Level II  #3 An Emergency room or urgent care facility visit when not used in lieu of a PCP visit. Direct care staff who work on weekends and holidays often take clients to ED or urgent care when a medical condition / injury ocurs since they are not medically trained to discern if the injury or medical symptoms can wait till a work day to contact a PCP....To meet the requirement, these will always be reported in CHRIS  even if they likely should not have been. Is there any quidance as to what providers can do in such cases.. Cane the level in CHRIS be changed, if after the fact, it is determined the incident should not have been reported in CHRIS?

Level II #4. An unplanned psychiatric or unplanned medical hospital admission. For level II , these would be reported if the incident occurs or originates during the provision of a service or on the premises of the provider. The guidance to this requirement is not clear to me. I believe the intent is that any of our clients who are active clients, receiving any service, has an unplanned psychiatric event or an unplanned  medical admission ,we should report this as a level II incident. However, if one takes into account the parameters of Level II,  that if the individual is not on the premise or receiving services at the time, we would only report on individuals who received an unplanned psychiatric event of unplanned medical admission from our residential programs or if the incident occured during the provision of a service such as MHSS. If the intent is to complete a Level II Incident report and an RCA for all unplanned psychiatric eents and unplanned medical admissions for all active clients, this will most certainly be an unachievable requirement. Please provide clearer guidance.