Caregiver Misconduct Investigation and Reporting Requirements

1. Caregiver Misconduct Investigation and Reporting Requirements Laurie Arkens Director, Office of Caregiver Quality September 12, 2013

2. Office of Caregiver Quality Role and Responsibilities • Track nurse aides eligible to work in Wisconsin • Approve and monitor nurse aide training, testing & Nurse Aide Registry • Oversee feeding assistant training programs • Receive reports of caregiver misconduct • Investigate reports of caregiver misconduct • Track caregivers with findings of misconduct • Complete caregiver background checks for DQA entity owners, operators and non-client residents Protecting and promoting the health and safety of the people of Wisconsin

3. The Wisconsin Caregiver Program • Caregiver Background Checks • Reporting and Investigating Caregiver Misconduct • Rehabilitation Reviews Protecting and promoting the health and safety of the people of Wisconsin

4. DQA Regulated Entities • Emergency Mental Health Service Programs • Outpatient Mental Health Clinics • Comprehensive Community Service • Community Mental Health Programs and Support Programs • Community Substance Abuse Services • Community Based Residential Facilities • Licensed Adult Family Homes Protecting and promoting the health and safety of the people of Wisconsin

5. DQA Regulated Entities • Residential Care Apartment Complexes • Personal Care Worker Agencies • Hospitals • Hospices and Home Health Agencies • Nursing Homes • Facilities for Individuals with Intellectual Disabilities Protecting and promoting the health and safety of the people of Wisconsin

6. Investigating and Reporting Requirements • Definitions • Protocol • Elements of an Investigation • Incident-Specific Elements • Reporting Caregiver Misconduct in Nursing Homes • Resources Protecting and promoting the health and safety of the people of Wisconsin

7. Federal Definitions for Nursing Homes Misconduct • Abuse • Neglect • Misappropriation • Injury of Unknown Source (possibly) Protecting and promoting the health and safety of the people of Wisconsin

8. Investigation Protocol • Develop a Written Protocol • Identify a Lead Investigator • Share the Protocol • Implement the Protocol Protecting and promoting the health and safety of the people of Wisconsin

9. Investigating the Allegation • Investigation = Fact Finding Mission • All Allegations Must be Investigated • All Investigations Should be Written • Employment Actions are Internal Entity Decisions Protecting and promoting the health and safety of the people of Wisconsin

10. Elements of an Investigation • Who, What, Where, When, Why, How • Contact Law Enforcement • Preserve Evidence • Document the Effect on the Victim • Document the Caregiver’s Duty • Diagram the Scene • Develop of List of Interviewees • Write the Investigation Report Protecting and promoting the health and safety of the people of Wisconsin

11. Incident-Specific Elements • Physical Abuse • Verbal/Psychological Abuse • Sexual Abuse • Neglect • Misappropriation • Resident-to-Resident Altercations Protecting and promoting the health and safety of the people of Wisconsin

12. Reporting the Allegation • NH’s – Online Immediate Report • Initial Evaluation • Reasonable Suspicion of a Crime – Report to Law Enforcement and to OCQ • Incident Report F-62447 Within 5 Days • Incidents Involving Credentialed Staff – Send to OCQ • Adults-at-Risk – Send to OCQ Protecting and promoting the health and safety of the people of Wisconsin

13. Screening and Investigating Reports of Caregiver Misconduct Protecting and promoting the health and safety of the people of Wisconsin

14. OCQ Screening Guidelines Step 1: Screen Incident Report • Screen Incident Report for Immediate Jeopardy • Determine OCQ Jurisdiction • Determine Further Investigation Required • Send Accused Notice of Screening Decision • Send Copy to Facility, Reporter, DQA Program Manager Goal: Complete Screening Within 5 Days Protecting and promoting the health and safety of the people of Wisconsin

15. OCQ Investigation Guidelines Step 2: Complete Investigation • Assign Case to OCQ Investigator • Conduct Investigation • Write Investigation Report • Submit to Supervisor for Review • Send Accused Notice of Determination • Send Copy to Facility, Reporter, DQA Program Manager Goal: Complete Investigation Within 60 Days Protecting and promoting the health and safety of the people of Wisconsin

16. Caregiver Misconduct Registry • Any Caregiver with a Substantiated Finding of Misconduct • Nurse Aides Cannot Work in any Federally Certified NH or Intermediate Care Facility • Caregiver Cannot Work as a Caregiver in any DQA Regulated Facility • Rehabilitation Review Protecting and promoting the health and safety of the people of Wisconsin

17. Important Resources • http://dhs.wisconsin.gov.caregiver/index.htm • Wisconsin Caregiver Manual • Wisconsin Statutes ss. 50.065 and 146, Stats. • Wisconsin Administrative Codes: • Chapter 12 – Caregiver Background Check Requirements • Chapter 13 – Investigating and Reporting Requirements Office of Caregiver Quality PO Box 2969 Madison, WI 53701-2969 608-261-8319 Protecting and promoting the health and safety of the people of Wisconsin

18. Wisconsin Caregiver Program Questions • Caregiver Background Checks? Contact DQA Office of Caregiver Quality at 608-261-8319 or dhscaregiverintake@wi.gov • DOJ Criminal History? Contact DOJ Crime Information Bureau at 608 266-7780 • Rehabilitation Review Process? Contact DHS Office of Legal Counsel at 608-266-1900 or RebabRC@dhs.state.wi.us Protecting and promoting the health and safety of the people of Wisconsin

19. Wisconsin Caregiver Program Questions • Misconduct Reporting? Contact DQA Office of Caregiver Quality at 608-261-8319 or dhscaregiverintake@wi.gov • Substantiated Finding? Verify status on www.pearsonvue.com (Wisconsin Nurse Aides) Protecting and promoting the health and safety of the people of Wisconsin

20. Thank you! Protecting and promoting the health and safety of the people of Wisconsin