Reporting Critical Incidents (Required)

• What is a Critical Incident?
  • An event that jeopardizes the participant’s health or welfare, including:
    • Death, serious injury, or hospitalization of a participant
    • Provider and staff member misconduct including deliberate, willful, unlawful, or dishonest activities
    • Abuse, including infliction of injury, unreasonable confinement, intimidation, punishment or mental anguish of the participant, abuse can be physical, psychological, sexual, or verbal
    • Neglect
    • Exploitation
    • Service interruption (participant unable to receive services AND puts participant’s health or welfare at risk)
    • Medication errors that result in hospitalization or medical intervention
  • Not a Critical Incident:
    • A complaint is different from a critical incident
    • Pre-scheduled hospitalizations, or hospitalizations for routine illnesses
    • A death due to natural causes
  • Program fraud and financial abuse should not be reported as critical incidents, but in accordance with OLTL Fraud and Financial Abuse.

• Critical Incident Reporting Procedures
  • Before reporting the critical incident, measures must be taken to safeguard the participant.
    • Call 911
    • Contact Adult Protective Services (if necessary)
    • Contact law enforcement, fire department, or other authorities
  • After the health and welfare of participant is safeguarded, it needs to be determined if the incident is reportable or not.
  • The entity that first discovers or learns of the critical incident is responsible for reporting.
  • The provider agency must submit the critical incident report within 48 hours to OLTL. If the incident occurs on a weekend, a written report must be entered on the first business day after the incident occurred. Providers have to inform the Service Coordinator of the critical incident within 24 hours.

• Best Practices: Each critical incident should show:
  • Steps taken immediately to ensure the participant’s health and welfare
  • What fact-finding steps were taken, and what information was found
  • What corrective steps were taken.
  • How the critical incident will be prevented from happening in the future
  • Any changes to the service plan because of the critical incident
  • Because people use abbreviations differently, they should not be included in the report
  • Be sure to include as much information as possible to describe a detailed picture of the situation

• Critical Incident reports include:
  • Reporter information
  • Participant demographics
  • OLTL program information
  • Event details and type
  • Description of the incident
  • Actions taken to immediately secure the participant’s health and welfare