Event Notifications. In addition to other reporting requirements provided for herein, Provider shall notify immediately notify CMHSP of any of the following events: A. Any death that occurs as a result of suspected staff member action or inaction, or any death that is the subject of a Recipient Rights, licensing, or police investigation. This report shall be submitted within twenty-four (24) hours of either the death, Provider’s receipt of notification of the death, or Provider’s receipt of notification that a Recipient Rights, licensing, or police investigation has commenced. At minimum, Provider shall include in the report: 1. Name of the Covered Person. 2. Covered Person’s identification number (e.g. Medicaid, MIChild, etc.) 3. Consumer ID (“CONID”), if no beneficiary ID number. 4. Date, time, and place of death, including license number of facility if applicable. 5. Preliminary cause of death, if known, or known facts surrounding the event. 6. Contact person’s name, phone number, and e-mail address. B. Relocation of a Covered Person’s placement due to licensing issues. C. An occurrence that requires relocation of Provider, a Provider service site, governance, or administrative operation for more than twenty-four (24) hours for any reason. D. The conviction of Provider or a Provider staff member for any offense related to the performance of their job duties or responsibilities which results in exclusion from participation in federal reimbursement.
Appears in 2 contracts
Sources: Provider Service Agreement, Provider Service Agreement