In the event that a provider or county or entity is unable to report a 24-hour incident through the Home and Community Services Information System (HCSIS), faxed contingency reporting is to be utilized.
Incidents that are reported via fax are to be recorded on a copy of the attached Incident Management Contingency Form. This reporting method will satisfy regulatory requirements to report an incident. In the event of a serious incident (such as abuse with injury, suspicious death), a provider should also call its OMR Regional Office and County MH/MR Program to alert OMR and the county of the incident.
Once complete, the Incident Management Contingency Form is to be faxed to the appropriate OMR Regional Office and to the County MH/MR Program. The form should have a fax cover sheet that identifies the fax as a reportable incident and states the reason that the report needed to be faxed. Faxing the Incident Management Contingency Form is a short-term solution for meeting regulatory requirements for reporting incidents; however, once access to HCSIS can be established, the incident must be entered into HCSIS.
CONTACT INFORMATION:
OMR Regional Office Fax Numbers:
* Northeast Region (570) 963-3177
* Southeast Region (215) 560-3043
* Central Region (717) 772-6483
* Western Region (412) 565-5479
OMR Regional Office Phone Numbers:
* Northeast Region (570) 963-4391
* Southeast Region (215) 560-2242
* Central Region (717) 772-6507
* Western Region (412) 565-5144
Pa. Code tit. 55, pt. VIII, subpt. A, ch. 6000, subch. R, STATUTES, app J
This appendix cited in 55 Pa. Code § 6000.924 (relating to incident management contingency plan).