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Provider Rule Training - PowerPoint PPT Presentation

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Provider Rule Training. Effective 7/1/07 . 2007 Trends. Neglect Not following Supervision Plan Left Alone at Home Sleeping Left in Vehicle Physical Abuse Punched Slapped Pushed Grabbed Sexual Abuse Peer – Sexual Contact about 65% of the time. Misappropriation

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Provider Rule Training

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provider rule training

Provider Rule Training


2007 trends
2007 Trends
  • Neglect
  • Not following Supervision Plan
  • Left Alone at Home
  • Sleeping
  • Left in Vehicle
  • Physical Abuse
  • Punched
  • Slapped
  • Pushed
  • Grabbed
  • Sexual Abuse
  • Peer – Sexual Contact about 65% of the time
  • Misappropriation
  • Credit Cards
  • Utilities
  • Cell Phone Expenses
  • Lack of Agency/Co. Bd. Oversight
  • Home Manager – All Control > No oversight
  • Verbal Abuse
  • Harsh Abusive Language
  • Not Reported – Tolerated by Other Staff
incident reporting
Incident Reporting

(M)(1) Each agency provider shall develop and implement a policy/procedure that:

(a) Identifies what is to be reported as a UI

(b) Requires anyone who becomes aware of a UI to report to the person designated by the provider who can initiate proper action

(c) Requires written report no later than 24 hours after the incident occurred

(d) Requires appropriate actions be taken to protect the health/safety of any at-risk individual.


Agency Provider and County Board

as provider report to County Board MUI or IA Section

reporting timeframes
Reporting Timeframes
  • Immediate for potential Abuse/Neglect/Exploitation or Misappropriation, Peer-to-Peer, and all Deaths
  • Others to County Board IA by next working day
incident reporting form
Incident Reporting Form
  • Who – What – Where – How - When – Why
  • Detail
  • Timeframes
mui means
MUI Means…
  • Alleged, suspected or actual occurrence
  • Reason to believe a person is at risk of harm based on facts present not opinion
  • Receiving services or will be as a result of incident
physical abuse
Physical Abuse
  • Physical force
  • Reasonably be expected to result in harm

Examples: Hitting, slapping, pushing, dragging or throwing an object when the allegation indicates that it could reasonably result in harm

sexual abuse
Sexual Abuse
  • Unlawful sexual contact
  • Unlawful sexual conduct
  • Public indecency, voyeurism,

importuning, etc.

verbal abuse
Verbal Abuse
  • Purposeful use of words or gestures
  • Threaten, coerce, intimidate, harass, humiliate
attempted suicide
Attempted Suicide
  • Physical attempt that:
    • Results in ER treatment


    • Inpatient observation


    • Hospital admission
  • All deaths of individuals served

Unlawful or improper act Using

individual Individual’s resources

for personal benefit, profit, or gain

failure to report criminal 5123 61 c
Failure to Report (Criminal) 5123.61(C)
  • Person has reason to believe
  • Individual suffered or faces a substantial risk of suffering
  • Any wound, injury, disability or condition to reasonably indicate Abuse or Neglect (including Misappropriation)
  • Did not immediately report or cause reports to be made to law enforcement or a county board
failure to report registry
Failure to Report (Registry)
  • MR/DD employee unreasonably failed to report Abuse or Neglect pursuant to 5123.61(C)
  • Knew or should have known
  • Failure would result in a substantial risk of harm
known injury
Known Injury
  • Known cause
  • Not Abuse or Neglect
  • Requires:
      • Immobilization or casting
      • Five or more sutures or equivalent
      • 2nd or 3rd degree burns
      • Dental injuries
      • Injury that prohibits participation in daily routine tasks for more than 2 consecutive days
unknown injury
Unknown Injury
  • Unknown cause
  • Not considered possible Abuse or Neglect
  • Requires treatment that only a physician, physician assistant, or nurse practitioner can provide
law enforcement
Law Enforcement

Individual is: charged (C)

incarcerated (I)

arrested (A)

medical emergency
Medical Emergency

Emergency medical intervention

required to save one’s life includes

Heimlich Maneuver, CPR, and IV

for dehydration, etc.

  • With intent
  • Deprive, defraud, or otherwise obtain real or personal property
  • As prohibited in Ohio Revised Code 2911 and 2913
missing individual
Missing Individual
  • Has been reviewed for neglect
  • Not located per ISP and actions identified in plan and in search of immediate surrounding area


  • Circumstances indicate immediate jeopardy


  • Law enforcement was called to assist
  • When you have a duty and you
  • Fail to provide treatment, care, goods, supervision or services
  • That result in a reasonable risk of harm
peer to peer acts
Peer-to-Peer Acts
  • One individual against another
  • Physical Abuse with intent to harm
  • Verbal Abuse with intent to threaten, coerce, intimidate, harass or humiliate
  • Any Sexual Abuse
  • Any Exploitation
  • Any intentional Misappropriation of significant value
prohibited sexual relations
Prohibited Sexual Relations
  • MR/DD employee
  • Consensual sexual conduct or contact
  • With an individual who is not their spouse
  • Employed or under contract to provide care to the individual at the time of the incident
  • Anyone in the MR/DD employee’s supervisory chain of command
rights code violation
Rights Code Violation
  • Any violation of rights listed in Ohio Revised Code 5123.62 and it creates a reasonable risk of harm
unapproved behavior support
Unapproved Behavior Support
  • Any adverse strategy or intervention
  • Implemented without approval by committee and guardian or without informed consent
unscheduled hospitalization
Unscheduled Hospitalization
  • Hospital admission that is not scheduled


  • Due to condition specified in ISP or nursing care plan
  • Specific symptoms and criteria must be listed that lead to hospitalization
unusual incident
Event not consistent with routine operation, policy and procedure, or care or plan for the individual

Includes but not limited to:

Medication errors


Peer-to-peer that are not MUIs

Overnight relocation

Injury that is not an MUI

Refusal to take meds

Unusual Incident
l 1 mui analysis for trends and patterns two times per year
(L)(1) MUI Analysis for Trends and Patterns Two Times Per Year
  • Quarterly trends and patterns are to be completed by all agency providers and county board as providers
  • The county board shall review all agency providers for quarterly trends and patterns
l 1 mui analysis for trends and patterns two times per year1
(L)(1) MUI Analysis for Trends and Patterns Two Times Per Year
  • The semi-annual review shall be cumulative for the first two quarters and include an in-depth analysis
  • The annual review shall be inclusive for the year and include an in-depth analysis
l 1 county board s analysis and follow up
(L)(1) County Board’s Analysis and Follow-Up
  • Each review shall take preventive measures to address trends and patterns
  • All reviews and analysis are to be completed within 30 days following the end of the quarter
l 3 agency provider analysis and follow up
(L)(3) Agency Provider Analysis and Follow-Up
  • For all programs in the county
  • Sent by August 31st and February 28th to the county board
  • Kept on file and made available upon request to the Department
  • Individual providers make reports to the

person designated by the county board on the same day as discovery

  • The county board designates a person to log the incidents
m 5 unusual incidents are reviewed at least monthly
(M)(5) Unusual Incidents are Reviewed at Least Monthly
  • Who – agency providers and county board as a provider
  • Appropriate preventive measures
  • Trends and patterns identified and addressed
m 7 maintain a log of unusual incidents
(M)(7) Maintain a Log of Unusual Incidents
  • Who – agency providers and county

board as a provider

  • Name of individual
  • Brief description of incident
  • Any injuries
  • Time/date/location
  • Preventive measures
m 8 county board review of representative sampling of logs
(M)(8) County Board Review of Representative Sampling of Logs
  • Monthly
  • Provider logs, individual logs, and county

board as a provider

  • Ensure none are MUIs
  • Ensure trends and patterns have been

identified and addressed

  • Provide to Department to review upon


m 10 trends and patterns of unusual incidents addressed in the isp
(M)(10) Trends and Patterns of Unusual Incidents Addressed in the ISP
  • Who – agency provider and county board as a provider

MUI Rule training is required for all

county, state, and provider personnel.

p 1 training on identification and reporting requirements
(P)(1) Training on Identification and Reporting Requirements

Who: All agency providers and county


When: Prior to unsupervised contact

and no later than 30 calendar days

after employment and annually

thereafter (calendar year). Includes

review of health/safety Alerts issued

since the last training.

p 2 individual provider training on identification and reporting
(P)(2) Individual Provider Training on Identification and Reporting
  • Based accordingly to certification requirements
  • Annually, based on certification date
  • Includes review of Alerts issued since the previous year’s training