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Risk Management & Patient Safety Program | On-Line Reporting | Risk Manager | Reporting | Newsletter | Articles | Quarterly Report | Annual Report | Statutes & Rules | Florida Center

REPORTING

Chapter 395 F.S. currently requires reporting of the following types of incidents to the Agency by hospitals and ambulatory surgical centers at this time. They must also report any injuries of which they are aware occurring through any health care service, which would include nursing homes, home health organizations, doctors' offices, dentists' offices, or any other purveyor of health care service. Additionally, Chapter 641.55 requires similar reporting of patient injury incidents by HMOs. The patient injury incidents are reported through two different types of reporting mechanisms:

The facility Annual Report -- must reflect all adverse incidents according to statutory definition, which occur in the facility in the course of a calendar year, due in to the Agency, Risk Management & Patient Safety Program, after the first of each year for the previous year; and

The Code 15 Report -- reports in detail and analyzes each serious patient injury, as defined by statute, and due in to the Agency, Risk Management & Patient Safety Program, within 15 days from the time of the occurrence of the injury.


*On-Line Reporting of Code 15 Reports or Annual Reports

*Get a Logon and/or Password [88kb .doc]



Reporting Forms and Information

Code 15 Report Form
[126kb .doc]*

Code 15 Reporting Instructions
[44kb .pdf]

Code 15 Report Form -
HMOs
[141kb .doc]*

Adverse Incident Reporting Guide
[31kb .pdf]
Code 15 Extension Form
[87kb .doc]
Annual Report Cover Letter - December 24, 2003
[17kb .pdf]
Annual Report Form
[315kb .doc]
Annual Report Instructions
[36kb .pdf]
Contacts- Risk Management Program Staff
[52kb .pdf]
   *  Computerized template in Word format.

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Updated December 30, 2008

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Risk Management & Patient Safety Program | On-Line Reporting | Risk Manager | Reporting | Newsletter | Articles | Quarterly Report | Annual Report | Statutes & Rules | Florida Center