We are committed to ensuring the health and safety of all our members. As such, we are required to monitor certain incidents that occur involving contract providers and providers who operate within our catchment area.
An incident is an event (at a facility or in a service) that is likely to lead to adverse effects upon a member. Incidents are classified into several categories according to the severity of the incident. Contract providers are required to report all Level II and Level III incidents in the State’s Incident Response Improvement System (IRIS). Failure to do so is a violation of your contract and the North Carolina Administrative Code. In addition, you must submit a summary of all Level I incidents to Vaya Health on a quarterly basis. Out-of-state providers must submit paper copies of the incident report to DHHS and to us.
Incident reports are submitted via the Incident Response Improvement System (IRIS).
Please be prepared to respond promptly to follow-up inquiries requesting clarification or additional information by IRT.
To reduce the number of these requests, please check to ensure all of the following items are included:
- A clear and detailed description of what caused the incident
- Actions taken in response to the incident
- A plan that explains how such an incident can be prevented from happening in the future
- Any supporting documentation that may help in assessment of the incident
Indicate requested documentation in the Comments Section (e.g. Medical Examiner’s report, death certificate, DSS response letter, etc.) https://vayahealth.com/wp/wp-content/uploads/2017/02/February_2017_Backup_Staffing_Incident_Log_TEMPLATE.pdf
In addition, please complete this form in the event of Failing to Provide BackUp Staff for an Innovations Incident. Providers are not required to submit this information to us directly but are required to have it upon request from Care Coordinators or Provider Monitoring.
Below is a video of the Incident Response Improvement System (IRIS) webinar training that we hosted for providers. The Incidence Response Team will be still available for questions by email or phone and to do one on one trainings of IRIS.
Providers must report ALL consumer deaths whenever they become aware of it—even if the death occurred while the individual was not under the provider’s care.
Providers must give verbal notification within 24 hours of discovery. This can be done via phone, voicemail, or email. The associated Incident Report should be submitted within 72 hours.
All deaths are considered to be due by ‘unknown cause’ until official documentation from a Medical Examiner determines otherwise.
All providers who have not received a waiver are required to submit a quarterly report of Level I incidents to Vaya Health. Incident report summaries must include:
- Restrictive interventions
- Medication errors
- Search or seizure of a client’s property or possession
Please submit summaries by the following dates:
|Report||Months Covered||Due Date|
|Quarter 1||July, August, September||October 10|
|Quarter 2||October, November, December||January 10|
|Quarter 3||January, February, March||April 10|
|Quarter 4||April, May, June||July 10|
How to Submit the Summary:
Providers should use the QM-11 Quarterly Level 1 Provider Report form to complete the report. Email or fax the report to the Incident Report Specialist.