(a) All accredited providers shall adhere to the current accreditation requirements for complaints or grievances.
(b) A provider who believes a participant's health or safety is in jeopardy, shall immediately contact the Division, Protection & Advocacy, and other governmental agencies, such as law enforcement or DFS to report incidents or concerns.
(c) A provider shall have policies and procedures for complaints, including: - (i) How it will attempt to resolve the complaint;
- (ii) How it will document actions, follow-up, and resolution of the complaint;
- (iii) How and when information shall be shared with the complainant, legally authorized representative, and the case manager; and
- (iv) How the complainant will be informed of the process to file a formal complaint with the Division.
(d) Complaints may be filed with the Division in writing or verbally. If a provider files a complaint, the complaint shall be submitted in writing unless the complaint involves a participant whose health or safety is in jeopardy. Upon receipt of a complaint from any person, the Division shall: - (i) Notify the complainant within fifteen (15) business days in writing that the complaint is received. The notification shall address:
- (A) Anticipated timeframe for completing the follow-up and resolution of a complaint, and
- (B) The authority for taking actions.
- (ii) Notify the provider in writing within fifteen (15) business days when a complaint is received involving that provider, unless the complaint involves significant health, safety, or rights concerns, which require an unannounced on-site visit. In these cases, the Division shall provide written documentation to the provider at the time of the on-site visit that indicates a complaint has been received, the nature of the complaint, and that complaint follow-up is being conducted.
- (iii) Within fifteen (15) business days of complaint resolution, notify the complainant in writing that the complaint has been resolved.
- (iv) Within fifteen (15) business days of the complaint resolution, submit a written report to the provider(s) involved in the complaint summarizing the results of the complaint findings. The report may include findings, recommendations, and timeframes to address the recommendations through a corrective action plan. If the complaint involves a specific participant, the report will also be sent to the participant and legally authorized representative.
- (v) A provider's failure to complete a corrective action plan may result in sanctions per Section 30 of this Chapter.
048-45 Wyo. Code R. § 45-21