in itself unreasonable.  It would seem to be more appropriate to have a business day requirement or some other arrangement to would help providers report quickly, but in a reasonable time frame.  Be that as it may, as the only way to acceptably enter data is through the CHRIS system, the threat of a citation if outside the 24 hours window is unreasonable.   The provider's first concern should be care of the individual, not being disciplined for not reporting quickly enough.  The system is not always reliable and, even with agency systems for reporting, many providers are not IT savvy.  Often events occur when trying to report that are not within the provider's control.  If providers are held to this standard, the department should have 24/7 IT support available.

The current CHRIS system also requires that incidents that are possibly both a serious incident and a neglect/abuse be entered twice under different taps.  This is required prior to the provider having adequate time to investigate the incident.  If the provider enters it as an injury and later determines it might have been abuse, the second entry is considered a late entry.  This puts an additional burden on the provider.  This is especially true if the incident will result in a threat to the agency, which was trying to report in a timely manner, and its license.  In addition, the provider often is required by the OHR to add a neglect report, even if the provider disagrees.  This entry, under the direction of the OHR, results in a late report as well. 

The requirement to enter a follow-up within 48 hours is not reasonable.  Often doctors and hospitals do not have information to the provider in that time frame.  In addition, if an incident occurs on a weekend, 48 hours will pass with no information being made available to the provider.  The need to report at this time will result in inaccurate and incomplete information being entered.  These requirements only seem to be related to appearing to appease the DOJ, but do nothing toward providing better support and care to the individuals.  

Any threat to the license should be appealed by the provider as allowed under 37.2-415 and 37.2-418.  These will be time consuming and detract from the care of those under the provider's care.  Large providers who report regularly will be constantly fighting this issue of late reporting.  Although providers strive toward compliance, filing a report late does not indicate poor care.  

The only result of this guidance will be punishing providers who report and reducing the number of providers.