QAPI Program Utilization_Manual

ADVERSE EVENT OUTCOME REPORT-DC'd to Community with Behavioral Problems QUESTION YES NO IE COMMENTS Patient Status - Mental Was the patient cognitively impaired? Did the patient have a history of unsafe behavior? Was the patient mentally competent? Caregiver - Support Systems Did the patient have a resident or paid caregiver? If not, were appropriate referrals given, e.g. private duty, MSW, etc. Conclusions Based on the documentation, could this adverse outcome have been prevented? YES NO UNSURE If yes, what may have been done to prevent the adverse outcome: If no, explain: If uncertain, explain: 51