and analysis: Continuously and ongoing. Percent of reports related to Data source: MCO abuse, neglect and exploitation neglect, or exploitation database. of participants where an Data collection responsible investigation was initiated party: MCO. within the established Frequency of data collection: timeframe. Monthly. Sampling: 100% review. Data aggregation responsible Number and percent of party: DOH. substantiated cases of abuse, Frequency of data aggregation neglect and exploitation where and analysis: Monthly. recommended actions to protect health and welfare were implemented. Number and percent of The State demonstrates Data source: MCO critical participants’ critical incidents that an incident incidents database that were reported, initiated, management system is in Data collection responsible reviewed and completed place that effectively party: MCO. within required timeframes as resolves those incidents Frequency of data collection: specified in the approved and prevents further similar Monthly. waiver. incidents to the extent Sampling: 100% review. possible. Data aggregation responsible party: MCO.
and analysis: Continuously and ongoing. Percent of reports related to neglect and exploitation of participants where an investigation was initiated within the established timeframe. Number and percent of substantiated cases of abuse, neglect and exploitation where recommended actions to protect health and welfare were implemented. Data source: MCO abuse, neglect, or exploitation database. Data collection responsible party: MCO. Frequency of data collection: Monthly. Sampling: 100% review. Data aggregation responsible party: DOH. Frequency of data aggregation and analysis: Monthly. The State demonstrates that an incident management system is in place that effectively resolves those incidents and prevents further similar incidents to the extent possible. Number and percent of participants’ critical incidents that were reported, initiated, reviewed and completed within required timeframes as specified in the approved waiver. Data source: MCO critical incidents database Data collection responsible party: MCO. Frequency of data collection: Monthly. Sampling: 100% review. Data aggregation responsible party: MCO.