Section He-C 4001.23 - Incident Reports(a) Program staff directly involved in or witness to any incident shall complete a legible, written incident report whenever there is an incident, as defined in He-C 4001.01(y).(b) For reportable incidents, as defined in He-C 4001.01(bc), licensees shall have responsibility for: (1) Completing a preliminary review of an incident to determine if abuse or neglect could have been a contributing factor to the incident;(2) Providing the following information to the department within 48 hours of a reportable incident: b. A description of the incident, including what led to the incident, where it occurred and identification of injuries, if applicable;c. The name of the licensee(s) or personnel involved in, witnessing, or responding to the reportable incident; d. The name of resident(s) involved in or witnessing the reportable incident;e. The date and the beginning and ending time of the reportable incident;f. The action taken in direct response to the reportable incident, including any follow-up;g. If medical intervention was required, by whom, and the date and time;h. When the resident's guardian, agent, surrogate decision-maker, or personal representative, if any, was notified; i. The signature of the person reporting the reportable incident; j. The date and time the resident's licensed practitioner was notified, if applicable; and k. The date the licensee performed the preliminary review required by (1) above; and(3) For uses of seclusion, restraint, or other intentional physical contact with a child which is in response to a resident's aggression, misconduct, or disruptive behavior, in addition to (2) above, the following:a. Authorization by the staff in charge; andb. Documentation as required by He-C 4001.23(b)(2) and either RSA 126-U:7 or RSA 126-U:10.(c) Incident reports shall be maintained as part of the involved resident's records and be made available on the premises of the program for review by the department.(d) Program staff shall provide the resident's parents with information regarding incident reports on the next business day, which shall include all of the information included on the incident report. (e) If the parent(s) do not have a telephone or cannot be reached, program staff shall document their efforts to notify the parent(s) and send a written copy of the incident report to the parent(s).(f) For uses of seclusion, restraint, or other intentional physical contact with a child which is response to a child's aggression, misconduct, or disruptive behavior, program staff shall notify the resident's parents or guardians in accordance with RSA 126-U:7 including verbal and written documentation.(g) Immediately following any fire or emergency incident, licensees shall notify the department by phone, followed by written notification within 72 hours, with the exception of a false alarm or emergency medical services (EMS) transport for a non-emergent reason.(h) The written notification required by (g) above shall include: (1) The date and time of the incident;(2) A description of the location and extent of the incident, including any injury or damage;(3) A description of events preceding and following the incident;(4) The name of any personnel or residents who were evacuated as a result of the incident, if applicable;(5) The name of any personnel or residents who required medical treatment as a result of the incident, if applicable; and(6) The name of the individual the licensee wishes the department to contact if additional information is required.(i) As soon as is practicable but no longer than 24 hours after the use of a medication restraint, the resident's licensed practitioner shall be notified of the use of such restraint.(j) When a resident has an unexplained absence, after searching the building and grounds without finding the resident, and it has been determined that the resident is a danger to themselves or others, the licensee shall immediately notify the local police department, the department and the resident's guardian, agent, surrogate decision-maker, or personal representative, if any.N.H. Admin. Code § He-C 4001.23
#2664, eff 3-30-84, EXPIRED: 3-30-90
New. #8581, eff 4-20-06, EXPIRED: 4-20-06
New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14
Amended byVolume XXXIV Number 46, Filed November 13, 2014, Proposed by #10705, Effective 10/23/2014, Expires10/23/2024.Amended by Volume XLI Number 06, Filed February 11, 2021, Proposed by #13151, Effective 12/30/2020, Expires 12/30/2020.The amended version of this section by New Hampshire Register Number 24, eff. 5/29/2024 is not yet available.