Serious Occurrence Reporting(SOR) New Policy Effective March 2011 CSB 305
Serious Occurrence Report System Division has established a system of reporting and monitoring serious incidents in order to: • Identify • Manage • Mitigate Risk to the health and safety of our consumers
What is an SOR? • Serious Occurrence means: • A significant event involving a consumer which affects the health, welfare or safety of the individual served • Event must be reported under the following 10 circumstances:
Suspected or known exploitation, physical, emotional, sexual or verbal abuse Provider agencies are mandatory reporters Neglect of the consumer, self-neglect, or neglect by a paid caregiver Sexual harassment by an agency employee or consumer SOR Circumstances
4. Any injury that results in hospital emergency room or equivalent level of treatment. The injury may be observed or discovered. Only report injuries in QAMS within the last 90 days 5. Unsafe or unsanitary working or living environment that puts the worker and/or consumer at risk SOR Circumstances cont.
6. Reports to APS, CPS, Law Enforcement, Ombudsman or QAD/Licensing 7. Referral to Medicaid Fraud SOR Circumstances cont.
SOR Circumstances cont. 8. Psychiatric Emergency • Admission to hospital or mental health facility for a psychiatric emergency 9. Medication Emergency • Discrepancy between the medication that is prescribed and what the individual actually takes and this results in hospital or ER level of treatment • Any medication error that occurs during the provision of Medicaid reimbursed nursing 10. Suicide, suicide attempt or suicide threat
Who Reports? • The provider that is notified about an event that meets the SOR criteria is required to report the incident in QAMS • This provider is the Initiating Provider • If the SOR concerns another provider the initiating provider must include the appropriate provider in QAMS as a secondary provider
Provider Responsibility • The Initiating and Secondary providers are responsible for: • Responding to the event and documenting activity • Entering and completing all of the corrective action items for the report
Initiating Provider Role:Reporting the Event • Provider has 10 working days to report the event, once it is discovered, in QAMS and submit it to the RPO for review • Must provide detail about the date the event occurred, the date it was reported, who was involved, what happened and the response and follow-up that was provided or is planned • Must include appropriate secondary provider • If there are additional providers send an electronic version to them
Working Together • PAS Providers and CMT must work together to ensure health and welfare of consumers • RPO reviews report to ensure appropriate action is taken • Goal is to use QAMS to the best of our ability to track incidents and ensure quality standards are met in how we handle serious occurrences
Provider Responsibility: Consumer Health and Safety • Provider agency is responsible for assessing the severity of the incident, reporting it, if appropriate, and responding appropriately, regardless of circumstance. • All providers must follow-up on incidents that involve consumers or affect the provider’s ability to provide services
Provider Documentation of incidents • If it qualifies as an SOR . . . • Document your actions in QAMS • If you aren’t sure if it is an SOR . . . • Contact your RPO • If it isn’t an SOR . . . • Document your follow-up action in chart notes • Consider a case conference • Consider contacting the RPO • Consider whether the service plan/authorization needs to be changed
SORs Happen Don’t Forget to Report! . If your agency has not submitted an SOR in the last year it is a red flag You may need to retrain staff, attendants, and consumers to be better reporters