BMS Provider Manual, Chapter 501 Aged and Disabled Waiver (ADW) — Incident Management and Documentation and Record Retention Requirements (Sections 501.7–501.8)

What this rule requires your agency to do

• 1Anyone providing services who suspects abuse, neglect, or exploitation must verbally report immediately to WV Centralized Intake (1-800-352-6513), followed by a written report to the local DHHR within 48 hours for APS and 24 hours for CPS (§501.7).(BMS Provider Manual, Chapter 501 Aged and Disabled Waiver (ADW) — Incident Management and Documentation and Record Retention Requirements (Sections 501.7–501.8))
• 2Suspected sexual assault/abuse, serious physical abuse, or exploitation must also be reported to local law enforcement when appropriate, and any incident attributable to staff failure that compromises member health or safety is neglect and must be reported to APS (§501.7).(BMS Provider Manual, Chapter 501 Aged and Disabled Waiver (ADW) — Incident Management and Documentation and Record Retention Requirements (Sections 501.7–501.8))
• 3Providers must review and analyze incident reports to identify health and safety trends and incorporate remediation strategies into the agency Quality Management Plan, which must be made available to the OA (§501.7.2).(BMS Provider Manual, Chapter 501 Aged and Disabled Waiver (ADW) — Incident Management and Documentation and Record Retention Requirements (Sections 501.7–501.8))
• 4All required documentation must be safely and securely maintained for at least five years, or three years after audits with exceptions resolved by BMS, and until the end of any dispute or five years, whichever is greater (§501.8).(BMS Provider Manual, Chapter 501 Aged and Disabled Waiver (ADW) — Incident Management and Documentation and Record Retention Requirements (Sections 501.7–501.8))
• 5Any incidents involving a member must be entered into the WV IMS within one business day of learning of the incident, and an Incident Report documenting outcomes of the review must be entered within 14 calendar days (§501.7.1).(BMS Provider Manual, Chapter 501 Aged and Disabled Waiver (ADW) — Incident Management and Documentation and Record Retention Requirements (Sections 501.7–501.8))
• 6Providers must maintain records that substantiate services billed were provided on the dates listed and for the actual amount of time and number of units claimed, using only forms developed and published by BMS (§501.8).(BMS Provider Manual, Chapter 501 Aged and Disabled Waiver (ADW) — Incident Management and Documentation and Record Retention Requirements (Sections 501.7–501.8))
• 7If a member dies, the agency that first learns of the death must complete the IMS death report within one business day, complete and submit a Notification of Death Form to the OA, and notify the member's other agency within the same timeframe (§501.7.1).(BMS Provider Manual, Chapter 501 Aged and Disabled Waiver (ADW) — Incident Management and Documentation and Record Retention Requirements (Sections 501.7–501.8))
• 8The agency is responsible for reviewing all incidents, including those reported to APS, and must delay its own review upon APS request, documenting the request in the WV IMS and contacting the OA (§501.7.1).(BMS Provider Manual, Chapter 501 Aged and Disabled Waiver (ADW) — Incident Management and Documentation and Record Retention Requirements (Sections 501.7–501.8))