Percent of reports related to Data source: MCO abuse, abuse, neglect and neglect, or exploitation database. exploitation of participants Data collection responsible where an investigation was party: MCO. initiated 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 critical incidents participants’ 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. Frequency of data aggregation and analysis: Monthly. Number and percent of The State policies and Data source: MCO restrictive unauthorized uses of procedures for the use or interventions database or restrictive interventions that prohibition of restrictive records review, on-site were appropriately reported. interventions (including Data collection responsible restraints and seclusion) party: MCO.
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. Frequency of data aggregation and analysis: Monthly. The State policies and procedures for the use or prohibition of restrictive interventions (including restraints and seclusion) Number and percent of unauthorized uses of restrictive interventions that were appropriately reported. Data source: MCO restrictive interventions database or records review, on-site Data collection responsible party: MCO.
final-rfq.docx