Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0037 - Medicaid
Chapter 34 - HOME AND COMMUNITY BASED SERVICES COMMUNITY CHOICES WAIVER PROGRAM
Section 34-15 - Incident Reporting and Complaints

Universal Citation: WY Code of Rules 34-15

Current through September 21, 2024

(a) A provider shall develop and maintain incident reporting policies and procedures, and shall review internal incident data in accordance with Department requirements.

(b) After assuring the health and safety of the participant, a provider shall immediately report the following critical incidents to the Department, the participant's case manager, and legal guardian in accordance with Department requirements:

(i) Suspected abuse as defined by W.S. 35-20-102;

(ii) Suspected neglect as defined by W.S. 35-20-102;

(iii) Suspected self-neglect as defined by W.S. 35-20-102;

(iv) Suspected abandonment as defined by W.S. 35-20-102;

(v) Suspected exploitation, including sexual exploitation and medication diversion, as defined by W.S. 35-20-102;

(vi) Suspected intimidation as defined by W.S. 35-20-102;

(vii) Suspected sexual abuse as defined by W.S. 35-20-102; and

(viii) Death that is not the result of an expected medical diagnosis.

(c) After assuring the health and safety of the participant, a provider shall report the following non-critical incidents to the Department, the participant's case manager, and the legal guardian within three (3) business days:

(i) Serious injury to the participant;

(ii) Elopement;

(iii) Any use of seclusion;

(iv) Unscheduled medical or behavioral admissions and emergency room visits that occur while the participant is receiving a CCW service;

(v) Use of restraint;

(vi) Unauthorized use of restrictive interventions; and

(vii) Other incidents of death.

(d) A provider shall comply with the Department, case manager, and other state agency or law enforcement requests for information relating to any incident.

(e) A provider's failure to report incidents in accordance with this Section may result in corrective or adverse action, including the provider's decertification.

(f) The Department or its designee shall conduct an investigation of all reported incidents. The scope and duration of the investigation will vary based upon incident circumstances and follow up actions required. The investigation is not considered concluded until all follow up actions have been taken to reasonably assure the health and safety of the participant(s).

(g) A provider shall have policies and procedures for handling complaints in accordance with any requirements of the Long Term Care Ombudsman and the Department.

Disclaimer: These regulations may not be the most recent version. Wyoming may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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