What is a Critical Incident Report?
- Tracy Archuleta
- Emily Goleski
The following documents provide the requirements for what constitutes a Critical Incident Report and therefore should be reported to LCA.
HSD/MAD Health and Safety Incident Reporting Requirements for the Statewide Entity (SE)
Definition:
Health and Safety Incident: An incident that poses an immediate threat to the welfare of the member up to and including, loss of life, physical harm, and/or physical, sexual, psychological abuse or exploitation.
Infectious Disease: Major infectious disease occurrences or outbreaks in a facility -described as potentially communicable through common social or sexual contact, and poses a significant health risk if contracted, i.e. diseases such as but not limited to TB, Hepatitis A, B, or C, or serious sexually transmitted diseases as tracked by the Center for Disease Control but which only need to be reported if there is a threat of transmission of the disease to staff or other residents.
Reporting Requirements:
The SE shall report the following health and safety incidents to Human Services Department/Medical Assistance Division/Quality Assurance Bureau (HSD/MAD/QAB) via fax, within 24 hours of notification.
Significant injuries related to seclusion or restraints, requiring urgent care or Emergency Room visit.
Injuries or emergency services occurring in a facility or Provider’s office that are unanticipated and require urgent care or Emergency Room visit.
Serious adverse reactions to treatment including medication errors that result in the need for Emergency Room visits.
Incident reports of sexual behaviors with other consumers, staff, or a third party whether consensual or not, that occur while in any treatment setting. (i.e. sexual contact of any type, sexual abuse, sexual assault, rape, attempted rape, touching, or indecent exposure).
Incident reports of physical/psychological abuse or neglect by staff or other consumers that jeopardize the life or health of consumers or could result in physical/psychological harm while receiving services in any treatment setting.
Unexpected death, occurring in any setting that is not related to the natural course of the patient’s medical illness or underlying condition.
Attempted suicide or attempted homicide occurring in any treatment setting
Major infectious disease occurrences or outbreaks in a facility -described as potentially communicable through common social or sexual contact, and poses a significant health risk if contracted i.e. diseases such as but not limited to TB, Hepatitis A, B, or C, or serious sexually transmitted diseases as tracked by the Center for Disease Control but which only need to be reported if there is a threat of transmission of the disease to staff or other residents.
Firesetting or property damage that results in life-threatening danger to self or others.
Other occurrences representing actual serious harm to a member not listed above, e.g., staff misconduct, unexpected closure of a facility, environmental hazard, inadequate SE CCM follow-up. (Discretionary – the SE may contact an Oversight Team staff member to discuss any particular situation if it is questionable).
For additional information please refer to the below Incident Reporting Regulations document:
