Long Term Care Facility - Self-reported Incident Form is a legal document that was released by the Kentucky Secretary of State - a government authority operating within Kentucky.
Q: What is a Long Term Care Facility?
A: A Long Term Care Facility is a residential facility that provides 24-hour care and assistance for individuals who need help with daily activities such as bathing, dressing, and medication management.
Q: What is a self-reported incident form?
A: A self-reported incident form is a document that allows individuals or staff members at a Long Term Care Facility to report any accidents, injuries, or incidents that occur within the facility.
Q: Why is it important to fill out a self-reported incident form?
A: Filling out a self-reported incident form is important to ensure that all incidents within a Long Term Care Facility are properly documented. This helps to identify potential areas for improvement and ensures the safety and well-being of the residents.
Q: Who can fill out a self-reported incident form?
A: Both staff members and residents or their representatives can fill out a self-reported incident form. Anyone who witnesses or is involved in an incident should complete the form as soon as possible.
Q: What information should be included on a self-reported incident form?
A: A self-reported incident form should include details such as the date and time of the incident, a description of what happened, any injuries or property damage, and the names of individuals involved or witnesses.
Form Details:
Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Kentucky Secretary of State.