OLTL Bulletin 5-23-02 et al. — Critical Incident Management

What this rule requires your agency to do

• 1All MCOs, SCs, and providers must develop and implement written critical-incident-management policies and procedures covering prevention, reporting, notification, investigation, and management (per 55 Pa. Code § 52.17(b)-(c)).(OLTL Bulletin 5-23-02 et al. — Critical Incident Management)
• 2A provider (or MCO/SC) that discovers or has firsthand knowledge of a critical incident must submit the first section of the critical incident report to OLTL through OLTL's critical incident management system within 48 hours of discovery (counting from 12:00 AM the first business day when discovered on a weekend or holiday).(OLTL Bulletin 5-23-02 et al. — Critical Incident Management)
• 3A critical incident case may require the involved employee to be removed or suspended; a participant-directed employee must be suspended without pay and the participant's back-up plan put in place until the investigation is completed.(OLTL Bulletin 5-23-02 et al. — Critical Incident Management)
• 4MCOs, SCs, and providers are mandatory reporters under the Adult Protective Services Act (participants ages 18-59) and OAPSA (ages 60+) and must report suspected abuse, neglect, exploitation, or abandonment (verbal report line 1-800-490-8505) and cooperate with protective services investigations.(OLTL Bulletin 5-23-02 et al. — Critical Incident Management)
• 5Providers must analyze causes and trends of critical incidents to reduce preventable incidents and document the risk-mitigation methods on the provider's Quality Management Plan (per § 52.17(d) and (f)).(OLTL Bulletin 5-23-02 et al. — Critical Incident Management)
• 6Providers must ensure they have staff trained and available to report critical incidents in the required timeframes and must implement standard annual staff training covering prevention of abuse/exploitation, reporting critical incidents, complaint resolution, Department-issued policies, and the provider's quality management plan (per § 52.21).(OLTL Bulletin 5-23-02 et al. — Critical Incident Management)
• 7A provider must inform the participant's Service Coordinator within 24 hours of discovering or first learning of a critical incident, and must immediately contact the SC or call 911 if the participant needs immediate intervention or medical attention.(OLTL Bulletin 5-23-02 et al. — Critical Incident Management)
• 8The agency staff who discovered the critical incident must notify the participant (and representative, if requested and not suspected of involvement) that a critical incident report has been filed, within 24 hours and in a cognitively and linguistically accessible format.(OLTL Bulletin 5-23-02 et al. — Critical Incident Management)