Effective risk assessment, planning and mitigation requires sufficient background, experience, and training in  each specialized risk area. For instance risks assessment concerning infection control is drastically different from risk assessment of workplace violence , cyber security, patient privacy breaches,  property damage/loss, patient suicidality, physical plant safety, fleet safety, or financial fraud .  While I do not know what kind of risk management training will be offered/required of providers I suspect it will cover the general elements of risk assessment and management which is insufficient to adequately assess and manage risk in highly specialized areas of operation.  As a solution I propose that DBHDS offer a variety of risk management trainings and tools for each specialized area of risk they want providers to assess, plan for , and mitigate. Additionally, I suggest that risk assessment of each specialized area occur at least every 3-5 years instead of annually, That way providers can focus on one or two areas of risk assessment each year and rotate the areas they focus on.  

Regarding the sections on corrective actions I agree with others that the recurrence of an issue, after corrective action has been put into place, should not automatically necessitate either additional measures or new corrective action. It should be acceptable, under some circumstances, for a provider to determine that the recurrence of the issue was not due to an issue with the corrective action itself. Such a determination should be documented and justified by the provider.  

I also suggest that DBHDS take on a more collaborative role in identifying corrective actions necessary to address cited deficiencies. Particularly in cases where the provider's initial corrective action did not have the desired effect. Technical assistance and collaborative problem solving are more likely to generate results than citing providers when their solutions are labeled as ineffective in resolving the issue at hand. 

Lastly, I agree with others' comments that it is unnecessary for providers to identify flashlights, or fire extinguishers on poster floor plans. Instead providers should label the actual location of these materials. For providers to have to revise all posted floor plans to contain this information is an unnecessary burden as no person will reasonably look to a floor plan to find a flashlight or fire extinguisher.