agenda - healthwest...apr 12, 2019 · police chief-december 2014-present police lieutenant-january...

Main Office

376 E. Apple Ave. | Muskegon, MI 49442 | P (231) 724-1111 | F (231) 724-3659

HealthWest.net

PROGRAM AND PERSONNEL COMMITTEE

Friday, April 12, 20198:00 a.m.

Mental Health Center – Board Room

Program and Personnel Committee Chair: Cheryl NatteProgram and Personnel Committee Vice-Chair: John Schrier

AGENDA

Disposition1) Call to Order Quorum

2) Approval of Minutes of February 8, 2019 meeting as written.(Previously Forwarded)

Action

3) Items for Consideration

A) Authorization to Submit Two (2) Candidates to the LRE forConsideration for Seats on the Executive Board(Attachment #1)

B) Authorization to Appoint Board Members to Sit on VariousHealthWest Committees(Attachment #2)

C) Authorization to add a Waiver Coordinator Position(Attachment #3)

Action

Action

Action

4) Old Business

5) New Business

6) Communication Information

7) Director’s Comments Information

8) Audience Participation

9) Adjournment Action

REQUEST FOR HEALTHWEST BOARD CONSIDERATION AND AUTHORIZATION

COMMITTEEProgram/Personnel

BUDGETED NON BUDGETED PARTIALLY BUDGETEDX

REQUESTING DIVISIONAdministration

REQUEST DATEApril 12, 2019

REQUESTOR SIGNATUREJulia Rupp, Executive Director

SUMMARY OF REQUEST (GENERAL DESCRIPTION, FINANCING, OTHER OPERATIONAL IMPACT, POSSIBLE ALTERNATIVES)

Authorization is requested for the HealthWest Executive Director to recommend two candidates to the LakeshoreRegional Entity (LRE) for consideration.

HealthWest is required to fill three (3) seats on the LRE Executive Board. At this time, two of those seats arevacant. The individuals below have expressed an interest in fulfilling those two vacancies and their applicationswill be submitted for consideration:

Jon Gale, Chief of Police, Norton Shores Police Department

Stevi Riel, Executive Director, The Health Project

SUGGESTED MOTION (STATE EXACTLY AS IT SHOULD APPEAR IN THE MINUTES)

I move authorize the Executive Director to submit applications for Ms. Stevi Riel and Mr. Jon Gale to theLakeshore Regional Entity for consideration to fulfill HealthWest’s obligation to fill two vacant seats on theLakeshore Regional Entity’s Executive Board.

COMMITTEE DATE COMMITTEE APPROVALYes No Other

BOARD DATE BOARD APPROVALYes No Other

HWB 087-P

amber.berndt

Typewriter

Attachment #1

AT-LARGE BOARD MEMBER APPLICATION

NAME: Gale Aubrey JonLAST FIRST MIDDLE

ADDRESS: 4814 Henry, Norton Shores, Mi 49441

EMAIL [email protected] PRIMARY PHONE: 231-578-8154

COUNTY OF RESIDENCE: Muskegon ALTERNATE PHONE: 231-733-2691

Why do you want to be considered for this appointment?

I enjoy serving the community. I have the relevant expertise to assist in the planning and decision making inMental Health Service Programs. This experience will also give me learning opportunities to assist in my careerin Law Enforcement and the several committees I am associated with.

Describe your interest in the delivery of services and supports for people with mental illness,substance use disorders, intellectual and developmental disabilities, and children with severeemotional disturbances.

I have learned through my experiences with the Governor’s Mental Health Diversion Council and the MuskegonCounty Jail Committee that Western Michigan is leading the way throughout the state in Mental Health initiatives.However, there are many areas of concern that need to be addressed including training for Law Enforcement,Medical first responders, Dispatcher, Emergency room personal and many others. My interest is in helpingthese initiatives succeed and continue.

Describe your experience in serving on governing boards or the boards of civic and othersimilar organizations?

Currently I serve on several Mental Health Boards and Committees including; Governor’s Mental Health DiversionCommittee, the Muskegon County Jail Diversion Committee through Health West, Advisory Committee for theManaging Mental Health Crisis, Michigan Crisis Intervention Team, Opiate task force, Coalition for a Drug FreeMuskegon, Muskegon ALI

Other boards and civic groups, Rotary of the Lakeshore, Central Police Operations board, Vice President of theWest Michigan Association of Police Chiefs, and Sportsmen for Youth.

What is your primary occupation, area of expertise, or main areas of interest related tomental health and/or substance abuse services?I have been a police officer for 27 years and I am currently the Chief of Police at the Norton ShoresPolice Department. My participation in many of the above boards and committees have directed myinterest towards Mental Health and a better knowledge and understanding of it.

Lakeshore Regional Entity Board of directors sets a minimum attendance expectation of75% for all members. If appointed, will you be able to comply with the terms of theattendance requirement?

X YES No If no, please explain

Does Lakeshore Regional Entity, Member CMHSP’s or network providers employ you or anymembers of your family?

Yes X No If yes, please explain

AREAS OF INTEREST/EXPEREINCE (civic organizations, clubs, volunteer work, etc.)

ORGANIZATION ACTIVITIES DATESRotary of the Lakeshore Youth Mentorships 01/2016- present

Sportsmen for Youth Youth outdoor experiencesoutoutdoors

09/2005- present

Governor’s Mental Health DiversionCouncil

MACP representative 01/2017-present

Coalition for a Drug Free Muskegon Muskegon ALI, Ride with Pride 2008-present

Is there any additional information you would like to share about yourself?As explained above, I have dedicated my free time and work time towards prevention and Mental Health Initiatives.Law Enforcement needs to be involved in prevention and to assist people with issues that may lead to someonegetting hurt.

EDUCATION AND EMPLOYMENT HISTORY- PLEASE ATTACH YOUR RESUME

Board Member Application 2 | P a g e

[email protected]

AUBREY JON GALE

EXECUTIVE PROFILE Police Executive with twenty seven years of experience directing andleading all levels of law enforcement. Specializing in special events,including budgeting and administration.

SKILL HIGHLIGHTS · Leadership/communication skills

· Project management· Training and development

· Department operations management· Team leadership

EXPERIENCENORTON SHORES POLICE DEPARTMENT

Police Chief- December 2014-Present

Police Lieutenant- January 2005- December 2014

Police Sergeant- May 2001- January 2005

Undercover Narcotics Officer- October 1999-May 2001

Patrol Officer- January 1996- July 1997

BAKER COLLEGE

Adjunct Professor- January 2016- Present

NORTH MUSKEGON POLICE DEPARTMENT

Police Officer- January 1991- January 1996

EDUCATIONGRAND VALLEY STATE UNIVERSITY- MASTER OF PUBLIC ADMINSTRATION

Pi Alpha Alpha member, GPA 3.97Graduated April 2006INTERNATIONAL CHIEFS OF POLICE- LEADERSHIP IN POLICE ORGANIZATIONS

Graduated May 2013

NORTHWESTERN UNIVERSITY - EXECUTIVE MANAGEMENT PROGRAM

Graduated November 2009FEDERAL BUREAU OF INVESTIGATIONS POLICE EXECUTIVE DEVELOPMENT

Graduated September 2003

COREACCOMPLISHMENTS

OPERATIONS MANAGEMENT:

Manage Road Patrol, Investigations, Muskegon County EmergencyResponse Team, and Special Services DivisionsHandle all functions related to training, scheduling and budgetadministration

LEADERSHIP· Governor Mental Health Diversion Council

· Western Michigan Chiefs of Police Vice President 2019· Ride With Pride-Chair 2019

· Alcohol Liability Initiative Chair-2013· Sportsmen for Youth Vice President- 2012, 2013

· West Michigan Criminal Justice Training Consortium GrantCommittee Chair

· Muskegon County School Safety Initiative Chair

· Incident Commander for several large events including; JessicaHeeringa Abduction Task Force, National Motor Cycle Hill climb,Muskegon Airshow, and police involved shootings

AT-LARGE BOARD MEMBER APPLICATION

NAME: Riel SteviLAST FIRST MIDDLE

ADDRESS: 565 W. Western Ave Muskegon, MI 49441

EMAIL [email protected] PRIMARY PHONE: 231.672.3201

COUNTY OF RESIDENCE: Muskegon ALTERNATE PHONE: 517.927.5876

Why do you want to be considered for this appointment?

The work the LRE invests in and oversees aligns with the overall efforts of a safe and well community,which is the work that me and my organization are focused on. I'm interested in further aligning the different systemswithin our communities.

Describe your interest in the delivery of services and supports for people with mental illness,substance use disorders, intellectual and developmental disabilities, and children with severeemotional disturbances.

I think we have a lot of opportunity to strengthen the systems of care for our most vulnerable people,particularly those living with disability, substance use and behavioral health disorders. I'm interested in betterintegrating the delivery of traditional medical care with evidence-based treatments for substance use disorder andbehavioral health that encompass the social influencers of health while reducing stigma and promoting preventionand wellness.

Describe your experience in serving on governing boards or the boards of civic and othersimilar organizations?

I've served on multiple boards in the last decade with various degrees of oversight, ranging from a fullgoverning board such as Call 211 to an Advisory Board (ProMed) as well as several functional committees and socialservice agencies. I also manage an Advisory Board of Directors as the Director for the Health Project.

What is your primary occupation, area of expertise, or main areas of interest related tomental health and/or substance abuse services?

Community Health & Well-Being, social determinants of health and prevention.

Lakeshore Regional Entity Board of directors sets a minimum attendance expectation of75% for all members. If appointed, will you be able to comply with the terms of theattendance requirement?

YES No If no, please explain

YES (I tried to check the box)

Does Lakeshore Regional Entity, Member CMHSP’s or network providers employ you or anymembers of your family?

Yes No If yes, please explainNo, not to my knowledge

AREAS OF INTEREST/EXPEREINCE (civic organizations, clubs, volunteer work, etc.)

ORGANIZATION ACTIVITIES DATESMuskegon Rotary Club 1 in 21 June 2015

Greater Muskegon Jaycees Member at Large and BOD August 2016

Is there any additional information you would like to share about yourself?

EDUCATION AND EMPLOYMENT HISTORY- PLEASE ATTACH YOUR RESUME

Board Member Application 2 | P a g e

1

Stevi Riel 2204 Surfwood Drive | Muskegon, MI 49441 | [email protected] | 517. 927.5876

PERSONAL Engaged, highly-motivated professional known for an innovative approach to healthcareSTATEMENT delivery, with accolades for creating dynamic programs, optimizing internal operations and engaging

the community for local solutions to identified population and community health issues

EXPERIENCE Executive Director/Community Benefit Ministry Officer | Muskegon Community HealthProject/Mercy Health Muskegon | June 2014 – present

§ Provides oversight of Community Benefit function and related activities to fulfill charitableobligation of the health system, with final responsibility for the Health Project organization

§ Responsible for all regulatory and compliance requirements by IRS§ Oversees extensive community health and population health program portfolio including

finance, operations and evaluation

Community Benefit Operations Manager | Muskegon Community Health Project| Muskegon,MI |October 2012 – June 2014Responsible for the development, implementation and oversight of the community benefit programportfolio that align with the organization's mission and commitment to communities that areunderserved.

§ Governance and Administration§ Understanding of core community benefit competencies and IRS regulations that

maintain organization tax-exempt status; demonstrated ability to communicateregulations; high comfort level with public speaking

§ Revised the format of the Health Project Board of Director's to include a profile ofkey program operations; prepares a high-level draft of the bi-monthly written reportfor submission to the Executive Director; demonstrated ability to prepare writtenbriefings for senior leaders relevant to community benefit operations and policy

§ Personnel management for twenty-eight colleagues, responsibility for four sites,including two store-front operations and ensured timely performance evaluationsand critical coaching/feedback that aligns with organization guidelines

§ Stewardship§ Proven skill to secure outside funding and increase capacity in cost-effect manner

for the health system; ability to leverage funding and external program utilizationthat offset direct community benefit program expenses

§ Co-led strategic enrollment process to improve revenue recapture, utilizing the roleof Community Health Workers with recovery of outstanding accounts inpartnership with the Unified Revenue Organization

§ Regional Community Benefit§ Led regional community benefit operations for the enrollment initiative and

community benefit goals and implemented the use of Community Health Workersto enhance ability to coordinate care and support enabling service staff in MissionClinics

§ Primary Care Network – Ambulatory Services Integration§ Linked community benefit services with the primary care network to satisfy PCMH

need; streamlined the ability for providers to refer to programs and services thatstabilize the social determinants of health

§ Worked to align care coordination programs of the Health Project with the healthsystem's current case management practices to enhance the coordination of care andambulatory delivery

Innovation Advisor's Program Appointee | Centers for Medicare and Medicaid Innovation,Baltimore, MD, Jan 2012 – Jan 2013

2

§ Innovation Advisors work within the Innovation Center to test new models of care deliveryin their own organizations and create partnerships to find new ideas that work and themacross the country.

§ Developed process to use Community Health Workers to intervene with high-risk patientswith multiple social determinants of health factors and who used hospital servicesinappropriately

Pharmaceutical Access Program Manager | Muskegon Community Health Project |Muskegon,MI | July 2007 – October 2012

§ Developed and implemented Pharmaceutical Access Program – brought $10 million worthof free pharmaceuticals back to community through PAP and community benefit initiativesand implemented a discharge plan for at risk patients emerging from Hospital ER

§ Co-led internal enrollment team to expand non-profit hospital governance procedures forfree and reduced care

§ Co-led system wide Affinity Group (Trinity Health) to develop standardized QualityReporting Metrics for Pharmaceutical Assistance Programs

§ Implemented a Pharmaceutical Access Coalition to identify and address access issues withincommunity that are related to medication adherence issues

§ Michigan Prisoner Re-entry Initiative Health aspect – medication access§ Co-Chair of Muskegon County Case Manager’s Committee – increased committee

membership by 80% and implemented committee objectives into long term strategicplanning for social service agencies of the county.

LEADERSHIP Vice President, Management Development | Board of Directors | Greater Muskegon Jaycees |January 2017 – current

§ Event Chairman, Greater Muskegon Jaycees Snowfest§ General member since September 2016

Chairman, Leadership Committee | 1 in 21 Muskegon County | Muskegon Rotary Club | July2016 – July 20171 in 21 is a community initiative designed to improve overall health behaviors and raise the healthstatus of the Muskegon community. Focused on smoking and obesity as two driver issues, the 1 in21 leadership committee provides oversight to activities that align with the strategic plan framework

Chairman, Executive Committee | Muskegon Homelessness Continuum of Care |Muskegon County Consortium | January 2008 – December 2017The Muskegon County Homeless Continuum of Care Network (MCHCCN) is the collaborative andcoordinating system that increases awareness and acts to promote and support services to eradicatehomelessness in Muskegon County.

Board of Directors, Appointed Member | Mission for Area People | September 2007 –December 2013Mission for Area People, a local faith-based not for profit organization dedicated to serving the basicneeds of the community through a food, clothing and personal care pantry, community medical fundand assistance with Emergency Food and Shelter Program dollars

§ Fund Development Committee Chair, February 09 – March 10§ Program Committee participant

Case Manager's Committee of Muskegon County, Co-Chair | January 2008 – August 2014The Case Manager's Committee of Muskegon County is a network of service agencies that provide asafety-net for critical, unmet needs through information sharing, advocacy, and case reviews.Committee is a sub-committee of the Homelessness Continuum of Care Network and United Wayof the Lakeshore's Emergency Needs Committee

3

§ Implemented county-wide standardized case management tool to be used as a safety net forunmet needs

§ Developed annual educational forum to provide continuing education and planning tocontinue the work of the committee and support the participating direct service staff andtheir agencies

§ Work closely with larger planning bodies throughout the community in order to keep thecommunity needs at the forefront of program and policy design and implementation

§ Committee membership and participation grew from 40 members to a list-serve of over 215and monthly meeting attendance of 50+

RECOGNITION Athena Young Professional Award | Nominee | October 2016§ The ATHENA Leadership Award is presented to a woman, or man, who is honored for

attaining professional excellence, community service and for actively assisting women intheir achievement of professional excellence and leadership skills.

Future 15 – Young Leader Award | Muskegon Lakeshore Chamber of Commerce | June 2016§ Program to recognize area young up-and-coming 'under 40 year old' leaders and

professionals in Muskegon who live or work in Muskegon County and excel "within theirplaces of employment and in the community."

Emerging Leader in Healthcare Transformation | Communities Joined in Action | November2014

§ CJA recognizes individuals with less than or equal to 5 years in the field, up to the age of 35years old, with a life-goal commitment to effective healthcare delivery. This award isdesigned to encourage further investment into community organizing, healthcaretransformation, data collection, or other critical areas of this work.

Rising Hero Award | Alliance for Health | November 2012§ Alliance for Health celebrates and honors outstanding work and heroic actions of local

health care professionals who go above and beyond to promote health and help people inneed, who create positive, healthy change in their communities

Patrick E. Ludwig Community Benefit Award | Michigan Health & Hospital Association | June2010

§ Awarded annually to health care organizations that demonstrate community benefit byimproving the health and well-being of their communities through health care, economic orsocial initiatives

§ 1 of 4 programs awarded in the state

EDUCATION Bachelor of Arts in Writing |Grand Valley State University |Allendale, MI, 2007.§ Minor in Business

Leadership Development | Trinity Health§ Strategic Leadership Program |October 2016 – January 2018§ Foundations in Leadership | January 2012 – December 2012

§ Three transfer credits from Seattle Pacific University§ Essential Skills for New Leaders | January 2011 – December 2011§ Leadership Development Institute | October 2012 - Ongoing

REFERENCES: Gary Allore, President and CEO, Mercy Health [email protected] | 231.672.3901

Dr. F. Remington Sprague, Chief Medical Officer, Mercy HealthBoard Chair, Muskegon Community Health Project

4

[email protected] | 231.727.4570

Michael Poulin, Sheriff, Muskegon County Sheriff's DepartmentBoard member, Muskegon Community Health [email protected] | 231.206.5808

Jennifer Stewart, Supports Supervisor, Community Mental Health of Muskegon [email protected] | 231.724.1161


COMMITTEE

Program/Personnel/Rights Committee

BUDGETED NON BUDGETED PARTIALLY BUDGETED

X

REQUESTING DIVISION

Administration

REQUEST DATE

April 12, 2019

REQUESTOR SIGNATURE

Janet Thomas, Board Chair


The HealthWest Board Chair, Ms. Janet Thomas, is requesting confirmation of the following Committee appointments:

Mr. Jason Coleman to be appointed as a member of the HealthWest Finance Committee effective April 26, 2019.

Ms. Stephanie Umlor to be appointed as a member of the HealthWest Finance Committee effective April 26, 2019.

Commissioner Marcia Hovey-Wright to be appointed as a member of the HealthWest Finance Committee effective April 26, 2019.

Ms. Janine Norwood to be appointed as a member of the HealthWest Program/Personnel/Recipient Rights Advisory Committee effective April 26, 2019.

Mr. Thomas Hardy to be appointed as a member of the HealthWest Program/Personnel/Recipient Rights Advisory Committee effective April 26, 2019.


I move to confirm the appointment of Mr. Jason Coleman, Ms. Stephanie Umlor, and Commissioner Marcia Hovey-Wright as members of the HealthWest Finance Committee and Ms. Janine Norwood as a member of the Program/Personnel/Recipient Rights Advisory Committee effective April 26, 2019.

COMMITTEE DATE COMMITTEE APPROVAL

Yes No Other

BOARD DATE BOARD APPROVAL

Yes No Other

HWB 088-P

amber.berndt

Typewriter

Amended Attachment #2


COMMITTEEProgram/Personnel Committee

BUDGETED NON BUDGETED PARTIALLY BUDGETEDX



REQUESTOR SIGNATUREBrandy Carlson, Chief Financial Officer


Request for Waiver Coordinator Position

Coordination of waiver programs is currently being handled by multiple employees throughout HealthWestand the LRE. In preparation of moving towards the 298 Pilot, HealthWest is requesting the addition of aWaiver Coordinator Position to process all waiver programs and HCBS surveys. Once we enter the 298Pilot, we will be required to manage additional work the LRE is currently doing. In order to meet all thedemands of the multiple waiver programs, we feel strongly that we need an individual committed solely tothese needs.


I move to authorize the addition of a Waiver Coordinator position (Pay grade HX-00160, funding org 7705)effective April 26, 2019.



HWB 089- P

amber.berndt

Typewriter

Amended Attachment #3

amber.berndt

Typewriter

The County of Muskegon will provide necessary reasonable auxiliary aids and services, such as signers for the hearing impaired and audiotapes of printed materials being considered at the meeting, to individuals with disabilities who want to attend the meeting, upon 24-hoursnotice to the County of Muskegon. Individuals with disabilities requiring auxiliary aids or services should contact the County of Muskegonby writing or calling Administration, Hall of Justice, Fourth Floor, 990 Terrace Street, Muskegon, MI 49442 (231) 724-6505, TDD (231) 722-4103.

RECIPIENT RIGHTS ADVISORY COMMITTEE

April 12, 2019 – 8:00 a.m.Mental Health Center – Board Room

Recipient Rights Committee Chair: John SchrierRecipient Rights Committee Vice-Chair: Stephanie Umlor

REVISED AGENDA

1) Call to Order Quorum

2) Approval of Minutes of February 2019 Action(Previously Forwarded)

3) Items for Consideration

A. Motion to Accept Recipient Rights Bi-Monthly Report for February/ ActionMarch 2019(Attachment #1)

B. Flatrock Manor – Prone Immobilization Information(Attachment #2)

4) Old Business Information

5) New Business Information

6) Communications Information

7) Director's Comments Information

8) Audience Participation Information

9) Adjournment


COMMITTEERecipient Rights Advisory Committee

BUDGETED NONBUDGETED PARTIALLY BUDGETEDX



REQUESTOR SIGNATUREJulia Rupp, Executive Director


Approval is requested to accept the Recipient Rights Report of February/March 2019. The report includes:

· Training sessions conducted by the Rights Office in February/March 2019.· Site Reviews in February/March 2019.· Incident Reports and Rights Allegations for February/March 2019.· Formal Complaints and Interventions for February/March 2019.· Deaths reported for February/March 2019.


I move to approve the Recipient Rights Report for the month of February/March 2019.



HWB 091-R

amber.berndt

Typewriter

Attachment #1

BI-MONTHLY RECIPIENT RIGHTS REPORT

Date: April 12, 2019

To: Recipient Rights Advisory Committee

From: The Office of Recipient Rights

Subject: Recipient Rights Report for February and March 2019

I. TRAINING

A. February 4, 2019, SUD Orientation for 3 Muskegon Recovery Center outpatient CherryHealth employees.

B. February 12, 2019, Rights Update for 15 MI Adult Supports Coordination case

management HealthWest employees.

C. February 12, 2019, SUD Rights Update for 11 Muskegon Recovery Center outpatient

Cherry Health employees.

D. February 13, 2019, New Employee Training for 4 HealthWest and 11 Provideremployees.

E. February 15, 2019, Rights Update for 5 HealthWest and 3 Provider employees.

F. February 22, 2019, SUD Rights Update for 3 Muskegon Recovery Center outpatient

Cherry Health employees.

G. February 25, 2019, SUD Rights Update for 1 Muskegon Recovery Center outpatient

Cherry Health employee.

H. February 27, 2019, New Employee Training for 2 HealthWest and 12 Provideremployees.

I. March 7, 2019, Rights Update for 14 MI Adult Supports Coordinators case management

HealthWest employees.

J. March 13, 2019, New Employee Training for 1 HealthWest and 11 Provideremployees.

K. March 15, 2019, Rights Update for 8 HealthWest and 1 Provider employees.

Recipient Rights ReportApril 12, 2019Page 2 of 7

L. March 27, 2019, New Employee Training for 9 Provider employees.

Forty-nine HealthWest and 65 Provider employees were trained for the months ofFebruary and March.

II. STATISTICAL INFORMATION

The Office of Recipient Rights received 575 incident reports and 32 rights allegations forthe months of February and March. Provided for your review is the statistical datashowing type and location.

III. FORMAL INVESTIGATIONS

Old Business:

A. December 17, 2018, out of county Flatrock Manor of Fenton mixed residential Flatrock Manor aResident was found with unexplained bruises. The allegation of SERVICESSUITED TO CONDITION is NOT SUBSTANTIATED.

B. January 4, 2019, Brinks Crisis Residential mixed residential HealthWest a Resident askedthe Mental Health Worker for a razor and was told “Shut up and get out of my face.”The Mental Health Worker then turned to a co-worker and said, “She talks to d---nmuch!” The investigation into the allegation of DIGNITY AND RESPECT isNOT SUBSTANTIATED.

C. January 10, 2019, Eastwood Cottage I mixed residential Turning Leaf ResidentialRehabilitation Services two Residents were missing 30 days’ worth of theirmedications from the pharmacy delivery. The allegation of SERVICES SUITEDTO CONDITION is SUBSTANTIATED. The Staff did not follow the standardof practice for checking the medication delivery, so there was no way to know ifthe medication was actually delivered. The Staff received written reprimandsand additional training.

D. January 10, 2019, Walker residential DD HGA Non-Profit Homes Inc. a Resident is nothaving her C-PAP machine applied as required by her plan of service. Theallegation of SERVICES SUITED TO CONDITION is SUBSTANTIATED. TheResponsible Staff received written warnings, and the lead Staff received alsoreceived a one day suspension.

E. January 10, 2019, Slocum residential DD MOKA Non-Profit Services Corp. a Staff begantalking about a Resident in uncomplimentary terms in front of him and the otherResidents. The allegation of DIGNITY AND RESPECT is SUBSTANTIATED.The Staff received verbal counseling.


F. January 10, 2019, ACT Program ACT HealthWest a Recipient is not allowed to livewith her boyfriend, and he is not allowed to participate in her medication reviews.The allegation of SERVICES SUITED TO CONDITION is NOTSUBSTANTIATED.

G. January 15, 2019, Northridge mixed residential Turning Leaf Residential RehabilitationServices two Staff are mistreating and antagonizing the Residents. The allegation ofDIGNITY AND RESPECT is SUBSTANTIATED. The Staff left employmentwith Turning Leaf Residential Rehabilitation Services before the end of theinvestigation.

H. January 15, 2019, Eastwood SIL sip Turning Leaf Residential Rehabilitation Servicesa Resident was missing three Tramadol from medication storage. The allegation ofPOSSESSION AND USE is SUBSTANTIATED. The Staff was terminated fromemployment, additional secure storage has been purchased, and alternativepharmaceutical packaging is being explored.

I. January 25, 2019, Mary’s House residential DD Covenant Enabling Residences ofMichigan Inc. the Residents do not receive their money before scheduled outings,they have been placed on portion controls regarding food without being addressed intheir plans of service, they are not allowed to spend their money as they wish, theyare not allowed to use ketchup, One resident is denied coffee if she wet the bed thenight before, One Resident was told to stop saying she was going to kill herself andjust do it, the charger for the IPad of a Resident was broken by a Staff who was “sickof her sh-t,” One Resident is made to stay in her room if she misbehaves, andResidents’ belongings are searched without permission. The allegation ofSERVICES SUITED TO CONDITION is SUBSTANTIATED. The charger wasreplaced. New policies have been implemented to address the other citedviolations. All staff have been trained on the new policies.

New Business:

A. February 6, 2019, out of county Flatrock Manor of Lapeer mixed residential Flatrock Manor Inc.Michigan Protection and Advocacy file a Complaint involving an incident thatoccurred in February 2018 involving a Resident from Muskegon who had beeninjured by another Resident. In addition they state the Guardian was not informed ina timely way. The Muskegon Resident was moved to Muskegon County a few weeksafter the incident occurred. The allegations of SAFE ENVIRONMENT andDIGNITY AND RESPECT (FAMILY) are NOT SUBSTANTIATED.

B. February 14, 2019, Pioneer Resources Community Living Supports other PioneerResources the fourth quarter documentation for the Recipient’s occupational therapywas not done. The allegation of SERVICES SUITED TO CONDITION is NOTSUBSTANTIATED. This is not a covered Community Living Supports service.


This is eligible for Adult Home Help through the Department of Health andHuman Services.

C. February 14, 2019, HGA Support Services other HGA Non-Profit Homes Inc. aBehavior Analyst Technician pushed the Recipient down in response to having beenpushed. The allegation of ABUSE II – UNREASONABLE FORCE isSUBSTANTIATED. The Staff left employment with HGA Non-Profit HomesInc. before the completion of the investigation.

D. February 14, 2019, Beacon Home at Blue Lake mixed residential Beacon SpecializedLiving Services a Resident was held down by a Staff causing bruises. The allegationof ABUSE II – UNREASONABLE FORCE is NOT SUBSTANTIATED. Theallegation of FAILURE TO REPORT is SUBSTANTIATED. The Staff receiveda written reprimand and additional training.

E. February 15, 2019, Pioneer Plus (Community Connections) other Pioneer Resourcesthe fourth quarter documentation for the Recipient’s occupational therapy was notdone. The allegation of SERVICES SUITED TO CONDITION is NOTSUBSTANTIATED. This is a Community Living Supports program, and this isnot a covered Community Living Supports service.

F. February 16, 2019, Mental Health Center other HealthWest a Recipient of Adult MIServices was treated rudely by Staff at the front desk. The allegation of DIGNITYAND RESPECT is SUBSTANTIATED. The plan of action has not beenreceived.

G. February 19, 2019, Oxford Circle mixed residential MOKA Non-Profit Services Corp. aStaff became loud and angry with a Resident and then punched the wall in anger overchanging the toilet paper. The allegation of ABUSE III is SUBSTANTIATED.The Staff was terminated from employment.

H. February 20, 2019, Pioneer Resources other a Recipient’s full name and information ontheir treatment status was posted on the Pioneer Resources Facebook page withoutauthorization from the Recipient’s Guardian. The allegation of DISCLOSURE OFCONFIDENTIAL INFORMATION is SUBSTANTIATED. The post was takendown and an apology was sent to the guardian.

I. February 28, 2019, Psychiatric Services outpatient HealthWest during a medicationreview after acknowledging the use of medical marijuana, the Prescriber said to theStaff in front of the Recipient, “He is a hopeless case.” The allegation of DIGNITYAND RESPECT is SUBSTANTIATED. The plan of action has not beenreceived.


J. March 1, 2019, Graceland mixed residential MOKA Non-Profit Services Corp. a Staffyelled a Resident to “shut up!” The allegation of DIGNITY AND RESPECT isSUBSTANTIATED. The Staff received a written reprimand.

K. March 5, 2019, Graceland mixed residential MOKA Non-Profit Services Corp. on twooccasions, Staff failed to administer the Resident’s enema as required by their plan ofservice. The allegation of NEGLECT III is SUBSTANTIATED. The plan ofaction has not been received.

L. March 5, 2019, Walker residential DD HGA Non-Profit Homes Inc., a Resident’smedications have not been administered as prescribed, and there have been numerousdocumentation errors for an extended period. The allegation of SERVICESSUITED TO CONDITION is SUBSTANTIATED. The plan of action has notbeen received.

M. March 12, 2019, Lakeview Manor mixed residential Beacon Specialized Living Services aResident was verbally aggressive towards a Staff who pushed him three times inresponse. The investigation into the allegation of ABUSE II NON-ACCIDENTAL ACT is not complete.

N. March 13, 2019, Brookmere mixed residential MOKA Non-Profit Services Corp. Staff kepttelling one Resident he had to stay in his bedroom and another Resident she had tostay sitting in her chair. The investigation into the allegation of DIGNITY ANDRESPECT is NOT COMPLETE.

O. March 15, 2019, MOKA Van other MOKA Non-Profit Services Corp. a van wasobserved at a private residence with Recipients inside and staff coming and goingfrom the house. The investigation into the allegation of NEGLECT III is notcomplete.

P. March 19, 2019, Lakeview Manor mixed residential Beacon Specialized Living Services aStaff treats a Resident in a racist and disrespectful manner. The investigation intothe allegation of DIGNITY AND RESPECT is not complete.

Q. March 21, 2019, Eastwood Cottage I mixed residential Turning Leaf ResidentialRehabilitation Services a Staff was sleeping on the job. The allegations ofNEGLECT III and NEGLECT III – FAILURE TO REPORT areSUBSTANTIATED. The plan of action has not been received.

R. March 25, 2019, MI Adult Supports Coordination/ Office of Recipient Rights case

management HealthWest the paperwork the Recipient has requested to be completed forthe Michigan State Housing Development Authority has not been completed, and theRecipient Rights Officer is biased against the Recipient. The investigation into theallegation of SERVICES SUITED TO CONDITION has been assigned to the


Community Mental Health Ottawa County Office of Recipient Rights in order toavoid any conflict of interest.

S. March 27, 2019, out of county Beacon Springs mixed residential Beacon Specialized LivingServices the Licensing Consultant for the Bureau of Licensing and RegulatoryAffairs, while conducting an unrelated investigation, was made aware that a Residentwas taken to the floor and held in a prone position. The investigation into theallegation of ABUSE II – UNREASONABLE FORCE is not complete.

T. March 28, 2019, out of county River Valley 1 mixed residential Hope Network BehavioralHealth Services a Staff is refusing to administer medications to the Resident, becauseshe is afraid of him. The investigation into the allegation of SERVICES SUITEDTO CONDITION is not complete.

IV. INTERVENTIONS

Old Business:

None

New Business:

A. January 27, 2019, Brinks Crisis Residential mixed residential HealthWest a Resident fromWest Michigan Community Mental Health was called a “dumb f---ing b---ch” by theResident Care Supervisor when she asked for a glass of water. OUTSIDEPROVIDER JURISDICTION this matter was referred to the West MichiganCMH Office of Recipient Rights for investigation.

B. March 1, 2019, MI Adults Supports Coordination case management HealthWest a Recipientwas upset with how the Muskegon Police Department treated them when theyexecuted a pick-up order for hospitalization. OUTSIDE PROVIDERJURISDICTION the Recipient was given the contact information to file acomplaint with the Muskegon Police Department.

C. March 4, 2019, DD Adult Supports Coordination case management HealthWest a Recipientis not receiving the amount of Adult Home Help services from the Department ofHealth and Human Services. NO RIGHT INVOLVED this is not a HealthWestprovided service. The Recipient’s Supports Coordinator is working with DHHSand the Recipient to facilitate a resolution.

V. SUBSTANCE USE DISORDER

Old Business:

None


New Business:

None

VI. DEATHS

A. December 23, 2018, a 37 year old male Recipient died of unknown natural causeswhile at his family’s cabin for Christmas.

B. February 9, 2019, a 66 year old male Recipient living at Lawrence residential DD PioneerResources died from an apparent heart attack. This was the same individual that wasthe victim of physical abuse that resulted in a spiral fracture of his femur.

C. February 19, 2019, a 53 year old male Recipient living at Ducey Residential DD Samaritasdied from aspiration pneumonia.

D. March 21, 2019, a 48 year old male Recipient receiving MI Adult SupportsCoordination committed suicide by overdose in the community.

Recipient Rights Summary by Incident Type w/Action

For the Period from October 1, 2018

Friday, March 29, 2019

This Report Printed:

9:51:22 AM

through March 31, 2019

Recipient Rights Violations reported grouped by MDCH Violation Code, sorted in ascending order by date of occurrence, with subtotals by

group and grand totals.

Reported Incidents by State Violation Code

Communication and Visits

7266 Uncensored MailActions by Provider ResolutionActions by ORR

2018-84656 N.V. 49 F10/23/18 Other Investigation Not Substantiated

Reported Incidents for this Code: 1

Reported Incidents for this Group: 1

Confidentiality/Privileged Communication/Disclosure

7481 Disclosure of Confidential InformationActions by Provider ResolutionActions by ORR

2018-85025 D.R. 55 M12/03/18 Verbal Counseling Investigation Substantiated

2019-85776 M.V. 27 M02/18/19 Environmental Repair/Enhan Investigation Substantiated



Financial Rights

7360 Labor & CompensationActions by Provider ResolutionActions by ORR

2018-84652 N.V. 49 F10/23/18 Other Investigation Not Substantiated



Freedom from Abuse

72221 Abuse Class II - Non-Accidental ActActions by Provider ResolutionActions by ORR

2018-84811 J.E. 66 M11/15/18 Other Investigation Not Substantiated

2019-86062 E.G. 26 M03/12/19 Investigation

2018-84223 R.N. 44 M10/04/18 Employment Termination Investigation Substantiated

2018-84757 H.T. 57 F11/05/18 Other Investigation Not Substantiated

2018-84758 D.J. 71 M11/13/18 Other Investigation Not Substantiated


72222 Abuse, Class II - Unreasonable ForceActions by Provider ResolutionActions by ORR

2019-85674 B.C. 21 F02/09/19 Other Investigation Not Substantiated

2019-86391 T.K. 58 M03/13/19 Investigation

2019-85673 L.J. 11 M02/05/19 Employee Left the Agency, b Investigation Substantiated


7223 Abuse Class IIIActions by Provider ResolutionActions by ORR

2018-84655 B.D. 31 F10/23/18 Other Investigation Not Substantiated



Freedom from Neglect

72261 Neglect Class IIActions by Provider ResolutionActions by ORR

2018-84844 P.D. 66 M11/18/18 Written Reprimand Investigation Substantiated

Page 1 of 4



72271 Neglect Class IIIActions by Provider ResolutionActions by ORR

2018-84845 I.C. 23 F11/18/18 Employee Left the Agency, b Investigation Substantiated

2019-86380 M.H. 61 F03/07/19 Investigation Substantiated

2019-86337 E.R. 35 F03/07/19 Investigation Substantiated

2019-86381 B.J. 59 F03/07/19 Investigation Substantiated

2019-86382 P.G. 69 F03/07/19 Investigation Substantiated

2019-86383 R.T. 52 F03/07/19 Investigation Substantiated

2019-86384 A.B. 67 F03/07/19 Investigation Substantiated

2018-84846 D.R. 59 M11/18/18 Employee Left the Agency, b Investigation Substantiated

2018-84708 J.T. 30 F10/25/18 Written Reprimand Investigation Substantiated

2019-86065 M.D.01/31/19 Investigation


72272 Neglect, Class III - Failure to ReportActions by Provider ResolutionActions by ORR

2019-86390 A.B. 67 F03/07/19 Investigation Substantiated

2019-86386 M.H. 61 F03/07/19 Investigation Substantiated

2019-86389 R.T. 52 F03/07/19 Investigation Substantiated

2019-86385 E.R. 35 F03/07/19 Investigation Substantiated

2019-86387 B.J. 59 F03/07/19 Investigation Substantiated

2019-86388 P.G. 69 F03/07/19 Investigation Substantiated



No Right Involved

0000 No Right InvolvedActions by Provider ResolutionActions by ORR

2019-85962 R.B. 64 F02/14/19 Other Intervention Referral

2018-85251 W.P. 4112/21/18 Other Intervention Referral

2019-85963 A.F. 46 F02/26/19 Other Intervention Referral

2018-84220 C.M. 22 M10/01/18 Other Intervention Not Substantiated

2018-84441 S.N. 49 F10/12/18 Other Intervention Not Substantiated

2019-85471 S.N. 50 F01/25/19 Other Intervention Referral



Outside Provider Jurisdiction

0001 Outside Provider JurisdictionActions by Provider ResolutionActions by ORR

2018-84219 C.M. 22 M10/02/18 Other Intervention Not Substantiated

2018-85252 R.C. 4312/20/18 Other Intervention Referral

2019-86379 L.B. 48 M03/25/19 Intervention

2019-85485 K.D. 24 F01/26/19 Other Intervention Referral



Personal Property

7281 Possession and UseActions by Provider ResolutionActions by ORR

2019-85427 K.H. 42 M12/24/18 Written Reprimand Investigation Substantiated

2018-85231 J.W. 53 F12/19/18 Other Investigation Not Substantiated

2019-85428 M.T. 60 M12/24/18 Training Investigation Substantiated

2019-85456 L.B. 45 F01/14/19 Employment Termination Investigation Substantiated


Page 2 of 4



Rights Protection System

7520 Failure to ReportActions by Provider ResolutionActions by ORR

2019-86061 B.C. 21 F02/09/19 Written Reprimand Investigation Substantiated


7545 Retaliation/HarassmentActions by Provider ResolutionActions by ORR

2018-85092 B.D. 31 F10/23/18 Other Investigation Not Substantiated

2018-85184 J.E. 66 M11/26/18 Other Investigation Not Substantiated


7840 Appeal/MediationActions by Provider ResolutionActions by ORR

2019-85361 J.T. 30 F10/25/18 Other Grievance/Dispute Review Grievance/Dispute Denied



Substance Abuse

0300 Substance Abuse ComplaintActions by Provider ResolutionActions by ORR

2018-84843 K.M. 38 F11/14/18 Investigation



Suitable Services

7080 Services Suited to Condition/MedicationActions by Provider ResolutionActions by ORR

2019-85468 E.K. 35 F01/25/19 Policy Revision/Development Investigation Substantiated

2019-86392 A.B. 69 M03/26/19 Investigation

2019-85467 B.G. 44 F01/25/19 Policy Revision/Development Investigation Substantiated

2019-85470 C.O. 33 F01/25/19 Environmental Repair/Enhan Investigation Substantiated

2019-85670 A.P. 35 F02/11/19 Other Investigation Not Substantiated

2019-85426 L.K. 56 F12/02/18 Written Reprimand Investigation Substantiated

2019-86023 L.K. 57 F03/05/19 Investigation Substantiated

2019-85466 S.C. 39 F01/25/19 Policy Revision/Development Investigation Substantiated

2018-84651 J.R. 66 F10/21/18 Suspension Investigation Substantiated

2019-85469 B.N. 48 F01/25/19 Policy Revision/Development Investigation Substantiated

2019-85425 C.M. 47 F01/09/19 Other Investigation Not Substantiated

2018-85024 B.M. 42 M10/26/18 Other Investigation Not Substantiated

2019-85675 K.D. 32 F02/10/19 Other Investigation Not Substantiated

2019-85998 N.I. 46 F02/26/19 Investigation Substantiated

2018-84710 X.S. 23 M11/06/18 Other Investigation Not Substantiated

2018-85185 D.D. 23 F12/16/18 Other Investigation Not Substantiated

2018-84222 V.P. 59 M10/02/18 Plan of Service Revision Investigation Substantiated

2018-84948 J.E. 66 M11/15/18 Verbal Counseling Investigation Substantiated



Treatment Environment

1708 Dignity & RespectActions by Provider ResolutionActions by ORR

2019-85362 S.H. 22 F01/01/19 Other Investigation Not Substantiated

2018-84573 A.C. 27 F10/15/18 Other Investigation Not Substantiated

2018-84688 M.F. 65 M11/30/18 Employment Termination Investigation Substantiated

Page 3 of 4


2019-85676 J.W. 23 M02/17/19 Employment Termination Investigation Substantiated

2018-84653 J.K. 41 F10/05/18 Other Investigation Not Substantiated

2019-85890 S.T. 49 F01/16/19 Investigation Substantiated

2018-84654 J.K. 41 F10/14/18 Other Investigation Not Substantiated

2019-86063 J.J. 57 M03/04/19 Investigation

2018-84709 N.C. 28 M10/24/18 Verbal Counseling Investigation Substantiated

2018-84575 C.A. 64 M10/22/18 Written Counseling Investigation Substantiated

2019-86103 E.G. 26 F03/18/19 Investigation

2019-85455 D.K. 43 M01/10/19 Verbal Counseling Investigation Substantiated

2018-84687 D.C. 34 F10/30/18 Employment Termination Investigation Substantiated

2019-85672 S.B. 21 F01/15/19 Employee Left the Agency, b Investigation Substantiated

2019-85671 R.R. 46 M01/15/19 Employee Left the Agency, b Investigation Substantiated

2018-84574 K.B. 52 F10/23/18 Other Investigation Not Substantiated

2019-85457 E.G. 68 M01/15/19 Employee Left the Agency, b Investigation Substantiated

2019-85961 S.C. 68 F02/27/19 Written Reprimand Investigation Substantiated

2018-84912 D.P. 41 M11/19/18 Suspension Investigation Substantiated

2019-85959 C.W. 31 M02/26/19 Investigation Substantiated

2018-84234 L.K. 56 F10/04/18 Written Reprimand Investigation Substantiated

2018-84576 S.M. 61 F10/22/18 Written Counseling Investigation Substantiated

2019-86064 L.P. 59 F03/04/19 Investigation


7081 SafetyActions by Provider ResolutionActions by ORR

2018-84227 S.A. 30 M10/02/18 Verbal Counseling Investigation Substantiated

2018-84228 J.L. 31 F10/02/18 Verbal Counseling Investigation Substantiated

2018-84221 Z.P. 26 M10/02/18 Verbal Counseling Investigation Substantiated

2018-84225 J.G. 33 F10/02/18 Verbal Counseling Investigation Substantiated

2018-84226 M.V. 26 M10/02/18 Verbal Counseling Investigation Substantiated

2018-84224 K.B. 32 M10/02/18 Verbal Counseling Investigation Substantiated

2018-84229 D.S. 35 F10/02/18 Verbal Counseling Investigation Substantiated

2018-84230 L.K. 21 F10/02/18 Verbal Counseling Investigation Substantiated

2018-84231 T.K. 54 F10/02/18 Verbal Counseling Investigation Substantiated

2018-84232 A.S. 32 M10/02/18 Verbal Counseling Investigation Substantiated

2018-84233 K.D. 56 F10/02/18 Verbal Counseling Investigation Substantiated



Report rRecipient Rights Violations - State Codes w/Action based on

Query qRecipient Rights Violations - State Codes Rev 060898

Reported Incidents for this Period: 101

Page 4 of 4

Recipient Rights Summary by Incident Type

For the Period from February 1, 2019



9:53:18 AM


Recipient Rights Violations reported grouped by MDCH Violation Code, sorted in ascending order by date of occurrence, with subtotals by

group and grand totals.


Confidentiality/Privileged Communication/Disclosure

7481 Disclosure of Confidential Information

2019-85776 M.V. 27 M02/18/19



Freedom from Abuse

72221 Abuse Class II - Non-Accidental Act

2019-86062 E.G. 26 M03/12/19


72222 Abuse, Class II - Unreasonable Force

2019-85674 B.C. 21 F02/09/19

2019-86391 T.K. 58 M03/13/19

2019-85673 L.J. 11 M02/05/19



Freedom from Neglect

72271 Neglect Class III

2019-86337 E.R. 35 F03/07/19

2019-86381 B.J. 59 F03/07/19

2019-86380 M.H. 61 F03/07/19

2019-86384 A.B. 67 F03/07/19

2019-86383 R.T. 52 F03/07/19

2019-86382 P.G. 69 F03/07/19


72272 Neglect, Class III - Failure to Report

2019-86387 B.J. 59 F03/07/19

2019-86390 A.B. 67 F03/07/19

2019-86385 E.R. 35 F03/07/19

2019-86388 P.G. 69 F03/07/19

2019-86389 R.T. 52 F03/07/19

2019-86386 M.H. 61 F03/07/19



No Right Involved

0000 No Right Involved

2019-85962 R.B. 64 F02/14/19

2019-85963 A.F. 46 F02/26/19



Outside Provider Jurisdiction

0001 Outside Provider Jurisdiction

2019-86379 L.B. 48 M03/25/19



Rights Protection System

7520 Failure to Report

2019-86061 B.C. 21 F02/09/19



Suitable Services

7080 Services Suited to Condition/Medication

2019-86392 A.B. 69 M03/26/19

2019-85675 K.D. 32 F02/10/19

2019-85670 A.P. 35 F02/11/19

2019-85998 N.I. 46 F02/26/19

2019-86023 L.K. 57 F03/05/19



Treatment Environment

1708 Dignity & Respect

2019-85961 S.C. 68 F02/27/19

2019-85959 C.W. 31 M02/26/19

2019-86063 J.J. 57 M03/04/19

2019-86064 L.P. 59 F03/04/19

2019-86103 E.G. 26 F03/18/19

2019-85676 J.W. 23 M02/17/19



Page 1 of 2


Report rRecipient Rights Violations - State Codes based on Query

qRecipient Rights Violations - State Codes Rev 060898


Page 2 of 2

Recipient Rights Summary by Incident Type

For the Period from February 1, 2019



9:54:34 AM


Recipient Rights Violations reported grouped by CMH Violation Code, sorted in ascending order by date of occurrence, with subtotals by group

and grand totals.

Reported Incidents by Local Violation Code

Incident Type

0100 Aggressive Target

2019-86008 S.C. 6802/27/19

2019-85938 A.M. 1502/20/19

2019-86333 A.V. 503/15/19

2019-86394 C.H. 5703/04/19

2019-86396 S.F. 4203/08/19

2019-86397 S.T. 2803/09/19

2019-85870 D.P. 4202/06/19

2019-86400 S.F. 4203/04/19

2019-86022 R.A. 902/28/19

2019-86395 C.H. 5703/09/19

2019-85980 M.B. 3002/17/19

2019-85895 E.G. 2602/17/19

2019-86124 L.P. 5903/06/19

2019-86038 J.H. 1503/01/19

2019-86348 I.C. 2403/21/19

2019-85820 A.C. 1502/11/19

2019-85929 M.T. 6102/10/19

2019-86027 T.D. 702/24/19

2019-85981 J.D. 4502/17/19

2019-85988 A.L. 602/21/19

2019-85742 S.M. 1402/04/19

2019-86123 J.J. 5703/06/19

2019-86349 D.R. 6003/21/19


0102 Disruptive Behavior

2019-85730 C.P. 1902/05/19

2019-86402 T.E. 4503/14/19

2019-85690 E.G. 2602/02/19

2019-85698 D.P. 4202/03/19

2019-86179 A.B. 6703/11/19

2019-86393 N.I. 4603/10/19

2019-85747 P.M. 5602/03/19

2019-85711 E.J. 6902/02/19

2019-85787 B.J. 5902/07/19

2019-86168 T.G. 4503/01/19

2019-85860 A.D. 1902/10/19

2019-86127 R.B. 4803/12/19

2019-85748 B.H. 1202/05/19

2019-86373 A.E. 2803/14/19

2019-85760 C.P. 1902/05/19

2019-86120 E.G. 2603/12/19

2019-85786 J.M. 3202/05/19

2019-86116 D.B. 2303/10/19

2019-85780 K.H. 4302/07/19

2019-86034 R.T. 5203/04/19

2019-85785 B.J. 5902/07/19

2019-85733 D.B. 2302/04/19

2019-85788 B.J. 5902/08/19

2019-86119 E.G. 2603/11/19

2019-85835 K.H. 4302/12/19

2019-86098 K.H. 4303/05/19

2019-86114 N.P. 3903/11/19

2019-85804 N.B. 2302/08/19

2019-86093 K.S. 503/07/19

2019-85814 R.W. 5602/03/19

2019-86339 D.S. 5203/16/19

2019-85837 K.H. 4302/12/19

2019-86113 E.G. 2603/10/19

2019-86347 A.B. 6903/21/19

2019-85832 B.J. 5902/13/19

2019-86371 J.M. 3203/13/19

2019-86139 N.I. 4603/06/19

2019-86136 S.C. 6803/06/19

2019-85833 B.J. 5902/12/19

2019-86115 S.S. 5603/11/19

2019-86340 D.B. 2303/17/19

2019-85822 I.C. 2402/11/19

2019-85836 K.H. 4302/12/19

2019-86178 E.R. 3503/13/19

2019-85784 K.H. 4302/07/19

2019-86137 S.F. 4203/06/19

2019-86138 S.T. 2803/06/19

2019-86096 K.H. 4303/08/19

2019-85885 P.S. 2202/03/19

2019-86019 S.K. 4102/28/19

2019-86021 A.B. 6702/27/19

2019-85982 S.C. 6802/18/19

2019-86087 E.G. 2603/07/19

2019-86086 E.G. 2603/07/19

2019-85927 J.M. 3202/10/19

2019-85892 E.G. 2602/14/19

2019-86314 E.G. 2603/16/19

2019-86312 N.D. 2603/14/19

2019-86320 J.M. 3203/15/19

2019-86018 E.G. 2602/27/19

2019-86309 J.M. 3203/13/19

2019-86234 A.W. 6902/22/19

2019-85883 P.S. 2202/01/19

2019-86310 J.M. 3203/13/19

2019-85897 A.D. 1902/17/19

2019-85905 D.B. 2302/10/19

2019-86070 T.C. 5303/05/19

2019-85917 K.A. 1802/19/19

2019-86261 J.H. 3603/04/19

2019-86327 F.B. 5102/24/19

2019-85752 H.D. 5802/06/19

2019-86224 J.H. 3602/09/19

2019-85893 S.K. 4102/17/19

2019-85901 B.J. 5902/14/19

2019-85975 C.H. 5702/16/19

Page 1 of 7


2019-86017 D.W. 3702/27/19

2019-85940 A.D. 1902/20/19

2019-86057 S.M. 2902/27/19

2019-86053 T.C. 5303/04/19

2019-85951 B.J. 5902/17/19

2019-86328 K.S. 2203/06/19

2019-85952 B.D. 3202/21/19

2019-85856 E.G. 2602/12/19

2019-85957 E.G. 2602/22/19

2019-86058 S.M. 2902/27/19

2019-85936 E.G. 2602/20/19

2019-86035 R.T. 5203/04/19

2019-86012 J.H. 6902/20/19

2019-86251 L.P. 5902/21/19

2019-86006 E.G. 2602/26/19

2019-85970 J.D. 4502/12/19

2019-86000 B.J. 5902/26/19

2019-85979 M.B. 3002/16/19

2019-85992 B.D. 3202/23/19

2019-86287 J.P. 403/12/19

2019-86044 D.S. 3102/27/19

2019-85928 J.M. 3202/11/19

2019-86001 E.R. 3502/21/19


0103 Charting Error

2019-86195 L.K. 5702/22/19

2019-86191 L.K. 5703/08/19

2019-86305 L.J. 6703/02/19

2019-86197 L.K. 5703/07/19

2019-86192 L.K. 5703/08/19

2019-86193 L.K. 5703/07/19

2019-86306 L.J. 6703/03/19

2019-86194 L.K. 5703/04/19


0105 Treatment Error

2019-86241 J.W. 6002/25/19


0106 Medication Refused

2019-85990 T.H. 2502/20/19

2019-86032 R.B. 4803/02/19

2019-86180 C.P. 1903/09/19

2019-85707 L.P. 3202/01/19

2019-85817 C.P. 1902/10/19

2019-85923 C.P. 1902/18/19

2019-85924 A.B. 6902/16/19

2019-85925 A.B. 6902/17/19

2019-85946 D.B. 2302/21/19

2019-85947 D.B. 2302/19/19

2019-85989 D.B. 2302/19/19

2019-85993 B.D. 3202/23/19

2019-86025 R.B. 4802/28/19

2019-85763 H.D. 5802/07/19

2019-85908 C.P. 1902/13/19

2019-86072 A.B. 6903/05/19

2019-86074 A.B. 6902/28/19

2019-85956 R.B. 4802/24/19

2019-85829 L.P. 3202/06/19

2019-85709 C.R. 5802/03/19

2019-86066 T.H. 2503/02/19

2019-86321 B.J. 5903/16/19

2019-86288 D.B. 2303/14/19

2019-86346 A.B. 6903/21/19

2019-86231 L.C. 7202/14/19

2019-86323 D.B. 2303/15/19

2019-85828 L.P. 3202/05/19

2019-85904 D.B. 2302/12/19

2019-85830 L.P. 3202/07/19

2019-85834 K.H. 4302/11/19

2019-85859 C.B. 6702/10/19

2019-85894 R.B. 4802/16/19

2019-85898 C.P. 1902/16/19

2019-85902 A.B. 6902/15/19

2019-85903 D.B. 2302/13/19

2019-85913 D.B. 2302/16/19

2019-86076 A.B. 6903/03/19

2019-85791 C.P. 1902/05/19

2019-85816 C.P. 1902/09/19

2019-85912 S.N. 5002/15/19

2019-86106 A.B. 6903/06/19

2019-86068 T.H. 2503/02/19

2019-86051 S.N. 5003/03/19

2019-85778 D.B. 2302/06/19

2019-86075 A.B. 6903/01/19

2019-86067 T.H. 2503/03/19

2019-86100 P.M. 5703/05/19

2019-86095 D.B. 2303/06/19

2019-86094 D.B. 2303/07/19

2019-85906 D.B. 2302/14/19

2019-86169 T.I. 3102/28/19

2019-85750 H.D. 5802/06/19

2019-85710 C.R. 5802/03/19

2019-86111 S.N. 5003/09/19

2019-85739 R.B. 4802/05/19

2019-85732 D.B. 2302/04/19

2019-85736 H.D. 5802/05/19

2019-86073 A.B. 6902/28/19

2019-85738 D.B. 2302/04/19

2019-85777 D.B. 2302/09/19

2019-85740 D.B. 2302/05/19

2019-85746 A.B. 6902/03/19

2019-85749 H.D. 5802/07/19

2019-85827 L.P. 3202/04/19

2019-85772 H.D. 5802/08/19

2019-85825 L.P. 3202/09/19

2019-85764 H.D. 5802/08/19

2019-85768 R.B. 4802/10/19

2019-85769 D.R. 6002/09/19

2019-85753 H.D. 5802/07/19

2019-85737 H.D. 5802/05/19

2019-85773 H.D. 5802/08/19


0107 Medication Error - Time

2019-86177 S.F. 1302/22/19

2019-86255 F.M. 7802/28/19

2019-85762 L.P. 3202/04/19

2019-86369 C.U. 5003/12/19

Page 2 of 7


2019-86037 P.G. 6902/28/19

2019-86304 K.S. 5502/28/19

2019-86190 L.K. 5703/07/19

2019-86167 T.G. 4502/27/19

2019-85865 C.B. 6902/08/19

2019-86046 B.R. 4503/01/19

2019-86149 L.F. 6103/01/19

2019-86365 S.B. 2103/19/19

2019-85911 S.N. 5002/13/19

2019-85976 S.T. 2802/16/19

2019-86004 E.R. 3502/26/19

2019-86189 J.J. 5703/07/19

2019-86239 R.G. 5902/22/19

2019-85751 L.P. 3202/04/19

2019-86047 J.L. 2203/01/19

2019-85826 L.P. 3202/10/19

2019-86343 S.B. 2103/19/19

2019-86188 J.J. 5703/05/19

2019-86148 L.F. 6102/24/19

2019-86186 L.P. 5903/07/19

2019-85965 G.B. 4402/18/19

2019-86324 E.R. 3503/16/19

2019-86262 L.K. 5703/04/19

2019-85889 E.G. 2602/13/19

2019-86147 L.F. 6102/21/19

2019-86299 S.L. 4302/18/19

2019-85824 L.P. 3202/08/19


0108 Medication Not Available to Administer

2019-86183 L.P. 5903/10/19

2019-85798 J.R. 5202/03/19

2019-85783 E.R. 3502/05/19

2019-86243 G.K. 7402/18/19

2019-86185 L.P. 5903/10/19

2019-85792 C.P. 1902/07/19

2019-86144 C.H. 5702/23/19

2019-86184 L.P. 5903/09/19

2019-85960 L.P. 3202/26/19

2019-86145 S.C. 6802/28/19

2019-86130 J.D. 4503/10/19

2019-86028 C.P. 1902/27/19

2019-86143 S.F. 4202/23/19

2019-86128 J.D. 4502/26/19

2019-86009 L.P. 3202/26/19

2019-86129 J.D. 4503/09/19

2019-86097 B.J. 5903/08/19

2019-85797 B.R. 6502/03/19

2019-86216 L.P. 5902/11/19

2019-86276 L.K. 5702/14/19

2019-86217 G.K. 7402/10/19

2019-86122 L.P. 5903/01/19

2019-85900 C.P. 1902/14/19

2019-86218 L.P. 5902/10/19

2019-85899 C.P. 1902/16/19

2019-86219 L.P. 5902/09/19

2019-86220 L.P. 5902/10/19

2019-86302 B.G. 6702/25/19

2019-86301 B.G. 6702/26/19

2019-86300 L.J. 6702/07/19

2019-86081 D.C. 6103/03/19

2019-85941 R.R. 4602/21/19

2019-86228 C.O. 7302/17/19

2019-86279 L.K. 5702/15/19


0113 Death

2019-86015 R.D. 5402/19/19

2019-86403 T.S. 4903/22/19

2019-85805 P.D. 67 M02/09/19


0114 Equipment Failure

2019-86163 A.P. 3502/12/19

2019-86221 D.K. 5502/12/19

2019-86229 J.H. 3602/14/19


0115 Fall

2019-86401 B.R. 4503/14/19

2019-86045 H.G. 5302/19/19

2019-86275 L.P. 5902/08/19

2019-86240 T.K. 6002/17/19

2019-86238 B.P. 5702/05/19

2019-85954 L.S. 52 F02/25/19

2019-85955 K.S. 502/22/19

2019-86024 I.C. 2402/28/19

2019-86003 M.T. 6102/25/19

2019-86232 R.J. 6202/19/19

2019-86233 J.P. 3602/14/19

2019-85953 D.S. 5202/16/19

2019-86245 G.K. 7402/16/19

2019-86254 L.P. 5902/28/19

2019-86372 M.B. 6503/15/19

2019-86134 V.A. 5702/28/19

2019-85872 R.L. 4802/01/19

2019-86140 B.J. 2503/01/19

2019-85849 M.K. 4502/04/19

2019-86154 N.I. 4602/24/19

2019-86155 N.I. 4602/24/19

2019-86158 M.B. 3903/07/19

2019-86159 S.O. 3203/05/19

2019-86133 T.R. 3702/28/19

2019-86363 K.S. 2203/15/19

2019-85977 N.I. 4602/03/19

2019-86374 E.D. 6003/14/19

2019-86187 L.P. 5903/03/19

2019-86303 J.R. 5202/25/19

2019-85987 B.T. 3102/18/19

2019-86084 G.P. 5303/03/19

2019-86298 K.L. 6002/16/19

2019-86222 L.P. 5902/09/19

2019-86296 K.G. 5502/21/19

2019-85782 A.B. 6702/08/19

2019-86011 S.C. 3902/21/19

2019-86319 O.P. 303/13/19

2019-86131 D.G. 7203/05/19

2019-86246 L.P. 5902/23/19

2019-86249 L.P. 5902/26/19

2019-86010 S.C. 5102/21/19

Page 3 of 7


2019-85964 B.N. 4802/14/19

2019-86260 J.V. 7502/25/19

2019-86250 L.P. 5902/26/19

2019-86273 L.P. 5902/03/19

2019-86223 L.P. 5902/08/19

2019-86236 R.J. 6202/13/19

2019-85712 E.J. 6902/02/19

2019-86247 L.P. 5902/27/19

2019-86334 W.R. 5703/07/19

2019-86150 S.O. 3203/05/19

2019-86330 N.S. 3102/21/19

2019-85950 E.R. 3502/19/19

2019-86272 L.P. 5902/07/19

2019-86332 J.S. 5702/21/19

2019-86181 G.C. 4203/12/19


0117 Inappropriate Sexual Expression

2019-86398 N.J. 3203/14/19

2019-86338 D.S. 5203/16/19

2019-86071 P.M. 5603/04/19

2019-85995 E.G. 2602/25/19

2019-86118 E.G. 2603/11/19


0118 Medical Problem

2019-86040 J.L. 2202/16/19

2019-86102 M.P. 3903/07/19

2019-86020 D.S. 5202/25/19

2019-86036 P.G. 6902/28/19

2019-86235 R.J. 6202/13/19

2019-85726 M.D. 8602/02/19

2019-86041 J.L. 2202/17/19

2019-86160 R.W. 5603/06/19

2019-86278 L.P. 5902/19/19

2019-86042 K.S. 4002/23/19

2019-86170 T.S. 3602/21/19

2019-86244 J.J. 5702/15/19

2019-86105 A.B. 6903/07/19

2019-86060 R.B. 4803/04/19

2019-86171 F.J. 3402/20/19

2019-86237 K.B. 4502/10/19

2019-86230 R.K. 3302/17/19

2019-86203 M.D. 8602/02/19

2019-86256 L.P. 5902/19/19

2019-86226 R.B. 6402/11/19

2019-86002 B.J. 5902/24/19

2019-86126 N.I. 4603/08/19

2019-86112 E.G. 2603/09/19

2019-86225 R.B. 6402/07/19

2019-86325 D.W. 3602/11/19

2019-86253 H.P. 4103/01/19

2019-85922 T.H. 2502/16/19

2019-86274 L.P. 5902/04/19

2019-86285 J.J. 5703/11/19

2019-86263 L.K. 5703/04/19

2019-85779 D.B. 2302/07/19

2019-85991 M.B. 1502/21/19

2019-85949 E.R. 3502/19/19

2019-86286 G.M. 5603/09/19

2019-86259 L.K. 5702/24/19

2019-85799 G.H. 5802/03/19

2019-85926 E.J. 6902/18/19

2019-86335 S.K. 4103/18/19

2019-85972 D.G. 7202/13/19

2019-85818 A.B. 6902/10/19

2019-86284 R.G. 5903/11/19

2019-86368 M.N. 3503/22/19

2019-86326 J.S. 5703/11/19

2019-86029 T.K. 5802/26/19

2019-86265 H.P. 4103/05/19

2019-86308 R.D. 6303/02/19

2019-86311 B.D. 3203/14/19

2019-85819 P.M. 5602/11/19

2019-86317 T.K. 6003/08/19

2019-85851 A.W. 6902/11/19

2019-85896 B.J. 5902/17/19

2019-85869 L.S. 5102/14/19


0119 Non-Serious Injury

2019-86257 H.P. 4102/25/19

2019-86016 A.K. 1102/26/19

2019-86242 J.W. 6003/01/19

2019-86213 R.B. 6402/13/19

2019-86329 A.D. 3502/21/19

2019-86258 H.P. 4102/28/19

2019-86055 P.S. 2202/12/19

2019-86264 D.S. 6802/10/19

2019-85971 D.G. 7202/15/19

2019-86052 L.P. 3203/03/19

2019-85850 R.W. 4702/08/19

2019-86377 N.I. 4603/10/19

2019-85910 B.R. 4502/07/19

2019-86370 M.D. 8603/07/19

2019-85939 M.H. 402/21/19

2019-86056 P.S. 2202/12/19

2019-86030 E.B. 303/01/19

2019-86141 D.G. 7202/28/19

2019-86092 A.C. 702/28/19

2019-85795 B.S. 5502/04/19

2019-86152 N.I. 4602/08/19

2019-85888 M.J. 402/12/19

2019-85840 V.D. 3902/05/19

2019-86151 N.I. 4603/06/19

2019-86297 J.E. 6703/03/19

2019-86142 D.G. 7202/28/19

2019-86248 J.J. 5702/26/19

2019-86227 R.K. 3302/11/19


0120 Destructive Behavior

2019-85813 R.W. 5602/03/19

2019-86117 D.B. 2303/11/19

2019-86161 L.P. 3203/06/19

2019-85884 P.S. 2202/01/19

2019-85731 C.P. 1902/05/19

2019-85691 E.G. 2602/01/19

2019-85855 D.S. 5202/12/19

2019-85907 C.P. 1902/12/19

Page 4 of 7


2019-85937 E.G. 2602/20/19

2019-86375 N.I. 4603/08/19

2019-85958 E.G. 2602/24/19

2019-85930 L.P. 3202/19/19

2019-86079 S.B. 2103/03/19

2019-85812 R.W. 5602/02/19

2019-85809 R.W. 5602/02/19


0121 Serious Injury

2019-85770 D.B. 66 M02/06/19

2019-86080 E.R. 3503/04/19

2019-86033 P.M. 5703/02/19


0122 Medication Error - Dosage

2019-86361 R.B. 4803/17/19

2019-86354 R.B. 4803/10/19

2019-86355 R.B. 4803/11/19

2019-86356 R.B. 4803/12/19

2019-86357 R.B. 4803/13/19

2019-86358 R.B. 4803/14/19

2019-86198 L.K. 5703/08/19

2019-86360 R.B. 4803/16/19

2019-86353 R.B. 4803/09/19

2019-86359 R.B. 4803/15/19

2019-86351 R.B. 4803/07/19

2019-86345 J.M. 2502/21/19

2019-86199 L.K. 5703/08/19

2019-86200 L.K. 5703/08/19

2019-86352 R.B. 4803/08/19

2019-86196 L.K. 5703/02/19

2019-86362 R.B. 4803/18/19


0124 ULOA (Unauthorized Leave or Elopement)

2019-86104 A.P. 4203/09/19

2019-85997 A.P. 4202/25/19

2019-85996 L.P. 3202/25/19

2019-85916 S.N. 5002/18/19

2019-85806 B.W. 2102/06/19

2019-85781 K.H. 4302/06/19

2019-86005 D.B. 2302/25/19

2019-85831 L.P. 3202/11/19


0125 Other

2019-86291 R.D. 2903/15/19

2019-86294 S.P. 4103/15/19

2019-85683 D.Y. 5802/01/19

2019-86289 C.B. 2703/15/19

2019-86290 T.C. 3603/15/19

2019-85945 R.S. 5902/25/19

2019-85944 T.K. 5402/25/19

2019-86295 R.W. 2703/15/19

2019-86088 J.B. 3403/11/19

2019-86293 M.M. 3103/15/19

2019-85933 A.W. 3402/22/19

2019-85932 W.J. 4802/22/19

2019-86090 C.M. 1903/11/19

2019-85943 A.C. 2802/25/19

2019-86089 J.G. 2003/11/19

2019-86110 D.D. 5503/12/19

2019-86108 C.K. 4003/12/19

2019-86059 S.J. 2003/06/19

2019-86109 S.W. 3103/12/19

2019-85867 B.V. 2202/19/19

2019-86107 D.B. 2603/12/19

2019-85931 A.C. 2802/22/19

2019-85706 C.W. 3002/05/19

2019-86315 K.H. 2603/18/19

2019-86316 C.W. 3003/18/19

2019-86091 D.D. 5503/11/19

2019-86292 N.H. 5403/15/19

2019-85999 M.S. 3002/27/19

2019-86013 C.B. 2303/01/19

2019-85868 T.W. 3702/19/19

2019-85863 T.L. 4902/15/19

2019-85774 T.B. 2902/12/19

2019-86366 D.E. 3303/25/19

2019-86367 J.R. 3603/25/19

2019-85767 T.H. 2802/11/19

2019-85862 R.K. 2502/15/19

2019-85789 P.M. 5602/07/19

2019-85858 L.S. 2902/14/19

2019-85861 G.B. 4702/15/19

2019-85765 S.C. 5002/11/19

2019-86175 C.B. 2703/14/19

2019-85864 B.V. 2202/15/19

2019-85766 H.D. 5802/11/19

2019-86082 A.K. 5003/07/19

2019-86014 A.D. 4803/01/19

2019-85857 J.R. 3602/14/19

2019-86146 K.W. 5702/21/19

2019-86121 N.A. 2403/13/19

2019-86176 T.M. 3803/14/19

2019-85919 A.G. 3002/21/19

2019-85921 S.M. 4502/15/19

2019-85915 T.V. 4902/20/19

2019-86083 A.M. 3003/07/19

2019-85775 J.S. 4802/12/19

2019-85920 J.P. 2402/21/19

2019-85790 A.B. 6902/07/19

2019-85866 T.C. 3602/19/19

2019-86344 K.H. 5103/22/19

2019-86342 R.J. 3003/21/19

2019-86125 S.M. 4503/05/19

2019-86162 A.P. 3502/12/19

2019-85942 M.B. 4002/25/19


0126 Traffic Accident

2019-86135 V.A. 5703/04/19

2019-86214 G.C. 5902/13/19

2019-86215 R.B. 6402/13/19

2019-86132 J.L. 2203/05/19


0127 Dangerous Behavior

Page 5 of 7


2019-85918 E.G. 2602/19/19

2019-85821 E.G. 2602/11/19

2019-86341 A.B. 6903/19/19

2019-86099 D.P. 4203/05/19

2019-86313 E.G. 2603/15/19

2019-85811 R.W. 5602/02/19

2019-86031 C.R. 802/27/19

2019-85914 D.P. 4202/14/19

2019-85810 R.W. 5602/02/19

2019-86350 E.G. 2603/21/19

2019-86322 E.R. 3503/16/19

2019-86153 N.I. 4602/10/19

2019-86318 W.R. 6502/25/19

2019-85935 E.G. 2002/19/19

2019-86157 C.D. 4303/07/19

2019-86156 N.I. 4603/05/19

2019-85891 E.G. 2602/14/19

2019-85808 R.W. 5602/02/19

2019-85823 L.P. 3202/06/19

2019-85948 L.P. 32 M02/22/19

2019-86101 D.P. 4203/09/19

2019-85887 P.S. 2202/08/19

2019-86399 N.I. 4603/03/19

2019-86069 L.P. 3202/27/19

2019-86364 K.S. 2203/18/19

2019-85978 N.I. 4602/03/19

2019-85909 D.D. 2402/16/19

2019-86331 B.B. 3602/26/19

2019-85734 D.B. 2302/04/19

2019-85886 P.S. 2202/06/19

2019-85974 N.I. 4602/02/19

2019-85994 K.R. 5102/15/19

2019-86182 E.G. 2603/12/19

2019-86026 R.D. 2702/27/19

2019-86376 N.I. 4603/09/19

2019-86378 N.I. 4603/10/19

2019-85735 C.R. 5802/04/19

2019-85771 H.D. 58 F02/08/19

2019-86336 R.B. 4803/15/19

2019-85761 C.P. 1902/06/19

2019-85741 S.N. 5002/05/19


0128 Medication Error - Inventory

2019-86172 B.S. 3202/13/19

2019-86085 L.J. 6703/06/19

2019-86048 J.L. 2202/08/19

2019-86077 D.Q. 6402/08/19

2019-86050 B.R. 4502/08/19

2019-85839 F.M. 7802/05/19

2019-85973 D.G. 7202/15/19

2019-86049 D.G. 7202/08/19

2019-86174 A.S. 3302/13/19

2019-86173 R.L. 4802/13/19


0129 Impermissible Disclosure

2019-86078 M.N. 5503/06/19



Page 6 of 7


Report rRecipient Rights Violations - Local Codes based on Query

qRecipient Rights Violations - Local Codes Rev 060898


Page 7 of 7

amber.berndt

Typewriter

Attachment #2

Courtesy of www.michigan.gov/orr

has legal custody of a minor recipient, then the stated objections of the recipient or his or

her guardian or the parent who has legal custody of a minor recipient shall be included in

the plan.

History: 1979 AC; 1984 AACS; 1986 AACS; 1990 AACS; 1998 AACS; 2007 AACS; 2009

AACS; 2012 AACS.

R 330.7205 Rescinded.

History: 1979 AC; 1998 AACS.


History: 1979 AC; 1981 AACS; 1983 AACS; 1998 AACS.






History: 1979 AC; 1983 AACS; 1998 AACS.



R 330.7243 Restraint seclusion, and physical management.

Rule 7243. (1) A provider shall keep a separate, permanent chronological

record specifically identifying all instances when restraint or seclusion has been used.

The record shall include all of the following information:

(a) The name of the recipient.

(b) The type of restraint or conditions of seclusion.

(c) The name of the authorizing and ordering physician.

(d) The date and time placed in temporary, authorized, and ordered restraint or

seclusion.

Courtesy of www.michigan.gov/orr

(e) The date and time the recipient was removed from temporary, authorized,

and ordered restraint or seclusion.

(2) A recipient who is in restraint or seclusion shall be inspected at least once

every 15 minutes by designated personnel.

(3) A provider shall ensure that documentation of staff monitoring and

observation is entered into the medical record of the recipient.

(4) A recipient in restraint or seclusion shall be provided hourly access to a toilet.

(5) A recipient in restraint or seclusion shall have an opportunity to bathe, or

shall be bathed as often as needed, but at least once every 24 hours.

(6) If an order for restraint or seclusion is to expire and the continued use of

restraint or seclusion is clinically indicated and must be extended, then a physician's

reauthorization or reordering of restraint or seclusion shall comply with both of the

following provisions:

(a) If the restraint device is a cloth vest and is used to limit the resident's

movement at night to prevent the recipient from injuring himself or herself in bed, the

physician may reauthorize or reorder the continued use of the cloth vest device

pursuant to section 740(4) and(5) of the act.

(b) Except as specified in subdivision (a) of this subrule, a physician who orders

or reorders restraint or seclusion shall do so in accordance with sections 740(5) and

742(5) of the act. The required examination by a physician shall be conducted not

more than 30 minutes before the expiration of the expiring order for restraint or

seclusion.

(7) If a recipient is removed from restraint or seclusion for more than 30 minutes,

then the order or authorization shall terminate.

(8) A provider shall ensure that a secluded or restrained recipient is given an

explanation of why he or she is being secluded or restrained and what he or she needs

to do to have the restraint or seclusion order removed. The explanation shall be

provided in clear behavioral terms and documented in the record.

(9) For restrained recipients, a provider shall ensure that an assessment of the

circulation status of restrained limbs is conducted and documented at 15-minute

intervals or more often if medically indicated.

(10) For purposes of this rule, a time out or therapeutic de-escalation

program, as defined in R 330.7001, is not a form of seclusion.

(11) Physical management as defined in R 330.7001 (m) may only be used in

situations when a recipient is presenting an imminent risk of serious or non-serious

physical harm to himself, herself or others and lesser restrictive interventions

have been unsuccessful in reducing or eliminating the imminent risk of serious or

non-serious physical harm. Both of the following shall apply:

(i) Physical management shall not be included as a component in a behavior

treatment plan.

(ii) Prone immobilization of a recipient for the purpose of behavior control is

prohibited unless implementation of physical management techniques other than prone

immobilization is medically contraindicated and documented in the recipient's record.

History: 1979 AC; 1981 AACS; 1983 AACS; 1984 AACS; 1998 AACS; 2007 AACS; 2009 AACS.

amber.berndt

Highlight

APF 171 1 of 10 USE OF RESTRAINT AND SECLUSION APB 2015-003

10-1-2015

ADMINISTRATIVE POLICY FACILITIES/HOSPITAL STATE OF MICHIGAN

DEPARTMENT OF HEALTH & HUMAN SERVICES

PURPOSE

The purpose of this policy is to assure that implementation of restraint, including physical management (manual hold) and seclusion with patients who exhibit violent/self-destructive behavior in state operated psychiatric hospitals and centers is consistent and complies with the provisions of applicable state and federal laws and regulations, whichever is the most stringent.

REVISION HISTORY

Previously promulgated as Subpart U of Administrative Directive 07-C-1752/AD-00 (Use of Restraint) and Subpart V of Administrative Directive 07-C-1752/AD-00 (Use of Seclusion). Rescinds and replaces both. This policy rescinds and replaces Policy and Procedure 10.7.1 Use of Restraint and Physical Management and Policy and Procedure 10.7.2 Use of Seclusion both issued May 14, 2010.

DEFINITIONS

Anatomical support means body positioning or a physical support ordered by a physician or occupational therapist for the purpose of maintaining or improving a patient’s physical functioning. An anatomical support is not considered a restraint.

Emergency situation for purposes of this policy, means those occasions when unanticipated, severely aggressive or destructive behavior places the patient or others in imminent danger.

Imminent risk means a risk that is impending, on the point of happening, reasonably certain to occur.

Less restrictive therapeutic intervention means those professionally recognized strategies which are intended to recognize the early signs of impending dangerous behaviors, to identify and ameliorate the cause(s) of such behaviors and to implement non-aversive techniques to minimize the consequences of a patient’s potentially harmful behavior.

Physical management means a technique approved by the hospital or center that is used by staff as an emergency intervention to restrict the movement of a patient by direct physical contact to prevent the patient from harming himself, herself or others. Physical management shall be considered a manual method of restraint.

amber.berndt

Highlight

APF 171 2 of 10 USE OF RESTRAINT AND SECLUSION APB 2015-003

10-1-2015

ADMINISTRATIVE POLICY FACILITIES/HOSPITAL STATE OF MICHIGAN

DEPARTMENT OF HEALTH & HUMAN SERVICES

Prone immobilization means a manual method of restraint of a patient in a prone (face down) position, usually on the floor, where force is applied to the patient’s body in a manner that prevents him or her from moving out of the prone position.

Protective device means a device or physical barrier to prevent the patient from causing serious self-injury associated with documented and frequent incidents of the behavior. A protective device as defined here and incorporated in the written individual plan of service shall not be considered restraint.

Restraint means any manual method, physical or mechanical device, material, or equipment that immobilizes or reduces the ability of the patient to move his or her arms, legs, body or head freely; or chemical restraint which is a drug or medication when it is used as a restriction to manage the patient’s behavior or restrict the patient’s freedom of movement and is not a standard treatment or dosage for the patient’s condition.

a. Restraint does not include devices, such as orthopedically prescribed devices, surgical dressings or bandages, protective helmets, or other methods that Involve the physical holding of a patient for the purpose of conducting routine physical examinations or tests, or to protect the patient from falling out of bed, or to permit the patient to participate in activities without the risk of physical harm (this does not include a physical escort).

b. Physically holding a patient for forced medication is a restraint.

Seclusion means the temporary placement of a patient in a room, alone, where egress is prevented by any means and may only be used if essential to prevent the patient from physically harming others.

Therapeutic de-escalation means an intervention, the implementation of which is incorporated in the individualized written plan of service, wherein the patient is placed in a room, accompanied by staff who shall therapeutically engage the patient in behavioral de-escalation techniques and debriefing as to the cause and future prevention of the target behavior.

Time-out means a voluntary response to a therapeutic suggestion to a patient to remove himself or herself from a stressful situation in order to prevent a potentially hazardous situation.

amber.berndt

Highlight

agenda - healthwest...apr 12, 2019 · police chief-december 2014-present police lieutenant-january...

Documents