April 01, 2022

Tennessee: Review the latest criteria for reportable events

As of Jan. 1, 2022, all TennCare CHOICES in Long Term Services (CHOICES) and Employment and Community First (ECF) providers must use the reportable event management (REM) process developed by the Department of Developmental Disabilities (DIDD) and TennCare.

Tier 1 reportable events

A Tier 1 reportable event includes acts or allegations of wrongful conduct (including abuse or neglect) that result when a member:

  • Requires medical treatment or intervention (assessment is not a Tier 1 reportable event)
  • Needs hospitalization
  • Requires an intervention such as calling the police
  • Alleges sexual abuse
  • Dies because of the event
  • Experiences exploitation or misappropriation of their money or property exceeding a value of $1,000

How to report

  • Report to DIDD Abuse Hotline 888-633-1313 or online within 4 hours of the event or the discovery of it
  • Report to Adult Protective Services (APS) by phone at 888-APS-TENN (888-277-8366), by fax at 866-294-3961 or online, as required by law
  • Child Protective Services (CPS) Calling the Child Abuse Hotline to report child abuse or neglect in the State of Tennessee 877-237-0004, as required by law
  • Police, as required by law

If your staff is with the person and an event poses an immediate threat to the health or safety of that person, they must:

  • Report the event and stay with the person until the threat is removed or the person receives appropriate medical attention
  • Complete a written reportable event form (REF) and email TN_Quality_Review@uhc.com and report to DIDD as described in the section above by the next business day

Tier 2

A Tier 2 reportable event includes acts or allegations of wrongful conduct (including abuse or neglect) that results when a member:

  • Verbalizes an event that does not cause harm to the member
  • Needs no medical attention
  • Requires no intervention, such as calling the police
  • Experiences an exploitation of the member or of money or property with a value at $250 to $1,000, or any prescription-controlled medications

How to report

  • Report to DIDD and UnitedHealthcare as referenced in the Tier 1 section within the next business day after the event or the discovery of it
  • Report to Adult Protective Services (APS), Child Protective Services (CPS) or the police, as required by law
  • The DIDD investigations specialist and UnitedHealthcare will review the REF for the proper classification
  • DIDD or UnitedHealthcare will notify you if additional information is needed
  • When a DIDD investigator classifies an event as a Tier 2 reportable event, they’ll send you the established anchor date

Other reportable events

Complete a reportable event form. Submit it to us and report to DIDD as outlined above by the end of the next business day for:

  • Behavioral/psychiatric events
  • Reportable medical events
  • Other events like COVID-19 positive cases, elopement over 1 hour, vehicular accidents and any unsafe conditions

The person who discovers the event completes the reportable event form and submits it. For example, if your staff finds out that the member went to the hospital, emergency room or urgent care, you’re responsible for reporting the event. 

Questions?

If you have questions:

  • See the Tennessee Department of Intellectual & Developmental Disabilities, frequently asked questions on reportable event management
  • Contact your clinical quality analyst or provider advocate

To contact us directly:

  • Tier 1 and Tier 2 events
     
    email: stephanie_atuah-kyei@uhc.com or call: 952-406-5979
  • All other reportable medical events including CHOICES and ECF
    email: bonnie_creel@uhc.com or call: 615-440-9761
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