and analysis: Continuously and ongoing. Percent of reports related to Data source: MCO abuse, abuse, neglect and neglect, or exploitation exploitation of participants database. where an investigation was Data collection responsible initiated within the party: MCO. established timeframe. Frequency of data collection: Monthly. Sampling: 100% review. Number and percent of Data aggregation responsible substantiated cases of abuse, party: DOH. neglect and exploitation Frequency of data aggregation where recommended actions and analysis: Monthly. to protect health and welfare were implemented. Number and percent of The State demonstrates Data source: MCO critical critical incidents that an incident participants’ 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 abuse, 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.
expedited-rest-state-rfq.docx