(6271,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1513,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"120\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"The provider \\u2013 and the person\\u2019s team - expected the person\\u2019s challenging behavior to dissipate after intake not only because they thought the environment would suit the person, but they assumed that a behavior support plan would positively effect change and decrease the person\\u2019s interfering behavior and that other external services would be able to assist with challenging episodes. Unfortunately, upon arrival the provider found there was a lack of external behavior services in their area and that they had a lack of information about what mental health services were available. \\nAlong with the lack of mental health resources, the provider also noted there was a lack of behavioral resources available to the person. Some practitioners had recommended that the person be admitted to an inpatient facility where they could try a \\u201cmed holiday\\u201d \\u2013 taking the person off all their meds and slowly re-introducing medication to determine their effectiveness. The provider could only find 1 program in the state that offered \\u201cmed holidays\\u201d, and that program had only 9 beds and waiting list of 25 people. The mapping team noted that the Jensen Settlement, which limited community base intensive services and the interventions they could use, influenced the lack of behavioral services like this one. \\n\\nAnother factor as to why this person was placed in an atypical placement was that the provider was willing to take a risk by accepting someone who didn\\u2019t fit the typical profile for this home. They were willing to take a risk because they did have an open ICF\\/DD bed that needed to be filled and hadn\\u2019t had much interest from other people in\\n\\nAlong with the provider being willing to take a risk by accepting the person\\u2019s placement in this atypical setting was that both the case manager and the person\\u2019s guardian were willing to take a risk by placing the person in a home that didn\\u2019t fit the \\u2018typical\\u2019 profile. The person had failed at multiple community-based settings before so they both reported being interested in trying something different. Their options were likely limited too because this region has a lack of residential placement beds, which is also the trend statewide. This lack of residential beds is seen as influenced by a statewide moratorium on foster care beds as well as a moratorium on ICF\\/DD beds. The providers in the room also noted that the current statewide workforce shortage prohibits them from opening new programs as well as influences the closure of other residential sites. Without staff, programs cannot open or even stay open as providers can\\u2019t meet the supervision needs of the people living there.\\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:08 pm\",\"created_at\":\"4\\/28\\/2021 9:21:08 pm\",\"id\":1513}','68.53.115.247','2021-04-29 02:21:08'),(6272,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1514,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"126\",\"question_type\":\"Free_Text\",\"text_answer\":\"Without interventions that met the needs of the person, coupled with the lack of training of the staff, the provider noted their staff were stressed at the site. They often times engaged in power struggles with the individual and spent time trying to keep the other 3 residents safe\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:26 pm\",\"created_at\":\"4\\/28\\/2021 9:21:26 pm\",\"id\":1514}','68.53.115.247','2021-04-29 02:21:26'),(6273,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1515,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"432\",\"question_type\":\"Yes_or_No\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:26 pm\",\"created_at\":\"4\\/28\\/2021 9:21:26 pm\",\"id\":1515}','68.53.115.247','2021-04-29 02:21:26'),(6274,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports','update',21,'{\"id\":21,\"form_id\":\"23\",\"user_id\":\"81\",\"question_id\":null,\"organization_id\":\"10\",\"tab_id\":null,\"question_type\":null,\"text_answer\":\"{\\\"Short_Answer__76\\\":\\\"Care Manager\\\",\\\"Date__77\\\":\\\"12\\\\\\/16\\\\\\/2019\\\",\\\"Multiple_Choice__78\\\":\\\"Charles Young\\\",\\\"Multiple_Choice__79\\\":\\\"Kristie Pittman\\\",\\\"Short_Answer__80\\\":\\\"Harry Meyering\\\",\\\"Short_Answer__81\\\":\\\"Emily Britz \\\\\\/ Tana Helleksen\\\",\\\"Short_Answer__82\\\":\\\"ebritz \\\\\\/ thelleksen \\\\\\/@harrymeyeringcenter.org\\\",\\\"Multiple_Choice__84\\\":\\\"Termination of Services\\\",\\\"Multiple_Choice__85\\\":\\\"Blue Earth County\\\",\\\"Date__86\\\":\\\"03\\\\\\/19\\\\\\/2019\\\",\\\"Multiple_Choice__96\\\":\\\"2\\\",\\\"Short_Answer__91\\\":\\\"Person\'s services were terminated due to challenging behavior\\\",\\\"True_or_False__94\\\":\\\"Yes\\\",\\\"Free_Text__100\\\":\\\"\\\\\\\"Influencing why the ICF\\\\\\/DD provider terminated this person\\\\u2019s services due to challenging behavior was that the person was posing a safety risk to others in the home. The other 3 individuals in the home were considered to be more vulnerable to abuse due to their lower functioning levels, and so the person posed a greater risk to them. The provider had to balance their responsibility to protect the health and safety of three people in the home with their responsibility to meet the needs of the person whose services they terminated. The guardians of the other 3 individuals had an expectation that the provider would keep them safe, and due to their higher vulnerability the guardians expressed their concern often in this instance. Another impact to the provider\\\\u2019s responsibility for people\\\\u2019s health and safety include county case managers assigning this function to providers via the CSSP. Unique to ICF\\\\\\/DDs is that they are licensed by both the Department of Human Services and the Minnesota Department of Health. Both Departments require providers to protect the health and safety of the people they serve. Minnesota Statutes 245D outlines the requirements for providers enforced by DHS while MDH relies on other statutory requirements in Minnesota statutes 144 and Rule. A unique requirement enforced by MDH is that ICF\\\\\\/DDs are expected to protect the people they serve from \\\\u201cimmediate jeopardy\\\\u201d. The provider in this instance noted that many times in the past they had been asked after a critical incident how they were going to protect the people they served from \\\\u201cimmediate jeopardy\\\\u201d in the future, so this mandate shaped the perception of the provider\\\\u2019s managers and supervisors whenever a health and safety concern arose and placed pressure on them to prioritize their response in a way that would satisfy MDH reviewers. The provider in this instance noted that terminating the person\\\\u2019s services was part of their response as to how they would respond to MDH\\\\u2019s questioning of how they were protecting the health and safety of the other people in the home. Between the requirements of DHS and MDH as well as the expectations of the guardians and case managers, the provider felt a strong need to act in this situation and felt that termination was the only way they could keep the majority of the people in the home safe. \\\\r\\\\nThe provider noted that the team had explored the possibility of implementing rights restrictions with the individual, but the team determined they wouldn\\\\u2019t be possible due to the requirements of 245D surrounding rights restrictions, or wouldn\\\\u2019t be sufficient to meet the safety needs of the person and others in the home. Due to the ineffectiveness of a rights restriction, the provider felt they had few options to address the person\\\\u2019s challenging behavior. \\\\r\\\\nAnother influence as to why the provider terminated a person\\\\u2019s services due to challenging behavior was that the person\\\\u2019s challenging behavior did not dissipate as expected after the person moved to the home. While it was known prior to intake that the person sometimes exhibited challenging behavior, there was an assumption by the team that this environment would likely help decrease the triggers that impacted the challenging behavior in the past. \\\\r\\\\nA number of factors were identified that  person\\\\u2019s challenging behavior not dissipating. For one, the provider noted that the staff at the site were trained more on meeting the medical needs of the other people in the home than de-escalating challenging behavior. While Minnesota Statutes 245D and the Positive Supports Rule (9544) required the provider to ensure their staff had training and were competent on positive support strategies, de-escalation techniques and the use of restrictive interventions, because the other people in the home didn\\\\u2019t exhibit challenging behavior, the focus of their training was centered more on medical needs than \\\\u2018behavioral needs\\\\u2019. The provider also noted that the staff felt a fear to administer pro re nata (PRN) medication to the person during mental health episodes due to the stigma of providing medication at these times and the training and reporting requirements of the Positive Supports Rule. The Positive Supports Rule (MN Rule 9544) requires providers to report the use of PRN medications when administered in a behavioral situation, and there was a belief among staff that the use of PRNs in this manner were not ok because they required reporting. \\\\r\\\\nThe provider \\\\u2013 and the person\\\\u2019s team - expected the person\\\\u2019s challenging behavior to dissipate after intake not only because they thought the environment would suit the person, but they assumed that a behavior support plan would positively effect change and decrease the person\\\\u2019s interfering behavior and that other external services would be able to assist with challenging episodes. Unfortunately, upon arrival the provider found there was a lack of external behavior services in their area and that they had a lack of information about what mental health services were available. Additionally, the person\\\\u2019s case manager \\\\u2013 who would typically be expected to also help find needed services \\\\u2013 was very busy and unable to devote much time to the person\\\\u2019s case. A number of influences as to why case managers would be busy were identified \\\\u2013 between high case load and recent federal and state initiatives changing services. MnCHOICES, HCBS rule and person-centered planning initiatives were all noted as positive changes, but changes that took a lot of time away from case managers to learn and meet the new requirements. This program was located in southern Minnesota, and the team noted that this region in particular has a scarcity of mental health resources. The provider and the team did find a neuropsych practitioner that was willing to work with the person, but unfortunately they were too far away and the drive was too long. This made it hard to make regular meetings and implement the neuropsych\\\\u2019s recommendations. Additionally, the provider was able to bring the person to a nearby hospital during challenging episodes, but noted that any interventions offered by the hospital unfortunately were ineffective.\\\\r\\\\nAlong with the lack of mental health resources, the provider also noted there was a lack of behavioral resources available to the person. Some practitioners had recommended that the person be admitted to an inpatient facility where they could try a \\\\u201cmed holiday\\\\u201d \\\\u2013 taking the person off all their meds and slowly re-introducing medication to determine their effectiveness. The provider could only find 1 program in the state that offered \\\\u201cmed holidays\\\\u201d, and that program had only 9 beds and waiting list of 25 people. The mapping team noted that the Jensen Settlement, which limited community base intensive services and the interventions they could use, influenced the lack of behavioral services like this one. \\\\r\\\\nWithout interventions that met the needs of the person, coupled with the lack of training of the staff, the provider noted their staff were stressed at the site. They often times engaged in power struggles with the individual and spent time trying to keep the other 3 residents safe. The provider did note that one option they wanted to explore before terminating the person\\\\u2019s services was to find out if they could obtain 1 on 1 staffing for the individual, but didn\\\\u2019t know who to ask or where to start. ICF\\\\\\/DD rates have many regulations and oftentimes hard to navigate they noted. The provider noted that the ability to obtain reimbursement beyond the facility\\\\u2019s establish rate was a mystifying process.\\\",\\\"Yes_or_No__128\\\":\\\"Yes\\\",\\\"Free_Text__132\\\":\\\"\\\\\\\"Influencing why this person was placed in what was seen as an atypical placement was that the person had never stayed at an ICF\\\\\\/DD before and the other people in the home were seen as having more medical needs than behavioral challenges. Despite these differences, the team, including the case manager, guardian and the provider thought this could be a good fit for the person because they could have more attention from staff and the person wouldn\\\\u2019t see the other roommates as a \\\\u2018threat\\\\u2019. \\\\r\\\\nAnother factor into this placement was that the provider had an open ICFs\\\\\\/DD bed. The fact it was an ICF\\\\\\/DD bed was one of the reasons why the bed was open. The providers in the room noted that there isn\\\\u2019t much interest in ICF\\\\\\/DD beds any more. Regionally, statewide and nationally, ICF or other institutional placements are seen as undesirable and passed over for foster care or other community-based settings. A number of factors have influenced this opinion about ICFs\\\\\\/DDs, including; public sentiment shifting away from institutions and large settings; the HCBS settings rule which has required systems to move towards community settings; the Minnesota Olmstead Plan which reflects the Supreme Court\\\\u2019s 1999 Olmstead ruling determining people should be served in the \\\\u201cmost integrated setting\\\\u201d, and; the Jensen Settlement Agreement which resulted in both Minnesota\\\\u2019s Olmstead Plan and the closure of some institutional services.\\\\r\\\\nAnother factor as to why this person was placed in an atypical placement was that the provider was willing to take a risk by accepting someone who didn\\\\u2019t fit the typical profile for this home. They were willing to take a risk because they did have an open ICF\\\\\\/DD bed that needed to be filled and hadn\\\\u2019t had much interest from other people in. The provider was also willing to take a risk because they determined the person could do well at the site.  This determination impacted the placement and was impacted by a number of factors. While the other people in the home didn\\\\u2019t have similar needs as this person, the team thought this might work well in this case. The other five people in the home had higher Activities of Daily Living (ADL) needs than this person so it was thought the person wouldn\\\\u2019t add much to the staff\\\\u2019s workload in this area. The five people also exhibited challenging behavior that was more easily redirected and managed by staff, so it was thought the house wouldn\\\\u2019t be overwhelming for staff to manage challenging behavior in the home as a whole. Additionally, it seemed to the provider that the person\\\\u2019s challenging behavior appeared manageable. This was due to a number of influences such as the case manager reporting there weren\\\\u2019t major recent behavioral concerns and the paperwork received from the person\\\\u2019s previous provider before intake. Beyond the concerns around the person\\\\u2019s challenging behavior, the paperwork from the previous provider supported the new provider\\\\u2019s assessment that the person could do well at this site. The person\\\\u2019s psychiatrist also weighed in and supported this particular placement, contributing to this assessment.\\\\r\\\\nAlong with the provider being willing to take a risk by accepting the person\\\\u2019s placement in this atypical setting was that both the case manager and the person\\\\u2019s guardian were willing to take a risk by placing the person in a home that didn\\\\u2019t fit the \\\\u2018typical\\\\u2019 profile. The person had failed at multiple community-based settings before so they both reported being interested in trying something different. Their options were likely limited too because this region has a lack of residential placement beds, which is also the trend statewide. This lack of residential beds is seen as influenced by a statewide moratorium on foster care beds as well as a moratorium on ICF\\\\\\/DD beds. The providers in the room also noted that the current statewide workforce shortage prohibits them from opening new programs as well as influences the closure of other residential sites. Without staff, programs cannot open or even stay open as providers can\\\\u2019t meet the supervision needs of the people living there.\\\",\\\"Multiple_Choice__101\\\":\\\"2\\\",\\\"Free_Text__102\\\":\\\"Unique to ICF\\\\\\/DDs is that they are licensed by both the Department of Human Services and the Minnesota Department of Health. Both Departments require providers to protect the health and safety of the people they serve. Minnesota Statutes 245D outlines the requirements for providers enforced by DHS while MDH relies on other statutory requirements in Minnesota statutes 144 and Rule. A unique requirement enforced by MDH is that ICF\\\\\\/DDs are expected to protect the people they serve from \\\\u201cimmediate jeopardy\\\\u201d. The provider in this instance noted that many times in the past they had been asked after a critical incident how they were going to protect the people they served from \\\\u201cimmediate jeopardy\\\\u201d in the future, so this mandate shaped the perception of the provider\\\\u2019s managers and supervisors whenever a health and safety concern arose and placed pressure on them to prioritize their response in a way that would satisfy MDH reviewers. The provider in this instance noted that terminating the person\\\\u2019s services was part of their response as to how they would respond to MDH\\\\u2019s questioning of how they were protecting the health and safety of the other people in the home. Between the requirements of DHS and MDH as well as the expectations of the guardians and case managers, the provider felt a strong need to act in this situation and felt that termination was the only way they could keep the majority of the people in the home safe.\\\",\\\"Multiple_Choice__109\\\":\\\"2\\\",\\\"Free_Text__110\\\":\\\"The provider \\\\u2013 and the person\\\\u2019s team - expected the person\\\\u2019s challenging behavior to dissipate after intake not only because they thought the environment would suit the person, but they assumed that a behavior support plan would positively effect change and decrease the person\\\\u2019s interfering behavior and that other external services would be able to assist with challenging episodes. Unfortunately, upon arrival the provider found there was a lack of external behavior services in their area and that they had a lack of information about what mental health services were available. Additionally, the person\\\\u2019s case manager \\\\u2013 who would typically be expected to also help find needed services \\\\u2013 was very busy and unable to devote much time to the person\\\\u2019s case. A number of influences as to why case managers would be busy were identified \\\\u2013 between high case load and recent federal and state initiatives changing services.\\\",\\\"Multiple_Choice__115\\\":\\\"3\\\",\\\"Free_Text__116\\\":\\\"Influencing why the ICF\\\\\\/DD provider terminated this person\\\\u2019s services due to challenging behavior was that the person was posing a safety risk to others in the home. The other 3 individuals in the home were considered to be more vulnerable to abuse due to their lower functioning levels, and so the person posed a greater risk to them. The provider had to balance their responsibility to protect the health and safety of three people in the home with their responsibility to meet the needs of the person whose services they terminated.\\\",\\\"Multiple_Choice__119\\\":\\\"3\\\",\\\"Free_Text__120\\\":\\\"\\\\\\\"The provider \\\\u2013 and the person\\\\u2019s team - expected the person\\\\u2019s challenging behavior to dissipate after intake not only because they thought the environment would suit the person, but they assumed that a behavior support plan would positively effect change and decrease the person\\\\u2019s interfering behavior and that other external services would be able to assist with challenging episodes. Unfortunately, upon arrival the provider found there was a lack of external behavior services in their area and that they had a lack of information about what mental health services were available. \\\\r\\\\nAlong with the lack of mental health resources, the provider also noted there was a lack of behavioral resources available to the person. Some practitioners had recommended that the person be admitted to an inpatient facility where they could try a \\\\u201cmed holiday\\\\u201d \\\\u2013 taking the person off all their meds and slowly re-introducing medication to determine their effectiveness. The provider could only find 1 program in the state that offered \\\\u201cmed holidays\\\\u201d, and that program had only 9 beds and waiting list of 25 people. The mapping team noted that the Jensen Settlement, which limited community base intensive services and the interventions they could use, influenced the lack of behavioral services like this one. \\\\r\\\\n\\\\r\\\\nAnother factor as to why this person was placed in an atypical placement was that the provider was willing to take a risk by accepting someone who didn\\\\u2019t fit the typical profile for this home. They were willing to take a risk because they did have an open ICF\\\\\\/DD bed that needed to be filled and hadn\\\\u2019t had much interest from other people in\\\\r\\\\n\\\\r\\\\nAlong with the provider being willing to take a risk by accepting the person\\\\u2019s placement in this atypical setting was that both the case manager and the person\\\\u2019s guardian were willing to take a risk by placing the person in a home that didn\\\\u2019t fit the \\\\u2018typical\\\\u2019 profile. The person had failed at multiple community-based settings before so they both reported being interested in trying something different. Their options were likely limited too because this region has a lack of residential placement beds, which is also the trend statewide. This lack of residential beds is seen as influenced by a statewide moratorium on foster care beds as well as a moratorium on ICF\\\\\\/DD beds. The providers in the room also noted that the current statewide workforce shortage prohibits them from opening new programs as well as influences the closure of other residential sites. Without staff, programs cannot open or even stay open as providers can\\\\u2019t meet the supervision needs of the people living there.\\\\\\\"\\\",\\\"Multiple_Choice__125\\\":\\\"2\\\",\\\"Free_Text__126\\\":\\\"Without interventions that met the needs of the person, coupled with the lack of training of the staff, the provider noted their staff were stressed at the site. They often times engaged in power struggles with the individual and spent time trying to keep the other 3 residents safe\\\",\\\"Yes_or_No__432\\\":\\\"Yes\\\"}\",\"mcq_answer\":null,\"other_answer\":\"0\",\"status\":\"1\",\"created_by\":\"81\",\"updated_by\":81,\"created_at\":\"4\\/28\\/2021 9:16:29 pm\",\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"deleted_at\":null,\"report_name\":\"CY_Harry Meyering-BEC-2019-11\"}','68.53.115.247','2021-04-29 02:21:30'),(6275,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1516,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Care Manager\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1516}','68.53.115.247','2021-04-29 02:21:30'),(6276,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1517,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"12\\/16\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1517}','68.53.115.247','2021-04-29 02:21:30'),(6277,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1518,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"78\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Charles Young\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1518}','68.53.115.247','2021-04-29 02:21:30'),(6278,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1519,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Kristie Pittman\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1519}','68.53.115.247','2021-04-29 02:21:30'),(6279,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1520,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Harry Meyering\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1520}','68.53.115.247','2021-04-29 02:21:30'),(6280,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1521,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Emily Britz \\/ Tana Helleksen\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1521}','68.53.115.247','2021-04-29 02:21:30'),(6281,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1522,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"ebritz \\/ thelleksen \\/@harrymeyeringcenter.org\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1522}','68.53.115.247','2021-04-29 02:21:30'),(6282,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1523,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"83\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1523}','68.53.115.247','2021-04-29 02:21:30'),(6283,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1524,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"84\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Termination of Services\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1524}','68.53.115.247','2021-04-29 02:21:30'),(6284,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1525,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Blue Earth County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1525}','68.53.115.247','2021-04-29 02:21:30'),(6285,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1526,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"03\\/19\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1526}','68.53.115.247','2021-04-29 02:21:30'),(6286,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1527,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1527}','68.53.115.247','2021-04-29 02:21:30'),(6287,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1528,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"96\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1528}','68.53.115.247','2021-04-29 02:21:30'),(6288,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1529,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Person\'s services were terminated due to challenging behavior\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1529}','68.53.115.247','2021-04-29 02:21:30'),(6289,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1530,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"94\",\"question_type\":\"True_or_False\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1530}','68.53.115.247','2021-04-29 02:21:30'),(6290,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1531,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1531}','68.53.115.247','2021-04-29 02:21:30'),(6291,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1532,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1532}','68.53.115.247','2021-04-29 02:21:30'),(6292,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1533,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"99\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1533}','68.53.115.247','2021-04-29 02:21:30'),(6293,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1534,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Influencing why the ICF\\/DD provider terminated this person\\u2019s services due to challenging behavior was that the person was posing a safety risk to others in the home. The other 3 individuals in the home were considered to be more vulnerable to abuse due to their lower functioning levels, and so the person posed a greater risk to them. The provider had to balance their responsibility to protect the health and safety of three people in the home with their responsibility to meet the needs of the person whose services they terminated. The guardians of the other 3 individuals had an expectation that the provider would keep them safe, and due to their higher vulnerability the guardians expressed their concern often in this instance. Another impact to the provider\\u2019s responsibility for people\\u2019s health and safety include county case managers assigning this function to providers via the CSSP. Unique to ICF\\/DDs is that they are licensed by both the Department of Human Services and the Minnesota Department of Health. Both Departments require providers to protect the health and safety of the people they serve. Minnesota Statutes 245D outlines the requirements for providers enforced by DHS while MDH relies on other statutory requirements in Minnesota statutes 144 and Rule. A unique requirement enforced by MDH is that ICF\\/DDs are expected to protect the people they serve from \\u201cimmediate jeopardy\\u201d. The provider in this instance noted that many times in the past they had been asked after a critical incident how they were going to protect the people they served from \\u201cimmediate jeopardy\\u201d in the future, so this mandate shaped the perception of the provider\\u2019s managers and supervisors whenever a health and safety concern arose and placed pressure on them to prioritize their response in a way that would satisfy MDH reviewers. The provider in this instance noted that terminating the person\\u2019s services was part of their response as to how they would respond to MDH\\u2019s questioning of how they were protecting the health and safety of the other people in the home. Between the requirements of DHS and MDH as well as the expectations of the guardians and case managers, the provider felt a strong need to act in this situation and felt that termination was the only way they could keep the majority of the people in the home safe. \\r\\nThe provider noted that the team had explored the possibility of implementing rights restrictions with the individual, but the team determined they wouldn\\u2019t be possible due to the requirements of 245D surrounding rights restrictions, or wouldn\\u2019t be sufficient to meet the safety needs of the person and others in the home. Due to the ineffectiveness of a rights restriction, the provider felt they had few options to address the person\\u2019s challenging behavior. \\r\\nAnother influence as to why the provider terminated a person\\u2019s services due to challenging behavior was that the person\\u2019s challenging behavior did not dissipate as expected after the person moved to the home. While it was known prior to intake that the person sometimes exhibited challenging behavior, there was an assumption by the team that this environment would likely help decrease the triggers that impacted the challenging behavior in the past. \\r\\nA number of factors were identified that  person\\u2019s challenging behavior not dissipating. For one, the provider noted that the staff at the site were trained more on meeting the medical needs of the other people in the home than de-escalating challenging behavior. While Minnesota Statutes 245D and the Positive Supports Rule (9544) required the provider to ensure their staff had training and were competent on positive support strategies, de-escalation techniques and the use of restrictive interventions, because the other people in the home didn\\u2019t exhibit challenging behavior, the focus of their training was centered more on medical needs than \\u2018behavioral needs\\u2019. The provider also noted that the staff felt a fear to administer pro re nata (PRN) medication to the person during mental health episodes due to the stigma of providing medication at these times and the training and reporting requirements of the Positive Supports Rule. The Positive Supports Rule (MN Rule 9544) requires providers to report the use of PRN medications when administered in a behavioral situation, and there was a belief among staff that the use of PRNs in this manner were not ok because they required reporting. \\r\\nThe provider \\u2013 and the person\\u2019s team - expected the person\\u2019s challenging behavior to dissipate after intake not only because they thought the environment would suit the person, but they assumed that a behavior support plan would positively effect change and decrease the person\\u2019s interfering behavior and that other external services would be able to assist with challenging episodes. Unfortunately, upon arrival the provider found there was a lack of external behavior services in their area and that they had a lack of information about what mental health services were available. Additionally, the person\\u2019s case manager \\u2013 who would typically be expected to also help find needed services \\u2013 was very busy and unable to devote much time to the person\\u2019s case. A number of influences as to why case managers would be busy were identified \\u2013 between high case load and recent federal and state initiatives changing services. MnCHOICES, HCBS rule and person-centered planning initiatives were all noted as positive changes, but changes that took a lot of time away from case managers to learn and meet the new requirements. This program was located in southern Minnesota, and the team noted that this region in particular has a scarcity of mental health resources. The provider and the team did find a neuropsych practitioner that was willing to work with the person, but unfortunately they were too far away and the drive was too long. This made it hard to make regular meetings and implement the neuropsych\\u2019s recommendations. Additionally, the provider was able to bring the person to a nearby hospital during challenging episodes, but noted that any interventions offered by the hospital unfortunately were ineffective.\\r\\nAlong with the lack of mental health resources, the provider also noted there was a lack of behavioral resources available to the person. Some practitioners had recommended that the person be admitted to an inpatient facility where they could try a \\u201cmed holiday\\u201d \\u2013 taking the person off all their meds and slowly re-introducing medication to determine their effectiveness. The provider could only find 1 program in the state that offered \\u201cmed holidays\\u201d, and that program had only 9 beds and waiting list of 25 people. The mapping team noted that the Jensen Settlement, which limited community base intensive services and the interventions they could use, influenced the lack of behavioral services like this one. \\r\\nWithout interventions that met the needs of the person, coupled with the lack of training of the staff, the provider noted their staff were stressed at the site. They often times engaged in power struggles with the individual and spent time trying to keep the other 3 residents safe. The provider did note that one option they wanted to explore before terminating the person\\u2019s services was to find out if they could obtain 1 on 1 staffing for the individual, but didn\\u2019t know who to ask or where to start. ICF\\/DD rates have many regulations and oftentimes hard to navigate they noted. The provider noted that the ability to obtain reimbursement beyond the facility\\u2019s establish rate was a mystifying process.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1534}','68.53.115.247','2021-04-29 02:21:30'),(6294,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1535,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"127\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1535}','68.53.115.247','2021-04-29 02:21:30'),(6295,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1536,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"128\",\"question_type\":\"Yes_or_No\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1536}','68.53.115.247','2021-04-29 02:21:30'),(6296,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1537,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"129\",\"question_type\":\"Date\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1537}','68.53.115.247','2021-04-29 02:21:30'),(6297,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1538,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"130\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1538}','68.53.115.247','2021-04-29 02:21:30'),(6298,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1539,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"131\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1539}','68.53.115.247','2021-04-29 02:21:30'),(6299,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1540,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"132\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Influencing why this person was placed in what was seen as an atypical placement was that the person had never stayed at an ICF\\/DD before and the other people in the home were seen as having more medical needs than behavioral challenges. Despite these differences, the team, including the case manager, guardian and the provider thought this could be a good fit for the person because they could have more attention from staff and the person wouldn\\u2019t see the other roommates as a \\u2018threat\\u2019. \\r\\nAnother factor into this placement was that the provider had an open ICFs\\/DD bed. The fact it was an ICF\\/DD bed was one of the reasons why the bed was open. The providers in the room noted that there isn\\u2019t much interest in ICF\\/DD beds any more. Regionally, statewide and nationally, ICF or other institutional placements are seen as undesirable and passed over for foster care or other community-based settings. A number of factors have influenced this opinion about ICFs\\/DDs, including; public sentiment shifting away from institutions and large settings; the HCBS settings rule which has required systems to move towards community settings; the Minnesota Olmstead Plan which reflects the Supreme Court\\u2019s 1999 Olmstead ruling determining people should be served in the \\u201cmost integrated setting\\u201d, and; the Jensen Settlement Agreement which resulted in both Minnesota\\u2019s Olmstead Plan and the closure of some institutional services.\\r\\nAnother factor as to why this person was placed in an atypical placement was that the provider was willing to take a risk by accepting someone who didn\\u2019t fit the typical profile for this home. They were willing to take a risk because they did have an open ICF\\/DD bed that needed to be filled and hadn\\u2019t had much interest from other people in. The provider was also willing to take a risk because they determined the person could do well at the site.  This determination impacted the placement and was impacted by a number of factors. While the other people in the home didn\\u2019t have similar needs as this person, the team thought this might work well in this case. The other five people in the home had higher Activities of Daily Living (ADL) needs than this person so it was thought the person wouldn\\u2019t add much to the staff\\u2019s workload in this area. The five people also exhibited challenging behavior that was more easily redirected and managed by staff, so it was thought the house wouldn\\u2019t be overwhelming for staff to manage challenging behavior in the home as a whole. Additionally, it seemed to the provider that the person\\u2019s challenging behavior appeared manageable. This was due to a number of influences such as the case manager reporting there weren\\u2019t major recent behavioral concerns and the paperwork received from the person\\u2019s previous provider before intake. Beyond the concerns around the person\\u2019s challenging behavior, the paperwork from the previous provider supported the new provider\\u2019s assessment that the person could do well at this site. The person\\u2019s psychiatrist also weighed in and supported this particular placement, contributing to this assessment.\\r\\nAlong with the provider being willing to take a risk by accepting the person\\u2019s placement in this atypical setting was that both the case manager and the person\\u2019s guardian were willing to take a risk by placing the person in a home that didn\\u2019t fit the \\u2018typical\\u2019 profile. The person had failed at multiple community-based settings before so they both reported being interested in trying something different. Their options were likely limited too because this region has a lack of residential placement beds, which is also the trend statewide. This lack of residential beds is seen as influenced by a statewide moratorium on foster care beds as well as a moratorium on ICF\\/DD beds. The providers in the room also noted that the current statewide workforce shortage prohibits them from opening new programs as well as influences the closure of other residential sites. Without staff, programs cannot open or even stay open as providers can\\u2019t meet the supervision needs of the people living there.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1540}','68.53.115.247','2021-04-29 02:21:30'),(6300,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1541,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"101\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1541}','68.53.115.247','2021-04-29 02:21:30'),(6301,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1542,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":\"Unique to ICF\\/DDs is that they are licensed by both the Department of Human Services and the Minnesota Department of Health. Both Departments require providers to protect the health and safety of the people they serve. Minnesota Statutes 245D outlines the requirements for providers enforced by DHS while MDH relies on other statutory requirements in Minnesota statutes 144 and Rule. A unique requirement enforced by MDH is that ICF\\/DDs are expected to protect the people they serve from \\u201cimmediate jeopardy\\u201d. The provider in this instance noted that many times in the past they had been asked after a critical incident how they were going to protect the people they served from \\u201cimmediate jeopardy\\u201d in the future, so this mandate shaped the perception of the provider\\u2019s managers and supervisors whenever a health and safety concern arose and placed pressure on them to prioritize their response in a way that would satisfy MDH reviewers. The provider in this instance noted that terminating the person\\u2019s services was part of their response as to how they would respond to MDH\\u2019s questioning of how they were protecting the health and safety of the other people in the home. Between the requirements of DHS and MDH as well as the expectations of the guardians and case managers, the provider felt a strong need to act in this situation and felt that termination was the only way they could keep the majority of the people in the home safe.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1542}','68.53.115.247','2021-04-29 02:21:30'),(6302,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1543,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"103\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1543}','68.53.115.247','2021-04-29 02:21:30'),(6303,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1544,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"104\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1544}','68.53.115.247','2021-04-29 02:21:30'),(6304,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1545,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"105\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1545}','68.53.115.247','2021-04-29 02:21:30'),(6305,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1546,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"106\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1546}','68.53.115.247','2021-04-29 02:21:30'),(6306,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1547,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"107\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1547}','68.53.115.247','2021-04-29 02:21:30'),(6307,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1548,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"108\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1548}','68.53.115.247','2021-04-29 02:21:30'),(6308,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1549,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"109\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1549}','68.53.115.247','2021-04-29 02:21:30'),(6309,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1550,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"110\",\"question_type\":\"Free_Text\",\"text_answer\":\"The provider \\u2013 and the person\\u2019s team - expected the person\\u2019s challenging behavior to dissipate after intake not only because they thought the environment would suit the person, but they assumed that a behavior support plan would positively effect change and decrease the person\\u2019s interfering behavior and that other external services would be able to assist with challenging episodes. Unfortunately, upon arrival the provider found there was a lack of external behavior services in their area and that they had a lack of information about what mental health services were available. Additionally, the person\\u2019s case manager \\u2013 who would typically be expected to also help find needed services \\u2013 was very busy and unable to devote much time to the person\\u2019s case. A number of influences as to why case managers would be busy were identified \\u2013 between high case load and recent federal and state initiatives changing services.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1550}','68.53.115.247','2021-04-29 02:21:30'),(6310,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1551,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"111\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1551}','68.53.115.247','2021-04-29 02:21:30'),(6311,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1552,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"112\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1552}','68.53.115.247','2021-04-29 02:21:30'),(6312,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1553,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"113\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1553}','68.53.115.247','2021-04-29 02:21:30'),(6313,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1554,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"114\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1554}','68.53.115.247','2021-04-29 02:21:30'),(6314,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1555,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"115\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1555}','68.53.115.247','2021-04-29 02:21:30'),(6315,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1556,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"116\",\"question_type\":\"Free_Text\",\"text_answer\":\"Influencing why the ICF\\/DD provider terminated this person\\u2019s services due to challenging behavior was that the person was posing a safety risk to others in the home. The other 3 individuals in the home were considered to be more vulnerable to abuse due to their lower functioning levels, and so the person posed a greater risk to them. The provider had to balance their responsibility to protect the health and safety of three people in the home with their responsibility to meet the needs of the person whose services they terminated.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1556}','68.53.115.247','2021-04-29 02:21:30'),(6316,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1557,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"117\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1557}','68.53.115.247','2021-04-29 02:21:30'),(6317,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1558,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"118\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1558}','68.53.115.247','2021-04-29 02:21:30'),(6318,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1559,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"119\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1559}','68.53.115.247','2021-04-29 02:21:30'),(6319,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1560,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"120\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"The provider \\u2013 and the person\\u2019s team - expected the person\\u2019s challenging behavior to dissipate after intake not only because they thought the environment would suit the person, but they assumed that a behavior support plan would positively effect change and decrease the person\\u2019s interfering behavior and that other external services would be able to assist with challenging episodes. Unfortunately, upon arrival the provider found there was a lack of external behavior services in their area and that they had a lack of information about what mental health services were available. \\r\\nAlong with the lack of mental health resources, the provider also noted there was a lack of behavioral resources available to the person. Some practitioners had recommended that the person be admitted to an inpatient facility where they could try a \\u201cmed holiday\\u201d \\u2013 taking the person off all their meds and slowly re-introducing medication to determine their effectiveness. The provider could only find 1 program in the state that offered \\u201cmed holidays\\u201d, and that program had only 9 beds and waiting list of 25 people. The mapping team noted that the Jensen Settlement, which limited community base intensive services and the interventions they could use, influenced the lack of behavioral services like this one. \\r\\n\\r\\nAnother factor as to why this person was placed in an atypical placement was that the provider was willing to take a risk by accepting someone who didn\\u2019t fit the typical profile for this home. They were willing to take a risk because they did have an open ICF\\/DD bed that needed to be filled and hadn\\u2019t had much interest from other people in\\r\\n\\r\\nAlong with the provider being willing to take a risk by accepting the person\\u2019s placement in this atypical setting was that both the case manager and the person\\u2019s guardian were willing to take a risk by placing the person in a home that didn\\u2019t fit the \\u2018typical\\u2019 profile. The person had failed at multiple community-based settings before so they both reported being interested in trying something different. Their options were likely limited too because this region has a lack of residential placement beds, which is also the trend statewide. This lack of residential beds is seen as influenced by a statewide moratorium on foster care beds as well as a moratorium on ICF\\/DD beds. The providers in the room also noted that the current statewide workforce shortage prohibits them from opening new programs as well as influences the closure of other residential sites. Without staff, programs cannot open or even stay open as providers can\\u2019t meet the supervision needs of the people living there.\\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1560}','68.53.115.247','2021-04-29 02:21:30'),(6320,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1561,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"121\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1561}','68.53.115.247','2021-04-29 02:21:30'),(6321,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1562,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"122\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1562}','68.53.115.247','2021-04-29 02:21:30'),(6322,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1563,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"123\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1563}','68.53.115.247','2021-04-29 02:21:30'),(6323,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1564,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"124\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1564}','68.53.115.247','2021-04-29 02:21:30'),(6324,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1565,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"125\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1565}','68.53.115.247','2021-04-29 02:21:30'),(6325,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1566,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"126\",\"question_type\":\"Free_Text\",\"text_answer\":\"Without interventions that met the needs of the person, coupled with the lack of training of the staff, the provider noted their staff were stressed at the site. They often times engaged in power struggles with the individual and spent time trying to keep the other 3 residents safe\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1566}','68.53.115.247','2021-04-29 02:21:30'),(6326,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1567,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"432\",\"question_type\":\"Yes_or_No\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:21:30 pm\",\"created_at\":\"4\\/28\\/2021 9:21:30 pm\",\"id\":1567}','68.53.115.247','2021-04-29 02:21:30'),(6327,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports','create',22,'{\"text_answer\":\"\",\"form_id\":\"23\",\"user_id\":81,\"report_name\":\"JT_MRCI-BEC-2019-05\",\"organization_id\":10,\"status\":1,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:23:07 pm\",\"created_at\":\"4\\/28\\/2021 9:23:07 pm\",\"id\":22}','68.53.115.247','2021-04-29 02:23:07'),(6328,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1568,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"201901929\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:23:07 pm\",\"created_at\":\"4\\/28\\/2021 9:23:07 pm\",\"id\":1568}','68.53.115.247','2021-04-29 02:23:07'),(6329,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1569,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"05\\/22\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:23:20 pm\",\"created_at\":\"4\\/28\\/2021 9:23:20 pm\",\"id\":1569}','68.53.115.247','2021-04-29 02:23:20'),(6330,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1570,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"MRCI\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:23:40 pm\",\"created_at\":\"4\\/28\\/2021 9:23:40 pm\",\"id\":1570}','68.53.115.247','2021-04-29 02:23:40'),(6331,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1571,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Cathy Groebner\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:23:45 pm\",\"created_at\":\"4\\/28\\/2021 9:23:45 pm\",\"id\":1571}','68.53.115.247','2021-04-29 02:23:45'),(6332,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1572,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"cgroebner@mymrci.org\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:24:02 pm\",\"created_at\":\"4\\/28\\/2021 9:24:02 pm\",\"id\":1572}','68.53.115.247','2021-04-29 02:24:02'),(6333,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1573,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"03\\/19\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:17 pm\",\"created_at\":\"4\\/28\\/2021 9:25:17 pm\",\"id\":1573}','68.53.115.247','2021-04-29 02:25:17'),(6334,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1574,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Wednesday March 13, 2019 at approximately 1:40pm, staff 1 noticed VA leave the Department 123 work area. Staff 1 stepped outside the room and saw VA going into the women\\u2019s bathroom located off of the production floor nearest to Department 123.  Staff 1 checked on VA at about 1:45pm and saw that VA was in the handicap stall with their green jacket off.  Staff 1 asked if VA was OK and they replied \\u201cyeah\\u201d and also asked if VA needed anything and they said \\u201cno\\u201d.  Staff 1 then went back to that same bathroom to assist another individual at approximately 1:50pm and VA was still in the same stall.  Staff 1 went back to the room at about 1:55pm.  It should be noted that the VA had been diagnosed with a mild UTI on Sunday 3\\/10\\/19 and was sent home early on Monday 3\\/11\\/19 due to them not feeling well.  VA also came in late on Tuesday, 3\\/12\\/19.  \\n\\nVA has eloped in the past, VA takes her lunch box with her.  Because of that, VA is required to leave the lunch box in the Team Leader\\u2019s office.  At approximately 2:00pm, staff 1 notice VA\\u2019s lunch box was still in the office.  Support Specialist Staff 2 went to that same bathroom that VA was in approximately 2:05pm and that VA was no longer in the bathroom.  A bus drive for the day program was driving the buss back to the program and notice someone in a green jacket standing in the street on Map Drive around 2pm.  There are no sidewalks on Map Drive.  Staff recognized the person as the VA and immediately called her supervisor at the program. And drove back to where the VA was walking.  It was reported that two \\u201cgood Samaritans\\u201d pulled over and stopped the VA on the sidewalk along stadium drive, which is the road that connects with Map Drive, and started walking with her back to the program until the staff arrived.  \\n\\nAt 2:07 the Supervisor received a phone call from the transportation supervisor stating VA was found walking on the sidewalk along Stadium Drive and was being walked back to the program\\u2019s building.  The program supervisor ran outside and saw VA with about four other program staff walking with VA.  The supervisor walked alongside VA all the way back to the office and the VA waited in the office until was time for VA to board the bus to go home.  While the office, VA was ask if VA thought what happened was safe and the VA said, \\u201cNo\\u201d. The VA was asked why it wasn\\u2019t and safe and the response was \\u201cI could get hurt\\u201d. Supervisor asked VA if it will ever happen again and VA shook their head \\u201cno\\u201d. Supervisor walked VA to the bus and fastened seatbelt and sat patiently until the bus departed.  \\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:27 pm\",\"created_at\":\"4\\/28\\/2021 9:25:27 pm\",\"id\":1574}','68.53.115.247','2021-04-29 02:25:27'),(6335,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1575,'{\"report_id\":22,\"form_id\":\"22\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"201901929\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:28 pm\",\"created_at\":\"4\\/28\\/2021 9:25:28 pm\",\"id\":1575}','68.53.115.247','2021-04-29 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02:25:28'),(6346,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1586,'{\"report_id\":22,\"form_id\":\"22\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Wednesday March 13, 2019 at approximately 1:40pm, staff 1 noticed VA leave the Department 123 work area. Staff 1 stepped outside the room and saw VA going into the women\\u2019s bathroom located off of the production floor nearest to Department 123.  Staff 1 checked on VA at about 1:45pm and saw that VA was in the handicap stall with their green jacket off.  Staff 1 asked if VA was OK and they replied \\u201cyeah\\u201d and also asked if VA needed anything and they said \\u201cno\\u201d.  Staff 1 then went back to that same bathroom to assist another individual at approximately 1:50pm and VA was still in the same stall.  Staff 1 went back to the room at about 1:55pm.  It should be noted that the VA had been diagnosed with a mild UTI on Sunday 3\\/10\\/19 and was sent home early on Monday 3\\/11\\/19 due to them not feeling well.  VA also came in late on Tuesday, 3\\/12\\/19.  \\r\\n\\r\\nVA has eloped in the past, VA takes her lunch box with her.  Because of that, VA is required to leave the lunch box in the Team Leader\\u2019s office.  At approximately 2:00pm, staff 1 notice VA\\u2019s lunch box was still in the office.  Support Specialist Staff 2 went to that same bathroom that VA was in approximately 2:05pm and that VA was no longer in the bathroom.  A bus drive for the day program was driving the buss back to the program and notice someone in a green jacket standing in the street on Map Drive around 2pm.  There are no sidewalks on Map Drive.  Staff recognized the person as the VA and immediately called her supervisor at the program. And drove back to where the VA was walking.  It was reported that two \\u201cgood Samaritans\\u201d pulled over and stopped the VA on the sidewalk along stadium drive, which is the road that connects with Map Drive, and started walking with her back to the program until the staff arrived.  \\r\\n\\r\\nAt 2:07 the Supervisor received a phone call from the transportation supervisor stating VA was found walking on the sidewalk along Stadium Drive and was being walked back to the program\\u2019s building.  The program supervisor ran outside and saw VA with about four other program staff walking with VA.  The supervisor walked alongside VA all the way back to the office and the VA waited in the office until was time for VA to board the bus to go home.  While the office, VA was ask if VA thought what happened was safe and the VA said, \\u201cNo\\u201d. The VA was asked why it wasn\\u2019t and safe and the response was \\u201cI could get hurt\\u201d. Supervisor asked VA if it will ever happen again and VA shook their head \\u201cno\\u201d. Supervisor walked VA to the bus and fastened seatbelt and sat patiently until the bus departed.  \\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:28 pm\",\"created_at\":\"4\\/28\\/2021 9:25:28 pm\",\"id\":1586}','68.53.115.247','2021-04-29 02:25:28'),(6347,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1587,'{\"report_id\":22,\"form_id\":\"22\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"96\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:28 pm\",\"created_at\":\"4\\/28\\/2021 9:25:28 pm\",\"id\":1587}','68.53.115.247','2021-04-29 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02:25:28'),(6372,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1612,'{\"report_id\":22,\"form_id\":\"22\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"115\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:28 pm\",\"created_at\":\"4\\/28\\/2021 9:25:28 pm\",\"id\":1612}','68.53.115.247','2021-04-29 02:25:28'),(6373,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1613,'{\"report_id\":22,\"form_id\":\"22\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"116\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:28 pm\",\"created_at\":\"4\\/28\\/2021 9:25:28 pm\",\"id\":1613}','68.53.115.247','2021-04-29 02:25:28'),(6374,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1614,'{\"report_id\":22,\"form_id\":\"22\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"117\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:28 pm\",\"created_at\":\"4\\/28\\/2021 9:25:28 pm\",\"id\":1614}','68.53.115.247','2021-04-29 02:25:28'),(6375,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1615,'{\"report_id\":22,\"form_id\":\"22\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"118\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:28 pm\",\"created_at\":\"4\\/28\\/2021 9:25:28 pm\",\"id\":1615}','68.53.115.247','2021-04-29 02:25:28'),(6376,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1616,'{\"report_id\":22,\"form_id\":\"22\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"119\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:28 pm\",\"created_at\":\"4\\/28\\/2021 9:25:28 pm\",\"id\":1616}','68.53.115.247','2021-04-29 02:25:28'),(6377,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1617,'{\"report_id\":22,\"form_id\":\"22\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"120\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:28 pm\",\"created_at\":\"4\\/28\\/2021 9:25:28 pm\",\"id\":1617}','68.53.115.247','2021-04-29 02:25:28'),(6378,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1618,'{\"report_id\":22,\"form_id\":\"22\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"121\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:28 pm\",\"created_at\":\"4\\/28\\/2021 9:25:28 pm\",\"id\":1618}','68.53.115.247','2021-04-29 02:25:28'),(6379,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1619,'{\"report_id\":22,\"form_id\":\"22\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"122\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:28 pm\",\"created_at\":\"4\\/28\\/2021 9:25:28 pm\",\"id\":1619}','68.53.115.247','2021-04-29 02:25:28'),(6380,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1620,'{\"report_id\":22,\"form_id\":\"22\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"123\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:28 pm\",\"created_at\":\"4\\/28\\/2021 9:25:28 pm\",\"id\":1620}','68.53.115.247','2021-04-29 02:25:28'),(6381,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1621,'{\"report_id\":22,\"form_id\":\"22\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"124\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:28 pm\",\"created_at\":\"4\\/28\\/2021 9:25:28 pm\",\"id\":1621}','68.53.115.247','2021-04-29 02:25:28'),(6382,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1622,'{\"report_id\":22,\"form_id\":\"22\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"125\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:28 pm\",\"created_at\":\"4\\/28\\/2021 9:25:28 pm\",\"id\":1622}','68.53.115.247','2021-04-29 02:25:28'),(6383,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1623,'{\"report_id\":22,\"form_id\":\"22\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"126\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:28 pm\",\"created_at\":\"4\\/28\\/2021 9:25:28 pm\",\"id\":1623}','68.53.115.247','2021-04-29 02:25:28'),(6384,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports','update',21,'{\"id\":21,\"form_id\":\"23\",\"user_id\":\"81\",\"question_id\":null,\"organization_id\":\"10\",\"tab_id\":null,\"question_type\":null,\"text_answer\":\"{\\\"Short_Answer__76\\\":\\\"Care Manager\\\",\\\"Date__77\\\":\\\"12\\\\\\/16\\\\\\/2019\\\",\\\"Multiple_Choice__78\\\":\\\"Charles Young\\\",\\\"Multiple_Choice__79\\\":\\\"Kristie Pittman\\\",\\\"Short_Answer__80\\\":\\\"Harry Meyering\\\",\\\"Short_Answer__81\\\":\\\"Emily Britz \\\\\\/ Tana Helleksen\\\",\\\"Short_Answer__82\\\":\\\"ebritz \\\\\\/ thelleksen \\\\\\/@harrymeyeringcenter.org\\\",\\\"Multiple_Choice__84\\\":\\\"Termination of Services\\\",\\\"Multiple_Choice__85\\\":\\\"Blue Earth County\\\",\\\"Multiple_Choice__96\\\":\\\"2\\\",\\\"Short_Answer__91\\\":\\\"Person\'s services were terminated due to challenging behavior\\\",\\\"True_or_False__94\\\":\\\"Yes\\\",\\\"Free_Text__100\\\":\\\"\\\\\\\"Influencing why the ICF\\\\\\/DD provider terminated this person\\\\u2019s services due to challenging behavior was that the person was posing a safety risk to others in the home. The other 3 individuals in the home were considered to be more vulnerable to abuse due to their lower functioning levels, and so the person posed a greater risk to them. The provider had to balance their responsibility to protect the health and safety of three people in the home with their responsibility to meet the needs of the person whose services they terminated. The guardians of the other 3 individuals had an expectation that the provider would keep them safe, and due to their higher vulnerability the guardians expressed their concern often in this instance. Another impact to the provider\\\\u2019s responsibility for people\\\\u2019s health and safety include county case managers assigning this function to providers via the CSSP. Unique to ICF\\\\\\/DDs is that they are licensed by both the Department of Human Services and the Minnesota Department of Health. Both Departments require providers to protect the health and safety of the people they serve. Minnesota Statutes 245D outlines the requirements for providers enforced by DHS while MDH relies on other statutory requirements in Minnesota statutes 144 and Rule. A unique requirement enforced by MDH is that ICF\\\\\\/DDs are expected to protect the people they serve from \\\\u201cimmediate jeopardy\\\\u201d. The provider in this instance noted that many times in the past they had been asked after a critical incident how they were going to protect the people they served from \\\\u201cimmediate jeopardy\\\\u201d in the future, so this mandate shaped the perception of the provider\\\\u2019s managers and supervisors whenever a health and safety concern arose and placed pressure on them to prioritize their response in a way that would satisfy MDH reviewers. The provider in this instance noted that terminating the person\\\\u2019s services was part of their response as to how they would respond to MDH\\\\u2019s questioning of how they were protecting the health and safety of the other people in the home. Between the requirements of DHS and MDH as well as the expectations of the guardians and case managers, the provider felt a strong need to act in this situation and felt that termination was the only way they could keep the majority of the people in the home safe. \\\\r\\\\nThe provider noted that the team had explored the possibility of implementing rights restrictions with the individual, but the team determined they wouldn\\\\u2019t be possible due to the requirements of 245D surrounding rights restrictions, or wouldn\\\\u2019t be sufficient to meet the safety needs of the person and others in the home. Due to the ineffectiveness of a rights restriction, the provider felt they had few options to address the person\\\\u2019s challenging behavior. \\\\r\\\\nAnother influence as to why the provider terminated a person\\\\u2019s services due to challenging behavior was that the person\\\\u2019s challenging behavior did not dissipate as expected after the person moved to the home. While it was known prior to intake that the person sometimes exhibited challenging behavior, there was an assumption by the team that this environment would likely help decrease the triggers that impacted the challenging behavior in the past. \\\\r\\\\nA number of factors were identified that  person\\\\u2019s challenging behavior not dissipating. For one, the provider noted that the staff at the site were trained more on meeting the medical needs of the other people in the home than de-escalating challenging behavior. While Minnesota Statutes 245D and the Positive Supports Rule (9544) required the provider to ensure their staff had training and were competent on positive support strategies, de-escalation techniques and the use of restrictive interventions, because the other people in the home didn\\\\u2019t exhibit challenging behavior, the focus of their training was centered more on medical needs than \\\\u2018behavioral needs\\\\u2019. The provider also noted that the staff felt a fear to administer pro re nata (PRN) medication to the person during mental health episodes due to the stigma of providing medication at these times and the training and reporting requirements of the Positive Supports Rule. The Positive Supports Rule (MN Rule 9544) requires providers to report the use of PRN medications when administered in a behavioral situation, and there was a belief among staff that the use of PRNs in this manner were not ok because they required reporting. \\\\r\\\\nThe provider \\\\u2013 and the person\\\\u2019s team - expected the person\\\\u2019s challenging behavior to dissipate after intake not only because they thought the environment would suit the person, but they assumed that a behavior support plan would positively effect change and decrease the person\\\\u2019s interfering behavior and that other external services would be able to assist with challenging episodes. Unfortunately, upon arrival the provider found there was a lack of external behavior services in their area and that they had a lack of information about what mental health services were available. Additionally, the person\\\\u2019s case manager \\\\u2013 who would typically be expected to also help find needed services \\\\u2013 was very busy and unable to devote much time to the person\\\\u2019s case. A number of influences as to why case managers would be busy were identified \\\\u2013 between high case load and recent federal and state initiatives changing services. MnCHOICES, HCBS rule and person-centered planning initiatives were all noted as positive changes, but changes that took a lot of time away from case managers to learn and meet the new requirements. This program was located in southern Minnesota, and the team noted that this region in particular has a scarcity of mental health resources. The provider and the team did find a neuropsych practitioner that was willing to work with the person, but unfortunately they were too far away and the drive was too long. This made it hard to make regular meetings and implement the neuropsych\\\\u2019s recommendations. Additionally, the provider was able to bring the person to a nearby hospital during challenging episodes, but noted that any interventions offered by the hospital unfortunately were ineffective.\\\\r\\\\nAlong with the lack of mental health resources, the provider also noted there was a lack of behavioral resources available to the person. Some practitioners had recommended that the person be admitted to an inpatient facility where they could try a \\\\u201cmed holiday\\\\u201d \\\\u2013 taking the person off all their meds and slowly re-introducing medication to determine their effectiveness. The provider could only find 1 program in the state that offered \\\\u201cmed holidays\\\\u201d, and that program had only 9 beds and waiting list of 25 people. The mapping team noted that the Jensen Settlement, which limited community base intensive services and the interventions they could use, influenced the lack of behavioral services like this one. \\\\r\\\\nWithout interventions that met the needs of the person, coupled with the lack of training of the staff, the provider noted their staff were stressed at the site. They often times engaged in power struggles with the individual and spent time trying to keep the other 3 residents safe. The provider did note that one option they wanted to explore before terminating the person\\\\u2019s services was to find out if they could obtain 1 on 1 staffing for the individual, but didn\\\\u2019t know who to ask or where to start. ICF\\\\\\/DD rates have many regulations and oftentimes hard to navigate they noted. The provider noted that the ability to obtain reimbursement beyond the facility\\\\u2019s establish rate was a mystifying process.\\\",\\\"Yes_or_No__128\\\":\\\"Yes\\\",\\\"Free_Text__132\\\":\\\"\\\\\\\"Influencing why this person was placed in what was seen as an atypical placement was that the person had never stayed at an ICF\\\\\\/DD before and the other people in the home were seen as having more medical needs than behavioral challenges. Despite these differences, the team, including the case manager, guardian and the provider thought this could be a good fit for the person because they could have more attention from staff and the person wouldn\\\\u2019t see the other roommates as a \\\\u2018threat\\\\u2019. \\\\r\\\\nAnother factor into this placement was that the provider had an open ICFs\\\\\\/DD bed. The fact it was an ICF\\\\\\/DD bed was one of the reasons why the bed was open. The providers in the room noted that there isn\\\\u2019t much interest in ICF\\\\\\/DD beds any more. Regionally, statewide and nationally, ICF or other institutional placements are seen as undesirable and passed over for foster care or other community-based settings. A number of factors have influenced this opinion about ICFs\\\\\\/DDs, including; public sentiment shifting away from institutions and large settings; the HCBS settings rule which has required systems to move towards community settings; the Minnesota Olmstead Plan which reflects the Supreme Court\\\\u2019s 1999 Olmstead ruling determining people should be served in the \\\\u201cmost integrated setting\\\\u201d, and; the Jensen Settlement Agreement which resulted in both Minnesota\\\\u2019s Olmstead Plan and the closure of some institutional services.\\\\r\\\\nAnother factor as to why this person was placed in an atypical placement was that the provider was willing to take a risk by accepting someone who didn\\\\u2019t fit the typical profile for this home. They were willing to take a risk because they did have an open ICF\\\\\\/DD bed that needed to be filled and hadn\\\\u2019t had much interest from other people in. The provider was also willing to take a risk because they determined the person could do well at the site.  This determination impacted the placement and was impacted by a number of factors. While the other people in the home didn\\\\u2019t have similar needs as this person, the team thought this might work well in this case. The other five people in the home had higher Activities of Daily Living (ADL) needs than this person so it was thought the person wouldn\\\\u2019t add much to the staff\\\\u2019s workload in this area. The five people also exhibited challenging behavior that was more easily redirected and managed by staff, so it was thought the house wouldn\\\\u2019t be overwhelming for staff to manage challenging behavior in the home as a whole. Additionally, it seemed to the provider that the person\\\\u2019s challenging behavior appeared manageable. This was due to a number of influences such as the case manager reporting there weren\\\\u2019t major recent behavioral concerns and the paperwork received from the person\\\\u2019s previous provider before intake. Beyond the concerns around the person\\\\u2019s challenging behavior, the paperwork from the previous provider supported the new provider\\\\u2019s assessment that the person could do well at this site. The person\\\\u2019s psychiatrist also weighed in and supported this particular placement, contributing to this assessment.\\\\r\\\\nAlong with the provider being willing to take a risk by accepting the person\\\\u2019s placement in this atypical setting was that both the case manager and the person\\\\u2019s guardian were willing to take a risk by placing the person in a home that didn\\\\u2019t fit the \\\\u2018typical\\\\u2019 profile. The person had failed at multiple community-based settings before so they both reported being interested in trying something different. Their options were likely limited too because this region has a lack of residential placement beds, which is also the trend statewide. This lack of residential beds is seen as influenced by a statewide moratorium on foster care beds as well as a moratorium on ICF\\\\\\/DD beds. The providers in the room also noted that the current statewide workforce shortage prohibits them from opening new programs as well as influences the closure of other residential sites. Without staff, programs cannot open or even stay open as providers can\\\\u2019t meet the supervision needs of the people living there.\\\",\\\"Multiple_Choice__101\\\":\\\"2\\\",\\\"Free_Text__102\\\":\\\"Unique to ICF\\\\\\/DDs is that they are licensed by both the Department of Human Services and the Minnesota Department of Health. Both Departments require providers to protect the health and safety of the people they serve. Minnesota Statutes 245D outlines the requirements for providers enforced by DHS while MDH relies on other statutory requirements in Minnesota statutes 144 and Rule. A unique requirement enforced by MDH is that ICF\\\\\\/DDs are expected to protect the people they serve from \\\\u201cimmediate jeopardy\\\\u201d. The provider in this instance noted that many times in the past they had been asked after a critical incident how they were going to protect the people they served from \\\\u201cimmediate jeopardy\\\\u201d in the future, so this mandate shaped the perception of the provider\\\\u2019s managers and supervisors whenever a health and safety concern arose and placed pressure on them to prioritize their response in a way that would satisfy MDH reviewers. The provider in this instance noted that terminating the person\\\\u2019s services was part of their response as to how they would respond to MDH\\\\u2019s questioning of how they were protecting the health and safety of the other people in the home. Between the requirements of DHS and MDH as well as the expectations of the guardians and case managers, the provider felt a strong need to act in this situation and felt that termination was the only way they could keep the majority of the people in the home safe.\\\",\\\"Multiple_Choice__109\\\":\\\"2\\\",\\\"Free_Text__110\\\":\\\"The provider \\\\u2013 and the person\\\\u2019s team - expected the person\\\\u2019s challenging behavior to dissipate after intake not only because they thought the environment would suit the person, but they assumed that a behavior support plan would positively effect change and decrease the person\\\\u2019s interfering behavior and that other external services would be able to assist with challenging episodes. Unfortunately, upon arrival the provider found there was a lack of external behavior services in their area and that they had a lack of information about what mental health services were available. Additionally, the person\\\\u2019s case manager \\\\u2013 who would typically be expected to also help find needed services \\\\u2013 was very busy and unable to devote much time to the person\\\\u2019s case. A number of influences as to why case managers would be busy were identified \\\\u2013 between high case load and recent federal and state initiatives changing services.\\\",\\\"Multiple_Choice__115\\\":\\\"3\\\",\\\"Free_Text__116\\\":\\\"Influencing why the ICF\\\\\\/DD provider terminated this person\\\\u2019s services due to challenging behavior was that the person was posing a safety risk to others in the home. The other 3 individuals in the home were considered to be more vulnerable to abuse due to their lower functioning levels, and so the person posed a greater risk to them. The provider had to balance their responsibility to protect the health and safety of three people in the home with their responsibility to meet the needs of the person whose services they terminated.\\\",\\\"Multiple_Choice__119\\\":\\\"3\\\",\\\"Free_Text__120\\\":\\\"\\\\\\\"The provider \\\\u2013 and the person\\\\u2019s team - expected the person\\\\u2019s challenging behavior to dissipate after intake not only because they thought the environment would suit the person, but they assumed that a behavior support plan would positively effect change and decrease the person\\\\u2019s interfering behavior and that other external services would be able to assist with challenging episodes. Unfortunately, upon arrival the provider found there was a lack of external behavior services in their area and that they had a lack of information about what mental health services were available. \\\\r\\\\nAlong with the lack of mental health resources, the provider also noted there was a lack of behavioral resources available to the person. Some practitioners had recommended that the person be admitted to an inpatient facility where they could try a \\\\u201cmed holiday\\\\u201d \\\\u2013 taking the person off all their meds and slowly re-introducing medication to determine their effectiveness. The provider could only find 1 program in the state that offered \\\\u201cmed holidays\\\\u201d, and that program had only 9 beds and waiting list of 25 people. The mapping team noted that the Jensen Settlement, which limited community base intensive services and the interventions they could use, influenced the lack of behavioral services like this one. \\\\r\\\\n\\\\r\\\\nAnother factor as to why this person was placed in an atypical placement was that the provider was willing to take a risk by accepting someone who didn\\\\u2019t fit the typical profile for this home. They were willing to take a risk because they did have an open ICF\\\\\\/DD bed that needed to be filled and hadn\\\\u2019t had much interest from other people in\\\\r\\\\n\\\\r\\\\nAlong with the provider being willing to take a risk by accepting the person\\\\u2019s placement in this atypical setting was that both the case manager and the person\\\\u2019s guardian were willing to take a risk by placing the person in a home that didn\\\\u2019t fit the \\\\u2018typical\\\\u2019 profile. The person had failed at multiple community-based settings before so they both reported being interested in trying something different. Their options were likely limited too because this region has a lack of residential placement beds, which is also the trend statewide. This lack of residential beds is seen as influenced by a statewide moratorium on foster care beds as well as a moratorium on ICF\\\\\\/DD beds. The providers in the room also noted that the current statewide workforce shortage prohibits them from opening new programs as well as influences the closure of other residential sites. Without staff, programs cannot open or even stay open as providers can\\\\u2019t meet the supervision needs of the people living there.\\\\\\\"\\\",\\\"Multiple_Choice__125\\\":\\\"2\\\",\\\"Free_Text__126\\\":\\\"Without interventions that met the needs of the person, coupled with the lack of training of the staff, the provider noted their staff were stressed at the site. They often times engaged in power struggles with the individual and spent time trying to keep the other 3 residents safe\\\",\\\"Yes_or_No__432\\\":\\\"Yes\\\"}\",\"mcq_answer\":null,\"other_answer\":\"0\",\"status\":\"1\",\"created_by\":\"81\",\"updated_by\":81,\"created_at\":\"4\\/28\\/2021 9:16:29 pm\",\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"deleted_at\":null,\"report_name\":\"CY_Harry Meyering-BEC-2019-11\"}','68.53.115.247','2021-04-29 02:25:44'),(6385,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1624,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Care Manager\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1624}','68.53.115.247','2021-04-29 02:25:44'),(6386,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1625,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"12\\/16\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1625}','68.53.115.247','2021-04-29 02:25:44'),(6387,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1626,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"78\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Charles Young\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1626}','68.53.115.247','2021-04-29 02:25:44'),(6388,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1627,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Kristie Pittman\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1627}','68.53.115.247','2021-04-29 02:25:44'),(6389,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1628,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Harry Meyering\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1628}','68.53.115.247','2021-04-29 02:25:44'),(6390,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1629,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Emily Britz \\/ Tana Helleksen\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1629}','68.53.115.247','2021-04-29 02:25:44'),(6391,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1630,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"ebritz \\/ thelleksen \\/@harrymeyeringcenter.org\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1630}','68.53.115.247','2021-04-29 02:25:44'),(6392,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1631,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"83\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1631}','68.53.115.247','2021-04-29 02:25:44'),(6393,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1632,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"84\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Termination of Services\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1632}','68.53.115.247','2021-04-29 02:25:44'),(6394,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1633,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Blue Earth County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1633}','68.53.115.247','2021-04-29 02:25:44'),(6395,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1634,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1634}','68.53.115.247','2021-04-29 02:25:44'),(6396,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1635,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1635}','68.53.115.247','2021-04-29 02:25:44'),(6397,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1636,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"96\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1636}','68.53.115.247','2021-04-29 02:25:44'),(6398,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1637,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Person\'s services were terminated due to challenging behavior\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1637}','68.53.115.247','2021-04-29 02:25:44'),(6399,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1638,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"94\",\"question_type\":\"True_or_False\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1638}','68.53.115.247','2021-04-29 02:25:44'),(6400,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1639,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1639}','68.53.115.247','2021-04-29 02:25:44'),(6401,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1640,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1640}','68.53.115.247','2021-04-29 02:25:44'),(6402,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1641,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"99\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1641}','68.53.115.247','2021-04-29 02:25:44'),(6403,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1642,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Influencing why the ICF\\/DD provider terminated this person\\u2019s services due to challenging behavior was that the person was posing a safety risk to others in the home. The other 3 individuals in the home were considered to be more vulnerable to abuse due to their lower functioning levels, and so the person posed a greater risk to them. The provider had to balance their responsibility to protect the health and safety of three people in the home with their responsibility to meet the needs of the person whose services they terminated. The guardians of the other 3 individuals had an expectation that the provider would keep them safe, and due to their higher vulnerability the guardians expressed their concern often in this instance. Another impact to the provider\\u2019s responsibility for people\\u2019s health and safety include county case managers assigning this function to providers via the CSSP. Unique to ICF\\/DDs is that they are licensed by both the Department of Human Services and the Minnesota Department of Health. Both Departments require providers to protect the health and safety of the people they serve. Minnesota Statutes 245D outlines the requirements for providers enforced by DHS while MDH relies on other statutory requirements in Minnesota statutes 144 and Rule. A unique requirement enforced by MDH is that ICF\\/DDs are expected to protect the people they serve from \\u201cimmediate jeopardy\\u201d. The provider in this instance noted that many times in the past they had been asked after a critical incident how they were going to protect the people they served from \\u201cimmediate jeopardy\\u201d in the future, so this mandate shaped the perception of the provider\\u2019s managers and supervisors whenever a health and safety concern arose and placed pressure on them to prioritize their response in a way that would satisfy MDH reviewers. The provider in this instance noted that terminating the person\\u2019s services was part of their response as to how they would respond to MDH\\u2019s questioning of how they were protecting the health and safety of the other people in the home. Between the requirements of DHS and MDH as well as the expectations of the guardians and case managers, the provider felt a strong need to act in this situation and felt that termination was the only way they could keep the majority of the people in the home safe. \\r\\nThe provider noted that the team had explored the possibility of implementing rights restrictions with the individual, but the team determined they wouldn\\u2019t be possible due to the requirements of 245D surrounding rights restrictions, or wouldn\\u2019t be sufficient to meet the safety needs of the person and others in the home. Due to the ineffectiveness of a rights restriction, the provider felt they had few options to address the person\\u2019s challenging behavior. \\r\\nAnother influence as to why the provider terminated a person\\u2019s services due to challenging behavior was that the person\\u2019s challenging behavior did not dissipate as expected after the person moved to the home. While it was known prior to intake that the person sometimes exhibited challenging behavior, there was an assumption by the team that this environment would likely help decrease the triggers that impacted the challenging behavior in the past. \\r\\nA number of factors were identified that  person\\u2019s challenging behavior not dissipating. For one, the provider noted that the staff at the site were trained more on meeting the medical needs of the other people in the home than de-escalating challenging behavior. While Minnesota Statutes 245D and the Positive Supports Rule (9544) required the provider to ensure their staff had training and were competent on positive support strategies, de-escalation techniques and the use of restrictive interventions, because the other people in the home didn\\u2019t exhibit challenging behavior, the focus of their training was centered more on medical needs than \\u2018behavioral needs\\u2019. The provider also noted that the staff felt a fear to administer pro re nata (PRN) medication to the person during mental health episodes due to the stigma of providing medication at these times and the training and reporting requirements of the Positive Supports Rule. The Positive Supports Rule (MN Rule 9544) requires providers to report the use of PRN medications when administered in a behavioral situation, and there was a belief among staff that the use of PRNs in this manner were not ok because they required reporting. \\r\\nThe provider \\u2013 and the person\\u2019s team - expected the person\\u2019s challenging behavior to dissipate after intake not only because they thought the environment would suit the person, but they assumed that a behavior support plan would positively effect change and decrease the person\\u2019s interfering behavior and that other external services would be able to assist with challenging episodes. Unfortunately, upon arrival the provider found there was a lack of external behavior services in their area and that they had a lack of information about what mental health services were available. Additionally, the person\\u2019s case manager \\u2013 who would typically be expected to also help find needed services \\u2013 was very busy and unable to devote much time to the person\\u2019s case. A number of influences as to why case managers would be busy were identified \\u2013 between high case load and recent federal and state initiatives changing services. MnCHOICES, HCBS rule and person-centered planning initiatives were all noted as positive changes, but changes that took a lot of time away from case managers to learn and meet the new requirements. This program was located in southern Minnesota, and the team noted that this region in particular has a scarcity of mental health resources. The provider and the team did find a neuropsych practitioner that was willing to work with the person, but unfortunately they were too far away and the drive was too long. This made it hard to make regular meetings and implement the neuropsych\\u2019s recommendations. Additionally, the provider was able to bring the person to a nearby hospital during challenging episodes, but noted that any interventions offered by the hospital unfortunately were ineffective.\\r\\nAlong with the lack of mental health resources, the provider also noted there was a lack of behavioral resources available to the person. Some practitioners had recommended that the person be admitted to an inpatient facility where they could try a \\u201cmed holiday\\u201d \\u2013 taking the person off all their meds and slowly re-introducing medication to determine their effectiveness. The provider could only find 1 program in the state that offered \\u201cmed holidays\\u201d, and that program had only 9 beds and waiting list of 25 people. The mapping team noted that the Jensen Settlement, which limited community base intensive services and the interventions they could use, influenced the lack of behavioral services like this one. \\r\\nWithout interventions that met the needs of the person, coupled with the lack of training of the staff, the provider noted their staff were stressed at the site. They often times engaged in power struggles with the individual and spent time trying to keep the other 3 residents safe. The provider did note that one option they wanted to explore before terminating the person\\u2019s services was to find out if they could obtain 1 on 1 staffing for the individual, but didn\\u2019t know who to ask or where to start. ICF\\/DD rates have many regulations and oftentimes hard to navigate they noted. The provider noted that the ability to obtain reimbursement beyond the facility\\u2019s establish rate was a mystifying process.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1642}','68.53.115.247','2021-04-29 02:25:44'),(6404,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1643,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"127\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1643}','68.53.115.247','2021-04-29 02:25:44'),(6405,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1644,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"128\",\"question_type\":\"Yes_or_No\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1644}','68.53.115.247','2021-04-29 02:25:44'),(6406,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1645,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"129\",\"question_type\":\"Date\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1645}','68.53.115.247','2021-04-29 02:25:44'),(6407,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1646,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"130\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1646}','68.53.115.247','2021-04-29 02:25:44'),(6408,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1647,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"131\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1647}','68.53.115.247','2021-04-29 02:25:44'),(6409,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1648,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"132\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Influencing why this person was placed in what was seen as an atypical placement was that the person had never stayed at an ICF\\/DD before and the other people in the home were seen as having more medical needs than behavioral challenges. Despite these differences, the team, including the case manager, guardian and the provider thought this could be a good fit for the person because they could have more attention from staff and the person wouldn\\u2019t see the other roommates as a \\u2018threat\\u2019. \\r\\nAnother factor into this placement was that the provider had an open ICFs\\/DD bed. The fact it was an ICF\\/DD bed was one of the reasons why the bed was open. The providers in the room noted that there isn\\u2019t much interest in ICF\\/DD beds any more. Regionally, statewide and nationally, ICF or other institutional placements are seen as undesirable and passed over for foster care or other community-based settings. A number of factors have influenced this opinion about ICFs\\/DDs, including; public sentiment shifting away from institutions and large settings; the HCBS settings rule which has required systems to move towards community settings; the Minnesota Olmstead Plan which reflects the Supreme Court\\u2019s 1999 Olmstead ruling determining people should be served in the \\u201cmost integrated setting\\u201d, and; the Jensen Settlement Agreement which resulted in both Minnesota\\u2019s Olmstead Plan and the closure of some institutional services.\\r\\nAnother factor as to why this person was placed in an atypical placement was that the provider was willing to take a risk by accepting someone who didn\\u2019t fit the typical profile for this home. They were willing to take a risk because they did have an open ICF\\/DD bed that needed to be filled and hadn\\u2019t had much interest from other people in. The provider was also willing to take a risk because they determined the person could do well at the site.  This determination impacted the placement and was impacted by a number of factors. While the other people in the home didn\\u2019t have similar needs as this person, the team thought this might work well in this case. The other five people in the home had higher Activities of Daily Living (ADL) needs than this person so it was thought the person wouldn\\u2019t add much to the staff\\u2019s workload in this area. The five people also exhibited challenging behavior that was more easily redirected and managed by staff, so it was thought the house wouldn\\u2019t be overwhelming for staff to manage challenging behavior in the home as a whole. Additionally, it seemed to the provider that the person\\u2019s challenging behavior appeared manageable. This was due to a number of influences such as the case manager reporting there weren\\u2019t major recent behavioral concerns and the paperwork received from the person\\u2019s previous provider before intake. Beyond the concerns around the person\\u2019s challenging behavior, the paperwork from the previous provider supported the new provider\\u2019s assessment that the person could do well at this site. The person\\u2019s psychiatrist also weighed in and supported this particular placement, contributing to this assessment.\\r\\nAlong with the provider being willing to take a risk by accepting the person\\u2019s placement in this atypical setting was that both the case manager and the person\\u2019s guardian were willing to take a risk by placing the person in a home that didn\\u2019t fit the \\u2018typical\\u2019 profile. The person had failed at multiple community-based settings before so they both reported being interested in trying something different. Their options were likely limited too because this region has a lack of residential placement beds, which is also the trend statewide. This lack of residential beds is seen as influenced by a statewide moratorium on foster care beds as well as a moratorium on ICF\\/DD beds. The providers in the room also noted that the current statewide workforce shortage prohibits them from opening new programs as well as influences the closure of other residential sites. Without staff, programs cannot open or even stay open as providers can\\u2019t meet the supervision needs of the people living there.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1648}','68.53.115.247','2021-04-29 02:25:44'),(6410,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1649,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"101\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1649}','68.53.115.247','2021-04-29 02:25:44'),(6411,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1650,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":\"Unique to ICF\\/DDs is that they are licensed by both the Department of Human Services and the Minnesota Department of Health. Both Departments require providers to protect the health and safety of the people they serve. Minnesota Statutes 245D outlines the requirements for providers enforced by DHS while MDH relies on other statutory requirements in Minnesota statutes 144 and Rule. A unique requirement enforced by MDH is that ICF\\/DDs are expected to protect the people they serve from \\u201cimmediate jeopardy\\u201d. The provider in this instance noted that many times in the past they had been asked after a critical incident how they were going to protect the people they served from \\u201cimmediate jeopardy\\u201d in the future, so this mandate shaped the perception of the provider\\u2019s managers and supervisors whenever a health and safety concern arose and placed pressure on them to prioritize their response in a way that would satisfy MDH reviewers. The provider in this instance noted that terminating the person\\u2019s services was part of their response as to how they would respond to MDH\\u2019s questioning of how they were protecting the health and safety of the other people in the home. Between the requirements of DHS and MDH as well as the expectations of the guardians and case managers, the provider felt a strong need to act in this situation and felt that termination was the only way they could keep the majority of the people in the home safe.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1650}','68.53.115.247','2021-04-29 02:25:44'),(6412,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1651,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"103\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1651}','68.53.115.247','2021-04-29 02:25:44'),(6413,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1652,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"104\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1652}','68.53.115.247','2021-04-29 02:25:44'),(6414,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1653,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"105\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1653}','68.53.115.247','2021-04-29 02:25:44'),(6415,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1654,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"106\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1654}','68.53.115.247','2021-04-29 02:25:44'),(6416,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1655,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"107\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1655}','68.53.115.247','2021-04-29 02:25:44'),(6417,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1656,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"108\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1656}','68.53.115.247','2021-04-29 02:25:44'),(6418,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1657,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"109\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1657}','68.53.115.247','2021-04-29 02:25:44'),(6419,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1658,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"110\",\"question_type\":\"Free_Text\",\"text_answer\":\"The provider \\u2013 and the person\\u2019s team - expected the person\\u2019s challenging behavior to dissipate after intake not only because they thought the environment would suit the person, but they assumed that a behavior support plan would positively effect change and decrease the person\\u2019s interfering behavior and that other external services would be able to assist with challenging episodes. Unfortunately, upon arrival the provider found there was a lack of external behavior services in their area and that they had a lack of information about what mental health services were available. Additionally, the person\\u2019s case manager \\u2013 who would typically be expected to also help find needed services \\u2013 was very busy and unable to devote much time to the person\\u2019s case. A number of influences as to why case managers would be busy were identified \\u2013 between high case load and recent federal and state initiatives changing services.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1658}','68.53.115.247','2021-04-29 02:25:44'),(6420,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1659,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"111\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1659}','68.53.115.247','2021-04-29 02:25:44'),(6421,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1660,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"112\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1660}','68.53.115.247','2021-04-29 02:25:44'),(6422,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1661,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"113\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1661}','68.53.115.247','2021-04-29 02:25:44'),(6423,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1662,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"114\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1662}','68.53.115.247','2021-04-29 02:25:44'),(6424,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1663,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"115\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1663}','68.53.115.247','2021-04-29 02:25:44'),(6425,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1664,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"116\",\"question_type\":\"Free_Text\",\"text_answer\":\"Influencing why the ICF\\/DD provider terminated this person\\u2019s services due to challenging behavior was that the person was posing a safety risk to others in the home. The other 3 individuals in the home were considered to be more vulnerable to abuse due to their lower functioning levels, and so the person posed a greater risk to them. The provider had to balance their responsibility to protect the health and safety of three people in the home with their responsibility to meet the needs of the person whose services they terminated.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1664}','68.53.115.247','2021-04-29 02:25:44'),(6426,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1665,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"117\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1665}','68.53.115.247','2021-04-29 02:25:44'),(6427,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1666,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"118\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1666}','68.53.115.247','2021-04-29 02:25:44'),(6428,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1667,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"119\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1667}','68.53.115.247','2021-04-29 02:25:44'),(6429,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1668,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"120\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"The provider \\u2013 and the person\\u2019s team - expected the person\\u2019s challenging behavior to dissipate after intake not only because they thought the environment would suit the person, but they assumed that a behavior support plan would positively effect change and decrease the person\\u2019s interfering behavior and that other external services would be able to assist with challenging episodes. Unfortunately, upon arrival the provider found there was a lack of external behavior services in their area and that they had a lack of information about what mental health services were available. \\r\\nAlong with the lack of mental health resources, the provider also noted there was a lack of behavioral resources available to the person. Some practitioners had recommended that the person be admitted to an inpatient facility where they could try a \\u201cmed holiday\\u201d \\u2013 taking the person off all their meds and slowly re-introducing medication to determine their effectiveness. The provider could only find 1 program in the state that offered \\u201cmed holidays\\u201d, and that program had only 9 beds and waiting list of 25 people. The mapping team noted that the Jensen Settlement, which limited community base intensive services and the interventions they could use, influenced the lack of behavioral services like this one. \\r\\n\\r\\nAnother factor as to why this person was placed in an atypical placement was that the provider was willing to take a risk by accepting someone who didn\\u2019t fit the typical profile for this home. They were willing to take a risk because they did have an open ICF\\/DD bed that needed to be filled and hadn\\u2019t had much interest from other people in\\r\\n\\r\\nAlong with the provider being willing to take a risk by accepting the person\\u2019s placement in this atypical setting was that both the case manager and the person\\u2019s guardian were willing to take a risk by placing the person in a home that didn\\u2019t fit the \\u2018typical\\u2019 profile. The person had failed at multiple community-based settings before so they both reported being interested in trying something different. Their options were likely limited too because this region has a lack of residential placement beds, which is also the trend statewide. This lack of residential beds is seen as influenced by a statewide moratorium on foster care beds as well as a moratorium on ICF\\/DD beds. The providers in the room also noted that the current statewide workforce shortage prohibits them from opening new programs as well as influences the closure of other residential sites. Without staff, programs cannot open or even stay open as providers can\\u2019t meet the supervision needs of the people living there.\\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1668}','68.53.115.247','2021-04-29 02:25:44'),(6430,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1669,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"121\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1669}','68.53.115.247','2021-04-29 02:25:44'),(6431,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1670,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"122\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1670}','68.53.115.247','2021-04-29 02:25:44'),(6432,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1671,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"123\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:44 pm\",\"created_at\":\"4\\/28\\/2021 9:25:44 pm\",\"id\":1671}','68.53.115.247','2021-04-29 02:25:44'),(6433,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1672,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"124\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:45 pm\",\"created_at\":\"4\\/28\\/2021 9:25:45 pm\",\"id\":1672}','68.53.115.247','2021-04-29 02:25:45'),(6434,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1673,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"125\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:45 pm\",\"created_at\":\"4\\/28\\/2021 9:25:45 pm\",\"id\":1673}','68.53.115.247','2021-04-29 02:25:45'),(6435,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1674,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"126\",\"question_type\":\"Free_Text\",\"text_answer\":\"Without interventions that met the needs of the person, coupled with the lack of training of the staff, the provider noted their staff were stressed at the site. They often times engaged in power struggles with the individual and spent time trying to keep the other 3 residents safe\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:45 pm\",\"created_at\":\"4\\/28\\/2021 9:25:45 pm\",\"id\":1674}','68.53.115.247','2021-04-29 02:25:45'),(6436,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1675,'{\"report_id\":21,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"432\",\"question_type\":\"Yes_or_No\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:25:45 pm\",\"created_at\":\"4\\/28\\/2021 9:25:45 pm\",\"id\":1675}','68.53.115.247','2021-04-29 02:25:45'),(6437,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1676,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Staff didn\\u2019t continuously monitor the person in bathroom and the person eloped without being seen\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:07 pm\",\"created_at\":\"4\\/28\\/2021 9:26:07 pm\",\"id\":1676}','68.53.115.247','2021-04-29 02:26:07'),(6438,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1677,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"94\",\"question_type\":\"True_or_False\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:07 pm\",\"created_at\":\"4\\/28\\/2021 9:26:07 pm\",\"id\":1677}','68.53.115.247','2021-04-29 02:26:07'),(6439,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1678,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"07\\/10\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:23 pm\",\"created_at\":\"4\\/28\\/2021 9:26:23 pm\",\"id\":1678}','68.53.115.247','2021-04-29 02:26:23'),(6440,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1679,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"VA has worked at the employment program for 10 years and the staff interviewed reported they have worked with her for most of that time.  Over this 10 years the VA lived with an aunt, then in an adult foster care setting (near her employment program) and at the time of the incident was living in an apartment.  \\n\\nVA enjoyed coloring\\/crafts, being outside, working, having attention and encouragement from staff.  VA enjoyed food (lunch at work and wouldn\\u2019t necessarily heat up a meal that typically would be a meal to heat up).\\n\\nVA has a staffing ratio at the employment program of a 1:3, most individuals there have 1:6 or 1:7.  At home VA had a 2:1 staffing ratio.  The 2:1 at home was higher because VA was more physically aggressive at home than at work.  Less aggression towards male staff-staff interviewed stated VA has less male staff at residence than at the employment program.  \\n\\nThe employment program has 200 individuals in their facility and approximately 45 in the area where VA works.  The day of the event there was 7-8 staff in the area for all of those individuals being served.  \\n\\nThe elopement protocol at the employment program was for the staff to have eyes on VA, except in the bathroom and just do 5 minute checks.  Keep the lunch and duffle bag in the supervisor\\u2019s office.  VA would have no antecedents prior to elopements or other incidents of maladaptive behavior (this day was no different.  The team agreed to this plan including the guardians (parents).\\n\\nVA works at the employment program Monday-Friday from 9am-3pm and typically VA shows signs of being done with work at around 2pm.  The day of the incident the VA had arrive late or had not been ready when the bus arrived to pick her up.  This was a common occurrence.  \\n\\nWhen at work the VA was a great worker completing piece work on the work floor.  That day there was not a lot of work available and the group had been doing other craft activities (VA enjoyed).  It is believed that VA had a possible UTI infection and VA had a history of GERD\\/esophagus issues (causing her to vomit and cause pain), however VA could not verbalize their needs all of the time.  Verbal skills were limited.  Over the time VA worked at the employment program they were able to get her to improve her verbal skills by encouraging VA to use her words.  If she were sick and she was about to vomit VA would attempt to express this to the employment staff and sometimes ask them for a Tums.  \\n\\nThe VA did not take the duffle bag or lunch when the elopement occurred which typically the VA would not have left the building without either of the bags.  The VA never was able to explain the reason for elopement, however the staff believe there is a Kwik Trip nearby that was the direction VA was headed and her previous residence was near the employment program.  VA did things with no antecedents and would do things for attention.  The staff believe potentially VA was not feeling well and potentially wanted to go outside because VA really enjoyed being outside.  Staff went outside after receiving phone call from transportation company and got the VA from the Good Samaritan that was walking with VA.  \\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:31 pm\",\"created_at\":\"4\\/28\\/2021 9:26:31 pm\",\"id\":1679}','68.53.115.247','2021-04-29 02:26:31'),(6441,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1680,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The staff not continuously monitoring the person in the bathroom was impacted by the staff adapting the person\\u2019s supervision protocol to allow for privacy in the bathroom.  It is the providers practice to allow all of the individual\\u2019s privacy in the restroom as this is influenced by societal norms.  The other factors contributing to adapt the protocol the day of the event was the individual was not feeling well, typically towards the end of the day this individual participates in work less (the time of incident was at the end of the work day), and there is a history of the person taking a long time in the restroom.  Further influencing the person\\u2019s ability to elope without staff noticing was the staff did not see the historical antecedent the person would display before eloping because in this case the individual eloped without taking their lunch bag out of the staff\\u2019s office.  Additionally, during this event there were multiple staff checking on the individual since in this setting there is not a specific staff assigned to one individual person working.  This process is the norm for the department as it is shaped by the support plan stating the need for a 1:3 staffing ratio. Thus the ratio allows the county to manage the budget allocation they are given by the state and federal allocations which is determined through the legislation.  Overall legislation determines the rates that are set which then is strengthened by MNCHOICES to determine the needs are met, thus to create the staffing patterns for the provider in the support plan.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:40 pm\",\"created_at\":\"4\\/28\\/2021 9:26:40 pm\",\"id\":1680}','68.53.115.247','2021-04-29 02:26:40'),(6442,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports','update',22,'{\"id\":22,\"form_id\":\"23\",\"user_id\":\"81\",\"question_id\":null,\"organization_id\":\"10\",\"tab_id\":null,\"question_type\":null,\"text_answer\":\"{\\\"Short_Answer__76\\\":\\\"201901929\\\",\\\"Date__77\\\":\\\"05\\\\\\/22\\\\\\/2019\\\",\\\"Multiple_Choice__78\\\":\\\"Jill Tilbury\\\",\\\"Multiple_Choice__79\\\":\\\"Kristie Pittman\\\",\\\"Short_Answer__80\\\":\\\"MRCI\\\",\\\"Short_Answer__81\\\":\\\"Cathy Groebner\\\",\\\"Short_Answer__82\\\":\\\"cgroebner@mymrci.org\\\",\\\"Multiple_Choice__84\\\":\\\"Elopement\\\",\\\"Multiple_Choice__85\\\":\\\"Blue Earth County\\\",\\\"Date__86\\\":\\\"03\\\\\\/19\\\\\\/2019\\\",\\\"Free_Text__87\\\":\\\"\\\\\\\"Wednesday March 13, 2019 at approximately 1:40pm, staff 1 noticed VA leave the Department 123 work area. Staff 1 stepped outside the room and saw VA going into the women\\\\u2019s bathroom located off of the production floor nearest to Department 123.  Staff 1 checked on VA at about 1:45pm and saw that VA was in the handicap stall with their green jacket off.  Staff 1 asked if VA was OK and they replied \\\\u201cyeah\\\\u201d and also asked if VA needed anything and they said \\\\u201cno\\\\u201d.  Staff 1 then went back to that same bathroom to assist another individual at approximately 1:50pm and VA was still in the same stall.  Staff 1 went back to the room at about 1:55pm.  It should be noted that the VA had been diagnosed with a mild UTI on Sunday 3\\\\\\/10\\\\\\/19 and was sent home early on Monday 3\\\\\\/11\\\\\\/19 due to them not feeling well.  VA also came in late on Tuesday, 3\\\\\\/12\\\\\\/19.  \\\\r\\\\n\\\\r\\\\nVA has eloped in the past, VA takes her lunch box with her.  Because of that, VA is required to leave the lunch box in the Team Leader\\\\u2019s office.  At approximately 2:00pm, staff 1 notice VA\\\\u2019s lunch box was still in the office.  Support Specialist Staff 2 went to that same bathroom that VA was in approximately 2:05pm and that VA was no longer in the bathroom.  A bus drive for the day program was driving the buss back to the program and notice someone in a green jacket standing in the street on Map Drive around 2pm.  There are no sidewalks on Map Drive.  Staff recognized the person as the VA and immediately called her supervisor at the program. And drove back to where the VA was walking.  It was reported that two \\\\u201cgood Samaritans\\\\u201d pulled over and stopped the VA on the sidewalk along stadium drive, which is the road that connects with Map Drive, and started walking with her back to the program until the staff arrived.  \\\\r\\\\n\\\\r\\\\nAt 2:07 the Supervisor received a phone call from the transportation supervisor stating VA was found walking on the sidewalk along Stadium Drive and was being walked back to the program\\\\u2019s building.  The program supervisor ran outside and saw VA with about four other program staff walking with VA.  The supervisor walked alongside VA all the way back to the office and the VA waited in the office until was time for VA to board the bus to go home.  While the office, VA was ask if VA thought what happened was safe and the VA said, \\\\u201cNo\\\\u201d. The VA was asked why it wasn\\\\u2019t and safe and the response was \\\\u201cI could get hurt\\\\u201d. Supervisor asked VA if it will ever happen again and VA shook their head \\\\u201cno\\\\u201d. Supervisor walked VA to the bus and fastened seatbelt and sat patiently until the bus departed.  \\\\\\\"\\\",\\\"Multiple_Choice__96\\\":\\\"1\\\",\\\"Short_Answer__91\\\":\\\"Staff didn\\\\u2019t continuously monitor the person in bathroom and the person eloped without being seen\\\",\\\"True_or_False__94\\\":\\\"Yes\\\",\\\"Date__97\\\":\\\"07\\\\\\/10\\\\\\/2019\\\",\\\"Free_Text__98\\\":\\\"\\\\\\\"VA has worked at the employment program for 10 years and the staff interviewed reported they have worked with her for most of that time.  Over this 10 years the VA lived with an aunt, then in an adult foster care setting (near her employment program) and at the time of the incident was living in an apartment.  \\\\r\\\\n\\\\r\\\\nVA enjoyed coloring\\\\\\/crafts, being outside, working, having attention and encouragement from staff.  VA enjoyed food (lunch at work and wouldn\\\\u2019t necessarily heat up a meal that typically would be a meal to heat up).\\\\r\\\\n\\\\r\\\\nVA has a staffing ratio at the employment program of a 1:3, most individuals there have 1:6 or 1:7.  At home VA had a 2:1 staffing ratio.  The 2:1 at home was higher because VA was more physically aggressive at home than at work.  Less aggression towards male staff-staff interviewed stated VA has less male staff at residence than at the employment program.  \\\\r\\\\n\\\\r\\\\nThe employment program has 200 individuals in their facility and approximately 45 in the area where VA works.  The day of the event there was 7-8 staff in the area for all of those individuals being served.  \\\\r\\\\n\\\\r\\\\nThe elopement protocol at the employment program was for the staff to have eyes on VA, except in the bathroom and just do 5 minute checks.  Keep the lunch and duffle bag in the supervisor\\\\u2019s office.  VA would have no antecedents prior to elopements or other incidents of maladaptive behavior (this day was no different.  The team agreed to this plan including the guardians (parents).\\\\r\\\\n\\\\r\\\\nVA works at the employment program Monday-Friday from 9am-3pm and typically VA shows signs of being done with work at around 2pm.  The day of the incident the VA had arrive late or had not been ready when the bus arrived to pick her up.  This was a common occurrence.  \\\\r\\\\n\\\\r\\\\nWhen at work the VA was a great worker completing piece work on the work floor.  That day there was not a lot of work available and the group had been doing other craft activities (VA enjoyed).  It is believed that VA had a possible UTI infection and VA had a history of GERD\\\\\\/esophagus issues (causing her to vomit and cause pain), however VA could not verbalize their needs all of the time.  Verbal skills were limited.  Over the time VA worked at the employment program they were able to get her to improve her verbal skills by encouraging VA to use her words.  If she were sick and she was about to vomit VA would attempt to express this to the employment staff and sometimes ask them for a Tums.  \\\\r\\\\n\\\\r\\\\nThe VA did not take the duffle bag or lunch when the elopement occurred which typically the VA would not have left the building without either of the bags.  The VA never was able to explain the reason for elopement, however the staff believe there is a Kwik Trip nearby that was the direction VA was headed and her previous residence was near the employment program.  VA did things with no antecedents and would do things for attention.  The staff believe potentially VA was not feeling well and potentially wanted to go outside because VA really enjoyed being outside.  Staff went outside after receiving phone call from transportation company and got the VA from the Good Samaritan that was walking with VA.  \\\\\\\"\\\",\\\"Free_Text__100\\\":\\\"The staff not continuously monitoring the person in the bathroom was impacted by the staff adapting the person\\\\u2019s supervision protocol to allow for privacy in the bathroom.  It is the providers practice to allow all of the individual\\\\u2019s privacy in the restroom as this is influenced by societal norms.  The other factors contributing to adapt the protocol the day of the event was the individual was not feeling well, typically towards the end of the day this individual participates in work less (the time of incident was at the end of the work day), and there is a history of the person taking a long time in the restroom.  Further influencing the person\\\\u2019s ability to elope without staff noticing was the staff did not see the historical antecedent the person would display before eloping because in this case the individual eloped without taking their lunch bag out of the staff\\\\u2019s office.  Additionally, during this event there were multiple staff checking on the individual since in this setting there is not a specific staff assigned to one individual person working.  This process is the norm for the department as it is shaped by the support plan stating the need for a 1:3 staffing ratio. Thus the ratio allows the county to manage the budget allocation they are given by the state and federal allocations which is determined through the legislation.  Overall legislation determines the rates that are set which then is strengthened by MNCHOICES to determine the needs are met, thus to create the staffing patterns for the provider in the support plan.\\\"}\",\"mcq_answer\":null,\"other_answer\":\"0\",\"status\":\"1\",\"created_by\":\"81\",\"updated_by\":81,\"created_at\":\"4\\/28\\/2021 9:23:07 pm\",\"updated_at\":\"4\\/28\\/2021 9:26:49 pm\",\"deleted_at\":null,\"report_name\":\"JT_MRCI-BEC-2019-05\"}','68.53.115.247','2021-04-29 02:26:49'),(6443,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1681,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"201901929\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:49 pm\",\"created_at\":\"4\\/28\\/2021 9:26:49 pm\",\"id\":1681}','68.53.115.247','2021-04-29 02:26:49'),(6444,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1682,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"05\\/22\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:49 pm\",\"created_at\":\"4\\/28\\/2021 9:26:49 pm\",\"id\":1682}','68.53.115.247','2021-04-29 02:26:49'),(6445,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1683,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"78\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Jill Tilbury\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:49 pm\",\"created_at\":\"4\\/28\\/2021 9:26:49 pm\",\"id\":1683}','68.53.115.247','2021-04-29 02:26:49'),(6446,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1684,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Kristie Pittman\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:49 pm\",\"created_at\":\"4\\/28\\/2021 9:26:49 pm\",\"id\":1684}','68.53.115.247','2021-04-29 02:26:49'),(6447,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1685,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"MRCI\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:49 pm\",\"created_at\":\"4\\/28\\/2021 9:26:49 pm\",\"id\":1685}','68.53.115.247','2021-04-29 02:26:49'),(6448,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1686,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Cathy Groebner\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:49 pm\",\"created_at\":\"4\\/28\\/2021 9:26:49 pm\",\"id\":1686}','68.53.115.247','2021-04-29 02:26:49'),(6449,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1687,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"cgroebner@mymrci.org\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:49 pm\",\"created_at\":\"4\\/28\\/2021 9:26:49 pm\",\"id\":1687}','68.53.115.247','2021-04-29 02:26:49'),(6450,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1688,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"83\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:49 pm\",\"created_at\":\"4\\/28\\/2021 9:26:49 pm\",\"id\":1688}','68.53.115.247','2021-04-29 02:26:49'),(6451,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1689,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"84\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Elopement\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:49 pm\",\"created_at\":\"4\\/28\\/2021 9:26:49 pm\",\"id\":1689}','68.53.115.247','2021-04-29 02:26:49'),(6452,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1690,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Blue Earth County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:49 pm\",\"created_at\":\"4\\/28\\/2021 9:26:49 pm\",\"id\":1690}','68.53.115.247','2021-04-29 02:26:49'),(6453,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1691,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"03\\/19\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:49 pm\",\"created_at\":\"4\\/28\\/2021 9:26:49 pm\",\"id\":1691}','68.53.115.247','2021-04-29 02:26:49'),(6454,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1692,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Wednesday March 13, 2019 at approximately 1:40pm, staff 1 noticed VA leave the Department 123 work area. Staff 1 stepped outside the room and saw VA going into the women\\u2019s bathroom located off of the production floor nearest to Department 123.  Staff 1 checked on VA at about 1:45pm and saw that VA was in the handicap stall with their green jacket off.  Staff 1 asked if VA was OK and they replied \\u201cyeah\\u201d and also asked if VA needed anything and they said \\u201cno\\u201d.  Staff 1 then went back to that same bathroom to assist another individual at approximately 1:50pm and VA was still in the same stall.  Staff 1 went back to the room at about 1:55pm.  It should be noted that the VA had been diagnosed with a mild UTI on Sunday 3\\/10\\/19 and was sent home early on Monday 3\\/11\\/19 due to them not feeling well.  VA also came in late on Tuesday, 3\\/12\\/19.  \\r\\n\\r\\nVA has eloped in the past, VA takes her lunch box with her.  Because of that, VA is required to leave the lunch box in the Team Leader\\u2019s office.  At approximately 2:00pm, staff 1 notice VA\\u2019s lunch box was still in the office.  Support Specialist Staff 2 went to that same bathroom that VA was in approximately 2:05pm and that VA was no longer in the bathroom.  A bus drive for the day program was driving the buss back to the program and notice someone in a green jacket standing in the street on Map Drive around 2pm.  There are no sidewalks on Map Drive.  Staff recognized the person as the VA and immediately called her supervisor at the program. And drove back to where the VA was walking.  It was reported that two \\u201cgood Samaritans\\u201d pulled over and stopped the VA on the sidewalk along stadium drive, which is the road that connects with Map Drive, and started walking with her back to the program until the staff arrived.  \\r\\n\\r\\nAt 2:07 the Supervisor received a phone call from the transportation supervisor stating VA was found walking on the sidewalk along Stadium Drive and was being walked back to the program\\u2019s building.  The program supervisor ran outside and saw VA with about four other program staff walking with VA.  The supervisor walked alongside VA all the way back to the office and the VA waited in the office until was time for VA to board the bus to go home.  While the office, VA was ask if VA thought what happened was safe and the VA said, \\u201cNo\\u201d. The VA was asked why it wasn\\u2019t and safe and the response was \\u201cI could get hurt\\u201d. Supervisor asked VA if it will ever happen again and VA shook their head \\u201cno\\u201d. Supervisor walked VA to the bus and fastened seatbelt and sat patiently until the bus departed.  \\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:49 pm\",\"created_at\":\"4\\/28\\/2021 9:26:49 pm\",\"id\":1692}','68.53.115.247','2021-04-29 02:26:49'),(6455,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1693,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"96\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"1\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:49 pm\",\"created_at\":\"4\\/28\\/2021 9:26:49 pm\",\"id\":1693}','68.53.115.247','2021-04-29 02:26:49'),(6456,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1694,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Staff didn\\u2019t continuously monitor the person in bathroom and the person eloped without being seen\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:49 pm\",\"created_at\":\"4\\/28\\/2021 9:26:49 pm\",\"id\":1694}','68.53.115.247','2021-04-29 02:26:49'),(6457,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1695,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"94\",\"question_type\":\"True_or_False\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:49 pm\",\"created_at\":\"4\\/28\\/2021 9:26:49 pm\",\"id\":1695}','68.53.115.247','2021-04-29 02:26:49'),(6458,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1696,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"07\\/10\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:49 pm\",\"created_at\":\"4\\/28\\/2021 9:26:49 pm\",\"id\":1696}','68.53.115.247','2021-04-29 02:26:49'),(6459,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1697,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"VA has worked at the employment program for 10 years and the staff interviewed reported they have worked with her for most of that time.  Over this 10 years the VA lived with an aunt, then in an adult foster care setting (near her employment program) and at the time of the incident was living in an apartment.  \\r\\n\\r\\nVA enjoyed coloring\\/crafts, being outside, working, having attention and encouragement from staff.  VA enjoyed food (lunch at work and wouldn\\u2019t necessarily heat up a meal that typically would be a meal to heat up).\\r\\n\\r\\nVA has a staffing ratio at the employment program of a 1:3, most individuals there have 1:6 or 1:7.  At home VA had a 2:1 staffing ratio.  The 2:1 at home was higher because VA was more physically aggressive at home than at work.  Less aggression towards male staff-staff interviewed stated VA has less male staff at residence than at the employment program.  \\r\\n\\r\\nThe employment program has 200 individuals in their facility and approximately 45 in the area where VA works.  The day of the event there was 7-8 staff in the area for all of those individuals being served.  \\r\\n\\r\\nThe elopement protocol at the employment program was for the staff to have eyes on VA, except in the bathroom and just do 5 minute checks.  Keep the lunch and duffle bag in the supervisor\\u2019s office.  VA would have no antecedents prior to elopements or other incidents of maladaptive behavior (this day was no different.  The team agreed to this plan including the guardians (parents).\\r\\n\\r\\nVA works at the employment program Monday-Friday from 9am-3pm and typically VA shows signs of being done with work at around 2pm.  The day of the incident the VA had arrive late or had not been ready when the bus arrived to pick her up.  This was a common occurrence.  \\r\\n\\r\\nWhen at work the VA was a great worker completing piece work on the work floor.  That day there was not a lot of work available and the group had been doing other craft activities (VA enjoyed).  It is believed that VA had a possible UTI infection and VA had a history of GERD\\/esophagus issues (causing her to vomit and cause pain), however VA could not verbalize their needs all of the time.  Verbal skills were limited.  Over the time VA worked at the employment program they were able to get her to improve her verbal skills by encouraging VA to use her words.  If she were sick and she was about to vomit VA would attempt to express this to the employment staff and sometimes ask them for a Tums.  \\r\\n\\r\\nThe VA did not take the duffle bag or lunch when the elopement occurred which typically the VA would not have left the building without either of the bags.  The VA never was able to explain the reason for elopement, however the staff believe there is a Kwik Trip nearby that was the direction VA was headed and her previous residence was near the employment program.  VA did things with no antecedents and would do things for attention.  The staff believe potentially VA was not feeling well and potentially wanted to go outside because VA really enjoyed being outside.  Staff went outside after receiving phone call from transportation company and got the VA from the Good Samaritan that was walking with VA.  \\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:49 pm\",\"created_at\":\"4\\/28\\/2021 9:26:49 pm\",\"id\":1697}','68.53.115.247','2021-04-29 02:26:49'),(6460,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1698,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"99\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:49 pm\",\"created_at\":\"4\\/28\\/2021 9:26:49 pm\",\"id\":1698}','68.53.115.247','2021-04-29 02:26:49'),(6461,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1699,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The staff not continuously monitoring the person in the bathroom was impacted by the staff adapting the person\\u2019s supervision protocol to allow for privacy in the bathroom.  It is the providers practice to allow all of the individual\\u2019s privacy in the restroom as this is influenced by societal norms.  The other factors contributing to adapt the protocol the day of the event was the individual was not feeling well, typically towards the end of the day this individual participates in work less (the time of incident was at the end of the work day), and there is a history of the person taking a long time in the restroom.  Further influencing the person\\u2019s ability to elope without staff noticing was the staff did not see the historical antecedent the person would display before eloping because in this case the individual eloped without taking their lunch bag out of the staff\\u2019s office.  Additionally, during this event there were multiple staff checking on the individual since in this setting there is not a specific staff assigned to one individual person working.  This process is the norm for the department as it is shaped by the support plan stating the need for a 1:3 staffing ratio. Thus the ratio allows the county to manage the budget allocation they are given by the state and federal allocations which is determined through the legislation.  Overall legislation determines the rates that are set which then is strengthened by MNCHOICES to determine the needs are met, thus to create the staffing patterns for the provider in the support plan.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:49 pm\",\"created_at\":\"4\\/28\\/2021 9:26:49 pm\",\"id\":1699}','68.53.115.247','2021-04-29 02:26:49'),(6462,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1700,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"127\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:49 pm\",\"created_at\":\"4\\/28\\/2021 9:26:49 pm\",\"id\":1700}','68.53.115.247','2021-04-29 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02:26:49'),(6493,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1731,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":\"The other factors contributing to adapt the protocol the day of the event was the individual was not feeling well, typically towards the end of the day this individual participates in work less (the time of incident was at the end of the work day), and there is a history of the person taking a long time in the restroom.  Further influencing the person\\u2019s ability to elope without staff noticing was the staff did not see the historical antecedent the person would display before eloping because in this case the individual eloped without taking their lunch bag out of the staff\\u2019s office.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:26:59 pm\",\"created_at\":\"4\\/28\\/2021 9:26:59 pm\",\"id\":1731}','68.53.115.247','2021-04-29 02:26:59'),(6494,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1732,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"116\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"The staff not continuously monitoring the person in the bathroom was impacted by the staff adapting the person\\u2019s supervision protocol to allow for privacy in the bathroom.  \\n\\nAdditionally, during this event there were multiple staff checking on the individual since in this setting there is not a specific staff assigned to one individual person working.  This process is the norm for the department as it is shaped by the support plan stating the need for a 1:3 staffing ratio.\\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:27:29 pm\",\"created_at\":\"4\\/28\\/2021 9:27:29 pm\",\"id\":1732}','68.53.115.247','2021-04-29 02:27:29'),(6495,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1733,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"124\",\"question_type\":\"Free_Text\",\"text_answer\":\"The staff not continuously monitoring the person in the bathroom was impacted by the staff adapting the person\\u2019s supervision protocol to allow for privacy in the bathroom.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:00 pm\",\"created_at\":\"4\\/28\\/2021 9:28:00 pm\",\"id\":1733}','68.53.115.247','2021-04-29 02:28:00'),(6496,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1734,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"432\",\"question_type\":\"Yes_or_No\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:06 pm\",\"created_at\":\"4\\/28\\/2021 9:28:06 pm\",\"id\":1734}','68.53.115.247','2021-04-29 02:28:06'),(6497,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports','update',22,'{\"id\":22,\"form_id\":\"23\",\"user_id\":\"81\",\"question_id\":null,\"organization_id\":\"10\",\"tab_id\":null,\"question_type\":null,\"text_answer\":\"{\\\"Short_Answer__76\\\":\\\"201901929\\\",\\\"Date__77\\\":\\\"05\\\\\\/22\\\\\\/2019\\\",\\\"Multiple_Choice__78\\\":\\\"Jill Tilbury\\\",\\\"Multiple_Choice__79\\\":\\\"Kristie Pittman\\\",\\\"Short_Answer__80\\\":\\\"MRCI\\\",\\\"Short_Answer__81\\\":\\\"Cathy Groebner\\\",\\\"Short_Answer__82\\\":\\\"cgroebner@mymrci.org\\\",\\\"Multiple_Choice__84\\\":\\\"Elopement\\\",\\\"Multiple_Choice__85\\\":\\\"Blue Earth County\\\",\\\"Date__86\\\":\\\"03\\\\\\/19\\\\\\/2019\\\",\\\"Free_Text__87\\\":\\\"\\\\\\\"Wednesday March 13, 2019 at approximately 1:40pm, staff 1 noticed VA leave the Department 123 work area. Staff 1 stepped outside the room and saw VA going into the women\\\\u2019s bathroom located off of the production floor nearest to Department 123.  Staff 1 checked on VA at about 1:45pm and saw that VA was in the handicap stall with their green jacket off.  Staff 1 asked if VA was OK and they replied \\\\u201cyeah\\\\u201d and also asked if VA needed anything and they said \\\\u201cno\\\\u201d.  Staff 1 then went back to that same bathroom to assist another individual at approximately 1:50pm and VA was still in the same stall.  Staff 1 went back to the room at about 1:55pm.  It should be noted that the VA had been diagnosed with a mild UTI on Sunday 3\\\\\\/10\\\\\\/19 and was sent home early on Monday 3\\\\\\/11\\\\\\/19 due to them not feeling well.  VA also came in late on Tuesday, 3\\\\\\/12\\\\\\/19.  \\\\r\\\\n\\\\r\\\\nVA has eloped in the past, VA takes her lunch box with her.  Because of that, VA is required to leave the lunch box in the Team Leader\\\\u2019s office.  At approximately 2:00pm, staff 1 notice VA\\\\u2019s lunch box was still in the office.  Support Specialist Staff 2 went to that same bathroom that VA was in approximately 2:05pm and that VA was no longer in the bathroom.  A bus drive for the day program was driving the buss back to the program and notice someone in a green jacket standing in the street on Map Drive around 2pm.  There are no sidewalks on Map Drive.  Staff recognized the person as the VA and immediately called her supervisor at the program. And drove back to where the VA was walking.  It was reported that two \\\\u201cgood Samaritans\\\\u201d pulled over and stopped the VA on the sidewalk along stadium drive, which is the road that connects with Map Drive, and started walking with her back to the program until the staff arrived.  \\\\r\\\\n\\\\r\\\\nAt 2:07 the Supervisor received a phone call from the transportation supervisor stating VA was found walking on the sidewalk along Stadium Drive and was being walked back to the program\\\\u2019s building.  The program supervisor ran outside and saw VA with about four other program staff walking with VA.  The supervisor walked alongside VA all the way back to the office and the VA waited in the office until was time for VA to board the bus to go home.  While the office, VA was ask if VA thought what happened was safe and the VA said, \\\\u201cNo\\\\u201d. The VA was asked why it wasn\\\\u2019t and safe and the response was \\\\u201cI could get hurt\\\\u201d. Supervisor asked VA if it will ever happen again and VA shook their head \\\\u201cno\\\\u201d. Supervisor walked VA to the bus and fastened seatbelt and sat patiently until the bus departed.  \\\\\\\"\\\",\\\"Multiple_Choice__96\\\":\\\"1\\\",\\\"Short_Answer__91\\\":\\\"Staff didn\\\\u2019t continuously monitor the person in bathroom and the person eloped without being seen\\\",\\\"True_or_False__94\\\":\\\"Yes\\\",\\\"Date__97\\\":\\\"07\\\\\\/10\\\\\\/2019\\\",\\\"Free_Text__98\\\":\\\"\\\\\\\"VA has worked at the employment program for 10 years and the staff interviewed reported they have worked with her for most of that time.  Over this 10 years the VA lived with an aunt, then in an adult foster care setting (near her employment program) and at the time of the incident was living in an apartment.  \\\\r\\\\n\\\\r\\\\nVA enjoyed coloring\\\\\\/crafts, being outside, working, having attention and encouragement from staff.  VA enjoyed food (lunch at work and wouldn\\\\u2019t necessarily heat up a meal that typically would be a meal to heat up).\\\\r\\\\n\\\\r\\\\nVA has a staffing ratio at the employment program of a 1:3, most individuals there have 1:6 or 1:7.  At home VA had a 2:1 staffing ratio.  The 2:1 at home was higher because VA was more physically aggressive at home than at work.  Less aggression towards male staff-staff interviewed stated VA has less male staff at residence than at the employment program.  \\\\r\\\\n\\\\r\\\\nThe employment program has 200 individuals in their facility and approximately 45 in the area where VA works.  The day of the event there was 7-8 staff in the area for all of those individuals being served.  \\\\r\\\\n\\\\r\\\\nThe elopement protocol at the employment program was for the staff to have eyes on VA, except in the bathroom and just do 5 minute checks.  Keep the lunch and duffle bag in the supervisor\\\\u2019s office.  VA would have no antecedents prior to elopements or other incidents of maladaptive behavior (this day was no different.  The team agreed to this plan including the guardians (parents).\\\\r\\\\n\\\\r\\\\nVA works at the employment program Monday-Friday from 9am-3pm and typically VA shows signs of being done with work at around 2pm.  The day of the incident the VA had arrive late or had not been ready when the bus arrived to pick her up.  This was a common occurrence.  \\\\r\\\\n\\\\r\\\\nWhen at work the VA was a great worker completing piece work on the work floor.  That day there was not a lot of work available and the group had been doing other craft activities (VA enjoyed).  It is believed that VA had a possible UTI infection and VA had a history of GERD\\\\\\/esophagus issues (causing her to vomit and cause pain), however VA could not verbalize their needs all of the time.  Verbal skills were limited.  Over the time VA worked at the employment program they were able to get her to improve her verbal skills by encouraging VA to use her words.  If she were sick and she was about to vomit VA would attempt to express this to the employment staff and sometimes ask them for a Tums.  \\\\r\\\\n\\\\r\\\\nThe VA did not take the duffle bag or lunch when the elopement occurred which typically the VA would not have left the building without either of the bags.  The VA never was able to explain the reason for elopement, however the staff believe there is a Kwik Trip nearby that was the direction VA was headed and her previous residence was near the employment program.  VA did things with no antecedents and would do things for attention.  The staff believe potentially VA was not feeling well and potentially wanted to go outside because VA really enjoyed being outside.  Staff went outside after receiving phone call from transportation company and got the VA from the Good Samaritan that was walking with VA.  \\\\\\\"\\\",\\\"Free_Text__100\\\":\\\"The staff not continuously monitoring the person in the bathroom was impacted by the staff adapting the person\\\\u2019s supervision protocol to allow for privacy in the bathroom.  It is the providers practice to allow all of the individual\\\\u2019s privacy in the restroom as this is influenced by societal norms.  The other factors contributing to adapt the protocol the day of the event was the individual was not feeling well, typically towards the end of the day this individual participates in work less (the time of incident was at the end of the work day), and there is a history of the person taking a long time in the restroom.  Further influencing the person\\\\u2019s ability to elope without staff noticing was the staff did not see the historical antecedent the person would display before eloping because in this case the individual eloped without taking their lunch bag out of the staff\\\\u2019s office.  Additionally, during this event there were multiple staff checking on the individual since in this setting there is not a specific staff assigned to one individual person working.  This process is the norm for the department as it is shaped by the support plan stating the need for a 1:3 staffing ratio. Thus the ratio allows the county to manage the budget allocation they are given by the state and federal allocations which is determined through the legislation.  Overall legislation determines the rates that are set which then is strengthened by MNCHOICES to determine the needs are met, thus to create the staffing patterns for the provider in the support plan.\\\",\\\"Multiple_Choice__101\\\":\\\"2\\\",\\\"Free_Text__102\\\":\\\"The other factors contributing to adapt the protocol the day of the event was the individual was not feeling well, typically towards the end of the day this individual participates in work less (the time of incident was at the end of the work day), and there is a history of the person taking a long time in the restroom.  Further influencing the person\\\\u2019s ability to elope without staff noticing was the staff did not see the historical antecedent the person would display before eloping because in this case the individual eloped without taking their lunch bag out of the staff\\\\u2019s office.\\\",\\\"Multiple_Choice__103\\\":\\\"0\\\",\\\"Multiple_Choice__105\\\":\\\"0\\\",\\\"Multiple_Choice__107\\\":\\\"0\\\",\\\"Multiple_Choice__109\\\":\\\"0\\\",\\\"Multiple_Choice__111\\\":\\\"0\\\",\\\"Multiple_Choice__113\\\":\\\"0\\\",\\\"Multiple_Choice__115\\\":\\\"3\\\",\\\"Free_Text__116\\\":\\\"\\\\\\\"The staff not continuously monitoring the person in the bathroom was impacted by the staff adapting the person\\\\u2019s supervision protocol to allow for privacy in the bathroom.  \\\\r\\\\n\\\\r\\\\nAdditionally, during this event there were multiple staff checking on the individual since in this setting there is not a specific staff assigned to one individual person working.  This process is the norm for the department as it is shaped by the support plan stating the need for a 1:3 staffing ratio.\\\\\\\"\\\",\\\"Multiple_Choice__117\\\":\\\"0\\\",\\\"Multiple_Choice__119\\\":\\\"0\\\",\\\"Multiple_Choice__121\\\":\\\"0\\\",\\\"Multiple_Choice__123\\\":\\\"2\\\",\\\"Free_Text__124\\\":\\\"The staff not continuously monitoring the person in the bathroom was impacted by the staff adapting the person\\\\u2019s supervision protocol to allow for privacy in the bathroom.\\\",\\\"Multiple_Choice__125\\\":\\\"0\\\",\\\"Yes_or_No__432\\\":\\\"Yes\\\"}\",\"mcq_answer\":null,\"other_answer\":\"0\",\"status\":\"1\",\"created_by\":\"81\",\"updated_by\":81,\"created_at\":\"4\\/28\\/2021 9:23:07 pm\",\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"deleted_at\":null,\"report_name\":\"JT_MRCI-BEC-2019-05\"}','68.53.115.247','2021-04-29 02:28:09'),(6498,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1735,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"201901929\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1735}','68.53.115.247','2021-04-29 02:28:09'),(6499,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1736,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"05\\/22\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1736}','68.53.115.247','2021-04-29 02:28:09'),(6500,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1737,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"78\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Jill Tilbury\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1737}','68.53.115.247','2021-04-29 02:28:09'),(6501,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1738,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Kristie Pittman\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1738}','68.53.115.247','2021-04-29 02:28:09'),(6502,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1739,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"MRCI\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1739}','68.53.115.247','2021-04-29 02:28:09'),(6503,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1740,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Cathy Groebner\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1740}','68.53.115.247','2021-04-29 02:28:09'),(6504,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1741,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"cgroebner@mymrci.org\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1741}','68.53.115.247','2021-04-29 02:28:09'),(6505,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1742,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"83\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1742}','68.53.115.247','2021-04-29 02:28:09'),(6506,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1743,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"84\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Elopement\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1743}','68.53.115.247','2021-04-29 02:28:09'),(6507,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1744,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Blue Earth County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1744}','68.53.115.247','2021-04-29 02:28:09'),(6508,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1745,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"03\\/19\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1745}','68.53.115.247','2021-04-29 02:28:09'),(6509,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1746,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Wednesday March 13, 2019 at approximately 1:40pm, staff 1 noticed VA leave the Department 123 work area. Staff 1 stepped outside the room and saw VA going into the women\\u2019s bathroom located off of the production floor nearest to Department 123.  Staff 1 checked on VA at about 1:45pm and saw that VA was in the handicap stall with their green jacket off.  Staff 1 asked if VA was OK and they replied \\u201cyeah\\u201d and also asked if VA needed anything and they said \\u201cno\\u201d.  Staff 1 then went back to that same bathroom to assist another individual at approximately 1:50pm and VA was still in the same stall.  Staff 1 went back to the room at about 1:55pm.  It should be noted that the VA had been diagnosed with a mild UTI on Sunday 3\\/10\\/19 and was sent home early on Monday 3\\/11\\/19 due to them not feeling well.  VA also came in late on Tuesday, 3\\/12\\/19.  \\r\\n\\r\\nVA has eloped in the past, VA takes her lunch box with her.  Because of that, VA is required to leave the lunch box in the Team Leader\\u2019s office.  At approximately 2:00pm, staff 1 notice VA\\u2019s lunch box was still in the office.  Support Specialist Staff 2 went to that same bathroom that VA was in approximately 2:05pm and that VA was no longer in the bathroom.  A bus drive for the day program was driving the buss back to the program and notice someone in a green jacket standing in the street on Map Drive around 2pm.  There are no sidewalks on Map Drive.  Staff recognized the person as the VA and immediately called her supervisor at the program. And drove back to where the VA was walking.  It was reported that two \\u201cgood Samaritans\\u201d pulled over and stopped the VA on the sidewalk along stadium drive, which is the road that connects with Map Drive, and started walking with her back to the program until the staff arrived.  \\r\\n\\r\\nAt 2:07 the Supervisor received a phone call from the transportation supervisor stating VA was found walking on the sidewalk along Stadium Drive and was being walked back to the program\\u2019s building.  The program supervisor ran outside and saw VA with about four other program staff walking with VA.  The supervisor walked alongside VA all the way back to the office and the VA waited in the office until was time for VA to board the bus to go home.  While the office, VA was ask if VA thought what happened was safe and the VA said, \\u201cNo\\u201d. The VA was asked why it wasn\\u2019t and safe and the response was \\u201cI could get hurt\\u201d. Supervisor asked VA if it will ever happen again and VA shook their head \\u201cno\\u201d. Supervisor walked VA to the bus and fastened seatbelt and sat patiently until the bus departed.  \\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1746}','68.53.115.247','2021-04-29 02:28:09'),(6510,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1747,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"96\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"1\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1747}','68.53.115.247','2021-04-29 02:28:09'),(6511,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1748,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Staff didn\\u2019t continuously monitor the person in bathroom and the person eloped without being seen\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1748}','68.53.115.247','2021-04-29 02:28:09'),(6512,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1749,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"94\",\"question_type\":\"True_or_False\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1749}','68.53.115.247','2021-04-29 02:28:09'),(6513,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1750,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"07\\/10\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1750}','68.53.115.247','2021-04-29 02:28:09'),(6514,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1751,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"VA has worked at the employment program for 10 years and the staff interviewed reported they have worked with her for most of that time.  Over this 10 years the VA lived with an aunt, then in an adult foster care setting (near her employment program) and at the time of the incident was living in an apartment.  \\r\\n\\r\\nVA enjoyed coloring\\/crafts, being outside, working, having attention and encouragement from staff.  VA enjoyed food (lunch at work and wouldn\\u2019t necessarily heat up a meal that typically would be a meal to heat up).\\r\\n\\r\\nVA has a staffing ratio at the employment program of a 1:3, most individuals there have 1:6 or 1:7.  At home VA had a 2:1 staffing ratio.  The 2:1 at home was higher because VA was more physically aggressive at home than at work.  Less aggression towards male staff-staff interviewed stated VA has less male staff at residence than at the employment program.  \\r\\n\\r\\nThe employment program has 200 individuals in their facility and approximately 45 in the area where VA works.  The day of the event there was 7-8 staff in the area for all of those individuals being served.  \\r\\n\\r\\nThe elopement protocol at the employment program was for the staff to have eyes on VA, except in the bathroom and just do 5 minute checks.  Keep the lunch and duffle bag in the supervisor\\u2019s office.  VA would have no antecedents prior to elopements or other incidents of maladaptive behavior (this day was no different.  The team agreed to this plan including the guardians (parents).\\r\\n\\r\\nVA works at the employment program Monday-Friday from 9am-3pm and typically VA shows signs of being done with work at around 2pm.  The day of the incident the VA had arrive late or had not been ready when the bus arrived to pick her up.  This was a common occurrence.  \\r\\n\\r\\nWhen at work the VA was a great worker completing piece work on the work floor.  That day there was not a lot of work available and the group had been doing other craft activities (VA enjoyed).  It is believed that VA had a possible UTI infection and VA had a history of GERD\\/esophagus issues (causing her to vomit and cause pain), however VA could not verbalize their needs all of the time.  Verbal skills were limited.  Over the time VA worked at the employment program they were able to get her to improve her verbal skills by encouraging VA to use her words.  If she were sick and she was about to vomit VA would attempt to express this to the employment staff and sometimes ask them for a Tums.  \\r\\n\\r\\nThe VA did not take the duffle bag or lunch when the elopement occurred which typically the VA would not have left the building without either of the bags.  The VA never was able to explain the reason for elopement, however the staff believe there is a Kwik Trip nearby that was the direction VA was headed and her previous residence was near the employment program.  VA did things with no antecedents and would do things for attention.  The staff believe potentially VA was not feeling well and potentially wanted to go outside because VA really enjoyed being outside.  Staff went outside after receiving phone call from transportation company and got the VA from the Good Samaritan that was walking with VA.  \\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1751}','68.53.115.247','2021-04-29 02:28:09'),(6515,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1752,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"99\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1752}','68.53.115.247','2021-04-29 02:28:09'),(6516,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1753,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The staff not continuously monitoring the person in the bathroom was impacted by the staff adapting the person\\u2019s supervision protocol to allow for privacy in the bathroom.  It is the providers practice to allow all of the individual\\u2019s privacy in the restroom as this is influenced by societal norms.  The other factors contributing to adapt the protocol the day of the event was the individual was not feeling well, typically towards the end of the day this individual participates in work less (the time of incident was at the end of the work day), and there is a history of the person taking a long time in the restroom.  Further influencing the person\\u2019s ability to elope without staff noticing was the staff did not see the historical antecedent the person would display before eloping because in this case the individual eloped without taking their lunch bag out of the staff\\u2019s office.  Additionally, during this event there were multiple staff checking on the individual since in this setting there is not a specific staff assigned to one individual person working.  This process is the norm for the department as it is shaped by the support plan stating the need for a 1:3 staffing ratio. Thus the ratio allows the county to manage the budget allocation they are given by the state and federal allocations which is determined through the legislation.  Overall legislation determines the rates that are set which then is strengthened by MNCHOICES to determine the needs are met, thus to create the staffing patterns for the provider in the support plan.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1753}','68.53.115.247','2021-04-29 02:28:09'),(6517,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1754,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"127\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1754}','68.53.115.247','2021-04-29 02:28:09'),(6518,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1755,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"129\",\"question_type\":\"Date\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1755}','68.53.115.247','2021-04-29 02:28:09'),(6519,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1756,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"130\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1756}','68.53.115.247','2021-04-29 02:28:09'),(6520,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1757,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"131\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1757}','68.53.115.247','2021-04-29 02:28:09'),(6521,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1758,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"132\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1758}','68.53.115.247','2021-04-29 02:28:09'),(6522,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1759,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"101\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1759}','68.53.115.247','2021-04-29 02:28:09'),(6523,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1760,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":\"The other factors contributing to adapt the protocol the day of the event was the individual was not feeling well, typically towards the end of the day this individual participates in work less (the time of incident was at the end of the work day), and there is a history of the person taking a long time in the restroom.  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This process is the norm for the department as it is shaped by the support plan stating the need for a 1:3 staffing ratio.\\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1774}','68.53.115.247','2021-04-29 02:28:09'),(6538,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1775,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"117\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:09 pm\",\"created_at\":\"4\\/28\\/2021 9:28:09 pm\",\"id\":1775}','68.53.115.247','2021-04-29 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02:28:32'),(6555,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1792,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"cgroebner@mymrci.org\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1792}','68.53.115.247','2021-04-29 02:28:32'),(6556,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1793,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"83\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1793}','68.53.115.247','2021-04-29 02:28:32'),(6557,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1794,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"84\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Elopement\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1794}','68.53.115.247','2021-04-29 02:28:32'),(6558,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1795,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Blue Earth County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1795}','68.53.115.247','2021-04-29 02:28:32'),(6559,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1796,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"03\\/19\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1796}','68.53.115.247','2021-04-29 02:28:32'),(6560,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1797,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Wednesday March 13, 2019 at approximately 1:40pm, staff 1 noticed VA leave the Department 123 work area. Staff 1 stepped outside the room and saw VA going into the women\\u2019s bathroom located off of the production floor nearest to Department 123.  Staff 1 checked on VA at about 1:45pm and saw that VA was in the handicap stall with their green jacket off.  Staff 1 asked if VA was OK and they replied \\u201cyeah\\u201d and also asked if VA needed anything and they said \\u201cno\\u201d.  Staff 1 then went back to that same bathroom to assist another individual at approximately 1:50pm and VA was still in the same stall.  Staff 1 went back to the room at about 1:55pm.  It should be noted that the VA had been diagnosed with a mild UTI on Sunday 3\\/10\\/19 and was sent home early on Monday 3\\/11\\/19 due to them not feeling well.  VA also came in late on Tuesday, 3\\/12\\/19.  \\r\\n\\r\\nVA has eloped in the past, VA takes her lunch box with her.  Because of that, VA is required to leave the lunch box in the Team Leader\\u2019s office.  At approximately 2:00pm, staff 1 notice VA\\u2019s lunch box was still in the office.  Support Specialist Staff 2 went to that same bathroom that VA was in approximately 2:05pm and that VA was no longer in the bathroom.  A bus drive for the day program was driving the buss back to the program and notice someone in a green jacket standing in the street on Map Drive around 2pm.  There are no sidewalks on Map Drive.  Staff recognized the person as the VA and immediately called her supervisor at the program. And drove back to where the VA was walking.  It was reported that two \\u201cgood Samaritans\\u201d pulled over and stopped the VA on the sidewalk along stadium drive, which is the road that connects with Map Drive, and started walking with her back to the program until the staff arrived.  \\r\\n\\r\\nAt 2:07 the Supervisor received a phone call from the transportation supervisor stating VA was found walking on the sidewalk along Stadium Drive and was being walked back to the program\\u2019s building.  The program supervisor ran outside and saw VA with about four other program staff walking with VA.  The supervisor walked alongside VA all the way back to the office and the VA waited in the office until was time for VA to board the bus to go home.  While the office, VA was ask if VA thought what happened was safe and the VA said, \\u201cNo\\u201d. The VA was asked why it wasn\\u2019t and safe and the response was \\u201cI could get hurt\\u201d. Supervisor asked VA if it will ever happen again and VA shook their head \\u201cno\\u201d. Supervisor walked VA to the bus and fastened seatbelt and sat patiently until the bus departed.  \\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1797}','68.53.115.247','2021-04-29 02:28:32'),(6561,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1798,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"96\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"1\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1798}','68.53.115.247','2021-04-29 02:28:32'),(6562,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1799,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Staff didn\\u2019t continuously monitor the person in bathroom and the person eloped without being seen\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1799}','68.53.115.247','2021-04-29 02:28:32'),(6563,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1800,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"94\",\"question_type\":\"True_or_False\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1800}','68.53.115.247','2021-04-29 02:28:32'),(6564,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1801,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"07\\/10\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1801}','68.53.115.247','2021-04-29 02:28:32'),(6565,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1802,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"VA has worked at the employment program for 10 years and the staff interviewed reported they have worked with her for most of that time.  Over this 10 years the VA lived with an aunt, then in an adult foster care setting (near her employment program) and at the time of the incident was living in an apartment.  \\r\\n\\r\\nVA enjoyed coloring\\/crafts, being outside, working, having attention and encouragement from staff.  VA enjoyed food (lunch at work and wouldn\\u2019t necessarily heat up a meal that typically would be a meal to heat up).\\r\\n\\r\\nVA has a staffing ratio at the employment program of a 1:3, most individuals there have 1:6 or 1:7.  At home VA had a 2:1 staffing ratio.  The 2:1 at home was higher because VA was more physically aggressive at home than at work.  Less aggression towards male staff-staff interviewed stated VA has less male staff at residence than at the employment program.  \\r\\n\\r\\nThe employment program has 200 individuals in their facility and approximately 45 in the area where VA works.  The day of the event there was 7-8 staff in the area for all of those individuals being served.  \\r\\n\\r\\nThe elopement protocol at the employment program was for the staff to have eyes on VA, except in the bathroom and just do 5 minute checks.  Keep the lunch and duffle bag in the supervisor\\u2019s office.  VA would have no antecedents prior to elopements or other incidents of maladaptive behavior (this day was no different.  The team agreed to this plan including the guardians (parents).\\r\\n\\r\\nVA works at the employment program Monday-Friday from 9am-3pm and typically VA shows signs of being done with work at around 2pm.  The day of the incident the VA had arrive late or had not been ready when the bus arrived to pick her up.  This was a common occurrence.  \\r\\n\\r\\nWhen at work the VA was a great worker completing piece work on the work floor.  That day there was not a lot of work available and the group had been doing other craft activities (VA enjoyed).  It is believed that VA had a possible UTI infection and VA had a history of GERD\\/esophagus issues (causing her to vomit and cause pain), however VA could not verbalize their needs all of the time.  Verbal skills were limited.  Over the time VA worked at the employment program they were able to get her to improve her verbal skills by encouraging VA to use her words.  If she were sick and she was about to vomit VA would attempt to express this to the employment staff and sometimes ask them for a Tums.  \\r\\n\\r\\nThe VA did not take the duffle bag or lunch when the elopement occurred which typically the VA would not have left the building without either of the bags.  The VA never was able to explain the reason for elopement, however the staff believe there is a Kwik Trip nearby that was the direction VA was headed and her previous residence was near the employment program.  VA did things with no antecedents and would do things for attention.  The staff believe potentially VA was not feeling well and potentially wanted to go outside because VA really enjoyed being outside.  Staff went outside after receiving phone call from transportation company and got the VA from the Good Samaritan that was walking with VA.  \\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1802}','68.53.115.247','2021-04-29 02:28:32'),(6566,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1803,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"99\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1803}','68.53.115.247','2021-04-29 02:28:32'),(6567,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1804,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The staff not continuously monitoring the person in the bathroom was impacted by the staff adapting the person\\u2019s supervision protocol to allow for privacy in the bathroom.  It is the providers practice to allow all of the individual\\u2019s privacy in the restroom as this is influenced by societal norms.  The other factors contributing to adapt the protocol the day of the event was the individual was not feeling well, typically towards the end of the day this individual participates in work less (the time of incident was at the end of the work day), and there is a history of the person taking a long time in the restroom.  Further influencing the person\\u2019s ability to elope without staff noticing was the staff did not see the historical antecedent the person would display before eloping because in this case the individual eloped without taking their lunch bag out of the staff\\u2019s office.  Additionally, during this event there were multiple staff checking on the individual since in this setting there is not a specific staff assigned to one individual person working.  This process is the norm for the department as it is shaped by the support plan stating the need for a 1:3 staffing ratio. Thus the ratio allows the county to manage the budget allocation they are given by the state and federal allocations which is determined through the legislation.  Overall legislation determines the rates that are set which then is strengthened by MNCHOICES to determine the needs are met, thus to create the staffing patterns for the provider in the support plan.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1804}','68.53.115.247','2021-04-29 02:28:32'),(6568,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1805,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"127\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1805}','68.53.115.247','2021-04-29 02:28:32'),(6569,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1806,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"129\",\"question_type\":\"Date\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1806}','68.53.115.247','2021-04-29 02:28:32'),(6570,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1807,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"130\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1807}','68.53.115.247','2021-04-29 02:28:32'),(6571,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1808,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"131\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1808}','68.53.115.247','2021-04-29 02:28:32'),(6572,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1809,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"132\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1809}','68.53.115.247','2021-04-29 02:28:32'),(6573,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1810,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"101\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1810}','68.53.115.247','2021-04-29 02:28:32'),(6574,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1811,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":\"The other factors contributing to adapt the protocol the day of the event was the individual was not feeling well, typically towards the end of the day this individual participates in work less (the time of incident was at the end of the work day), and there is a history of the person taking a long time in the restroom.  Further influencing the person\\u2019s ability to elope without staff noticing was the staff did not see the historical antecedent the person would display before eloping because in this case the individual eloped without taking their lunch bag out of the staff\\u2019s office.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1811}','68.53.115.247','2021-04-29 02:28:32'),(6575,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1812,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"103\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1812}','68.53.115.247','2021-04-29 02:28:32'),(6576,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1813,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"104\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1813}','68.53.115.247','2021-04-29 02:28:32'),(6577,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1814,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"105\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1814}','68.53.115.247','2021-04-29 02:28:32'),(6578,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1815,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"106\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1815}','68.53.115.247','2021-04-29 02:28:32'),(6579,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1816,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"107\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1816}','68.53.115.247','2021-04-29 02:28:32'),(6580,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1817,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"108\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1817}','68.53.115.247','2021-04-29 02:28:32'),(6581,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1818,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"109\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1818}','68.53.115.247','2021-04-29 02:28:32'),(6582,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1819,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"110\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1819}','68.53.115.247','2021-04-29 02:28:32'),(6583,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1820,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"111\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1820}','68.53.115.247','2021-04-29 02:28:32'),(6584,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1821,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"112\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1821}','68.53.115.247','2021-04-29 02:28:32'),(6585,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1822,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"113\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1822}','68.53.115.247','2021-04-29 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02:28:32'),(6588,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1825,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"116\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"The staff not continuously monitoring the person in the bathroom was impacted by the staff adapting the person\\u2019s supervision protocol to allow for privacy in the bathroom.  \\r\\n\\r\\nAdditionally, during this event there were multiple staff checking on the individual since in this setting there is not a specific staff assigned to one individual person working.  This process is the norm for the department as it is shaped by the support plan stating the need for a 1:3 staffing ratio.\\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1825}','68.53.115.247','2021-04-29 02:28:32'),(6589,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1826,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"117\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1826}','68.53.115.247','2021-04-29 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02:28:32'),(6596,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1833,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"124\",\"question_type\":\"Free_Text\",\"text_answer\":\"The staff not continuously monitoring the person in the bathroom was impacted by the staff adapting the person\\u2019s supervision protocol to allow for privacy in the bathroom.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 pm\",\"id\":1833}','68.53.115.247','2021-04-29 02:28:32'),(6597,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1834,'{\"report_id\":22,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"125\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:32 pm\",\"created_at\":\"4\\/28\\/2021 9:28:32 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02:28:32'),(6600,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports','create',23,'{\"text_answer\":\"\",\"form_id\":\"23\",\"user_id\":81,\"report_name\":\"KP_HaugBeck-BEC-2019-05\",\"organization_id\":10,\"status\":1,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:57 pm\",\"created_at\":\"4\\/28\\/2021 9:28:57 pm\",\"id\":23}','68.53.115.247','2021-04-29 02:28:57'),(6601,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1837,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"201900985\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:28:57 pm\",\"created_at\":\"4\\/28\\/2021 9:28:57 pm\",\"id\":1837}','68.53.115.247','2021-04-29 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02:29:25'),(6604,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1840,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Mike Beckius\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:29:33 pm\",\"created_at\":\"4\\/28\\/2021 9:29:33 pm\",\"id\":1840}','68.53.115.247','2021-04-29 02:29:33'),(6605,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1841,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"mikebeckius@gmail.com\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:29:40 pm\",\"created_at\":\"4\\/28\\/2021 9:29:40 pm\",\"id\":1841}','68.53.115.247','2021-04-29 02:29:40'),(6606,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1842,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"11\\/13\\/2018\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:02 pm\",\"created_at\":\"4\\/28\\/2021 9:30:02 pm\",\"id\":1842}','68.53.115.247','2021-04-29 02:30:02'),(6607,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1843,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Staff was meeting at another location with client\\u2019s guardian\\/mother. Client called her guardian\\/mother asking to have a private phone call, guardian reminded her that she could not do that, client abruptly ended the call.   A few minutes later a call came in that client ran away from the house.  Staff left to go look and kept in contact with guardian who was tracking client with the GPS on clients phone.   Staff arrived to clients location to a fire truck and someone directing traffic.  Staff was informed that client was struck by a vehicle and taken to the hospital by ambulance. \\n\\nIncident described by direct care staff.  Client came home from work and took phone without asking staff.  She locked herself in her room with the phone.  Staff knocked and asked her to open door, but did she did not respond.  Staff knocked again and explained to her the pone rules.  Client opened the door and yelled at staff using inappropriate words.  She then said she wanted to have a private phone call, locked herself in her room.  Staff unplugged the phone (per protocol) .  Client came out pissed and started kicking the pone and throwing it on the floor.  She picked the phone up and said she hated staff and that she was leaving.  She then got ready and left the house. \\n\\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:08 pm\",\"created_at\":\"4\\/28\\/2021 9:30:08 pm\",\"id\":1843}','68.53.115.247','2021-04-29 02:30:08'),(6608,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1844,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"201900985\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:08 pm\",\"created_at\":\"4\\/28\\/2021 9:30:08 pm\",\"id\":1844}','68.53.115.247','2021-04-29 02:30:08'),(6609,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1845,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"05\\/15\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:08 pm\",\"created_at\":\"4\\/28\\/2021 9:30:08 pm\",\"id\":1845}','68.53.115.247','2021-04-29 02:30:08'),(6610,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1846,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"78\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Kristie Pittman\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:08 pm\",\"created_at\":\"4\\/28\\/2021 9:30:08 pm\",\"id\":1846}','68.53.115.247','2021-04-29 02:30:08'),(6611,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1847,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Jill Tilbury\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:08 pm\",\"created_at\":\"4\\/28\\/2021 9:30:08 pm\",\"id\":1847}','68.53.115.247','2021-04-29 02:30:08'),(6612,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1848,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Haugbeck Support Services\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:08 pm\",\"created_at\":\"4\\/28\\/2021 9:30:08 pm\",\"id\":1848}','68.53.115.247','2021-04-29 02:30:08'),(6613,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1849,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Mike Beckius\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:08 pm\",\"created_at\":\"4\\/28\\/2021 9:30:08 pm\",\"id\":1849}','68.53.115.247','2021-04-29 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02:30:08'),(6616,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1852,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"84\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Elopement\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:08 pm\",\"created_at\":\"4\\/28\\/2021 9:30:08 pm\",\"id\":1852}','68.53.115.247','2021-04-29 02:30:08'),(6617,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1853,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Blue Earth County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:08 pm\",\"created_at\":\"4\\/28\\/2021 9:30:08 pm\",\"id\":1853}','68.53.115.247','2021-04-29 02:30:08'),(6618,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1854,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"11\\/13\\/2018\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:08 pm\",\"created_at\":\"4\\/28\\/2021 9:30:08 pm\",\"id\":1854}','68.53.115.247','2021-04-29 02:30:08'),(6619,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1855,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Staff was meeting at another location with client\\u2019s guardian\\/mother. Client called her guardian\\/mother asking to have a private phone call, guardian reminded her that she could not do that, client abruptly ended the call.   A few minutes later a call came in that client ran away from the house.  Staff left to go look and kept in contact with guardian who was tracking client with the GPS on clients phone.   Staff arrived to clients location to a fire truck and someone directing traffic.  Staff was informed that client was struck by a vehicle and taken to the hospital by ambulance. \\r\\n\\r\\nIncident described by direct care staff.  Client came home from work and took phone without asking staff.  She locked herself in her room with the phone.  Staff knocked and asked her to open door, but did she did not respond.  Staff knocked again and explained to her the pone rules.  Client opened the door and yelled at staff using inappropriate words.  She then said she wanted to have a private phone call, locked herself in her room.  Staff unplugged the phone (per protocol) .  Client came out pissed and started kicking the pone and throwing it on the floor.  She picked the phone up and said she hated staff and that she was leaving.  She then got ready and left the house. \\r\\n\\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:08 pm\",\"created_at\":\"4\\/28\\/2021 9:30:08 pm\",\"id\":1855}','68.53.115.247','2021-04-29 02:30:08'),(6620,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1856,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"96\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:08 pm\",\"created_at\":\"4\\/28\\/2021 9:30:08 pm\",\"id\":1856}','68.53.115.247','2021-04-29 02:30:08'),(6621,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1857,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:08 pm\",\"created_at\":\"4\\/28\\/2021 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02:30:23'),(6658,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1894,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"94\",\"question_type\":\"True_or_False\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:24 pm\",\"created_at\":\"4\\/28\\/2021 9:30:24 pm\",\"id\":1894}','68.53.115.247','2021-04-29 02:30:24'),(6659,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1895,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"06\\/24\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:44 pm\",\"created_at\":\"4\\/28\\/2021 9:30:44 pm\",\"id\":1895}','68.53.115.247','2021-04-29 02:30:44'),(6660,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1896,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Client is a 25 year old female diagnosed with fetal alcohol syndrome and reactive attachment disorder. She had been living in a corporate foster care since 2014. She lives with her identical twin sister. Her mother is her legal guardian. In September 2019, client had a crises placement due to increase in behaviors. \\n\\nCouple months prior to incident, client\'s behaviors not as predictable. Client had medication changes, was demonstrating suicidal ideation (superficial cutting) and was eloping 1 to 2 times a week. Staff report they use to be able to tell when client was going to elope and then it became harder to identify antecedents leading up to elopement. \\n\\nClient had an incident prior to this incident of running into Mankato and meeting up with a young man that she later accused of abusing her. Staff followed her until she reached a crowded area around Mankato State campus. Distance was over 6 miles. Client is in good physical shape. \\n\\nThere are 2-3 staff on evening shift. Home has 4 clients. Direct care staff involved in incident are no longer employed with provider. Staff reports a long history of elopement. \\n\\nA team (consisting of a case manager, guardian, house manager and administrative staff) developed an elopement protocol. Staff meetings occurred bi-weekly to address behaviors and concerns about client. Client\'s guardian had attended staff meetings to assist in training staff on how to work with her daughter. \\n\\nElopement protocol states that staff are to follow client during daytime hours when safe. Protocol directs staff not to follow when dark outside as this is a safety concern for staff. On day of incident, staff followed protocol and called supervisor. \\n\\nClient has a protocol in place where she can ask to go on a run. Protocol specifically states how long and where client can run. CLient can not go on a planned run after dark. When she asked she always comes back. Protocol in place so staff can identify the difference. \\n\\nClient would call guardian\\/mom when not happy with what staff was doing. Mom would change the rules\\/programs that were established when her daughter was upset. Guardian\\/mom directed day to day activities and would tell staff what things her daughter should do that day. The consistency of protocols were difficult for staff to follow due to the changes in decision making process being made by the guardian\\/mom. Program direct reports that as guardian become more inconsistent with following programs that elopement increased. \\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:48 pm\",\"created_at\":\"4\\/28\\/2021 9:30:48 pm\",\"id\":1896}','68.53.115.247','2021-04-29 02:30:48'),(6661,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1897,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Direct care staff not following the person who eloped from the facility was influenced foremost by the person\\u2019s elopement protocol. At the time of the elopement it was dark outside and the protocol directed staff to not follow when dark. Contributing to the staff\\u2019s decision not to follow the person was the team\\u2019s (case manager, guardian, provider staff) desire to ensure the safety of staff and the person which was impacted by the person\\u2019s history of exhibiting challenging behaviors when followed. When staff followed the person in past elopements, the person ran further and was difficult to find. The person\\u2019s home was in a rural location which also impacted staff\\u2019s decision to not follow in the dark due to safety concerns. The elopement protocol was developed by the provider and approved by the guardian and case manager. Staff were intimidated by the guardian, which influenced the staff\\u2019s decision to follow protocol the guardian helped create. Direct care staff not following during the elopement was further supported by the person wearing a tracking watch that allowed staff to track the person and not always rely on following them.\\n\\nThere are a lack of crises services and placement options available in the area of the person\\u2019s home. Because of this, the provider created the elopement protocol as a way to try to balance the support and safety of the person. Limited state funding for crises services impacted the provider\\u2019s decision to create an elopement protocol. This is further influenced by the provider\\u2019s license requirements of 245A and 245D to safeguard the person\\u2019s health, safety and well-being.\\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:56 pm\",\"created_at\":\"4\\/28\\/2021 9:30:56 pm\",\"id\":1897}','68.53.115.247','2021-04-29 02:30:56'),(6662,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports','update',23,'{\"id\":23,\"form_id\":\"23\",\"user_id\":\"81\",\"question_id\":null,\"organization_id\":\"10\",\"tab_id\":null,\"question_type\":null,\"text_answer\":\"{\\\"Short_Answer__76\\\":\\\"201900985\\\",\\\"Date__77\\\":\\\"05\\\\\\/15\\\\\\/2019\\\",\\\"Multiple_Choice__78\\\":\\\"Kristie Pittman\\\",\\\"Multiple_Choice__79\\\":\\\"Jill Tilbury\\\",\\\"Short_Answer__80\\\":\\\"Haugbeck Support Services\\\",\\\"Short_Answer__81\\\":\\\"Mike Beckius\\\",\\\"Short_Answer__82\\\":\\\"mikebeckius@gmail.com\\\",\\\"Multiple_Choice__84\\\":\\\"Elopement\\\",\\\"Multiple_Choice__85\\\":\\\"Blue Earth County\\\",\\\"Date__86\\\":\\\"11\\\\\\/13\\\\\\/2018\\\",\\\"Free_Text__87\\\":\\\"\\\\\\\"Staff was meeting at another location with client\\\\u2019s guardian\\\\\\/mother. Client called her guardian\\\\\\/mother asking to have a private phone call, guardian reminded her that she could not do that, client abruptly ended the call.   A few minutes later a call came in that client ran away from the house.  Staff left to go look and kept in contact with guardian who was tracking client with the GPS on clients phone.   Staff arrived to clients location to a fire truck and someone directing traffic.  Staff was informed that client was struck by a vehicle and taken to the hospital by ambulance. \\\\r\\\\n\\\\r\\\\nIncident described by direct care staff.  Client came home from work and took phone without asking staff.  She locked herself in her room with the phone.  Staff knocked and asked her to open door, but did she did not respond.  Staff knocked again and explained to her the pone rules.  Client opened the door and yelled at staff using inappropriate words.  She then said she wanted to have a private phone call, locked herself in her room.  Staff unplugged the phone (per protocol) .  Client came out pissed and started kicking the pone and throwing it on the floor.  She picked the phone up and said she hated staff and that she was leaving.  She then got ready and left the house. \\\\r\\\\n\\\\\\\"\\\",\\\"Multiple_Choice__96\\\":\\\"1\\\",\\\"Short_Answer__91\\\":\\\"Staff did not pursue person when they eloped\\\",\\\"True_or_False__94\\\":\\\"Yes\\\",\\\"Date__97\\\":\\\"06\\\\\\/24\\\\\\/2019\\\",\\\"Free_Text__98\\\":\\\"\\\\\\\"Client is a 25 year old female diagnosed with fetal alcohol syndrome and reactive attachment disorder. She had been living in a corporate foster care since 2014. She lives with her identical twin sister. Her mother is her legal guardian. In September 2019, client had a crises placement due to increase in behaviors. \\\\r\\\\n\\\\r\\\\nCouple months prior to incident, client\'s behaviors not as predictable. Client had medication changes, was demonstrating suicidal ideation (superficial cutting) and was eloping 1 to 2 times a week. Staff report they use to be able to tell when client was going to elope and then it became harder to identify antecedents leading up to elopement. \\\\r\\\\n\\\\r\\\\nClient had an incident prior to this incident of running into Mankato and meeting up with a young man that she later accused of abusing her. Staff followed her until she reached a crowded area around Mankato State campus. Distance was over 6 miles. Client is in good physical shape. \\\\r\\\\n\\\\r\\\\nThere are 2-3 staff on evening shift. Home has 4 clients. Direct care staff involved in incident are no longer employed with provider. Staff reports a long history of elopement. \\\\r\\\\n\\\\r\\\\nA team (consisting of a case manager, guardian, house manager and administrative staff) developed an elopement protocol. Staff meetings occurred bi-weekly to address behaviors and concerns about client. Client\'s guardian had attended staff meetings to assist in training staff on how to work with her daughter. \\\\r\\\\n\\\\r\\\\nElopement protocol states that staff are to follow client during daytime hours when safe. Protocol directs staff not to follow when dark outside as this is a safety concern for staff. On day of incident, staff followed protocol and called supervisor. \\\\r\\\\n\\\\r\\\\nClient has a protocol in place where she can ask to go on a run. Protocol specifically states how long and where client can run. CLient can not go on a planned run after dark. When she asked she always comes back. Protocol in place so staff can identify the difference. \\\\r\\\\n\\\\r\\\\nClient would call guardian\\\\\\/mom when not happy with what staff was doing. Mom would change the rules\\\\\\/programs that were established when her daughter was upset. Guardian\\\\\\/mom directed day to day activities and would tell staff what things her daughter should do that day. The consistency of protocols were difficult for staff to follow due to the changes in decision making process being made by the guardian\\\\\\/mom. Program direct reports that as guardian become more inconsistent with following programs that elopement increased. \\\\\\\"\\\",\\\"Free_Text__100\\\":\\\"\\\\\\\"Direct care staff not following the person who eloped from the facility was influenced foremost by the person\\\\u2019s elopement protocol. At the time of the elopement it was dark outside and the protocol directed staff to not follow when dark. Contributing to the staff\\\\u2019s decision not to follow the person was the team\\\\u2019s (case manager, guardian, provider staff) desire to ensure the safety of staff and the person which was impacted by the person\\\\u2019s history of exhibiting challenging behaviors when followed. When staff followed the person in past elopements, the person ran further and was difficult to find. The person\\\\u2019s home was in a rural location which also impacted staff\\\\u2019s decision to not follow in the dark due to safety concerns. The elopement protocol was developed by the provider and approved by the guardian and case manager. Staff were intimidated by the guardian, which influenced the staff\\\\u2019s decision to follow protocol the guardian helped create. Direct care staff not following during the elopement was further supported by the person wearing a tracking watch that allowed staff to track the person and not always rely on following them.\\\\r\\\\n\\\\r\\\\nThere are a lack of crises services and placement options available in the area of the person\\\\u2019s home. Because of this, the provider created the elopement protocol as a way to try to balance the support and safety of the person. Limited state funding for crises services impacted the provider\\\\u2019s decision to create an elopement protocol. This is further influenced by the provider\\\\u2019s license requirements of 245A and 245D to safeguard the person\\\\u2019s health, safety and well-being.\\\\\\\"\\\"}\",\"mcq_answer\":null,\"other_answer\":\"0\",\"status\":\"1\",\"created_by\":\"81\",\"updated_by\":81,\"created_at\":\"4\\/28\\/2021 9:28:57 pm\",\"updated_at\":\"4\\/28\\/2021 9:30:56 pm\",\"deleted_at\":null,\"report_name\":\"KP_HaugBeck-BEC-2019-05\"}','68.53.115.247','2021-04-29 02:30:56'),(6663,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1898,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"201900985\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:56 pm\",\"created_at\":\"4\\/28\\/2021 9:30:56 pm\",\"id\":1898}','68.53.115.247','2021-04-29 02:30:56'),(6664,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1899,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"05\\/15\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:56 pm\",\"created_at\":\"4\\/28\\/2021 9:30:56 pm\",\"id\":1899}','68.53.115.247','2021-04-29 02:30:56'),(6665,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1900,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"78\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Kristie Pittman\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:56 pm\",\"created_at\":\"4\\/28\\/2021 9:30:56 pm\",\"id\":1900}','68.53.115.247','2021-04-29 02:30:56'),(6666,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1901,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Jill Tilbury\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:56 pm\",\"created_at\":\"4\\/28\\/2021 9:30:56 pm\",\"id\":1901}','68.53.115.247','2021-04-29 02:30:56'),(6667,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1902,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Haugbeck Support Services\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:56 pm\",\"created_at\":\"4\\/28\\/2021 9:30:56 pm\",\"id\":1902}','68.53.115.247','2021-04-29 02:30:56'),(6668,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1903,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Mike Beckius\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:56 pm\",\"created_at\":\"4\\/28\\/2021 9:30:56 pm\",\"id\":1903}','68.53.115.247','2021-04-29 02:30:56'),(6669,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1904,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"mikebeckius@gmail.com\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:56 pm\",\"created_at\":\"4\\/28\\/2021 9:30:56 pm\",\"id\":1904}','68.53.115.247','2021-04-29 02:30:56'),(6670,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1905,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"83\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:56 pm\",\"created_at\":\"4\\/28\\/2021 9:30:56 pm\",\"id\":1905}','68.53.115.247','2021-04-29 02:30:56'),(6671,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1906,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"84\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Elopement\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:56 pm\",\"created_at\":\"4\\/28\\/2021 9:30:56 pm\",\"id\":1906}','68.53.115.247','2021-04-29 02:30:56'),(6672,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1907,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Blue Earth County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:57 pm\",\"created_at\":\"4\\/28\\/2021 9:30:57 pm\",\"id\":1907}','68.53.115.247','2021-04-29 02:30:57'),(6673,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1908,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"11\\/13\\/2018\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:57 pm\",\"created_at\":\"4\\/28\\/2021 9:30:57 pm\",\"id\":1908}','68.53.115.247','2021-04-29 02:30:57'),(6674,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1909,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Staff was meeting at another location with client\\u2019s guardian\\/mother. Client called her guardian\\/mother asking to have a private phone call, guardian reminded her that she could not do that, client abruptly ended the call.   A few minutes later a call came in that client ran away from the house.  Staff left to go look and kept in contact with guardian who was tracking client with the GPS on clients phone.   Staff arrived to clients location to a fire truck and someone directing traffic.  Staff was informed that client was struck by a vehicle and taken to the hospital by ambulance. \\r\\n\\r\\nIncident described by direct care staff.  Client came home from work and took phone without asking staff.  She locked herself in her room with the phone.  Staff knocked and asked her to open door, but did she did not respond.  Staff knocked again and explained to her the pone rules.  Client opened the door and yelled at staff using inappropriate words.  She then said she wanted to have a private phone call, locked herself in her room.  Staff unplugged the phone (per protocol) .  Client came out pissed and started kicking the pone and throwing it on the floor.  She picked the phone up and said she hated staff and that she was leaving.  She then got ready and left the house. \\r\\n\\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:57 pm\",\"created_at\":\"4\\/28\\/2021 9:30:57 pm\",\"id\":1909}','68.53.115.247','2021-04-29 02:30:57'),(6675,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1910,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"96\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"1\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:57 pm\",\"created_at\":\"4\\/28\\/2021 9:30:57 pm\",\"id\":1910}','68.53.115.247','2021-04-29 02:30:57'),(6676,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1911,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Staff did not pursue person when they eloped\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:57 pm\",\"created_at\":\"4\\/28\\/2021 9:30:57 pm\",\"id\":1911}','68.53.115.247','2021-04-29 02:30:57'),(6677,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1912,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"94\",\"question_type\":\"True_or_False\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:57 pm\",\"created_at\":\"4\\/28\\/2021 9:30:57 pm\",\"id\":1912}','68.53.115.247','2021-04-29 02:30:57'),(6678,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1913,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"06\\/24\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:57 pm\",\"created_at\":\"4\\/28\\/2021 9:30:57 pm\",\"id\":1913}','68.53.115.247','2021-04-29 02:30:57'),(6679,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1914,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Client is a 25 year old female diagnosed with fetal alcohol syndrome and reactive attachment disorder. She had been living in a corporate foster care since 2014. She lives with her identical twin sister. Her mother is her legal guardian. In September 2019, client had a crises placement due to increase in behaviors. \\r\\n\\r\\nCouple months prior to incident, client\'s behaviors not as predictable. Client had medication changes, was demonstrating suicidal ideation (superficial cutting) and was eloping 1 to 2 times a week. Staff report they use to be able to tell when client was going to elope and then it became harder to identify antecedents leading up to elopement. \\r\\n\\r\\nClient had an incident prior to this incident of running into Mankato and meeting up with a young man that she later accused of abusing her. Staff followed her until she reached a crowded area around Mankato State campus. Distance was over 6 miles. Client is in good physical shape. \\r\\n\\r\\nThere are 2-3 staff on evening shift. Home has 4 clients. Direct care staff involved in incident are no longer employed with provider. Staff reports a long history of elopement. \\r\\n\\r\\nA team (consisting of a case manager, guardian, house manager and administrative staff) developed an elopement protocol. Staff meetings occurred bi-weekly to address behaviors and concerns about client. Client\'s guardian had attended staff meetings to assist in training staff on how to work with her daughter. \\r\\n\\r\\nElopement protocol states that staff are to follow client during daytime hours when safe. Protocol directs staff not to follow when dark outside as this is a safety concern for staff. On day of incident, staff followed protocol and called supervisor. \\r\\n\\r\\nClient has a protocol in place where she can ask to go on a run. Protocol specifically states how long and where client can run. CLient can not go on a planned run after dark. When she asked she always comes back. Protocol in place so staff can identify the difference. \\r\\n\\r\\nClient would call guardian\\/mom when not happy with what staff was doing. Mom would change the rules\\/programs that were established when her daughter was upset. Guardian\\/mom directed day to day activities and would tell staff what things her daughter should do that day. The consistency of protocols were difficult for staff to follow due to the changes in decision making process being made by the guardian\\/mom. Program direct reports that as guardian become more inconsistent with following programs that elopement increased. \\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:57 pm\",\"created_at\":\"4\\/28\\/2021 9:30:57 pm\",\"id\":1914}','68.53.115.247','2021-04-29 02:30:57'),(6680,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1915,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"99\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:57 pm\",\"created_at\":\"4\\/28\\/2021 9:30:57 pm\",\"id\":1915}','68.53.115.247','2021-04-29 02:30:57'),(6681,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1916,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Direct care staff not following the person who eloped from the facility was influenced foremost by the person\\u2019s elopement protocol. At the time of the elopement it was dark outside and the protocol directed staff to not follow when dark. Contributing to the staff\\u2019s decision not to follow the person was the team\\u2019s (case manager, guardian, provider staff) desire to ensure the safety of staff and the person which was impacted by the person\\u2019s history of exhibiting challenging behaviors when followed. When staff followed the person in past elopements, the person ran further and was difficult to find. The person\\u2019s home was in a rural location which also impacted staff\\u2019s decision to not follow in the dark due to safety concerns. The elopement protocol was developed by the provider and approved by the guardian and case manager. Staff were intimidated by the guardian, which influenced the staff\\u2019s decision to follow protocol the guardian helped create. Direct care staff not following during the elopement was further supported by the person wearing a tracking watch that allowed staff to track the person and not always rely on following them.\\r\\n\\r\\nThere are a lack of crises services and placement options available in the area of the person\\u2019s home. Because of this, the provider created the elopement protocol as a way to try to balance the support and safety of the person. Limited state funding for crises services impacted the provider\\u2019s decision to create an elopement protocol. This is further influenced by the provider\\u2019s license requirements of 245A and 245D to safeguard the person\\u2019s health, safety and well-being.\\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:57 pm\",\"created_at\":\"4\\/28\\/2021 9:30:57 pm\",\"id\":1916}','68.53.115.247','2021-04-29 02:30:57'),(6682,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1917,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"127\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:30:57 pm\",\"created_at\":\"4\\/28\\/2021 9:30:57 pm\",\"id\":1917}','68.53.115.247','2021-04-29 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02:30:57'),(6713,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1948,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"116\",\"question_type\":\"Free_Text\",\"text_answer\":\"Direct care staff not following the person who eloped from the facility was influenced foremost by the person\\u2019s elopement protocol. At the time of the elopement it was dark outside and the protocol directed staff to not follow when dark. Contributing to the staff\\u2019s decision not to follow the person was the team\\u2019s (case manager, guardian, provider staff) desire to ensure the safety of staff and the person which was impacted by the person\\u2019s history of exhibiting challenging behaviors when followed. When staff followed the person in past elopements, the person ran further and was difficult to find. The person\\u2019s home was in a rural location which also impacted staff\\u2019s decision to not follow in the dark due to safety concerns.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:31:30 pm\",\"created_at\":\"4\\/28\\/2021 9:31:30 pm\",\"id\":1948}','68.53.115.247','2021-04-29 02:31:30'),(6714,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1949,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"120\",\"question_type\":\"Free_Text\",\"text_answer\":\"There are a lack of crises services and placement options available in the area of the person\\u2019s home. Because of this, the provider created the elopement protocol as a way to try to balance the support and safety of the person.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:31:51 pm\",\"created_at\":\"4\\/28\\/2021 9:31:51 pm\",\"id\":1949}','68.53.115.247','2021-04-29 02:31:51'),(6715,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1950,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"432\",\"question_type\":\"Yes_or_No\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:00 pm\",\"created_at\":\"4\\/28\\/2021 9:32:00 pm\",\"id\":1950}','68.53.115.247','2021-04-29 02:32:00'),(6716,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports','update',23,'{\"id\":23,\"form_id\":\"23\",\"user_id\":\"81\",\"question_id\":null,\"organization_id\":\"10\",\"tab_id\":null,\"question_type\":null,\"text_answer\":\"{\\\"Short_Answer__76\\\":\\\"201900985\\\",\\\"Date__77\\\":\\\"05\\\\\\/15\\\\\\/2019\\\",\\\"Multiple_Choice__78\\\":\\\"Kristie Pittman\\\",\\\"Multiple_Choice__79\\\":\\\"Jill Tilbury\\\",\\\"Short_Answer__80\\\":\\\"Haugbeck Support Services\\\",\\\"Short_Answer__81\\\":\\\"Mike Beckius\\\",\\\"Short_Answer__82\\\":\\\"mikebeckius@gmail.com\\\",\\\"Multiple_Choice__84\\\":\\\"Elopement\\\",\\\"Multiple_Choice__85\\\":\\\"Blue Earth County\\\",\\\"Date__86\\\":\\\"11\\\\\\/13\\\\\\/2018\\\",\\\"Free_Text__87\\\":\\\"\\\\\\\"Staff was meeting at another location with client\\\\u2019s guardian\\\\\\/mother. Client called her guardian\\\\\\/mother asking to have a private phone call, guardian reminded her that she could not do that, client abruptly ended the call.   A few minutes later a call came in that client ran away from the house.  Staff left to go look and kept in contact with guardian who was tracking client with the GPS on clients phone.   Staff arrived to clients location to a fire truck and someone directing traffic.  Staff was informed that client was struck by a vehicle and taken to the hospital by ambulance. \\\\r\\\\n\\\\r\\\\nIncident described by direct care staff.  Client came home from work and took phone without asking staff.  She locked herself in her room with the phone.  Staff knocked and asked her to open door, but did she did not respond.  Staff knocked again and explained to her the pone rules.  Client opened the door and yelled at staff using inappropriate words.  She then said she wanted to have a private phone call, locked herself in her room.  Staff unplugged the phone (per protocol) .  Client came out pissed and started kicking the pone and throwing it on the floor.  She picked the phone up and said she hated staff and that she was leaving.  She then got ready and left the house. \\\\r\\\\n\\\\\\\"\\\",\\\"Multiple_Choice__96\\\":\\\"1\\\",\\\"Short_Answer__91\\\":\\\"Staff did not pursue person when they eloped\\\",\\\"True_or_False__94\\\":\\\"Yes\\\",\\\"Date__97\\\":\\\"06\\\\\\/24\\\\\\/2019\\\",\\\"Free_Text__98\\\":\\\"\\\\\\\"Client is a 25 year old female diagnosed with fetal alcohol syndrome and reactive attachment disorder. She had been living in a corporate foster care since 2014. She lives with her identical twin sister. Her mother is her legal guardian. In September 2019, client had a crises placement due to increase in behaviors. \\\\r\\\\n\\\\r\\\\nCouple months prior to incident, client\'s behaviors not as predictable. Client had medication changes, was demonstrating suicidal ideation (superficial cutting) and was eloping 1 to 2 times a week. Staff report they use to be able to tell when client was going to elope and then it became harder to identify antecedents leading up to elopement. \\\\r\\\\n\\\\r\\\\nClient had an incident prior to this incident of running into Mankato and meeting up with a young man that she later accused of abusing her. Staff followed her until she reached a crowded area around Mankato State campus. Distance was over 6 miles. Client is in good physical shape. \\\\r\\\\n\\\\r\\\\nThere are 2-3 staff on evening shift. Home has 4 clients. Direct care staff involved in incident are no longer employed with provider. Staff reports a long history of elopement. \\\\r\\\\n\\\\r\\\\nA team (consisting of a case manager, guardian, house manager and administrative staff) developed an elopement protocol. Staff meetings occurred bi-weekly to address behaviors and concerns about client. Client\'s guardian had attended staff meetings to assist in training staff on how to work with her daughter. \\\\r\\\\n\\\\r\\\\nElopement protocol states that staff are to follow client during daytime hours when safe. Protocol directs staff not to follow when dark outside as this is a safety concern for staff. On day of incident, staff followed protocol and called supervisor. \\\\r\\\\n\\\\r\\\\nClient has a protocol in place where she can ask to go on a run. Protocol specifically states how long and where client can run. CLient can not go on a planned run after dark. When she asked she always comes back. Protocol in place so staff can identify the difference. \\\\r\\\\n\\\\r\\\\nClient would call guardian\\\\\\/mom when not happy with what staff was doing. Mom would change the rules\\\\\\/programs that were established when her daughter was upset. Guardian\\\\\\/mom directed day to day activities and would tell staff what things her daughter should do that day. The consistency of protocols were difficult for staff to follow due to the changes in decision making process being made by the guardian\\\\\\/mom. Program direct reports that as guardian become more inconsistent with following programs that elopement increased. \\\\\\\"\\\",\\\"Free_Text__100\\\":\\\"\\\\\\\"Direct care staff not following the person who eloped from the facility was influenced foremost by the person\\\\u2019s elopement protocol. At the time of the elopement it was dark outside and the protocol directed staff to not follow when dark. Contributing to the staff\\\\u2019s decision not to follow the person was the team\\\\u2019s (case manager, guardian, provider staff) desire to ensure the safety of staff and the person which was impacted by the person\\\\u2019s history of exhibiting challenging behaviors when followed. When staff followed the person in past elopements, the person ran further and was difficult to find. The person\\\\u2019s home was in a rural location which also impacted staff\\\\u2019s decision to not follow in the dark due to safety concerns. The elopement protocol was developed by the provider and approved by the guardian and case manager. Staff were intimidated by the guardian, which influenced the staff\\\\u2019s decision to follow protocol the guardian helped create. Direct care staff not following during the elopement was further supported by the person wearing a tracking watch that allowed staff to track the person and not always rely on following them.\\\\r\\\\n\\\\r\\\\nThere are a lack of crises services and placement options available in the area of the person\\\\u2019s home. Because of this, the provider created the elopement protocol as a way to try to balance the support and safety of the person. Limited state funding for crises services impacted the provider\\\\u2019s decision to create an elopement protocol. This is further influenced by the provider\\\\u2019s license requirements of 245A and 245D to safeguard the person\\\\u2019s health, safety and well-being.\\\\\\\"\\\",\\\"Multiple_Choice__101\\\":\\\"0\\\",\\\"Multiple_Choice__103\\\":\\\"0\\\",\\\"Multiple_Choice__105\\\":\\\"0\\\",\\\"Multiple_Choice__107\\\":\\\"0\\\",\\\"Multiple_Choice__109\\\":\\\"0\\\",\\\"Multiple_Choice__111\\\":\\\"0\\\",\\\"Multiple_Choice__113\\\":\\\"0\\\",\\\"Multiple_Choice__115\\\":\\\"3\\\",\\\"Free_Text__116\\\":\\\"Direct care staff not following the person who eloped from the facility was influenced foremost by the person\\\\u2019s elopement protocol. At the time of the elopement it was dark outside and the protocol directed staff to not follow when dark. Contributing to the staff\\\\u2019s decision not to follow the person was the team\\\\u2019s (case manager, guardian, provider staff) desire to ensure the safety of staff and the person which was impacted by the person\\\\u2019s history of exhibiting challenging behaviors when followed. When staff followed the person in past elopements, the person ran further and was difficult to find. The person\\\\u2019s home was in a rural location which also impacted staff\\\\u2019s decision to not follow in the dark due to safety concerns.\\\",\\\"Multiple_Choice__117\\\":\\\"1\\\",\\\"Multiple_Choice__119\\\":\\\"3\\\",\\\"Free_Text__120\\\":\\\"There are a lack of crises services and placement options available in the area of the person\\\\u2019s home. Because of this, the provider created the elopement protocol as a way to try to balance the support and safety of the person.\\\",\\\"Multiple_Choice__121\\\":\\\"0\\\",\\\"Multiple_Choice__123\\\":\\\"0\\\",\\\"Multiple_Choice__125\\\":\\\"0\\\",\\\"Yes_or_No__432\\\":\\\"Yes\\\"}\",\"mcq_answer\":null,\"other_answer\":\"0\",\"status\":\"1\",\"created_by\":\"81\",\"updated_by\":81,\"created_at\":\"4\\/28\\/2021 9:28:57 pm\",\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"deleted_at\":null,\"report_name\":\"KP_HaugBeck-BEC-2019-05\"}','68.53.115.247','2021-04-29 02:32:03'),(6717,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1951,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"201900985\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1951}','68.53.115.247','2021-04-29 02:32:03'),(6718,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1952,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"05\\/15\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1952}','68.53.115.247','2021-04-29 02:32:03'),(6719,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1953,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"78\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Kristie Pittman\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1953}','68.53.115.247','2021-04-29 02:32:03'),(6720,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1954,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Jill Tilbury\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1954}','68.53.115.247','2021-04-29 02:32:03'),(6721,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1955,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Haugbeck Support Services\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1955}','68.53.115.247','2021-04-29 02:32:03'),(6722,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1956,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Mike Beckius\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1956}','68.53.115.247','2021-04-29 02:32:03'),(6723,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1957,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"mikebeckius@gmail.com\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1957}','68.53.115.247','2021-04-29 02:32:03'),(6724,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1958,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"83\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1958}','68.53.115.247','2021-04-29 02:32:03'),(6725,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1959,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"84\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Elopement\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1959}','68.53.115.247','2021-04-29 02:32:03'),(6726,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1960,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Blue Earth County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1960}','68.53.115.247','2021-04-29 02:32:03'),(6727,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1961,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"11\\/13\\/2018\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1961}','68.53.115.247','2021-04-29 02:32:03'),(6728,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1962,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Staff was meeting at another location with client\\u2019s guardian\\/mother. Client called her guardian\\/mother asking to have a private phone call, guardian reminded her that she could not do that, client abruptly ended the call.   A few minutes later a call came in that client ran away from the house.  Staff left to go look and kept in contact with guardian who was tracking client with the GPS on clients phone.   Staff arrived to clients location to a fire truck and someone directing traffic.  Staff was informed that client was struck by a vehicle and taken to the hospital by ambulance. \\r\\n\\r\\nIncident described by direct care staff.  Client came home from work and took phone without asking staff.  She locked herself in her room with the phone.  Staff knocked and asked her to open door, but did she did not respond.  Staff knocked again and explained to her the pone rules.  Client opened the door and yelled at staff using inappropriate words.  She then said she wanted to have a private phone call, locked herself in her room.  Staff unplugged the phone (per protocol) .  Client came out pissed and started kicking the pone and throwing it on the floor.  She picked the phone up and said she hated staff and that she was leaving.  She then got ready and left the house. \\r\\n\\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1962}','68.53.115.247','2021-04-29 02:32:03'),(6729,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1963,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"96\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"1\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1963}','68.53.115.247','2021-04-29 02:32:03'),(6730,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1964,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Staff did not pursue person when they eloped\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1964}','68.53.115.247','2021-04-29 02:32:03'),(6731,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1965,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"94\",\"question_type\":\"True_or_False\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1965}','68.53.115.247','2021-04-29 02:32:03'),(6732,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1966,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"06\\/24\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1966}','68.53.115.247','2021-04-29 02:32:03'),(6733,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1967,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Client is a 25 year old female diagnosed with fetal alcohol syndrome and reactive attachment disorder. She had been living in a corporate foster care since 2014. She lives with her identical twin sister. Her mother is her legal guardian. In September 2019, client had a crises placement due to increase in behaviors. \\r\\n\\r\\nCouple months prior to incident, client\'s behaviors not as predictable. Client had medication changes, was demonstrating suicidal ideation (superficial cutting) and was eloping 1 to 2 times a week. Staff report they use to be able to tell when client was going to elope and then it became harder to identify antecedents leading up to elopement. \\r\\n\\r\\nClient had an incident prior to this incident of running into Mankato and meeting up with a young man that she later accused of abusing her. Staff followed her until she reached a crowded area around Mankato State campus. Distance was over 6 miles. Client is in good physical shape. \\r\\n\\r\\nThere are 2-3 staff on evening shift. Home has 4 clients. Direct care staff involved in incident are no longer employed with provider. Staff reports a long history of elopement. \\r\\n\\r\\nA team (consisting of a case manager, guardian, house manager and administrative staff) developed an elopement protocol. Staff meetings occurred bi-weekly to address behaviors and concerns about client. Client\'s guardian had attended staff meetings to assist in training staff on how to work with her daughter. \\r\\n\\r\\nElopement protocol states that staff are to follow client during daytime hours when safe. Protocol directs staff not to follow when dark outside as this is a safety concern for staff. On day of incident, staff followed protocol and called supervisor. \\r\\n\\r\\nClient has a protocol in place where she can ask to go on a run. Protocol specifically states how long and where client can run. CLient can not go on a planned run after dark. When she asked she always comes back. Protocol in place so staff can identify the difference. \\r\\n\\r\\nClient would call guardian\\/mom when not happy with what staff was doing. Mom would change the rules\\/programs that were established when her daughter was upset. Guardian\\/mom directed day to day activities and would tell staff what things her daughter should do that day. The consistency of protocols were difficult for staff to follow due to the changes in decision making process being made by the guardian\\/mom. Program direct reports that as guardian become more inconsistent with following programs that elopement increased. \\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1967}','68.53.115.247','2021-04-29 02:32:03'),(6734,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1968,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"99\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1968}','68.53.115.247','2021-04-29 02:32:03'),(6735,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1969,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Direct care staff not following the person who eloped from the facility was influenced foremost by the person\\u2019s elopement protocol. At the time of the elopement it was dark outside and the protocol directed staff to not follow when dark. Contributing to the staff\\u2019s decision not to follow the person was the team\\u2019s (case manager, guardian, provider staff) desire to ensure the safety of staff and the person which was impacted by the person\\u2019s history of exhibiting challenging behaviors when followed. When staff followed the person in past elopements, the person ran further and was difficult to find. The person\\u2019s home was in a rural location which also impacted staff\\u2019s decision to not follow in the dark due to safety concerns. The elopement protocol was developed by the provider and approved by the guardian and case manager. Staff were intimidated by the guardian, which influenced the staff\\u2019s decision to follow protocol the guardian helped create. Direct care staff not following during the elopement was further supported by the person wearing a tracking watch that allowed staff to track the person and not always rely on following them.\\r\\n\\r\\nThere are a lack of crises services and placement options available in the area of the person\\u2019s home. Because of this, the provider created the elopement protocol as a way to try to balance the support and safety of the person. Limited state funding for crises services impacted the provider\\u2019s decision to create an elopement protocol. This is further influenced by the provider\\u2019s license requirements of 245A and 245D to safeguard the person\\u2019s health, safety and well-being.\\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1969}','68.53.115.247','2021-04-29 02:32:03'),(6736,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1970,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"127\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1970}','68.53.115.247','2021-04-29 02:32:03'),(6737,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1971,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"129\",\"question_type\":\"Date\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1971}','68.53.115.247','2021-04-29 02:32:03'),(6738,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1972,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"130\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1972}','68.53.115.247','2021-04-29 02:32:03'),(6739,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1973,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"131\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1973}','68.53.115.247','2021-04-29 02:32:03'),(6740,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1974,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"132\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1974}','68.53.115.247','2021-04-29 02:32:03'),(6741,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1975,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"101\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1975}','68.53.115.247','2021-04-29 02:32:03'),(6742,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1976,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:03 pm\",\"created_at\":\"4\\/28\\/2021 9:32:03 pm\",\"id\":1976}','68.53.115.247','2021-04-29 02:32:03'),(6743,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1977,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"103\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:04 pm\",\"created_at\":\"4\\/28\\/2021 9:32:04 pm\",\"id\":1977}','68.53.115.247','2021-04-29 02:32:04'),(6744,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1978,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"104\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:04 pm\",\"created_at\":\"4\\/28\\/2021 9:32:04 pm\",\"id\":1978}','68.53.115.247','2021-04-29 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02:32:04'),(6747,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1981,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"107\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:04 pm\",\"created_at\":\"4\\/28\\/2021 9:32:04 pm\",\"id\":1981}','68.53.115.247','2021-04-29 02:32:04'),(6748,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1982,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"108\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:04 pm\",\"created_at\":\"4\\/28\\/2021 9:32:04 pm\",\"id\":1982}','68.53.115.247','2021-04-29 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At the time of the elopement it was dark outside and the protocol directed staff to not follow when dark. Contributing to the staff\\u2019s decision not to follow the person was the team\\u2019s (case manager, guardian, provider staff) desire to ensure the safety of staff and the person which was impacted by the person\\u2019s history of exhibiting challenging behaviors when followed. When staff followed the person in past elopements, the person ran further and was difficult to find. The person\\u2019s home was in a rural location which also impacted staff\\u2019s decision to not follow in the dark due to safety concerns.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:04 pm\",\"created_at\":\"4\\/28\\/2021 9:32:04 pm\",\"id\":1990}','68.53.115.247','2021-04-29 02:32:04'),(6757,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1991,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"117\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"1\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:04 pm\",\"created_at\":\"4\\/28\\/2021 9:32:04 pm\",\"id\":1991}','68.53.115.247','2021-04-29 02:32:04'),(6758,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1992,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"118\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:04 pm\",\"created_at\":\"4\\/28\\/2021 9:32:04 pm\",\"id\":1992}','68.53.115.247','2021-04-29 02:32:04'),(6759,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1993,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"119\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:04 pm\",\"created_at\":\"4\\/28\\/2021 9:32:04 pm\",\"id\":1993}','68.53.115.247','2021-04-29 02:32:04'),(6760,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1994,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"120\",\"question_type\":\"Free_Text\",\"text_answer\":\"There are a lack of crises services and placement options available in the area of the person\\u2019s home. Because of this, the provider created the elopement protocol as a way to try to balance the support and safety of the person.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:04 pm\",\"created_at\":\"4\\/28\\/2021 9:32:04 pm\",\"id\":1994}','68.53.115.247','2021-04-29 02:32:04'),(6761,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1995,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"121\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:04 pm\",\"created_at\":\"4\\/28\\/2021 9:32:04 pm\",\"id\":1995}','68.53.115.247','2021-04-29 02:32:04'),(6762,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1996,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"122\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:04 pm\",\"created_at\":\"4\\/28\\/2021 9:32:04 pm\",\"id\":1996}','68.53.115.247','2021-04-29 02:32:04'),(6763,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1997,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"123\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:04 pm\",\"created_at\":\"4\\/28\\/2021 9:32:04 pm\",\"id\":1997}','68.53.115.247','2021-04-29 02:32:04'),(6764,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1998,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"124\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:04 pm\",\"created_at\":\"4\\/28\\/2021 9:32:04 pm\",\"id\":1998}','68.53.115.247','2021-04-29 02:32:04'),(6765,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',1999,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"125\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:04 pm\",\"created_at\":\"4\\/28\\/2021 9:32:04 pm\",\"id\":1999}','68.53.115.247','2021-04-29 02:32:04'),(6766,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2000,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"126\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:04 pm\",\"created_at\":\"4\\/28\\/2021 9:32:04 pm\",\"id\":2000}','68.53.115.247','2021-04-29 02:32:04'),(6767,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2001,'{\"report_id\":23,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"432\",\"question_type\":\"Yes_or_No\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:04 pm\",\"created_at\":\"4\\/28\\/2021 9:32:04 pm\",\"id\":2001}','68.53.115.247','2021-04-29 02:32:04'),(6768,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports','create',24,'{\"text_answer\":\"\",\"form_id\":\"23\",\"user_id\":81,\"report_name\":\"KP_REM Heartland-BEC-2019-07\",\"organization_id\":10,\"status\":1,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:49 pm\",\"created_at\":\"4\\/28\\/2021 9:32:49 pm\",\"id\":24}','68.53.115.247','2021-04-29 02:32:49'),(6769,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2002,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"201904216\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:49 pm\",\"created_at\":\"4\\/28\\/2021 9:32:49 pm\",\"id\":2002}','68.53.115.247','2021-04-29 02:32:49'),(6770,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2003,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"07\\/15\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:32:57 pm\",\"created_at\":\"4\\/28\\/2021 9:32:57 pm\",\"id\":2003}','68.53.115.247','2021-04-29 02:32:57'),(6771,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2004,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"REM Heartland - Couger Court\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:33:19 pm\",\"created_at\":\"4\\/28\\/2021 9:33:19 pm\",\"id\":2004}','68.53.115.247','2021-04-29 02:33:19'),(6772,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2005,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Devin Nelson\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:33:27 pm\",\"created_at\":\"4\\/28\\/2021 9:33:27 pm\",\"id\":2005}','68.53.115.247','2021-04-29 02:33:27'),(6773,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2006,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"83\",\"question_type\":\"Short_Answer\",\"text_answer\":\"507-223-4410\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:33:34 pm\",\"created_at\":\"4\\/28\\/2021 9:33:34 pm\",\"id\":2006}','68.53.115.247','2021-04-29 02:33:34'),(6774,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2007,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"On 6-8-2019, it was discovered that the person had been receiving only half of the prescribed dosage of her Mycophenolate.  The missed medications were then found in the medication cabinet.  Person received half of 9am and 3pm prescribed dosage from 6-1-2019 to 6-7-2019.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:33:51 pm\",\"created_at\":\"4\\/28\\/2021 9:33:51 pm\",\"id\":2007}','68.53.115.247','2021-04-29 02:33:51'),(6775,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2008,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"06\\/01\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:33:59 pm\",\"created_at\":\"4\\/28\\/2021 9:33:59 pm\",\"id\":2008}','68.53.115.247','2021-04-29 02:33:59'),(6776,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2009,'{\"report_id\":24,\"form_id\":\"24\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"201904216\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:02 pm\",\"created_at\":\"4\\/28\\/2021 9:34:02 pm\",\"id\":2009}','68.53.115.247','2021-04-29 02:34:02'),(6777,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2010,'{\"report_id\":24,\"form_id\":\"24\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"07\\/15\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:02 pm\",\"created_at\":\"4\\/28\\/2021 9:34:02 pm\",\"id\":2010}','68.53.115.247','2021-04-29 02:34:02'),(6778,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2011,'{\"report_id\":24,\"form_id\":\"24\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"78\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Kristie Pittman\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:02 pm\",\"created_at\":\"4\\/28\\/2021 9:34:02 pm\",\"id\":2011}','68.53.115.247','2021-04-29 02:34:02'),(6779,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2012,'{\"report_id\":24,\"form_id\":\"24\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Jill Tilbury\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:02 pm\",\"created_at\":\"4\\/28\\/2021 9:34:02 pm\",\"id\":2012}','68.53.115.247','2021-04-29 02:34:02'),(6780,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2013,'{\"report_id\":24,\"form_id\":\"24\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"REM Heartland - 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02:34:03'),(6824,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2057,'{\"report_id\":24,\"form_id\":\"24\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"126\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:03 pm\",\"created_at\":\"4\\/28\\/2021 9:34:03 pm\",\"id\":2057}','68.53.115.247','2021-04-29 02:34:03'),(6825,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2058,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Person received half of the prescribed dosage of medication.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:14 pm\",\"created_at\":\"4\\/28\\/2021 9:34:14 pm\",\"id\":2058}','68.53.115.247','2021-04-29 02:34:14'),(6826,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2059,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"94\",\"question_type\":\"True_or_False\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:14 pm\",\"created_at\":\"4\\/28\\/2021 9:34:14 pm\",\"id\":2059}','68.53.115.247','2021-04-29 02:34:14'),(6827,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2060,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"08\\/14\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:26 pm\",\"created_at\":\"4\\/28\\/2021 9:34:26 pm\",\"id\":2060}','68.53.115.247','2021-04-29 02:34:26'),(6828,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2061,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Staff 1 has been working for the company for the past 4 years and her role is a direct care staff. Staff 1 typically picks up of the medication from the pharmacy.  Sometimes Staff 1\\u2019s supervisor picks up the medications.  The staff who picks up the medications is responsible for organizing and separating the medications.  This medication usually come with one pill in two separate bubble packs and sometimes it will come with two pills in one bubble pack.  The person receives this medication at 9am and 3pm.  \\n\\nStaff 1 picked up the medication and then organized them.  Staff 1 felt that she put the correct medication and dosage in person\\u2019s medication area in the locked medication cabinet.  Staff does not recall anything out of the norm when organizing medications.  She said she was not distracted and that it was quiet at the house.  Staff 1said all medications are kept in each person\\u2019s area in the medication cabinet. Staff 1 said it is common practice for this facility for the first person who gives medication on the first of each month to double check that the medications were set up correctly. \\n\\nDebriefing with Staff #2 on 8-21-2019\\n\\nStaff 2 has worked for the company for the past 35 years and has held various position within the company.  Staff currently works the overnight shift which is from 10pm to 9am.  She is very familiar with the person and her medications as she has been with that group home for a long time.  \\n\\nOn the morning of June 1st, Staff 2 went to give 9am medications and noted that something \\u201cappeared off\\u201d with the medications. The medication typically comes in two single bubble packs, but there was only one bubble pack with one pill in the 9am medication. She said however that they do occasionally come with two pills in one bubble pack.  Staff 2 checked the dosage and then checked the 3pm medication and reported that they were the same, so she concluded that the dosage must have changed.  \\n\\nStaff 2 was not aware of the current procedure for storing extra medications.  Staff 2 said in the past when she held a different position that she would lock extra medications in the office desk. \\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:33 pm\",\"created_at\":\"4\\/28\\/2021 9:34:33 pm\",\"id\":2061}','68.53.115.247','2021-04-29 02:34:33'),(6829,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2062,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"The person receiving half of the prescribed dosage of medication for six days was influenced by Staff 1 believing that they set up the medications correctly after receiving them from the pharmacy.  An additional feature that influenced staff believing that the medications were set up correctly, was the medications were not always packaged the same when they came from the pharmacy.  Therefore, staff did not question when there was only one bubble pack for the person\\u2019s 9am medications and one bubble pack for person\\u2019s 3pm medications.  Staff 2 was the first staff to give medications after staff 1 set up medications in the med drawer for the month.   Staff 2 believed medications were set up correctly was influenced by the belief that the person\\u2019s medication dosage must have changed because of the way the meds were packaged.  Contributing to the staff\\u2019s belief that medication dosage changed was further influenced by the person\\u2019s 3pm medication dosage matching the 9am medication dosage.  This was further supported by staff 2 not finding the second bubble pack in the person\\u2019s medication drawer, which was the house norm for storing all medications.  Staff 2 also believed that staff 1 set up medications correctly.  \\n \\nAn additional factor that had other staff following staff 2\\u2019s lead in only giving half the med, rather than following medication protocol and ensuring that the med label and the Medication Administration Record (MAR) match the dosage in the bubble pack, is that there are a lot of policies for staff to know. This provider\\u2019s medication policies had changed due to the acquisition of another company, which then had both companies revise their policies to match each other. The introduction of 245D also required this provider to revise their medication administration policies. In the absence of stable policies the staff likely followed the veteran staff\\u2019s actions and assumed if there was a med change the veteran staff would have known as well as followed policies. \\n\\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"created_at\":\"4\\/28\\/2021 9:34:51 pm\",\"id\":2062}','68.53.115.247','2021-04-29 02:34:51'),(6830,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports','update',24,'{\"id\":24,\"form_id\":\"23\",\"user_id\":\"81\",\"question_id\":null,\"organization_id\":\"10\",\"tab_id\":null,\"question_type\":null,\"text_answer\":\"{\\\"Short_Answer__76\\\":\\\"201904216\\\",\\\"Date__77\\\":\\\"07\\\\\\/15\\\\\\/2019\\\",\\\"Multiple_Choice__78\\\":\\\"Kristie Pittman\\\",\\\"Multiple_Choice__79\\\":\\\"Jill Tilbury\\\",\\\"Short_Answer__80\\\":\\\"REM Heartland - Couger Court\\\",\\\"Short_Answer__81\\\":\\\"Devin Nelson\\\",\\\"Short_Answer__83\\\":\\\"507-223-4410\\\",\\\"Multiple_Choice__84\\\":\\\"Medication Error\\\",\\\"Multiple_Choice__85\\\":\\\"Blue Earth County\\\",\\\"Date__86\\\":\\\"06\\\\\\/01\\\\\\/2019\\\",\\\"Free_Text__87\\\":\\\"On 6-8-2019, it was discovered that the person had been receiving only half of the prescribed dosage of her Mycophenolate.  The missed medications were then found in the medication cabinet.  Person received half of 9am and 3pm prescribed dosage from 6-1-2019 to 6-7-2019.\\\",\\\"Multiple_Choice__96\\\":\\\"1\\\",\\\"Short_Answer__91\\\":\\\"Person received half of the prescribed dosage of medication.\\\",\\\"True_or_False__94\\\":\\\"Yes\\\",\\\"Date__97\\\":\\\"08\\\\\\/14\\\\\\/2019\\\",\\\"Free_Text__98\\\":\\\"\\\\\\\"Staff 1 has been working for the company for the past 4 years and her role is a direct care staff. Staff 1 typically picks up of the medication from the pharmacy.  Sometimes Staff 1\\\\u2019s supervisor picks up the medications.  The staff who picks up the medications is responsible for organizing and separating the medications.  This medication usually come with one pill in two separate bubble packs and sometimes it will come with two pills in one bubble pack.  The person receives this medication at 9am and 3pm.  \\\\r\\\\n\\\\r\\\\nStaff 1 picked up the medication and then organized them.  Staff 1 felt that she put the correct medication and dosage in person\\\\u2019s medication area in the locked medication cabinet.  Staff does not recall anything out of the norm when organizing medications.  She said she was not distracted and that it was quiet at the house.  Staff 1said all medications are kept in each person\\\\u2019s area in the medication cabinet. Staff 1 said it is common practice for this facility for the first person who gives medication on the first of each month to double check that the medications were set up correctly. \\\\r\\\\n\\\\r\\\\nDebriefing with Staff #2 on 8-21-2019\\\\r\\\\n\\\\r\\\\nStaff 2 has worked for the company for the past 35 years and has held various position within the company.  Staff currently works the overnight shift which is from 10pm to 9am.  She is very familiar with the person and her medications as she has been with that group home for a long time.  \\\\r\\\\n\\\\r\\\\nOn the morning of June 1st, Staff 2 went to give 9am medications and noted that something \\\\u201cappeared off\\\\u201d with the medications. The medication typically comes in two single bubble packs, but there was only one bubble pack with one pill in the 9am medication. She said however that they do occasionally come with two pills in one bubble pack.  Staff 2 checked the dosage and then checked the 3pm medication and reported that they were the same, so she concluded that the dosage must have changed.  \\\\r\\\\n\\\\r\\\\nStaff 2 was not aware of the current procedure for storing extra medications.  Staff 2 said in the past when she held a different position that she would lock extra medications in the office desk. \\\\\\\"\\\",\\\"Free_Text__100\\\":\\\"\\\\\\\"The person receiving half of the prescribed dosage of medication for six days was influenced by Staff 1 believing that they set up the medications correctly after receiving them from the pharmacy.  An additional feature that influenced staff believing that the medications were set up correctly, was the medications were not always packaged the same when they came from the pharmacy.  Therefore, staff did not question when there was only one bubble pack for the person\\\\u2019s 9am medications and one bubble pack for person\\\\u2019s 3pm medications.  Staff 2 was the first staff to give medications after staff 1 set up medications in the med drawer for the month.   Staff 2 believed medications were set up correctly was influenced by the belief that the person\\\\u2019s medication dosage must have changed because of the way the meds were packaged.  Contributing to the staff\\\\u2019s belief that medication dosage changed was further influenced by the person\\\\u2019s 3pm medication dosage matching the 9am medication dosage.  This was further supported by staff 2 not finding the second bubble pack in the person\\\\u2019s medication drawer, which was the house norm for storing all medications.  Staff 2 also believed that staff 1 set up medications correctly.  \\\\r\\\\n \\\\r\\\\nAn additional factor that had other staff following staff 2\\\\u2019s lead in only giving half the med, rather than following medication protocol and ensuring that the med label and the Medication Administration Record (MAR) match the dosage in the bubble pack, is that there are a lot of policies for staff to know. This provider\\\\u2019s medication policies had changed due to the acquisition of another company, which then had both companies revise their policies to match each other. The introduction of 245D also required this provider to revise their medication administration policies. In the absence of stable policies the staff likely followed the veteran staff\\\\u2019s actions and assumed if there was a med change the veteran staff would have known as well as followed policies. \\\\r\\\\n\\\\\\\"\\\"}\",\"mcq_answer\":null,\"other_answer\":\"0\",\"status\":\"1\",\"created_by\":\"81\",\"updated_by\":81,\"created_at\":\"4\\/28\\/2021 9:32:49 pm\",\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"deleted_at\":null,\"report_name\":\"KP_REM Heartland-BEC-2019-07\"}','68.53.115.247','2021-04-29 02:34:51'),(6831,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2063,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"201904216\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"created_at\":\"4\\/28\\/2021 9:34:51 pm\",\"id\":2063}','68.53.115.247','2021-04-29 02:34:51'),(6832,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2064,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"07\\/15\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"created_at\":\"4\\/28\\/2021 9:34:51 pm\",\"id\":2064}','68.53.115.247','2021-04-29 02:34:51'),(6833,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2065,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"78\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Kristie Pittman\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"created_at\":\"4\\/28\\/2021 9:34:51 pm\",\"id\":2065}','68.53.115.247','2021-04-29 02:34:51'),(6834,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2066,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Jill Tilbury\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"created_at\":\"4\\/28\\/2021 9:34:51 pm\",\"id\":2066}','68.53.115.247','2021-04-29 02:34:51'),(6835,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2067,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"REM Heartland - Couger Court\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"created_at\":\"4\\/28\\/2021 9:34:51 pm\",\"id\":2067}','68.53.115.247','2021-04-29 02:34:51'),(6836,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2068,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Devin Nelson\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"created_at\":\"4\\/28\\/2021 9:34:51 pm\",\"id\":2068}','68.53.115.247','2021-04-29 02:34:51'),(6837,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2069,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"created_at\":\"4\\/28\\/2021 9:34:51 pm\",\"id\":2069}','68.53.115.247','2021-04-29 02:34:51'),(6838,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2070,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"83\",\"question_type\":\"Short_Answer\",\"text_answer\":\"507-223-4410\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"created_at\":\"4\\/28\\/2021 9:34:51 pm\",\"id\":2070}','68.53.115.247','2021-04-29 02:34:51'),(6839,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2071,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"84\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Medication Error\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"created_at\":\"4\\/28\\/2021 9:34:51 pm\",\"id\":2071}','68.53.115.247','2021-04-29 02:34:51'),(6840,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2072,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Blue Earth County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"created_at\":\"4\\/28\\/2021 9:34:51 pm\",\"id\":2072}','68.53.115.247','2021-04-29 02:34:51'),(6841,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2073,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"06\\/01\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"created_at\":\"4\\/28\\/2021 9:34:51 pm\",\"id\":2073}','68.53.115.247','2021-04-29 02:34:51'),(6842,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2074,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"On 6-8-2019, it was discovered that the person had been receiving only half of the prescribed dosage of her Mycophenolate.  The missed medications were then found in the medication cabinet.  Person received half of 9am and 3pm prescribed dosage from 6-1-2019 to 6-7-2019.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"created_at\":\"4\\/28\\/2021 9:34:51 pm\",\"id\":2074}','68.53.115.247','2021-04-29 02:34:51'),(6843,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2075,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"96\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"1\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"created_at\":\"4\\/28\\/2021 9:34:51 pm\",\"id\":2075}','68.53.115.247','2021-04-29 02:34:51'),(6844,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2076,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Person received half of the prescribed dosage of medication.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"created_at\":\"4\\/28\\/2021 9:34:51 pm\",\"id\":2076}','68.53.115.247','2021-04-29 02:34:51'),(6845,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2077,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"94\",\"question_type\":\"True_or_False\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"created_at\":\"4\\/28\\/2021 9:34:51 pm\",\"id\":2077}','68.53.115.247','2021-04-29 02:34:51'),(6846,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2078,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"08\\/14\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"created_at\":\"4\\/28\\/2021 9:34:51 pm\",\"id\":2078}','68.53.115.247','2021-04-29 02:34:51'),(6847,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2079,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Staff 1 has been working for the company for the past 4 years and her role is a direct care staff. Staff 1 typically picks up of the medication from the pharmacy.  Sometimes Staff 1\\u2019s supervisor picks up the medications.  The staff who picks up the medications is responsible for organizing and separating the medications.  This medication usually come with one pill in two separate bubble packs and sometimes it will come with two pills in one bubble pack.  The person receives this medication at 9am and 3pm.  \\r\\n\\r\\nStaff 1 picked up the medication and then organized them.  Staff 1 felt that she put the correct medication and dosage in person\\u2019s medication area in the locked medication cabinet.  Staff does not recall anything out of the norm when organizing medications.  She said she was not distracted and that it was quiet at the house.  Staff 1said all medications are kept in each person\\u2019s area in the medication cabinet. Staff 1 said it is common practice for this facility for the first person who gives medication on the first of each month to double check that the medications were set up correctly. \\r\\n\\r\\nDebriefing with Staff #2 on 8-21-2019\\r\\n\\r\\nStaff 2 has worked for the company for the past 35 years and has held various position within the company.  Staff currently works the overnight shift which is from 10pm to 9am.  She is very familiar with the person and her medications as she has been with that group home for a long time.  \\r\\n\\r\\nOn the morning of June 1st, Staff 2 went to give 9am medications and noted that something \\u201cappeared off\\u201d with the medications. The medication typically comes in two single bubble packs, but there was only one bubble pack with one pill in the 9am medication. She said however that they do occasionally come with two pills in one bubble pack.  Staff 2 checked the dosage and then checked the 3pm medication and reported that they were the same, so she concluded that the dosage must have changed.  \\r\\n\\r\\nStaff 2 was not aware of the current procedure for storing extra medications.  Staff 2 said in the past when she held a different position that she would lock extra medications in the office desk. \\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"created_at\":\"4\\/28\\/2021 9:34:51 pm\",\"id\":2079}','68.53.115.247','2021-04-29 02:34:51'),(6848,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2080,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"99\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"created_at\":\"4\\/28\\/2021 9:34:51 pm\",\"id\":2080}','68.53.115.247','2021-04-29 02:34:51'),(6849,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2081,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"The person receiving half of the prescribed dosage of medication for six days was influenced by Staff 1 believing that they set up the medications correctly after receiving them from the pharmacy.  An additional feature that influenced staff believing that the medications were set up correctly, was the medications were not always packaged the same when they came from the pharmacy.  Therefore, staff did not question when there was only one bubble pack for the person\\u2019s 9am medications and one bubble pack for person\\u2019s 3pm medications.  Staff 2 was the first staff to give medications after staff 1 set up medications in the med drawer for the month.   Staff 2 believed medications were set up correctly was influenced by the belief that the person\\u2019s medication dosage must have changed because of the way the meds were packaged.  Contributing to the staff\\u2019s belief that medication dosage changed was further influenced by the person\\u2019s 3pm medication dosage matching the 9am medication dosage.  This was further supported by staff 2 not finding the second bubble pack in the person\\u2019s medication drawer, which was the house norm for storing all medications.  Staff 2 also believed that staff 1 set up medications correctly.  \\r\\n \\r\\nAn additional factor that had other staff following staff 2\\u2019s lead in only giving half the med, rather than following medication protocol and ensuring that the med label and the Medication Administration Record (MAR) match the dosage in the bubble pack, is that there are a lot of policies for staff to know. This provider\\u2019s medication policies had changed due to the acquisition of another company, which then had both companies revise their policies to match each other. The introduction of 245D also required this provider to revise their medication administration policies. In the absence of stable policies the staff likely followed the veteran staff\\u2019s actions and assumed if there was a med change the veteran staff would have known as well as followed policies. \\r\\n\\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"created_at\":\"4\\/28\\/2021 9:34:51 pm\",\"id\":2081}','68.53.115.247','2021-04-29 02:34:51'),(6850,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2082,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"127\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:34:51 pm\",\"created_at\":\"4\\/28\\/2021 9:34:51 pm\",\"id\":2082}','68.53.115.247','2021-04-29 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02:34:51'),(6881,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2113,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":\"This was further supported by staff 2 not finding the second bubble pack in the person\\u2019s medication drawer, which was the house norm for storing all medications. Staff 2 also believed that staff 1 setup medications correctly.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:35:06 pm\",\"created_at\":\"4\\/28\\/2021 9:35:06 pm\",\"id\":2113}','68.53.115.247','2021-04-29 02:35:06'),(6882,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2114,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"114\",\"question_type\":\"Free_Text\",\"text_answer\":\"The person receiving half of the prescribed dosage of medication for six days was influenced by Staff 1 believing that they set up the medications correctly after receiving them from the pharmacy. An additional feature that influenced staff believing that the medications were set up correctly, was the medications were not always packaged the same when they came from the pharmacy Therefore, staff did not question when there was only one bubble pack for the person\\u2019s 9am medications and one bubble pack for person\\u2019s 3pm medications.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:35:33 pm\",\"created_at\":\"4\\/28\\/2021 9:35:33 pm\",\"id\":2114}','68.53.115.247','2021-04-29 02:35:33'),(6883,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2115,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"124\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Staff 2 believed medications were set up correctly was influenced by the belief that the person\\u2019s medication dosage must have changed because of the way the meds were packaged.  Contributing to the staff\\u2019s belief that medication dosage changed was further influenced by the person\\u2019s 3pm medication dosage matching the 9am medication dosage.  \\n\\nAn additional factor that had other staff following staff 2\\u2019s lead in only giving half the med, rather than following medication protocol and ensuring that the med label and the Medication Administration Record (MAR) match the dosage in the bubble pack, is that there are a lot of policies for staff to know. In the absence of stable policies the staff likely followed the veteran staff\\u2019s actions and assumed if there was a med change the veteran staff would have known as well as followed policies.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:00 pm\",\"created_at\":\"4\\/28\\/2021 9:36:00 pm\",\"id\":2115}','68.53.115.247','2021-04-29 02:36:00'),(6884,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2116,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"432\",\"question_type\":\"Yes_or_No\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:03 pm\",\"created_at\":\"4\\/28\\/2021 9:36:03 pm\",\"id\":2116}','68.53.115.247','2021-04-29 02:36:03'),(6885,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports','update',24,'{\"id\":24,\"form_id\":\"23\",\"user_id\":\"81\",\"question_id\":null,\"organization_id\":\"10\",\"tab_id\":null,\"question_type\":null,\"text_answer\":\"{\\\"Short_Answer__76\\\":\\\"201904216\\\",\\\"Date__77\\\":\\\"07\\\\\\/15\\\\\\/2019\\\",\\\"Multiple_Choice__78\\\":\\\"Kristie Pittman\\\",\\\"Multiple_Choice__79\\\":\\\"Jill Tilbury\\\",\\\"Short_Answer__80\\\":\\\"REM Heartland - Couger Court\\\",\\\"Short_Answer__81\\\":\\\"Devin Nelson\\\",\\\"Short_Answer__83\\\":\\\"507-223-4410\\\",\\\"Multiple_Choice__84\\\":\\\"Medication Error\\\",\\\"Multiple_Choice__85\\\":\\\"Blue Earth County\\\",\\\"Date__86\\\":\\\"06\\\\\\/01\\\\\\/2019\\\",\\\"Free_Text__87\\\":\\\"On 6-8-2019, it was discovered that the person had been receiving only half of the prescribed dosage of her Mycophenolate.  The missed medications were then found in the medication cabinet.  Person received half of 9am and 3pm prescribed dosage from 6-1-2019 to 6-7-2019.\\\",\\\"Multiple_Choice__96\\\":\\\"1\\\",\\\"Short_Answer__91\\\":\\\"Person received half of the prescribed dosage of medication.\\\",\\\"True_or_False__94\\\":\\\"Yes\\\",\\\"Date__97\\\":\\\"08\\\\\\/14\\\\\\/2019\\\",\\\"Free_Text__98\\\":\\\"\\\\\\\"Staff 1 has been working for the company for the past 4 years and her role is a direct care staff. Staff 1 typically picks up of the medication from the pharmacy.  Sometimes Staff 1\\\\u2019s supervisor picks up the medications.  The staff who picks up the medications is responsible for organizing and separating the medications.  This medication usually come with one pill in two separate bubble packs and sometimes it will come with two pills in one bubble pack.  The person receives this medication at 9am and 3pm.  \\\\r\\\\n\\\\r\\\\nStaff 1 picked up the medication and then organized them.  Staff 1 felt that she put the correct medication and dosage in person\\\\u2019s medication area in the locked medication cabinet.  Staff does not recall anything out of the norm when organizing medications.  She said she was not distracted and that it was quiet at the house.  Staff 1said all medications are kept in each person\\\\u2019s area in the medication cabinet. Staff 1 said it is common practice for this facility for the first person who gives medication on the first of each month to double check that the medications were set up correctly. \\\\r\\\\n\\\\r\\\\nDebriefing with Staff #2 on 8-21-2019\\\\r\\\\n\\\\r\\\\nStaff 2 has worked for the company for the past 35 years and has held various position within the company.  Staff currently works the overnight shift which is from 10pm to 9am.  She is very familiar with the person and her medications as she has been with that group home for a long time.  \\\\r\\\\n\\\\r\\\\nOn the morning of June 1st, Staff 2 went to give 9am medications and noted that something \\\\u201cappeared off\\\\u201d with the medications. The medication typically comes in two single bubble packs, but there was only one bubble pack with one pill in the 9am medication. She said however that they do occasionally come with two pills in one bubble pack.  Staff 2 checked the dosage and then checked the 3pm medication and reported that they were the same, so she concluded that the dosage must have changed.  \\\\r\\\\n\\\\r\\\\nStaff 2 was not aware of the current procedure for storing extra medications.  Staff 2 said in the past when she held a different position that she would lock extra medications in the office desk. \\\\\\\"\\\",\\\"Free_Text__100\\\":\\\"\\\\\\\"The person receiving half of the prescribed dosage of medication for six days was influenced by Staff 1 believing that they set up the medications correctly after receiving them from the pharmacy.  An additional feature that influenced staff believing that the medications were set up correctly, was the medications were not always packaged the same when they came from the pharmacy.  Therefore, staff did not question when there was only one bubble pack for the person\\\\u2019s 9am medications and one bubble pack for person\\\\u2019s 3pm medications.  Staff 2 was the first staff to give medications after staff 1 set up medications in the med drawer for the month.   Staff 2 believed medications were set up correctly was influenced by the belief that the person\\\\u2019s medication dosage must have changed because of the way the meds were packaged.  Contributing to the staff\\\\u2019s belief that medication dosage changed was further influenced by the person\\\\u2019s 3pm medication dosage matching the 9am medication dosage.  This was further supported by staff 2 not finding the second bubble pack in the person\\\\u2019s medication drawer, which was the house norm for storing all medications.  Staff 2 also believed that staff 1 set up medications correctly.  \\\\r\\\\n \\\\r\\\\nAn additional factor that had other staff following staff 2\\\\u2019s lead in only giving half the med, rather than following medication protocol and ensuring that the med label and the Medication Administration Record (MAR) match the dosage in the bubble pack, is that there are a lot of policies for staff to know. This provider\\\\u2019s medication policies had changed due to the acquisition of another company, which then had both companies revise their policies to match each other. The introduction of 245D also required this provider to revise their medication administration policies. In the absence of stable policies the staff likely followed the veteran staff\\\\u2019s actions and assumed if there was a med change the veteran staff would have known as well as followed policies. \\\\r\\\\n\\\\\\\"\\\",\\\"Multiple_Choice__101\\\":\\\"2\\\",\\\"Free_Text__102\\\":\\\"This was further supported by staff 2 not finding the second bubble pack in the person\\\\u2019s medication drawer, which was the house norm for storing all medications. Staff 2 also believed that staff 1 setup medications correctly.\\\",\\\"Multiple_Choice__103\\\":\\\"0\\\",\\\"Multiple_Choice__105\\\":\\\"0\\\",\\\"Multiple_Choice__107\\\":\\\"0\\\",\\\"Multiple_Choice__109\\\":\\\"0\\\",\\\"Multiple_Choice__111\\\":\\\"0\\\",\\\"Multiple_Choice__113\\\":\\\"3\\\",\\\"Free_Text__114\\\":\\\"The person receiving half of the prescribed dosage of medication for six days was influenced by Staff 1 believing that they set up the medications correctly after receiving them from the pharmacy. An additional feature that influenced staff believing that the medications were set up correctly, was the medications were not always packaged the same when they came from the pharmacy Therefore, staff did not question when there was only one bubble pack for the person\\\\u2019s 9am medications and one bubble pack for person\\\\u2019s 3pm medications.\\\",\\\"Multiple_Choice__115\\\":\\\"0\\\",\\\"Multiple_Choice__117\\\":\\\"0\\\",\\\"Multiple_Choice__119\\\":\\\"0\\\",\\\"Multiple_Choice__121\\\":\\\"0\\\",\\\"Multiple_Choice__123\\\":\\\"3\\\",\\\"Free_Text__124\\\":\\\"\\\\\\\"Staff 2 believed medications were set up correctly was influenced by the belief that the person\\\\u2019s medication dosage must have changed because of the way the meds were packaged.  Contributing to the staff\\\\u2019s belief that medication dosage changed was further influenced by the person\\\\u2019s 3pm medication dosage matching the 9am medication dosage.  \\\\r\\\\n\\\\r\\\\nAn additional factor that had other staff following staff 2\\\\u2019s lead in only giving half the med, rather than following medication protocol and ensuring that the med label and the Medication Administration Record (MAR) match the dosage in the bubble pack, is that there are a lot of policies for staff to know. In the absence of stable policies the staff likely followed the veteran staff\\\\u2019s actions and assumed if there was a med change the veteran staff would have known as well as followed policies.\\\",\\\"Multiple_Choice__125\\\":\\\"0\\\",\\\"Yes_or_No__432\\\":\\\"Yes\\\"}\",\"mcq_answer\":null,\"other_answer\":\"0\",\"status\":\"1\",\"created_by\":\"81\",\"updated_by\":81,\"created_at\":\"4\\/28\\/2021 9:32:49 pm\",\"updated_at\":\"4\\/28\\/2021 9:36:05 pm\",\"deleted_at\":null,\"report_name\":\"KP_REM Heartland-BEC-2019-07\"}','68.53.115.247','2021-04-29 02:36:05'),(6886,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2117,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"201904216\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:05 pm\",\"created_at\":\"4\\/28\\/2021 9:36:05 pm\",\"id\":2117}','68.53.115.247','2021-04-29 02:36:05'),(6887,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2118,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"07\\/15\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:05 pm\",\"created_at\":\"4\\/28\\/2021 9:36:05 pm\",\"id\":2118}','68.53.115.247','2021-04-29 02:36:05'),(6888,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2119,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"78\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Kristie Pittman\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:05 pm\",\"created_at\":\"4\\/28\\/2021 9:36:05 pm\",\"id\":2119}','68.53.115.247','2021-04-29 02:36:05'),(6889,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2120,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Jill Tilbury\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:05 pm\",\"created_at\":\"4\\/28\\/2021 9:36:05 pm\",\"id\":2120}','68.53.115.247','2021-04-29 02:36:05'),(6890,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2121,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"REM Heartland - Couger Court\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:05 pm\",\"created_at\":\"4\\/28\\/2021 9:36:05 pm\",\"id\":2121}','68.53.115.247','2021-04-29 02:36:05'),(6891,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2122,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Devin Nelson\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:05 pm\",\"created_at\":\"4\\/28\\/2021 9:36:05 pm\",\"id\":2122}','68.53.115.247','2021-04-29 02:36:05'),(6892,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2123,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:05 pm\",\"created_at\":\"4\\/28\\/2021 9:36:05 pm\",\"id\":2123}','68.53.115.247','2021-04-29 02:36:05'),(6893,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2124,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"83\",\"question_type\":\"Short_Answer\",\"text_answer\":\"507-223-4410\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:05 pm\",\"created_at\":\"4\\/28\\/2021 9:36:05 pm\",\"id\":2124}','68.53.115.247','2021-04-29 02:36:05'),(6894,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2125,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"84\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Medication Error\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:05 pm\",\"created_at\":\"4\\/28\\/2021 9:36:05 pm\",\"id\":2125}','68.53.115.247','2021-04-29 02:36:06'),(6895,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2126,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Blue Earth County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2126}','68.53.115.247','2021-04-29 02:36:06'),(6896,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2127,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"06\\/01\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2127}','68.53.115.247','2021-04-29 02:36:06'),(6897,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2128,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"On 6-8-2019, it was discovered that the person had been receiving only half of the prescribed dosage of her Mycophenolate.  The missed medications were then found in the medication cabinet.  Person received half of 9am and 3pm prescribed dosage from 6-1-2019 to 6-7-2019.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2128}','68.53.115.247','2021-04-29 02:36:06'),(6898,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2129,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"96\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"1\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2129}','68.53.115.247','2021-04-29 02:36:06'),(6899,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2130,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Person received half of the prescribed dosage of medication.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2130}','68.53.115.247','2021-04-29 02:36:06'),(6900,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2131,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"94\",\"question_type\":\"True_or_False\",\"text_answer\":\"Yes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2131}','68.53.115.247','2021-04-29 02:36:06'),(6901,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2132,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"08\\/14\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2132}','68.53.115.247','2021-04-29 02:36:06'),(6902,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2133,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Staff 1 has been working for the company for the past 4 years and her role is a direct care staff. Staff 1 typically picks up of the medication from the pharmacy.  Sometimes Staff 1\\u2019s supervisor picks up the medications.  The staff who picks up the medications is responsible for organizing and separating the medications.  This medication usually come with one pill in two separate bubble packs and sometimes it will come with two pills in one bubble pack.  The person receives this medication at 9am and 3pm.  \\r\\n\\r\\nStaff 1 picked up the medication and then organized them.  Staff 1 felt that she put the correct medication and dosage in person\\u2019s medication area in the locked medication cabinet.  Staff does not recall anything out of the norm when organizing medications.  She said she was not distracted and that it was quiet at the house.  Staff 1said all medications are kept in each person\\u2019s area in the medication cabinet. Staff 1 said it is common practice for this facility for the first person who gives medication on the first of each month to double check that the medications were set up correctly. \\r\\n\\r\\nDebriefing with Staff #2 on 8-21-2019\\r\\n\\r\\nStaff 2 has worked for the company for the past 35 years and has held various position within the company.  Staff currently works the overnight shift which is from 10pm to 9am.  She is very familiar with the person and her medications as she has been with that group home for a long time.  \\r\\n\\r\\nOn the morning of June 1st, Staff 2 went to give 9am medications and noted that something \\u201cappeared off\\u201d with the medications. The medication typically comes in two single bubble packs, but there was only one bubble pack with one pill in the 9am medication. She said however that they do occasionally come with two pills in one bubble pack.  Staff 2 checked the dosage and then checked the 3pm medication and reported that they were the same, so she concluded that the dosage must have changed.  \\r\\n\\r\\nStaff 2 was not aware of the current procedure for storing extra medications.  Staff 2 said in the past when she held a different position that she would lock extra medications in the office desk. \\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2133}','68.53.115.247','2021-04-29 02:36:06'),(6903,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2134,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"99\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2134}','68.53.115.247','2021-04-29 02:36:06'),(6904,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2135,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"The person receiving half of the prescribed dosage of medication for six days was influenced by Staff 1 believing that they set up the medications correctly after receiving them from the pharmacy.  An additional feature that influenced staff believing that the medications were set up correctly, was the medications were not always packaged the same when they came from the pharmacy.  Therefore, staff did not question when there was only one bubble pack for the person\\u2019s 9am medications and one bubble pack for person\\u2019s 3pm medications.  Staff 2 was the first staff to give medications after staff 1 set up medications in the med drawer for the month.   Staff 2 believed medications were set up correctly was influenced by the belief that the person\\u2019s medication dosage must have changed because of the way the meds were packaged.  Contributing to the staff\\u2019s belief that medication dosage changed was further influenced by the person\\u2019s 3pm medication dosage matching the 9am medication dosage.  This was further supported by staff 2 not finding the second bubble pack in the person\\u2019s medication drawer, which was the house norm for storing all medications.  Staff 2 also believed that staff 1 set up medications correctly.  \\r\\n \\r\\nAn additional factor that had other staff following staff 2\\u2019s lead in only giving half the med, rather than following medication protocol and ensuring that the med label and the Medication Administration Record (MAR) match the dosage in the bubble pack, is that there are a lot of policies for staff to know. This provider\\u2019s medication policies had changed due to the acquisition of another company, which then had both companies revise their policies to match each other. The introduction of 245D also required this provider to revise their medication administration policies. In the absence of stable policies the staff likely followed the veteran staff\\u2019s actions and assumed if there was a med change the veteran staff would have known as well as followed policies. \\r\\n\\\"\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2135}','68.53.115.247','2021-04-29 02:36:06'),(6905,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2136,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"127\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2136}','68.53.115.247','2021-04-29 02:36:06'),(6906,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2137,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"129\",\"question_type\":\"Date\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2137}','68.53.115.247','2021-04-29 02:36:06'),(6907,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2138,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"130\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2138}','68.53.115.247','2021-04-29 02:36:06'),(6908,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2139,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"131\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2139}','68.53.115.247','2021-04-29 02:36:06'),(6909,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2140,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"132\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2140}','68.53.115.247','2021-04-29 02:36:06'),(6910,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2141,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"101\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2141}','68.53.115.247','2021-04-29 02:36:06'),(6911,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2142,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":\"This was further supported by staff 2 not finding the second bubble pack in the person\\u2019s medication drawer, which was the house norm for storing all medications. Staff 2 also believed that staff 1 setup medications correctly.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2142}','68.53.115.247','2021-04-29 02:36:06'),(6912,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2143,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"103\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2143}','68.53.115.247','2021-04-29 02:36:06'),(6913,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2144,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"104\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2144}','68.53.115.247','2021-04-29 02:36:06'),(6914,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2145,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"105\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2145}','68.53.115.247','2021-04-29 02:36:06'),(6915,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2146,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"106\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2146}','68.53.115.247','2021-04-29 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An additional feature that influenced staff believing that the medications were set up correctly, was the medications were not always packaged the same when they came from the pharmacy Therefore, staff did not question when there was only one bubble pack for the person\\u2019s 9am medications and one bubble pack for person\\u2019s 3pm medications.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2154}','68.53.115.247','2021-04-29 02:36:06'),(6924,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2155,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"115\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2155}','68.53.115.247','2021-04-29 02:36:06'),(6925,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2156,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"116\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2156}','68.53.115.247','2021-04-29 02:36:06'),(6926,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2157,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"117\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2157}','68.53.115.247','2021-04-29 02:36:06'),(6927,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2158,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"118\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2158}','68.53.115.247','2021-04-29 02:36:06'),(6928,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2159,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"119\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2159}','68.53.115.247','2021-04-29 02:36:06'),(6929,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2160,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"120\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2160}','68.53.115.247','2021-04-29 02:36:06'),(6930,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2161,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"121\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"0\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2161}','68.53.115.247','2021-04-29 02:36:06'),(6931,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2162,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"122\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2162}','68.53.115.247','2021-04-29 02:36:06'),(6932,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2163,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"123\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:36:06 pm\",\"created_at\":\"4\\/28\\/2021 9:36:06 pm\",\"id\":2163}','68.53.115.247','2021-04-29 02:36:06'),(6933,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2164,'{\"report_id\":24,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"124\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Staff 2 believed medications were set up correctly was influenced by the belief that the person\\u2019s medication dosage must have changed because of the way the meds were packaged.  Contributing to the staff\\u2019s belief that medication dosage changed was further influenced by the person\\u2019s 3pm medication dosage matching the 9am medication dosage.  \\r\\n\\r\\nAn additional factor that had other staff following staff 2\\u2019s lead in only giving half the med, rather than following medication protocol and ensuring that the med label and the Medication Administration Record (MAR) match the dosage in the bubble pack, is that there are a lot of policies for staff to know. 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02:38:01'),(6996,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2226,'{\"report_id\":25,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"This house had an asleep overnight shift that began at 10pm, as directed by the CSSPs for the four people living in the home. The staff fell asleep at 8pm when all was quiet, and all the people were presumably in their rooms for the night. The people being served in this house demonstrated low needs which allowed them to have unsupervised time, contributing to the staff feeling comfortable to lie down. An additional factor into the staff laying down was that the staff was tired.  This staff had fallen asleep on previous shifts and disclosed to management that he was tired due to a personal situation that left him homeless. The staff typically slept in his car during this period.  The provider tried to work with him to move to the overnight position which would allow him to sleep but he did not accept this offer.  The provider noted that the overnight shift made nearly $5 less per hour, which was one of the influences into the person staying on the awake shift.  The provider was experiencing a staff shortage which is one of the factors into why they wanted to work with the staff to find a position that would meet both of their needs. An additional influence in staff falling asleep is that the staff laid down to try out a newly purchased weighted blanket   \\n\\nAll clients in the home had their needs assessed by MnCHOICES, which supported the individuals having sleep staff as well as alone time. The provider had seen this house as a potential house to replace overnight staff with remote monitoring technology due to the low needs of the individuals. The provider\\u2019s push for more alone time and remote monitoring was impacted by their efforts to allow the dignity of risk by providing more opportunities for people they serve to have a choice and control over their lives.  The effort to encourage dignity of risk was influenced by statewide person-centered planning requirements and emphasis. However, one guardian was resistant to remote monitoring but compromised by allowing the person alone time in their plan.  It was common knowledge among staff that the clients demonstrated low needs, contributing to the staff feeling comfortable to lie down. \\n\\nThe staff\\u2019s unwillingness to move to the overnight shift was influenced by the lower rate of pay that asleep staff were paid. The sleep rate is factored into the provider\\u2019s overall reimbursement negotiated with the county through the 6790 and provides a lower rate asleep than awake hours. The 6790-negotiation process is influenced by the rates determined by the Legislature in the Disability Waiver Rate System and the assessed needs identified in MnCHOICES and the resulting supervision levels identified in the CSSP.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:38:20 pm\",\"created_at\":\"4\\/28\\/2021 9:38:20 pm\",\"id\":2226}','68.53.115.247','2021-04-29 02:38:20'),(6997,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports','update',25,'{\"id\":25,\"form_id\":\"23\",\"user_id\":\"81\",\"question_id\":null,\"organization_id\":\"10\",\"tab_id\":null,\"question_type\":null,\"text_answer\":\"{\\\"Short_Answer__76\\\":\\\"201905293\\\",\\\"Date__77\\\":\\\"09\\\\\\/16\\\\\\/2019\\\",\\\"Multiple_Choice__78\\\":\\\"Kristie Pittman\\\",\\\"Multiple_Choice__79\\\":\\\"Charles Young\\\",\\\"Short_Answer__80\\\":\\\"REM Heartland, Inc. - Chastworth\\\",\\\"Short_Answer__81\\\":\\\"Lori Larson\\\",\\\"Short_Answer__82\\\":\\\"Lori.Larson@TheMentorNetwork.com\\\",\\\"Multiple_Choice__84\\\":\\\"Staff Sleeping on Duty\\\",\\\"Multiple_Choice__85\\\":\\\"Blue Earth County\\\",\\\"Date__86\\\":\\\"07\\\\\\/19\\\\\\/2019\\\",\\\"Free_Text__87\\\":\\\"As the only staff present in the facility, David laid down after Damon went to bed at approximately 8:00 pm. He inadvertently fell asleep and was awoken by the night shift staff when they reported for their shift at approximately 9:50 pm. Damon was apparently asleep the entire time, but his staffing ratios only for 1 hour of alone time during the day and sleeping night staff.\\\",\\\"Multiple_Choice__96\\\":\\\"1\\\",\\\"Short_Answer__91\\\":\\\"Staff was sleeping during an evening shift\\\",\\\"True_or_False__94\\\":\\\"No\\\",\\\"Multiple_Choice__99\\\":\\\"Staff No Longer Employed\\\",\\\"Free_Text__100\\\":\\\"\\\\\\\"This house had an asleep overnight shift that began at 10pm, as directed by the CSSPs for the four people living in the home. The staff fell asleep at 8pm when all was quiet, and all the people were presumably in their rooms for the night. The people being served in this house demonstrated low needs which allowed them to have unsupervised time, contributing to the staff feeling comfortable to lie down. An additional factor into the staff laying down was that the staff was tired.  This staff had fallen asleep on previous shifts and disclosed to management that he was tired due to a personal situation that left him homeless. The staff typically slept in his car during this period.  The provider tried to work with him to move to the overnight position which would allow him to sleep but he did not accept this offer.  The provider noted that the overnight shift made nearly $5 less per hour, which was one of the influences into the person staying on the awake shift.  The provider was experiencing a staff shortage which is one of the factors into why they wanted to work with the staff to find a position that would meet both of their needs. An additional influence in staff falling asleep is that the staff laid down to try out a newly purchased weighted blanket   \\\\r\\\\n\\\\r\\\\nAll clients in the home had their needs assessed by MnCHOICES, which supported the individuals having sleep staff as well as alone time. The provider had seen this house as a potential house to replace overnight staff with remote monitoring technology due to the low needs of the individuals. The provider\\\\u2019s push for more alone time and remote monitoring was impacted by their efforts to allow the dignity of risk by providing more opportunities for people they serve to have a choice and control over their lives.  The effort to encourage dignity of risk was influenced by statewide person-centered planning requirements and emphasis. However, one guardian was resistant to remote monitoring but compromised by allowing the person alone time in their plan.  It was common knowledge among staff that the clients demonstrated low needs, contributing to the staff feeling comfortable to lie down. \\\\r\\\\n\\\\r\\\\nThe staff\\\\u2019s unwillingness to move to the overnight shift was influenced by the lower rate of pay that asleep staff were paid. The sleep rate is factored into the provider\\\\u2019s overall reimbursement negotiated with the county through the 6790 and provides a lower rate asleep than awake hours. The 6790-negotiation process is influenced by the rates determined by the Legislature in the Disability Waiver Rate System and the assessed needs identified in MnCHOICES and the resulting supervision levels identified in the CSSP.\\\"}\",\"mcq_answer\":null,\"other_answer\":\"0\",\"status\":\"1\",\"created_by\":\"81\",\"updated_by\":81,\"created_at\":\"4\\/28\\/2021 9:36:28 pm\",\"updated_at\":\"4\\/28\\/2021 9:38:20 pm\",\"deleted_at\":null,\"report_name\":\"KP_REM Heartland-BEC-2019-09\"}','68.53.115.247','2021-04-29 02:38:20'),(6998,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2227,'{\"report_id\":25,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"201905293\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:38:20 pm\",\"created_at\":\"4\\/28\\/2021 9:38:20 pm\",\"id\":2227}','68.53.115.247','2021-04-29 02:38:20'),(6999,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2228,'{\"report_id\":25,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"09\\/16\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:38:20 pm\",\"created_at\":\"4\\/28\\/2021 9:38:20 pm\",\"id\":2228}','68.53.115.247','2021-04-29 02:38:20'),(7000,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2229,'{\"report_id\":25,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"78\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Kristie Pittman\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:38:20 pm\",\"created_at\":\"4\\/28\\/2021 9:38:20 pm\",\"id\":2229}','68.53.115.247','2021-04-29 02:38:20'),(7001,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2230,'{\"report_id\":25,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Charles Young\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:38:20 pm\",\"created_at\":\"4\\/28\\/2021 9:38:20 pm\",\"id\":2230}','68.53.115.247','2021-04-29 02:38:20'),(7002,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2231,'{\"report_id\":25,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"REM Heartland, Inc. - Chastworth\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:38:20 pm\",\"created_at\":\"4\\/28\\/2021 9:38:20 pm\",\"id\":2231}','68.53.115.247','2021-04-29 02:38:20'),(7003,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2232,'{\"report_id\":25,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Lori Larson\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:38:20 pm\",\"created_at\":\"4\\/28\\/2021 9:38:20 pm\",\"id\":2232}','68.53.115.247','2021-04-29 02:38:20'),(7004,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2233,'{\"report_id\":25,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Lori.Larson@TheMentorNetwork.com\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:38:20 pm\",\"created_at\":\"4\\/28\\/2021 9:38:20 pm\",\"id\":2233}','68.53.115.247','2021-04-29 02:38:20'),(7005,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2234,'{\"report_id\":25,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"83\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:38:20 pm\",\"created_at\":\"4\\/28\\/2021 9:38:20 pm\",\"id\":2234}','68.53.115.247','2021-04-29 02:38:20'),(7006,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2235,'{\"report_id\":25,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"84\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Staff Sleeping on Duty\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:38:20 pm\",\"created_at\":\"4\\/28\\/2021 9:38:20 pm\",\"id\":2235}','68.53.115.247','2021-04-29 02:38:20'),(7007,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2236,'{\"report_id\":25,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Blue Earth County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:38:20 pm\",\"created_at\":\"4\\/28\\/2021 9:38:20 pm\",\"id\":2236}','68.53.115.247','2021-04-29 02:38:20'),(7008,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2237,'{\"report_id\":25,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"07\\/19\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:38:20 pm\",\"created_at\":\"4\\/28\\/2021 9:38:20 pm\",\"id\":2237}','68.53.115.247','2021-04-29 02:38:20'),(7009,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2238,'{\"report_id\":25,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"As the only staff present in the facility, David laid down after Damon went to bed at approximately 8:00 pm. He inadvertently fell asleep and was awoken by the night shift staff when they reported for their shift at approximately 9:50 pm. Damon was apparently asleep the entire time, but his staffing ratios only for 1 hour of alone time during the day and sleeping night staff.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:38:20 pm\",\"created_at\":\"4\\/28\\/2021 9:38:20 pm\",\"id\":2238}','68.53.115.247','2021-04-29 02:38:20'),(7010,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2239,'{\"report_id\":25,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"96\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"1\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:38:20 pm\",\"created_at\":\"4\\/28\\/2021 9:38:20 pm\",\"id\":2239}','68.53.115.247','2021-04-29 02:38:20'),(7011,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2240,'{\"report_id\":25,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Staff was sleeping during an evening shift\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:38:20 pm\",\"created_at\":\"4\\/28\\/2021 9:38:20 pm\",\"id\":2240}','68.53.115.247','2021-04-29 02:38:20'),(7012,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2241,'{\"report_id\":25,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"94\",\"question_type\":\"True_or_False\",\"text_answer\":\"No\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:38:20 pm\",\"created_at\":\"4\\/28\\/2021 9:38:20 pm\",\"id\":2241}','68.53.115.247','2021-04-29 02:38:20'),(7013,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2242,'{\"report_id\":25,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:38:20 pm\",\"created_at\":\"4\\/28\\/2021 9:38:20 pm\",\"id\":2242}','68.53.115.247','2021-04-29 02:38:20'),(7014,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2243,'{\"report_id\":25,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:38:20 pm\",\"created_at\":\"4\\/28\\/2021 9:38:20 pm\",\"id\":2243}','68.53.115.247','2021-04-29 02:38:20'),(7015,'NPjBSI5EwemkGnfYRh9kzsR4JJRPZEILZE1fN1bY',81,'reports_answer','create',2244,'{\"report_id\":25,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"99\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Staff No Longer Employed\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"4\\/28\\/2021 9:38:20 pm\",\"created_at\":\"4\\/28\\/2021 9:38:20 pm\",\"id\":2244}','68.53.115.247','2021-04-29 02:38:20');
