Question # Question Guidance/Additional Information Compliant Plan of Correction Yes/No (If not compliant) 8.001 Upon identification of a MUI, is there evidence The ICF-IID must ensure that when a that the ICF-IID took the following immediate staff person is not removed from the actions as appropriate: direct contact that the staff person Immediate and on-going medical has no unsupervised contact with the attention alleged victim or any other individual who may be considered at Removal of an employee from direct risk. contact with any at-risk individual when the employee is alleged to have The provider is responsible for been involved in abuse or neglect until notifying the county board or such time as the ICF-IID/DD has department when there are changes reasonably determined that such in protective actions (i.e. returning removal is no longer necessary employee to duty, change in supervision levels, etc.) Other necessary measures to protect the health and safety of at-risk individuals 5123:2-17-02 8.002 Is there evidence that the ICF-IID notified the Ask how the provider documents the county board about the below listed incidents date and time of the initial within 4 hours of discovery? notification. Abuse (physical, sexual and verbal) Check MUI ITS, fax cover sheet or Exploitation provider documents. Misappropriation Every CB is required to have 24-hour availability. Neglect Suspicious/Accidental Death Media Inquiry Peer to Peer 5123:2-17-02 8.003 Is there evidence that the ICF-IID submitted a written incident report to the county board contact or designee no later than three p.m. the next working day following initial knowledge of a potential or determined major unusual incident? 5123:2-17-02
Question # Question Guidance/Additional Information Compliant Yes/No Plan of Correction (If not compliant) 8.001 Upon identification of a MUI, is there evidence that the ICF-IID took the following immediate actions as appropriate: Immediate and on-going medical attention Removal of an employee from direct contact with any at-risk individual when the employee is alleged to have been involved in abuse or neglect until such time as the ICF-IID/DD has reasonably determined that such removal is no longer necessary Other necessary measures to protect the health and safety of at-risk individuals 5123:2-17-02 The ICF-IID must ensure that when a staff person is not removed from the direct contact that the staff person has no unsupervised contact with the alleged victim or any other individual who may be considered at risk. The provider is responsible for notifying the county board or department when there are changes in protective actions (i.e. returning employee to duty, change in supervision levels, etc.) 8.002 Is there evidence that the ICF-IID notified the county board about the below listed incidents within 4 hours of discovery? Abuse (physical, sexual and verbal) Exploitation Misappropriation Neglect Suspicious/Accidental Death Media Inquiry Peer to Peer 5123:2-17-02 Ask how the provider documents the date and time of the initial notification. Check MUI ITS, fax cover sheet or provider documents. Every CB is required to have 24-hour availability. 8.003 Is there evidence that the ICF-IID submitted a written incident report to the county board contact or designee no later than three p.m. the next working day following initial knowledge of a potential or determined major unusual incident? 5123:2-17-02
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