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Reportable Event Management

About Reportable Event Management (REM)

Reportable Event Management (REM) is an important component of an overall approach for ensuring the health, safety, individual freedom, and quality of life of people participating in home and community-based services (HCBS). REM in CHOICES, Employment and Community First (ECF) CHOICES, Katie Beckett and the 1915(c) waiver programs involves a partnership between TennCare, the Department of Intellectual and Developmental Disabilities (DIDD), Managed Care Organizations (MCOs), and HCBS providers who all have a role in making REM an effective tool for ensuring the highest possible quality of life by honoring the self-determination of people receiving HCBS.

This process aligns with the Dignity of Choice protocol which sets forth expectations for TennCare, MCOs, contracted providers, and DIDD regarding philosophies and practices specific to foreseeable risk identification, assessment, and mitigation in the home and community-based services. This protocol identifies a process for addressing dignity of choice through comprehensive assessment, the Person-Centered Support Plan (PCSP) process, and ongoing Support/Care Coordination/Case Management.

Dignity of choice is the right of a person to make an informed decision to engage in experiences of his or her own choosing, which are necessary for personal growth and development. Supporting dignity of choice means honoring a person’s right to make choices and engage in activities that may involve risk associated with these types of choices and activities, and committing to assist the person to identify, consider, and implement strategies to mitigate the identified potential negative consequences of these choices.

The aligned approach to REM ensures that people, involved family members, and/or natural supports, as appropriate, are informed about supporting dignity of choice, including informed decision making, tolerable risks, risk mitigation, and how to safely report an event that compromises the health, safety, individual freedom, and/or quality of life of a person supported.

People supported by home and community-based services (HCBS) such as CHOICES, Employment and Community First (ECF) CHOICES, Katie Beckett and the 1915(c) waiver programs are encouraged (with, whenever possible, the support and involvement of their families and natural supports) to pursue and achieve their goals, which inevitably involves taking informed, reasonable risks.

Within CHOICES, ECF CHOICES, Katie Beckett and the 1915(c) waivers, the REM system is designed to:

  1. Clarify non-reportable events that providers must address internally through their own quality assurance and event management processes;
  2. Define the reportable events that must be reported to DIDD, the MCO and the timeframes for reporting;
  3. Ensure that provider agencies, their staff, MCO Support Coordinators, the Fiscal Employer Agent (FEA), and others are well informed of their responsibilities to identify events that are reportable;
  4. Specify the types of reportable events that require investigation or review, by whom (DIDD or provider), the timeframes for such investigations or reviews, and how the person (and/or family and legal representative as appropriate), providers, and others are informed of the results of an investigation or review;
  5. Define the processes for requesting a file review of a completed class 1 investigation report, who may request a review, and timelines applicable to the review process; and
  6. Ensure a collaborative process between providers, MCOs, and DIDD that identifies and defines trends in order to evaluate the nature, frequency, and circumstances of all reportable events, in a manner that leads to actionable steps that are proactive in preventing or reducing similar occurrences.

Memos

September 1, 2021 REM Incentive Protocol

August 25, 2021 Training Memo Specific to CHOICES Providers

August 6, 2021 Training Memo (with Training Grid)
This memo includes IMPORTANT AND TIME-SENSITIVE INFORMATION regarding Reportable Event Management (REM), including Provider Investigator training requirements and opportunities to streamline the completion of these training requirements and to earn quality incentives for timely completion of REM Provider Investigator required training.


REM System Alignment

Provider Investigator Training Deadline Approaching

For Providers who are required to have a Provider Investigator, please be advised that there are only two additional training sessions available for the QuiLTSS training. The next session begins on 11/1/21 and the last session begins on 11/15/21. Every non-exempt providers must have an investigator registered for QuILTSS training prior to 11/11/21.

For those providers who have not yet submitted anyone as their identified Provider Investigator, please submit the registration form, which can be found on the REM Webpage under “Training” at https://www.tn.gov/didd/providers/r-e-m/rem-training.html.

Unless you are identified as an exempt provider, to meet compliance you are required to have a DIDD approved Provisional Investigator or a DIDD approved business agreement by 10/1/21 for ECF Choices, 1915c, ICF-IDD and certified Provider Investigator or business agreement by 12/31/21.

CHOICES only providers must meet compliance by having certified Provider Investigator or business agreement by 12/31/21.

Please refer to the provider investigator section on the DIDD REM Webpage at https://www.tn.gov/didd/providers/r-e-m for additional information.

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Provider Investigator Information

An updated Provider List has been posted pertaining to Provider Investigator Status. Please review the list on the REM webpage using the following link https://www.tn.gov/didd/providers/r-e-m.html. We ask the providers to let us know if there are errors or a change in status by emailing the information to the REM Help Desk at DIDD.REMHelp@tn.gov.

REM System Alignment WebEx Presentation

REM System Alignment WebEx Presentation previously scheduled for Thursday; October 21st, 2021 is cancelled. The DIDD REM HelpDesk has had a marked decline in the number of inquiries and questions. The questions currently received have been addressed in previous web-ex presentations and submitted by persons that were not in prior attendance. All questions submitted to the REM HelpDesk will be responded to. Should new questions or topics arise that would benefit all business partners, the information will be shared in the announcement section of the REM webpage. DIDD will hold another special session for CHOICES providers in December 2021, prior to the launch of the REM System for the CHOICES only service providers. Again, if you have questions before that time, please submit them to the REM HelpDesk and we will be happy to answer or assist you DIDD.REMHelp@tn.gov

Reportable Event Form (REF) Update:

The REF has been updated with the inclusion of the person’s Medicaid ID number. This number is utilized by the Managed Care Organizations (MCOs). Previously, providers were asked to include the Medicaid ID number in the body of the email. This is no longer necessary with the updated template of 10.1.21. The updated REF is located at https://www.tn.gov/didd/providers/r-e-m/rem-resources.html

REM System Substantiated Investigations Records Inquiry (SIRI) Registration

As a reminder, the SIRI tool (for searching the Substantiated Investigations Records Inquiry system) is open for registration for all providers, including TEIS, ECF CHOCIES, CHOICES, ICF-IID, Katie Becket and 1915c. This tool broadens your information base when selecting applicants for hire, and for making retention decisions concerning existing staff. Although it was optional in the past, it is now a requirement. Provider Investigators can register separately from agency HR personnel using the same procedure:

To register, an email from the Executive Director or designee must be sent to dd.investigation@tn.gov, providing the names and position titles, business emails, and business phone numbers and addresses of up to three personnel, including the Executive Director. (For agencies operating in more than one of the grand regions, each office should sign up separately.)

DIDD Provisional or LRA/TQI Provider Investigators can send an email directly with the agency’s Executive Director included on the cc line of the email.

If you have any questions or run into any problems, please email the same mailbox, or reach SIRI Coordinator Norah Glickstein at 615-253-5024.

REM Provider Incentives

DIDD and TennCare have established REM Provider Investigator incentives for providers. Providers will be awarded quality incentive payment upon the successful and timely completion of REM Provider Investigator training requirements. This payment will help offset the cost of staff time to complete the training and reward providers for their increased competency to perform high-quality Tier 2 investigations. The protocol linked below outlines the incentive opportunity which is available to provider agencies only for provider investigator training completed by December 31, 2021.

The protocol can also be found on the REM webpage: https://www.tn.gov/didd/providers/r-e-m.html REM Incentive Protocol

 

REM Provider Incentives

Starting 9/1/2021, any email correspondence being sent to DIDD Event Management should be sent to the DIDD Reportable Events Mailbox at DIDD.ReportableEvents@tn.gov.

As a result of the alignment, DIDD will be closing the Event Management REF email addresses for the DIDD Event Management address of DIDD.Incidentmgmt@tn.gov, and the ECF REF mailbox ECF.REF@tn.gov. Both email accounts will be closed on 9/15/2021.

 

REM Provisional One-Day Provider Investigator Training Deadline 8/27/21

August 27th, 2021 is the LAST DAY for registration for the DIDD One-Day Provider Investigator training.

The DIDD one-day trainings will ONLY be available until September 9, 2021. There will be no additional opportunity to complete the one-day training after September 9, 2021.

To register, complete the Provider Investigator Registration form located at http://www.tn.gov/didd/providers/r-e-m/rem-training.html Provider Investigator, Registration Form. If you have already registered, please submit your 3 preferred dates for this training to DIDD.REMHelp@tn.gov by August 27, 2021.

You are expected to attend the session for which you are registered. If you do not attend the one-day training for which you are registered, absent explanation from your executive management or leadership, you will not be permitted to register for another session. Any non-LRA-REM trained provider investigators will need to fully complete the TQI REM Investigator training, that will begin September 15, 2021, prior to completing any Tier 2 investigations.

In addition, the TQI Provider Investigation course starting September 15 will be closed to all new registration after September 2, 2021.

Providers that fail to ensure that staff complete applicable training requirements by the specified timeframe may face corrective actions, including sanctions and up to potential contract termination, since providers are required to meet all applicable qualifications (which include staff training requirements) as a condition of eligibility for Medicaid reimbursement.

Please contact DIDD.REMHelp@tn.gov and a response will be sent to your message as soon as possible.


REM System Alignment WebEx Presentation

Thursday, October 7, 2021 1:00 pm Central Daylight Time (Chicago, GMT-05:00)

REM Alignment Forum

Event address for attendees:
https://tn.webex.com/tn/onstage/g.php?MTID=ef9d2a2bda741ce103592f3404aa7097e

Duration:
1 hour 30 minutes

Event number:
2314 711 0498

Event password:
DIDD

Video Address: 23147110498@tn.webex.com You can also dial 173.243.2.68 and enter your meeting number.

Audio conference: To receive a call back, provide your phone number when you join the event, or call the number below and enter the access code.
US Toll +1-415-655-0001 Show all global call-in numbers Access code: 2314 711 0498


REM Training Reminder

  • For ECF Choices, 1915c, Katie Beckett, and ICF-IID providers the Reportable Event Training (RET) is the only required training for all staff and volunteers. This training must be completed by 9/1/21.
  • For ECF Choices, 1915c, Katie Beckett, and ICF-IID providers the Provider Reportable Event Response Team training is only for the provider’s Event management Staff. This training must be completed by 9/1/21.
  • For ECF Choices, 1915c, Katie Beckett, and ICF-IID providers the Provider Investigator training is only for the person designated by the provider to conduct Tier 2 investigations.
    • Provisional 1-Day Provider Investigator training must be completed by 9/9/21,
    • or a Labor Relations Alternative-REM trained investigator/ TQI trained Investigator,
    • or an approved business agreement by DIDD for a certified approved PI by 10/1/21.
  • CHOICES ONLY Providers must have all staff trained Reportable Event Training (RET), Provider Reportable Event Response Team, and a REM certified Provider Investigator or business agreement by 1/1/2021.

 

REM Implementation

 


REM Provisional One-Day Provider Investigator Training:

DIDD is scheduling staff to attend the 1-Day Provisional Investigator training based on the dates requested by the learner. Staff are not attending their scheduled training date. Classes have a capacity limit and by not attending the training on a date requested, your learner may be blocking a slot that someone else can attend. Please be courteous to all providers and attend on the date and time that you have requested and that you were sent the invitation for attending. If you are unable to attend, please email the REM HelpDesk at DIDD.REMHelp@tn.gov as soon as possible to be rescheduled and to allow another learner the opportunity.

MCO Message:
We encourage all providers to take advantage of this great opportunity. Registration is time sensitive and will only be offered during the noted timeframes. The 1 Day provisional training is a benefit and completely optional, and very much considered to be an advantage for our providers.

Some benefits of the 1 Day provisional training include: the designated provider investigator will have an opportunity for a more 1:1 classroom type learning environment presented by experienced State Investigators, the time commitment of the TQI training is less, and allows the designated provider investigator opportunity to complete investigations while also completing the TQI certification training (hands on experience) which helps when answering the competency based question aspects of the TQI training.

 


Provider Event Management EMC Training:

The Provider Event Management Training has been revised to include tracking and trending information, as well as updated definitions for reportable medical and reportable behavioral events.

Those who are currently enrolled in the original Relias training TNDIDD Provider Event Management Training, Course Code: TNDIDD_PEM-EMC_Training_2021must be completed by 7/15/21.

After which time, the revised Relias course TNDIDD Provider Event Management Training Course Code: TNDIDD_PRERT will be available for enrollment on 7/19/21.

For those who have completed the original course, the revised training will also be available on the REM Webpage to view for the supplemental information pertaining to the changes.

Reportable Event Training

As previously announced in the 6.25.21 Open Line article, the Reportable Event Form (REF) training is being renamed to Reportable Event Training.  This is to reflect the nature of the training as it is not limited to training on form completion.  The new training has expanded on the explanations for reportable medical and behavioral events, includes Choices specific examples, and enlightens staff in recognizing what is reportable, the timeframes for reporting, and the state’s requirement in how the events are reported.  The previously required Direct Support professional video is now optional for staff and at the discretion of the provider.  It will remain available on the webpage.

To allow those who are already in progress a chance to complete the course, we will be leaving the Reportable Event Form (REF) Training course in the current training plans until 7/14/21. Learners currently enrolled in the Reportable Event Form (REF) Training course will need to complete the course by 7/15/21, or they will need to be un-enrolled from the Reportable Event Form (REF) Training course and enrolled in the new Reportable Event Training course. All new hires should be enrolled in the new Reportable Event Training course. On 7/15/21, all incomplete enrollments in the Reportable Event Form (REF) Training course, will be unenrolled and the course will not be accessible. Once the Reportable Event Training course is accessible again, an announcement will appear in Open Line. It is anticipated that the transition to the new training and Training Plan will be completed by 7/19/21.

To allow agencies to easily unenroll learners who already completed the Reportable Event Form (REF) Training course and have satisfied the requirement, once the new Reportable Event Training course is uploaded to Relias, the DIDD Global Administrators will create a new Training Plan that will only contain the new Reportable Event training course. DIDD Global Administrators can assist with setting up Auto Enrollment upon request.

Please contact the TNDIDD Relias Help desk for assistance with Relias functionality.  DIDD.ISQA@tn.gov

Please contact the DIDD REM Help Desk with questions or concerns regarding requirements and timelines for this training. DIDD.REMHelp@tn.gov

Please note that this is still a one-time training, so users will NOT have to retake the training. However, the user will be able to return to Relias to review the material as needed. The REM training is posted to the webpage at www.tn.gov/didd/providers/r-e-m/rem-training.html. The webpage will always have the most current version of the training for you to download. 


REM MCO email address change

The Amerigroup REM email addresses have been consolidated into one inbox. REM Pilot providers, please start immediately submitting all REM correspondence to the consolidated email box noted below. All other providers will begin utilizing this mailbox when the REM goes live, which is on 09.01.2021. AGP REM new consolidated inbox for all things REM is: TN-REM@amerigroup.com

As a reminder, remember after the REM REF is reviewed, you shall submit the REF to DIDD Event Management and the MCO as soon as possible, but no later than the next business day after the event was reported, witnessed, or discovered. REFs must be submitted to the applicable MCO for all waiver types.  REFs are submitted via email to DIDD.ReportableEvents@tn.gov and the applicable MCO email address.

The MCO email contacts are:

 

REM Reportable Event Form Updated

When the REM Reportable Event Form (REF) goes live on 09.01.2021, you will find that a new category has been added to assist with tracking of exploitation. Exploitation will be tracked as financial exploitation and exploitation of a person supported. This new tracking of exploitation of a person supported will be categorized as follows:

Tier 1 – Alleged Exploitation of a Person Supported which requires intervention and treatment

Example: Staff used the supported person’s disability to gain access to an event in which the person had no expressed desire to attend. The person supported became upset at the event and engaged in verbal aggression and was shouting at a private citizen, resulting in the police being called.

Example: Staff posted a video on Facebook of a person supported engaging in challenging behaviors for personal gratification. The person supported saw the video on the Facebook page and read disparaging comments, which upset her and caused her to threaten suicide. Mobile Crisis was utilized

Tier 2 – Alleged Exploitation of a Person Supported which does not require intervention and treatment

Example: Staff used the person supported to obtain free items in which the staff took possession of.

Example: Staff had the person supported mow the staff’s lawn.

The most current version of the REM REF can always be located on the DIDD REM website. https://www.tn.gov/didd/providers/r-e-m/rem-resources.html