This page is intended to provide clarification to nursing homes on the reporting requirements under Federal (42 CFR 483.13(c)(2)-(4)) and State (Nevada Administrative Code 449.74491) regulations. Below is a link to the facility self-report form. The guidelines address the facility's obligations to report allegations and the results of the investigations of these alleged violations involving mistreatment, neglect, or abuse, including injuries of unknown sources, and misappropriation of resident property. The facility self-report form is to be completed and faxed to (702) 486-6520.
- Facility-Reported Incidents Form for Skilled Nursing Facilities
- Note that reporting requirements of the Aging and Disability Services Division to comply with Nevada Revised Statutes 200.5091-200.50995 may differ.
- Reporting is not required for falls without injuries, however this may be reported as an injury of unknown origin or as a result of abuse or neglect if determined by the facility investigation.
Federal Requirement
42 CFR 483.13(c)(2)-(4)
(2)The facility must ensure that all alleged violations involving mistreatment, neglect, or abuse, including injuries of unknown source, and misappropriation of resident property are reported immediately to the administrator of the facility and to other officials in accordance with State law through established procedures (including to the State survey and certification agency).
(3) The facility must have evidence that all alleged violations are thoroughly investigated, and must prevent further potential abuse while the investigation is in progress.
(4) The results of all investigations must be reported to the administrator or his designated representative and to other officials in accordance with State law (including to the State survey and certification agency) within 5 working days of the incident, and if the alleged violation is verified appropriate corrective action must be taken.
These alleged violations are defined as follows under the interpretive guidelines:
- Mistreatment: "inappropriate treatment or exploitation of a resident" (F609)
- Neglect: "failure to provide goods and services necessary to avoid physical harm, mental anguish or emotional distress" (42 CFR §488.301)
- Abuse: "The willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish" (42 C.F.R. §488.301).
- Injuries of unknown source: "An injury should be classified as an 'injury of unknown source' when both of the following conditions are met:
- The source of the injury was not observed by any person or the source of the injury could not be explained by the resident; and,
- The injury is suspicious because of the extent of the injury or the location of the injury (e.g., the injury is located in an area not generally vulnerable to trauma) or the number of injuries observed at one particular point in time or the incidence of injuries over time."
- Misappropriation of resident property: "The deliberate misplacement, exploitation, or wrongful, temporary or permanent use of a resident’s belongings or money without the resident’s consent" (42 C.F.R. §488.301).
Nevada Administrative Code 449.74491
Prohibition of certain practices regarding patients; investigation of certain violations and injuries to patients; unfit employees. (NRS 449.037)
- A facility for skilled nursing shall adopt and carry out written policies and procedures that prohibit:
- The mistreatment and neglect of the patients in the facility;
- The verbal, sexual, physical and mental abuse of the patients in the facility;
- Corporal punishment and involuntary seclusion; and
- The misappropriation of the property of the patients in the facility
- A facility for skilled nursing shall adopt procedures which ensure that all alleged violations of the policies adopted pursuant to subsection 1 and injuries to patients of unknown origin are reported immediately to the administrator of the facility, to the Bureau and to other officials in accordance with state law, and are thoroughly investigated. The procedures must ensure that further violations are prevented while the investigation is being conducted.
- The results of any investigation must be reported:
- To the administrator of the facility or his designated representative and to the Bureau within 5 working days after the alleged violation is reported.
- In the manner prescribed in NRS 200.5093 and 432B.220 and chapter 433 of NRS. The administrator of the facility shall take appropriate action to correct any violation.
Form Summary
To help skilled nursing facilities plan and train for reporting of required incidents, below is a summary of the information that will be input on the facility-reported incidents form linked above.
- Select your facility from a list (listed alphabetically by facility name followed by license number and city) or enter the information indicated below.
- Health facility name
- Health facility license number
- Street address
- City
- State
- ZIP Code
- Facility/incident contact
- Name
- Title
- Phone number
- Email address
- Date and time of the incident
- Which of the following apply to this facility-reported incident?
- Initial (1st report)
- Final (completed report)
- Initial and Final (1st report and conclusion)
- Type of incident (select all that apply)
- Emotional/mental abuse
- Physical abuse
- Verbal abuse
- Sexual abuse
- Neglect
- Injury of unknown origin
- Misappropriation of property
- None of these (selecting this option will take you to the end of the form, as only the incident types listed above are required to be reported)
- Provide a thorough description of the event.
- How many residents were involved in this incident?
- Provide names, dates of birth, admission dates and room numbers for each.
- Was the perpetrator(s) a staff member? Yes or no
- If yes, how many staff members were involved?
- If yes, names of staff involved (including license type and number, if applicable)
- Description of event impact on resident(s).
- Has resident(s) been discharged? Yes or No
- If yes, include date of discharge.
- Was resident(s) taken to emergency room? Yes or No
- If yes, name of hospital where resident(s) were taken.
- If yes, date that resident(s) were taken to the hospital.
- Has resident(s) returned to the facility? Yes or No
- If yes, date resident(s) returned to the facility.
- Describe resident(s’) care plan(s) pertaining to the incident.
Questions?
If you have any questions, contact the Bureau of Health Care Quality and Compliance at:
- Carson City office: (775) 684-1030
- Las Vegas office: (702) 486-6515