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Prior to this person being served told staff he was going to take a nap.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:28:56 pm\",\"created_at\":\"5\\/26\\/2021 4:28:56 pm\",\"id\":37114}','68.53.115.247','2021-05-26 21:28:56'),(25515,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37115,'{\"report_id\":202,\"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\":\"5\\/26\\/2021 4:28:56 pm\",\"created_at\":\"5\\/26\\/2021 4:28:56 pm\",\"id\":37115}','68.53.115.247','2021-05-26 21:28:56'),(25516,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37116,'{\"report_id\":202,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Person eloped from the home without staff knowledge\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:28:56 pm\",\"created_at\":\"5\\/26\\/2021 4:28:56 pm\",\"id\":37116}','68.53.115.247','2021-05-26 21:28:56'),(25517,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37117,'{\"report_id\":202,\"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\":\"5\\/26\\/2021 4:28:56 pm\",\"created_at\":\"5\\/26\\/2021 4:28:56 pm\",\"id\":37117}','68.53.115.247','2021-05-26 21:28:56'),(25518,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37118,'{\"report_id\":202,\"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\":\"5\\/26\\/2021 4:28:56 pm\",\"created_at\":\"5\\/26\\/2021 4:28:56 pm\",\"id\":37118}','68.53.115.247','2021-05-26 21:28:56'),(25519,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37119,'{\"report_id\":202,\"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\":\"5\\/26\\/2021 4:28:56 pm\",\"created_at\":\"5\\/26\\/2021 4:28:56 pm\",\"id\":37119}','68.53.115.247','2021-05-26 21:28:56'),(25520,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37120,'{\"report_id\":202,\"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\":\"5\\/26\\/2021 4:28:56 pm\",\"created_at\":\"5\\/26\\/2021 4:28:56 pm\",\"id\":37120}','68.53.115.247','2021-05-26 21:28:56'),(25521,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37121,'{\"report_id\":202,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The person eloping from the home without staff knowledge was influenced by the person telling staff that they were going to take a nap in their room.   This was further influenced by the person\\u2019s plan that was agreed upon by a new case manager and guardian that allowed for 4 hours of alone time at home.  This included their bedroom and further supported by providers having to allow for person\\u2019s privacy in their room as required by 245D rights and person-centered planning and directed in the CSSP.    The person eloping from the home without staff knowledge was also impacted by the person being new to the home with no history of elopement resulting in staff having no reason for concern that they would elope. Another influence of person eloping without staff knowledge was the home was a 4-person residence, staffed by one person and during this time staff was assisting other people.   \\r\\n\\r\\nThe person being served had expectations that they would be able to visit with family and friends in the area when they moved into the group home.   COVID 19-Pandemic resulted in an Executive stay at home order and MDH guidelines limiting the persons opportunity to go into the community resulting in increased anxiety that was reported by staff, influencing the person eloping from the home.  This was further supported by providers being unsure what guidance to follow during COVID-19 therefore impacting the amount of community outings being offered to the people they serve.  Person being served had unsupervised time in the community only when at work.   Health issues from wearing a mask at work impacted person\\u2019s ability to work in the community resulting in limited time in the community is an additional influence of the person eloping from the home.  The worker\\u2019s focus of attention at the time was on the three individuals in the communal area while the other resident exercised their right to privacy in their room which is supported and required by 245D.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:28:56 pm\",\"created_at\":\"5\\/26\\/2021 4:28:56 pm\",\"id\":37121}','68.53.115.247','2021-05-26 21:28:56'),(25522,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37122,'{\"report_id\":202,\"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\":\"5\\/26\\/2021 4:28:56 pm\",\"created_at\":\"5\\/26\\/2021 4:28:56 pm\",\"id\":37122}','68.53.115.247','2021-05-26 21:28:56'),(25523,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37123,'{\"report_id\":202,\"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\":\"5\\/26\\/2021 4:28:56 pm\",\"created_at\":\"5\\/26\\/2021 4:28:56 pm\",\"id\":37123}','68.53.115.247','2021-05-26 21:28:56'),(25524,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37124,'{\"report_id\":202,\"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\":\"5\\/26\\/2021 4:28:56 pm\",\"created_at\":\"5\\/26\\/2021 4:28:56 pm\",\"id\":37124}','68.53.115.247','2021-05-26 21:28:56'),(25525,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37125,'{\"report_id\":202,\"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\":\"5\\/26\\/2021 4:28:56 pm\",\"created_at\":\"5\\/26\\/2021 4:28:56 pm\",\"id\":37125}','68.53.115.247','2021-05-26 21:28:56'),(25526,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37126,'{\"report_id\":202,\"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\":\"5\\/26\\/2021 4:28:56 pm\",\"created_at\":\"5\\/26\\/2021 4:28:56 pm\",\"id\":37126}','68.53.115.247','2021-05-26 21:28:56'),(25527,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37127,'{\"report_id\":202,\"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\":\"5\\/26\\/2021 4:28:56 pm\",\"created_at\":\"5\\/26\\/2021 4:28:56 pm\",\"id\":37127}','68.53.115.247','2021-05-26 21:28:56'),(25528,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37128,'{\"report_id\":202,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":\"The person eloping from the home without staff knowledge was influenced by the person telling staff that they were going to take a nap in their room.   This was further influenced by the person\\u2019s plan that was agreed upon by a new case manager and guardian that allowed for 4 hours of alone time at home.  This included their bedroom and further supported by providers having to allow for person\\u2019s privacy in their room as required by 245D rights and person-centered planning and directed in the CSSP. \\r\\n\\r\\nThe worker\\u2019s focus of attention at the time was on the three individuals in the communal area while the other resident exercised their right to privacy in their room which is supported and required by 245D.\\r\\n\\r\\nThe person eloping from the home without staff knowledge was also impacted by the person being new to the home with no history of elopement resulting in staff having no reason for concern that they would elope.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:28:56 pm\",\"created_at\":\"5\\/26\\/2021 4:28:56 pm\",\"id\":37128}','68.53.115.247','2021-05-26 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21:28:56'),(25541,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37141,'{\"report_id\":202,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"115\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:28:56 pm\",\"created_at\":\"5\\/26\\/2021 4:28:56 pm\",\"id\":37141}','68.53.115.247','2021-05-26 21:28:56'),(25542,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37142,'{\"report_id\":202,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"116\",\"question_type\":\"Free_Text\",\"text_answer\":\"The person being served had expectations that they would be able to visit with family and friends in the area when they moved into the group home.   \\r\\n\\r\\nCOVID 19-Pandemic resulted in an Executive stay at home order and MDH guidelines limiting the persons opportunity to go into the community resulting in increased anxiety that was reported by staff, influencing the person eloping from the home.  This was further supported by providers being unsure what guidance to follow during COVID-19 therefore impacting the amount of community outings being offered to the people they serve\\r\\n\\r\\n This was further supported by providers being unsure what guidance to follow during COVID-19 therefore impacting the amount of community outings being offered to the people they serve.  Person being served had unsupervised time in the community only when at work.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:28:56 pm\",\"created_at\":\"5\\/26\\/2021 4:28:56 pm\",\"id\":37142}','68.53.115.247','2021-05-26 21:28:56'),(25543,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37143,'{\"report_id\":202,\"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\":\"5\\/26\\/2021 4:28:56 pm\",\"created_at\":\"5\\/26\\/2021 4:28:56 pm\",\"id\":37143}','68.53.115.247','2021-05-26 21:28:56'),(25544,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37144,'{\"report_id\":202,\"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\":\"5\\/26\\/2021 4:28:56 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21:29:37'),(25567,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37167,'{\"report_id\":203,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"Staff was administ3ring medication\'s on 11\\/11\\/2020 when they discovered that persons Spironolactone 25mg tablet had not been given from 11\\/7\\/2020 through 11\\/10\\/2020.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37167}','68.53.115.247','2021-05-26 21:29:37'),(25568,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37168,'{\"report_id\":203,\"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\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37168}','68.53.115.247','2021-05-26 21:29:37'),(25569,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37169,'{\"report_id\":203,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Staff did not follow policy requiring 3 checks\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37169}','68.53.115.247','2021-05-26 21:29:37'),(25570,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37170,'{\"report_id\":203,\"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\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37170}','68.53.115.247','2021-05-26 21:29:37'),(25571,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37171,'{\"report_id\":203,\"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\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37171}','68.53.115.247','2021-05-26 21:29:37'),(25572,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37172,'{\"report_id\":203,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"Another contributing factor to staff feeling rushed was that the home is single staffed in the mornings. Staffing patterns are impacted by the staff ratio, which is determined by the MNCHOICES assessment and Disability waiver rate system, as well as the expectation that person centered choices at the home are provided.  This allows for the work schedule to be adapted to accommodate more staffing during day shifts to allow for more outings, resulting in morning staff being limited to one, further influencing staff need to hurry to ensure all morning task were completed.  COVID-19 lead to the Governor\\u2019s executive stay at home order and Day services were then closed.  This increased the need for more staff to cover shifts at a time when staff shortage was at an all-time high.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37172}','68.53.115.247','2021-05-26 21:29:37'),(25573,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37173,'{\"report_id\":203,\"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\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37173}','68.53.115.247','2021-05-26 21:29:37'),(25574,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37174,'{\"report_id\":203,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The staff not following the policy that requires three medication checks prior to giving medications was influenced by the staff feeling comfortable and experienced with medication delivery after having worked at the facility for 6 years.  The people in the home being easy going and independent with some of their personal cares contributed to the staff feeling comfortable.  The Provider has a 2 step process for checking in meds from the pharmacy.  The first check is completed by the LPN, Program Manager, or Location Coordinator and the second check is completed by any of the aforementioned or a DSP.  The provider\\u2019s medication administration policies are influenced by 245D and outlined in the CSSP.  The provider\\u2019s policy are in place to protect the health and safety of people and to reduce errors that could result in Vulnerable Adult Maltreatment.  Medications are received in pill packs from the pharmacy and are checked two times, this further supports staff feeling comfortable when passing medications\\r\\nAnother influence to staff not completing the three medication check was that staff felt pressure to hurry to give person their morning medications. Person has a history of being inpatient to get morning medications as they then have to wait 30 minutes to eat as directed by their Physician.  The person being served has 12 morning medications that have to be recorded in the online Medication Administration Record which takes time for staff to complete. Staff was in a hurry to pass medications to avoid behaviors from person and to attend to other duties and responsibilities prior to the end of their shift.  Medication delivery is right before a shift change, so staff typically have to finish up with a number of tasks.   The home has 4 people and the people are active, interactive with staff, and need staff support which are additional influences to why the staff felt rushed.   \\r\\nAnother contributing factor to staff feeling rushed was that the home is single staffed in the mornings. Staffing patterns are impacted by the staff ratio, which is determined by the MNCHOICES assessment and Disability waiver rate system, as well as the expectation that person centered choices at the home are provided.  This allows for the work schedule to be adapted to accommodate more staffing during day shifts to allow for more outings, resulting in morning staff being limited to one, further influencing staff need to hurry to ensure all morning task were completed.  COVID-19 lead to the Governor\\u2019s executive stay at home order and Day services were then closed.  This increased the need for more staff to cover shifts at a time when staff shortage was at an all-time high.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37174}','68.53.115.247','2021-05-26 21:29:37'),(25575,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37175,'{\"report_id\":203,\"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\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37175}','68.53.115.247','2021-05-26 21:29:37'),(25576,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37176,'{\"report_id\":203,\"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\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37176}','68.53.115.247','2021-05-26 21:29:37'),(25577,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37177,'{\"report_id\":203,\"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\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37177}','68.53.115.247','2021-05-26 21:29:37'),(25578,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37178,'{\"report_id\":203,\"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\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37178}','68.53.115.247','2021-05-26 21:29:37'),(25579,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37179,'{\"report_id\":203,\"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\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37179}','68.53.115.247','2021-05-26 21:29:37'),(25580,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37180,'{\"report_id\":203,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"101\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37180}','68.53.115.247','2021-05-26 21:29:37'),(25581,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37181,'{\"report_id\":203,\"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\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37181}','68.53.115.247','2021-05-26 21:29:37'),(25582,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37182,'{\"report_id\":203,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"103\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37182}','68.53.115.247','2021-05-26 21:29:37'),(25583,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37183,'{\"report_id\":203,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"104\",\"question_type\":\"Free_Text\",\"text_answer\":\"Another contributing factor to staff feeling rushed was that the home is single staffed in the mornings. Staffing patterns are impacted by the staff ratio, which is determined by the MNCHOICES assessment and Disability waiver rate system, as well as the expectation that person centered choices at the home are provided.  This allows for the work schedule to be adapted to accommodate more staffing during day shifts to allow for more outings, resulting in morning staff being limited to one, further influencing staff need to hurry to ensure all morning task were completed.  COVID-19 lead to the Governor\\u2019s executive stay at home order and Day services were then closed.  This increased the need for more staff to cover shifts at a time when staff shortage was at an all-time high.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37183}','68.53.115.247','2021-05-26 21:29:37'),(25584,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37184,'{\"report_id\":203,\"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\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37184}','68.53.115.247','2021-05-26 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21:29:37'),(25595,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37195,'{\"report_id\":203,\"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\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37195}','68.53.115.247','2021-05-26 21:29:37'),(25596,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37196,'{\"report_id\":203,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"117\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37196}','68.53.115.247','2021-05-26 21:29:37'),(25597,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37197,'{\"report_id\":203,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"118\",\"question_type\":\"Free_Text\",\"text_answer\":\"Another influence to staff not completing the three medication check was that staff felt pressure to hurry to give person their morning medications. Person has a history of being inpatient to get morning medications as they then have to wait 30 minutes to eat as directed by their Physician.  The person being served has 12 morning medications that have to be recorded in the online Medication Administration Record which takes time for staff to complete. Staff was in a hurry to pass medications to avoid behaviors from person and to attend to other duties and responsibilities prior to the end of their shift. \\r\\nAnother contributing factor to staff feeling rushed was that the home is single staffed in the mornings\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37197}','68.53.115.247','2021-05-26 21:29:37'),(25598,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37198,'{\"report_id\":203,\"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\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37198}','68.53.115.247','2021-05-26 21:29:37'),(25599,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37199,'{\"report_id\":203,\"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\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37199}','68.53.115.247','2021-05-26 21:29:37'),(25600,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37200,'{\"report_id\":203,\"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\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37200}','68.53.115.247','2021-05-26 21:29:37'),(25601,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37201,'{\"report_id\":203,\"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\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37201}','68.53.115.247','2021-05-26 21:29:37'),(25602,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37202,'{\"report_id\":203,\"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\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37202}','68.53.115.247','2021-05-26 21:29:37'),(25603,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37203,'{\"report_id\":203,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"124\",\"question_type\":\"Free_Text\",\"text_answer\":\"The staff not following the policy that requires three medication checks prior to giving medications was influenced by the staff feeling comfortable and experienced with medication delivery after having worked at the facility for 6 years.  The people in the home being easy going and independent with some of their personal cares contributed to the staff feeling comfortable.  The Provider has a 2 step process for checking in meds from the pharmacy.  The first check is completed by the LPN, Program Manager, or Location Coordinator and the second check is completed by any of the aforementioned or a DSP.  The provider\\u2019s medication administration policies are influenced by 245D and outlined in the CSSP.  The provider\\u2019s policy are in place to protect the health and safety of people and to reduce errors that could result in Vulnerable Adult Maltreatment.  Medications are received in pill packs from the pharmacy and are checked two times, this further supports staff feeling comfortable when passing medications\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37203}','68.53.115.247','2021-05-26 21:29:37'),(25604,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37204,'{\"report_id\":203,\"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\":\"5\\/26\\/2021 4:29:37 pm\",\"created_at\":\"5\\/26\\/2021 4:29:37 pm\",\"id\":37204}','68.53.115.247','2021-05-26 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21:30:22'),(25615,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37215,'{\"report_id\":204,\"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\":\"5\\/26\\/2021 4:30:22 pm\",\"created_at\":\"5\\/26\\/2021 4:30:22 pm\",\"id\":37215}','68.53.115.247','2021-05-26 21:30:22'),(25616,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37216,'{\"report_id\":204,\"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\":\"5\\/26\\/2021 4:30:22 pm\",\"created_at\":\"5\\/26\\/2021 4:30:22 pm\",\"id\":37216}','68.53.115.247','2021-05-26 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21:30:22'),(25619,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37219,'{\"report_id\":204,\"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\":\"5\\/26\\/2021 4:30:22 pm\",\"created_at\":\"5\\/26\\/2021 4:30:22 pm\",\"id\":37219}','68.53.115.247','2021-05-26 21:30:22'),(25620,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37220,'{\"report_id\":204,\"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\":\"5\\/26\\/2021 4:30:22 pm\",\"created_at\":\"5\\/26\\/2021 4:30:22 pm\",\"id\":37220}','68.53.115.247','2021-05-26 21:30:22'),(25621,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37221,'{\"report_id\":204,\"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.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:30:22 pm\",\"created_at\":\"5\\/26\\/2021 4:30:22 pm\",\"id\":37221}','68.53.115.247','2021-05-26 21:30:22'),(25622,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37222,'{\"report_id\":204,\"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\":\"5\\/26\\/2021 4:30:22 pm\",\"created_at\":\"5\\/26\\/2021 4:30:22 pm\",\"id\":37222}','68.53.115.247','2021-05-26 21:30:22'),(25623,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37223,'{\"report_id\":204,\"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\":\"5\\/26\\/2021 4:30:22 pm\",\"created_at\":\"5\\/26\\/2021 4:30:22 pm\",\"id\":37223}','68.53.115.247','2021-05-26 21:30:22'),(25624,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37224,'{\"report_id\":204,\"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\":\"5\\/26\\/2021 4:30:22 pm\",\"created_at\":\"5\\/26\\/2021 4:30:22 pm\",\"id\":37224}','68.53.115.247','2021-05-26 21:30:22'),(25625,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37225,'{\"report_id\":204,\"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\":\"5\\/26\\/2021 4:30:22 pm\",\"created_at\":\"5\\/26\\/2021 4:30:22 pm\",\"id\":37225}','68.53.115.247','2021-05-26 21:30:22'),(25626,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37226,'{\"report_id\":204,\"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\":\"5\\/26\\/2021 4:30:22 pm\",\"created_at\":\"5\\/26\\/2021 4:30:22 pm\",\"id\":37226}','68.53.115.247','2021-05-26 21:30:22'),(25627,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37227,'{\"report_id\":204,\"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\":\"5\\/26\\/2021 4:30:22 pm\",\"created_at\":\"5\\/26\\/2021 4:30:22 pm\",\"id\":37227}','68.53.115.247','2021-05-26 21:30:22'),(25628,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37228,'{\"report_id\":204,\"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\":\"5\\/26\\/2021 4:30:22 pm\",\"created_at\":\"5\\/26\\/2021 4:30:22 pm\",\"id\":37228}','68.53.115.247','2021-05-26 21:30:22'),(25629,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37229,'{\"report_id\":204,\"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\":\"5\\/26\\/2021 4:30:22 pm\",\"created_at\":\"5\\/26\\/2021 4:30:22 pm\",\"id\":37229}','68.53.115.247','2021-05-26 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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\":\"5\\/26\\/2021 4:30:23 pm\",\"created_at\":\"5\\/26\\/2021 4:30:23 pm\",\"id\":37249}','68.53.115.247','2021-05-26 21:30:23'),(25650,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37250,'{\"report_id\":204,\"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\":\"5\\/26\\/2021 4:30:23 pm\",\"created_at\":\"5\\/26\\/2021 4:30:23 pm\",\"id\":37250}','68.53.115.247','2021-05-26 21:30:23'),(25651,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37251,'{\"report_id\":204,\"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\":\"5\\/26\\/2021 4:30:23 pm\",\"created_at\":\"5\\/26\\/2021 4:30:23 pm\",\"id\":37251}','68.53.115.247','2021-05-26 21:30:23'),(25652,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37252,'{\"report_id\":204,\"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\":\"5\\/26\\/2021 4:30:23 pm\",\"created_at\":\"5\\/26\\/2021 4:30:23 pm\",\"id\":37252}','68.53.115.247','2021-05-26 21:30:23'),(25653,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37253,'{\"report_id\":204,\"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\":\"5\\/26\\/2021 4:30:23 pm\",\"created_at\":\"5\\/26\\/2021 4:30:23 pm\",\"id\":37253}','68.53.115.247','2021-05-26 21:30:23'),(25654,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37254,'{\"report_id\":204,\"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\":\"5\\/26\\/2021 4:30:23 pm\",\"created_at\":\"5\\/26\\/2021 4:30:23 pm\",\"id\":37254}','68.53.115.247','2021-05-26 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21:31:08'),(25665,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37265,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37265}','68.53.115.247','2021-05-26 21:31:08'),(25666,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37266,'{\"report_id\":205,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37266}','68.53.115.247','2021-05-26 21:31:08'),(25667,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37267,'{\"report_id\":205,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Maplewood Homes\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37267}','68.53.115.247','2021-05-26 21:31:08'),(25668,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37268,'{\"report_id\":205,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Tabitha Snider\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37268}','68.53.115.247','2021-05-26 21:31:08'),(25669,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37269,'{\"report_id\":205,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"snider.tabatha@yahoo.com\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37269}','68.53.115.247','2021-05-26 21:31:08'),(25670,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37270,'{\"report_id\":205,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"83\",\"question_type\":\"Short_Answer\",\"text_answer\":\"218-576-6874\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37270}','68.53.115.247','2021-05-26 21:31:08'),(25671,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37271,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37271}','68.53.115.247','2021-05-26 21:31:08'),(25672,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37272,'{\"report_id\":205,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"St. Louis County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37272}','68.53.115.247','2021-05-26 21:31:08'),(25673,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37273,'{\"report_id\":205,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"08\\/13\\/2020\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37273}','68.53.115.247','2021-05-26 21:31:08'),(25674,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37274,'{\"report_id\":205,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"Termination of services is necessary for the person\'s welfare and the facility cannot meet the person\'s needs.  The safety of the person is endangered and positive support strategies were attempted and have not achieved and effectively maintained safety of the person or others.  The health of the person or others in the program would otherwise be endangered.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37274}','68.53.115.247','2021-05-26 21:31:08'),(25675,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37275,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37275}','68.53.115.247','2021-05-26 21:31:08'),(25676,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37276,'{\"report_id\":205,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Provider terminated services due to challenging behaviors\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37276}','68.53.115.247','2021-05-26 21:31:08'),(25677,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37277,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37277}','68.53.115.247','2021-05-26 21:31:08'),(25678,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37278,'{\"report_id\":205,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"11\\/30\\/2020\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37278}','68.53.115.247','2021-05-26 21:31:08'),(25679,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37279,'{\"report_id\":205,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"October 2020 Case Assignment\\r\\nMaplewood Homes\\r\\n\\r\\nLearning Point:  Person had their services terminated due to challenging behavior \\r\\n\\r\\nPerson was being served in a rural Family Foster Home setting from May until August of 2020.  Prior to admission into the family foster home, person had been residing at a crises home following service termination from another provider.  Person had a long history of verbalizing suicidal thoughts, self-harm, verbal and physical aggression.  It was reported that he enjoyed the attention he was given when he would be hospitalized, resulting in numerous attempts to become hospitalized.   It was reported that his team was not being successful in finding placement for him.  The team felt that a family foster care who could provide a one to one setting was something that had not been tried before.  Provider had no other clients at the time of initial placement.  Provider has over 20 years of experience in working with vulnerable populations.\\r\\nProvider reported a good working relationship with the person\\u2019s Guardian\\/Grandmother along with county case manager. Provider worked closely with psychologist, psychiatrist and ARMS worker.  Provider felt that the team was very supportive.  Things went well for a period of time and the person enjoyed all the attention they received.\\r\\nAs time went on, the person started to verbalize suicidal ideation to his Grandmother when talking to her on the phone.  One night he eloped following a series of texts to his Grandmother saying he wanted to kill himself.  Provider followed him and called the Sheriff who stated that they were not a \\u201ctaxi\\u201d service and would not assist.  He was taken to the Emergency Room and calmed down and was released with in a couple of hours.\\r\\nAnother client moved into the home shortly have this incident.  Person then stated he was going to burn the house down.  Provider had a volunteer at the home stay up all night to observe person as they were not sleeping.   The was again taken to the house admitted and released.   After he returned, he took a lighter and burned himself, this resulted in police being called to the home.  He calmed down once they arrived.  He started to text his Grandmother reporting that he wanted to kill himself.  Grandmother insisted that he return to the hospital.  Once at the hospital Grandmother insisted that he not return to providers home and he was admitted back to the crises home.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37279}','68.53.115.247','2021-05-26 21:31:08'),(25680,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37280,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37280}','68.53.115.247','2021-05-26 21:31:08'),(25681,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37281,'{\"report_id\":205,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The provider terminating a person\\u2019s services due to challenging behaviors was influenced by the behaviors escalating in frequency and intensity since service admission.  This was further supported by the person making multiple suicide threats, acts of self-harm by burning themselves, and threats to burn the house down.  The person did not have a history of fire starting prior to admission which further supports the intensity of his escalating behaviors.  The person seemed motivated by the attention he received from his grandmother\\/guardian and the hospital.  Person was hospitalized twice and released quickly on two occasions prior to the threat to burn the house down.  On one occasion, law enforcement responded to the providers 911 call and stated that they were not a taxi services and did not provide any mental health support.  Police in the area were overtaxed with 911 calls related to mental health and COVID calls.  In addition to that, at the time of this call, law enforcement from across the state were reporting to Minneapolis to assist with the George Floyd incident, impacting the providers view that law enforcement may not assist.  \\r\\n\\r\\nThe guardian and provider agreed that the safety of the person, others in the home, and staff could not be maintained.  This agreement was influenced by the provider attempting to remove all objects that were deemed dangerous.  Room searches were conducted regularly to remove dangerous objects. After the person returned from the hospital, they were still in possession of a lighter.  This further supported their decision that they could not prevent him from self-harm and fire starting behavior or maintain the safety and protection of all involved. \\r\\n\\r\\nProviders have a responsibility to protect the health and wellbeing of all people in the home was another influence to the service termination.  Providers responsibility for safety is directed by MnCHOICES and required by the CSSP of each person and as well as the requirement of 245D.   This was supported by the Guardian who was worried about the provider\\u2019s safety and the safety of the other person who had just recently moved into the home, resulting in the guardian refusing to allow the person to return to the home.\\r\\n\\r\\nThe person being served had several ER visits for suicidal ideation and behaviors and was not given in-patient psychiatric care. Provider and guardian had exhausted available services and felt that service termination was seen as a way to help person obtain in-patient psychiatric services.   COVID-19 Pandemic influenced hospitals to discharge quickly, due to the demand for mental health resources in the area, resulting in person being released from hospital and not receiving the psychiatric attention the team thought he needed, further impacting providers decision to terminate services\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37281}','68.53.115.247','2021-05-26 21:31:08'),(25682,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37282,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37282}','68.53.115.247','2021-05-26 21:31:08'),(25683,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37283,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37283}','68.53.115.247','2021-05-26 21:31:08'),(25684,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37284,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37284}','68.53.115.247','2021-05-26 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21:31:08'),(25687,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37287,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37287}','68.53.115.247','2021-05-26 21:31:08'),(25688,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37288,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37288}','68.53.115.247','2021-05-26 21:31:08'),(25689,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37289,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37289}','68.53.115.247','2021-05-26 21:31:08'),(25690,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37290,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37290}','68.53.115.247','2021-05-26 21:31:08'),(25691,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37291,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37291}','68.53.115.247','2021-05-26 21:31:08'),(25692,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37292,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37292}','68.53.115.247','2021-05-26 21:31:08'),(25693,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37293,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37293}','68.53.115.247','2021-05-26 21:31:08'),(25694,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37294,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37294}','68.53.115.247','2021-05-26 21:31:08'),(25695,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37295,'{\"report_id\":205,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"109\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37295}','68.53.115.247','2021-05-26 21:31:08'),(25696,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37296,'{\"report_id\":205,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"110\",\"question_type\":\"Free_Text\",\"text_answer\":\"On one occasion, law enforcement responded to the providers 911 call and stated that they were not a taxi services and did not provide any mental health support.  Police in the area were overtaxed with 911 calls related to mental health and COVID calls\\r\\n\\r\\nThe guardian and provider agreed that the safety of the person, others in the home, and staff could not be maintained.  This agreement was influenced by the provider attempting to remove all objects that were deemed dangerous.  Room searches were conducted regularly to remove dangerous objects. After the person returned from the hospital, they were still in possession of a lighter.  This further supported their decision that they could not prevent him from self-harm and fire starting behavior or maintain the safety and protection of all involved.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37296}','68.53.115.247','2021-05-26 21:31:08'),(25697,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37297,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37297}','68.53.115.247','2021-05-26 21:31:08'),(25698,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37298,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37298}','68.53.115.247','2021-05-26 21:31:08'),(25699,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37299,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37299}','68.53.115.247','2021-05-26 21:31:08'),(25700,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37300,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37300}','68.53.115.247','2021-05-26 21:31:08'),(25701,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37301,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37301}','68.53.115.247','2021-05-26 21:31:08'),(25702,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37302,'{\"report_id\":205,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"116\",\"question_type\":\"Free_Text\",\"text_answer\":\"The guardian and provider agreed that the safety of the person, others in the home, and staff could not be maintained.  This agreement was influenced by the provider attempting to remove all objects that were deemed dangerous.  Room searches were conducted regularly to remove dangerous objects. After the person returned from the hospital, they were still in possession of a lighter\\r\\n\\r\\nProviders have a responsibility to protect the health and wellbeing of all people in the home was another influence to the service termination.  Providers responsibility for safety is directed by MnCHOICES and required by the CSSP of each person and as well as the requirement of 245D.   This was supported by the Guardian who was worried about the provider\\u2019s safety and the safety of the other person who had just recently moved into the home, resulting in the guardian refusing to allow the person to return to the home.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37302}','68.53.115.247','2021-05-26 21:31:08'),(25703,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37303,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37303}','68.53.115.247','2021-05-26 21:31:08'),(25704,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37304,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37304}','68.53.115.247','2021-05-26 21:31:08'),(25705,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37305,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37305}','68.53.115.247','2021-05-26 21:31:08'),(25706,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37306,'{\"report_id\":205,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"120\",\"question_type\":\"Free_Text\",\"text_answer\":\"On one occasion, law enforcement responded to the providers 911 call and stated that they were not a taxi services and did not provide any mental health support.  Police in the area were overtaxed with 911 calls related to mental health and COVID calls.  \\r\\n\\r\\nThe person being served had several ER visits for suicidal ideation and behaviors and was not given in-patient psychiatric care. Provider and guardian had exhausted available services and felt that service termination was seen as a way to help person obtain in-patient psychiatric services.   COVID-19 Pandemic influenced hospitals to discharge quickly, due to the demand for mental health resources in the area, resulting in person being released from hospital and not receiving the psychiatric attention the team thought he needed, further impacting providers decision to terminate services\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37306}','68.53.115.247','2021-05-26 21:31:08'),(25707,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37307,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37307}','68.53.115.247','2021-05-26 21:31:08'),(25708,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37308,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37308}','68.53.115.247','2021-05-26 21:31:08'),(25709,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37309,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37309}','68.53.115.247','2021-05-26 21:31:08'),(25710,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37310,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37310}','68.53.115.247','2021-05-26 21:31:08'),(25711,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37311,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37311}','68.53.115.247','2021-05-26 21:31:08'),(25712,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37312,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37312}','68.53.115.247','2021-05-26 21:31:08'),(25713,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37313,'{\"report_id\":205,\"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\":\"5\\/26\\/2021 4:31:08 pm\",\"created_at\":\"5\\/26\\/2021 4:31:08 pm\",\"id\":37313}','68.53.115.247','2021-05-26 21:31:08'),(25714,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37314,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:15 pm\",\"created_at\":\"5\\/26\\/2021 4:36:15 pm\",\"id\":37314}','68.53.115.247','2021-05-26 21:36:15'),(25715,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37315,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:15 pm\",\"created_at\":\"5\\/26\\/2021 4:36:15 pm\",\"id\":37315}','68.53.115.247','2021-05-26 21:36:15'),(25716,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37316,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:29 pm\",\"created_at\":\"5\\/26\\/2021 4:36:29 pm\",\"id\":37316}','68.53.115.247','2021-05-26 21:36:29'),(25717,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37317,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37317}','68.53.115.247','2021-05-26 21:36:33'),(25718,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37318,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37318}','68.53.115.247','2021-05-26 21:36:33'),(25719,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37319,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37319}','68.53.115.247','2021-05-26 21:36:33'),(25720,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37320,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37320}','68.53.115.247','2021-05-26 21:36:33'),(25721,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37321,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37321}','68.53.115.247','2021-05-26 21:36:33'),(25722,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37322,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37322}','68.53.115.247','2021-05-26 21:36:33'),(25723,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37323,'{\"report_id\":206,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"507-223-4410\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37323}','68.53.115.247','2021-05-26 21:36:33'),(25724,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37324,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37324}','68.53.115.247','2021-05-26 21:36:33'),(25725,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37325,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37325}','68.53.115.247','2021-05-26 21:36:33'),(25726,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37326,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37326}','68.53.115.247','2021-05-26 21:36:33'),(25727,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37327,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37327}','68.53.115.247','2021-05-26 21:36:33'),(25728,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37328,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37328}','68.53.115.247','2021-05-26 21:36:33'),(25729,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37329,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37329}','68.53.115.247','2021-05-26 21:36:33'),(25730,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37330,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37330}','68.53.115.247','2021-05-26 21:36:33'),(25731,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37331,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37331}','68.53.115.247','2021-05-26 21:36:33'),(25732,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37332,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37332}','68.53.115.247','2021-05-26 21:36:33'),(25733,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37333,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37333}','68.53.115.247','2021-05-26 21:36:33'),(25734,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37334,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37334}','68.53.115.247','2021-05-26 21:36:33'),(25735,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37335,'{\"report_id\":206,\"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.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37335}','68.53.115.247','2021-05-26 21:36:33'),(25736,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37336,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37336}','68.53.115.247','2021-05-26 21:36:33'),(25737,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37337,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37337}','68.53.115.247','2021-05-26 21:36:33'),(25738,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37338,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37338}','68.53.115.247','2021-05-26 21:36:33'),(25739,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37339,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37339}','68.53.115.247','2021-05-26 21:36:33'),(25740,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37340,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37340}','68.53.115.247','2021-05-26 21:36:33'),(25741,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37341,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37341}','68.53.115.247','2021-05-26 21:36:33'),(25742,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37342,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37342}','68.53.115.247','2021-05-26 21:36:33'),(25743,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37343,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37343}','68.53.115.247','2021-05-26 21:36:33'),(25744,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37344,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37344}','68.53.115.247','2021-05-26 21:36:33'),(25745,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37345,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37345}','68.53.115.247','2021-05-26 21:36:33'),(25746,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37346,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37346}','68.53.115.247','2021-05-26 21:36:33'),(25747,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37347,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37347}','68.53.115.247','2021-05-26 21:36:33'),(25748,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37348,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37348}','68.53.115.247','2021-05-26 21:36:33'),(25749,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37349,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37349}','68.53.115.247','2021-05-26 21:36:33'),(25750,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37350,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37350}','68.53.115.247','2021-05-26 21:36:33'),(25751,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37351,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:33 pm\",\"created_at\":\"5\\/26\\/2021 4:36:33 pm\",\"id\":37351}','68.53.115.247','2021-05-26 21:36:33'),(25752,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37352,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:34 pm\",\"created_at\":\"5\\/26\\/2021 4:36:34 pm\",\"id\":37352}','68.53.115.247','2021-05-26 21:36:34'),(25753,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37353,'{\"report_id\":206,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"113\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:36:34 pm\",\"created_at\":\"5\\/26\\/2021 4:36:34 pm\",\"id\":37353}','68.53.115.247','2021-05-26 21:36:34'),(25754,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37354,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:34 pm\",\"created_at\":\"5\\/26\\/2021 4:36:34 pm\",\"id\":37354}','68.53.115.247','2021-05-26 21:36:34'),(25755,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37355,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:34 pm\",\"created_at\":\"5\\/26\\/2021 4:36:34 pm\",\"id\":37355}','68.53.115.247','2021-05-26 21:36:34'),(25756,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37356,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:34 pm\",\"created_at\":\"5\\/26\\/2021 4:36:34 pm\",\"id\":37356}','68.53.115.247','2021-05-26 21:36:34'),(25757,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37357,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:34 pm\",\"created_at\":\"5\\/26\\/2021 4:36:34 pm\",\"id\":37357}','68.53.115.247','2021-05-26 21:36:34'),(25758,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37358,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:34 pm\",\"created_at\":\"5\\/26\\/2021 4:36:34 pm\",\"id\":37358}','68.53.115.247','2021-05-26 21:36:34'),(25759,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37359,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:34 pm\",\"created_at\":\"5\\/26\\/2021 4:36:34 pm\",\"id\":37359}','68.53.115.247','2021-05-26 21:36:34'),(25760,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37360,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:34 pm\",\"created_at\":\"5\\/26\\/2021 4:36:34 pm\",\"id\":37360}','68.53.115.247','2021-05-26 21:36:34'),(25761,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37361,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:34 pm\",\"created_at\":\"5\\/26\\/2021 4:36:34 pm\",\"id\":37361}','68.53.115.247','2021-05-26 21:36:34'),(25762,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37362,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:34 pm\",\"created_at\":\"5\\/26\\/2021 4:36:34 pm\",\"id\":37362}','68.53.115.247','2021-05-26 21:36:34'),(25763,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37363,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:34 pm\",\"created_at\":\"5\\/26\\/2021 4:36:34 pm\",\"id\":37363}','68.53.115.247','2021-05-26 21:36:34'),(25764,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37364,'{\"report_id\":206,\"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. 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\":\"5\\/26\\/2021 4:36:34 pm\",\"created_at\":\"5\\/26\\/2021 4:36:34 pm\",\"id\":37364}','68.53.115.247','2021-05-26 21:36:34'),(25765,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37365,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:34 pm\",\"created_at\":\"5\\/26\\/2021 4:36:34 pm\",\"id\":37365}','68.53.115.247','2021-05-26 21:36:34'),(25766,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37366,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:34 pm\",\"created_at\":\"5\\/26\\/2021 4:36:34 pm\",\"id\":37366}','68.53.115.247','2021-05-26 21:36:34'),(25767,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37367,'{\"report_id\":206,\"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\":\"5\\/26\\/2021 4:36:34 pm\",\"created_at\":\"5\\/26\\/2021 4:36:34 pm\",\"id\":37367}','68.53.115.247','2021-05-26 21:36:34'),(25768,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37368,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:36:56 pm\",\"created_at\":\"5\\/26\\/2021 4:36:56 pm\",\"id\":37368}','68.53.115.247','2021-05-26 21:36:56'),(25769,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37369,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:04 pm\",\"created_at\":\"5\\/26\\/2021 4:37:04 pm\",\"id\":37369}','68.53.115.247','2021-05-26 21:37:04'),(25770,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37370,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:04 pm\",\"created_at\":\"5\\/26\\/2021 4:37:04 pm\",\"id\":37370}','68.53.115.247','2021-05-26 21:37:04'),(25771,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37371,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:04 pm\",\"created_at\":\"5\\/26\\/2021 4:37:04 pm\",\"id\":37371}','68.53.115.247','2021-05-26 21:37:04'),(25772,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37372,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:04 pm\",\"created_at\":\"5\\/26\\/2021 4:37:04 pm\",\"id\":37372}','68.53.115.247','2021-05-26 21:37:04'),(25773,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37373,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:04 pm\",\"created_at\":\"5\\/26\\/2021 4:37:04 pm\",\"id\":37373}','68.53.115.247','2021-05-26 21:37:04'),(25774,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37374,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:04 pm\",\"created_at\":\"5\\/26\\/2021 4:37:04 pm\",\"id\":37374}','68.53.115.247','2021-05-26 21:37:04'),(25775,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37375,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:04 pm\",\"created_at\":\"5\\/26\\/2021 4:37:04 pm\",\"id\":37375}','68.53.115.247','2021-05-26 21:37:04'),(25776,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37376,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:04 pm\",\"created_at\":\"5\\/26\\/2021 4:37:04 pm\",\"id\":37376}','68.53.115.247','2021-05-26 21:37:04'),(25777,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37377,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:04 pm\",\"created_at\":\"5\\/26\\/2021 4:37:04 pm\",\"id\":37377}','68.53.115.247','2021-05-26 21:37:04'),(25778,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37378,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:04 pm\",\"created_at\":\"5\\/26\\/2021 4:37:04 pm\",\"id\":37378}','68.53.115.247','2021-05-26 21:37:04'),(25779,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37379,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:04 pm\",\"created_at\":\"5\\/26\\/2021 4:37:04 pm\",\"id\":37379}','68.53.115.247','2021-05-26 21:37:04'),(25780,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37380,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:04 pm\",\"created_at\":\"5\\/26\\/2021 4:37:04 pm\",\"id\":37380}','68.53.115.247','2021-05-26 21:37:04'),(25781,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37381,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:04 pm\",\"created_at\":\"5\\/26\\/2021 4:37:04 pm\",\"id\":37381}','68.53.115.247','2021-05-26 21:37:04'),(25782,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37382,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:04 pm\",\"created_at\":\"5\\/26\\/2021 4:37:04 pm\",\"id\":37382}','68.53.115.247','2021-05-26 21:37:05'),(25783,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37383,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37383}','68.53.115.247','2021-05-26 21:37:05'),(25784,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37384,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37384}','68.53.115.247','2021-05-26 21:37:05'),(25785,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37385,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37385}','68.53.115.247','2021-05-26 21:37:05'),(25786,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37386,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37386}','68.53.115.247','2021-05-26 21:37:05'),(25787,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37387,'{\"report_id\":207,\"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   \\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.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37387}','68.53.115.247','2021-05-26 21:37:05'),(25788,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37388,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37388}','68.53.115.247','2021-05-26 21:37:05'),(25789,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37389,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37389}','68.53.115.247','2021-05-26 21:37:05'),(25790,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37390,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37390}','68.53.115.247','2021-05-26 21:37:05'),(25791,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37391,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37391}','68.53.115.247','2021-05-26 21:37:05'),(25792,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37392,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37392}','68.53.115.247','2021-05-26 21:37:05'),(25793,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37393,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37393}','68.53.115.247','2021-05-26 21:37:05'),(25794,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37394,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37394}','68.53.115.247','2021-05-26 21:37:05'),(25795,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37395,'{\"report_id\":207,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"103\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37395}','68.53.115.247','2021-05-26 21:37:05'),(25796,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37396,'{\"report_id\":207,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"104\",\"question_type\":\"Free_Text\",\"text_answer\":\"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. \\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\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37396}','68.53.115.247','2021-05-26 21:37:05'),(25797,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37397,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37397}','68.53.115.247','2021-05-26 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21:37:05'),(25808,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37408,'{\"report_id\":207,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"116\",\"question_type\":\"Free_Text\",\"text_answer\":\"All 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.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37408}','68.53.115.247','2021-05-26 21:37:05'),(25809,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37409,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37409}','68.53.115.247','2021-05-26 21:37:05'),(25810,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37410,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37410}','68.53.115.247','2021-05-26 21:37:05'),(25811,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37411,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37411}','68.53.115.247','2021-05-26 21:37:05'),(25812,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37412,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37412}','68.53.115.247','2021-05-26 21:37:05'),(25813,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37413,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37413}','68.53.115.247','2021-05-26 21:37:05'),(25814,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37414,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:05 pm\",\"created_at\":\"5\\/26\\/2021 4:37:05 pm\",\"id\":37414}','68.53.115.247','2021-05-26 21:37:06'),(25815,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37415,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:06 pm\",\"created_at\":\"5\\/26\\/2021 4:37:06 pm\",\"id\":37415}','68.53.115.247','2021-05-26 21:37:06'),(25816,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37416,'{\"report_id\":207,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"124\",\"question_type\":\"Free_Text\",\"text_answer\":\"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.\\r\\n\\r\\nIt was common knowledge among staff that the clients demonstrated low needs, contributing to the staff feeing comfortable to lie down.  An additional influence in staff falling asleep is that the staff laid down to try out a newly purchased weighted blanket\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:37:06 pm\",\"created_at\":\"5\\/26\\/2021 4:37:06 pm\",\"id\":37416}','68.53.115.247','2021-05-26 21:37:06'),(25817,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37417,'{\"report_id\":207,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"125\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:37:06 pm\",\"created_at\":\"5\\/26\\/2021 4:37:06 pm\",\"id\":37417}','68.53.115.247','2021-05-26 21:37:06'),(25818,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37418,'{\"report_id\":207,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"126\",\"question_type\":\"Free_Text\",\"text_answer\":\"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\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:37:06 pm\",\"created_at\":\"5\\/26\\/2021 4:37:06 pm\",\"id\":37418}','68.53.115.247','2021-05-26 21:37:06'),(25819,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37419,'{\"report_id\":207,\"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\":\"5\\/26\\/2021 4:37:06 pm\",\"created_at\":\"5\\/26\\/2021 4:37:06 pm\",\"id\":37419}','68.53.115.247','2021-05-26 21:37:06'),(25820,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37420,'{\"report_id\":208,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"10\\/19\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:37:37 pm\",\"created_at\":\"5\\/26\\/2021 4:37:37 pm\",\"id\":37420}','68.53.115.247','2021-05-26 21:37:37'),(25821,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37421,'{\"report_id\":208,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"201907799\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37421}','68.53.115.247','2021-05-26 21:37:45'),(25822,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37422,'{\"report_id\":208,\"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\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37422}','68.53.115.247','2021-05-26 21:37:45'),(25823,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37423,'{\"report_id\":208,\"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\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37423}','68.53.115.247','2021-05-26 21:37:45'),(25824,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37424,'{\"report_id\":208,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37424}','68.53.115.247','2021-05-26 21:37:45'),(25825,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37425,'{\"report_id\":208,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"REM Heartland, Inc. - Cougar Drive\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37425}','68.53.115.247','2021-05-26 21:37:45'),(25826,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37426,'{\"report_id\":208,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37426}','68.53.115.247','2021-05-26 21:37:45'),(25827,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37427,'{\"report_id\":208,\"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\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37427}','68.53.115.247','2021-05-26 21:37:45'),(25828,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37428,'{\"report_id\":208,\"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\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37428}','68.53.115.247','2021-05-26 21:37:45'),(25829,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37429,'{\"report_id\":208,\"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\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37429}','68.53.115.247','2021-05-26 21:37:45'),(25830,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37430,'{\"report_id\":208,\"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\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37430}','68.53.115.247','2021-05-26 21:37:45'),(25831,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37431,'{\"report_id\":208,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"10\\/19\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37431}','68.53.115.247','2021-05-26 21:37:45'),(25832,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37432,'{\"report_id\":208,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"The individual was setting up her medication for the week on Tuesday 10\\/15\\/19. The individual stated that she\\r\\ntook the bottle of pills from the box of medication that staff left unattended. Individual stated on 10\\/20\\/19 that she took 30 pills on 10\\/17\\/19\\r\\nand took 19 pills on 10\\/19\\/19. The medication was Hydroxyzine 25mg capsules. The individual did not have any apparent side effects from\\r\\ntaking the medications.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37432}','68.53.115.247','2021-05-26 21:37:45'),(25833,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37433,'{\"report_id\":208,\"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\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37433}','68.53.115.247','2021-05-26 21:37:45'),(25834,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37434,'{\"report_id\":208,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Staff left person unsupervised duirng medication setup\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37434}','68.53.115.247','2021-05-26 21:37:45'),(25835,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37435,'{\"report_id\":208,\"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\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37435}','68.53.115.247','2021-05-26 21:37:45'),(25836,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37436,'{\"report_id\":208,\"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\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37436}','68.53.115.247','2021-05-26 21:37:45'),(25837,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37437,'{\"report_id\":208,\"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\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37437}','68.53.115.247','2021-05-26 21:37:45'),(25838,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37438,'{\"report_id\":208,\"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\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37438}','68.53.115.247','2021-05-26 21:37:45'),(25839,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37439,'{\"report_id\":208,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"Person was left unsupervised during medication set up was influenced by DSP perception that the people who are their own guardians can direct their own services.  Person was their own guardian. Also contributing to the staff\\u2019s perception is the training they receive on person center planning which is a requirement of 245D.  The training offered to staff is impacted by the funding that is allowed in the Disability Waiver Rate Setting Tool, which doesn\\u2019t always capture the training staff may need to support a person with mental health issues. \\r\\n Also influencing the staff to leave someone unsupervised that there were 4 people in the home and the time of the day at the home was busy.  Staff are responsible for ensuring the safety of all people in the home which is a requirement by the CSSP of each person as well as the requirements of 245D. \\r\\nFurther impacting staff leaving the person unsupervised during medication setup is that staff at the home would often prioritize the needs of the other 3 people in the home due to their higher and lower autonomy.  . The moratorium decreased the number of beds available and created a bed shortage.\\r\\nThe final influence as to why the staff left the person unsupervised was the staff was comfortable leaving the person alone.  The person was high functioning and their own guardian.  Person being served had no history of abusing medications while residing in the home and no history of issues during medication set up influencing staff to have a trusting relationship with the person further impacting the staff being comfortable leaving the person unsupervised during medication set up.  The person had chosen to set up their medications independently with supervision.  The provider was assigned responsibility for medication set up with supervision by the case manager and agreed to by the person.  The mental health professionals involved did agree that there was a need for medication set up assistance, influencing why the provider was assigned medication set up responsibilities. The person\\u2019s MnCHOICES assessment did identify a need for medication responsibilities, which in turn was impacted by the levels of medication responsibilities identified in 245D.  The case manager\\u2019s awareness of the person\\u2019s history, which included a previous suicide attempt, further impacted the case manager assigning the provider medication set up assistance responsibility.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37439}','68.53.115.247','2021-05-26 21:37:45'),(25840,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37440,'{\"report_id\":208,\"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\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37440}','68.53.115.247','2021-05-26 21:37:45'),(25841,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37441,'{\"report_id\":208,\"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\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37441}','68.53.115.247','2021-05-26 21:37:45'),(25842,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37442,'{\"report_id\":208,\"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\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37442}','68.53.115.247','2021-05-26 21:37:45'),(25843,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37443,'{\"report_id\":208,\"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\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37443}','68.53.115.247','2021-05-26 21:37:45'),(25844,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37444,'{\"report_id\":208,\"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\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37444}','68.53.115.247','2021-05-26 21:37:45'),(25845,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37445,'{\"report_id\":208,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"101\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37445}','68.53.115.247','2021-05-26 21:37:45'),(25846,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37446,'{\"report_id\":208,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":\"Person was left unsupervised during medication set up was influenced by DSP perception that the people who are their own guardians can direct their own services\\r\\n Person being served had no history of abusing medications while residing in the home and no history of issues during medication set up influencing staff to have a trusting relationship with the person further impacting the staff being comfortable leaving the person unsupervised during medication set up.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37446}','68.53.115.247','2021-05-26 21:37:45'),(25847,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37447,'{\"report_id\":208,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"103\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37447}','68.53.115.247','2021-05-26 21:37:45'),(25848,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37448,'{\"report_id\":208,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"104\",\"question_type\":\"Free_Text\",\"text_answer\":\"The training offered to staff is impacted by the funding that is allowed in the Disability Waiver Rate Setting Tool, which doesn\\u2019t always capture the training staff may need to support a person with mental health issues.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37448}','68.53.115.247','2021-05-26 21:37:45'),(25849,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37449,'{\"report_id\":208,\"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\":\"5\\/26\\/2021 4:37:45 pm\",\"created_at\":\"5\\/26\\/2021 4:37:45 pm\",\"id\":37449}','68.53.115.247','2021-05-26 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21:38:32'),(25880,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37480,'{\"report_id\":209,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Toni Martindale\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37480}','68.53.115.247','2021-05-26 21:38:32'),(25881,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37481,'{\"report_id\":209,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"toni.martindale@brsduluth.com\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37481}','68.53.115.247','2021-05-26 21:38:32'),(25882,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37482,'{\"report_id\":209,\"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\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37482}','68.53.115.247','2021-05-26 21:38:32'),(25883,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37483,'{\"report_id\":209,\"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\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37483}','68.53.115.247','2021-05-26 21:38:32'),(25884,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37484,'{\"report_id\":209,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"St. Louis County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37484}','68.53.115.247','2021-05-26 21:38:32'),(25885,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37485,'{\"report_id\":209,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"08\\/13\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37485}','68.53.115.247','2021-05-26 21:38:32'),(25886,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37486,'{\"report_id\":209,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"Alix passed medications for the night to Rodney and the other residents. She had passed the meds to JT\\r\\n(resident) and she had to bring Rodney\'s upstairs to him because he says he has difficulty coming down the stairs. After giving Rodney\\r\\nhis medications JT came to her and told her that what she gave her was not her medications (250 mg of Clozapine). By the time Alix got to\\r\\nRodney he had already ingested the incorrect medications. She immediately called poison control and was referred to bring him to the\\r\\nER. The overnight staff arrived as the ambulance was getting there. Rodney was admitted for observation and intubated due to trouble\\r\\nbreathing and was released on 8\\/15\\/19 and is doing fine.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37486}','68.53.115.247','2021-05-26 21:38:32'),(25887,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37487,'{\"report_id\":209,\"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\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37487}','68.53.115.247','2021-05-26 21:38:32'),(25888,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37488,'{\"report_id\":209,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Staff administered the wrong medications to two individuals.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37488}','68.53.115.247','2021-05-26 21:38:32'),(25889,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37489,'{\"report_id\":209,\"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\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37489}','68.53.115.247','2021-05-26 21:38:32'),(25890,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37490,'{\"report_id\":209,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"10\\/22\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37490}','68.53.115.247','2021-05-26 21:38:32'),(25891,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37491,'{\"report_id\":209,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"The staff member has worked at the agency since February 2019 and is experienced working in similar settings. \\r\\n\\r\\nThe night of the incident, the staff member was working with the house manager earlier in the day, but believed it was around 4:30-5:00 p.m. when she started working alone, which is not uncommon for the house. She prepared dinner and typically waits until approximately 6:30 to begin clean up as one individual living in the home takes longer to finish eating. This evening, she recalled being behind in the cleaning and at 7:30, individuals requested their medications.\\r\\n\\r\\nThere is a medication procedure in the home, which the staff member explained that they are to use hand sanitizer, check medications and MARS, she places a dot next to the medication signifying that it was given, removes medications from med box and places in cup. Once given to the individual, the staff returns to the MARS and signs where the dot was left previously. When further asked about this, the staff member explained that the MARS shouldn\\u2019t be signed until after you ensure that the individual took their medication in case of refusals. When asked about whether or not this is done all at once for everyone or individually, she stated it should be done with each person; however, she has done this combined. She explained that she felt this was okay because she has seen other people do it and normally she is very attentive. \\r\\n\\r\\nThe staff member explained that this night she was in a rush because she was behind in cleaning and knew she was due to be done soon. She did the medications as she normally does, reviewing them, dotting the medications, and putting them into the cups. She stacks the cups based on the order she distributes them. She brings Individual 1\\u2019s first since she is on the first floor. She brought the cup to individual 1 who was relaxing in her room. The staff member then went upstairs to bring Individual 2 his medications. She had to wake him up to give him his medications so she did recall that he did not look in the cup that she handed him and just took his medications. It was at this time that Individual 1 came up to the staff member and told her that these were the wrong medications. The staff member realized then that she switched up the two medication cups having given Individual 2, Individual 1\\u2019s medications.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37491}','68.53.115.247','2021-05-26 21:38:32'),(25892,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37492,'{\"report_id\":209,\"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\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37492}','68.53.115.247','2021-05-26 21:38:32'),(25893,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37493,'{\"report_id\":209,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The staff administering the wrong medications to two individuals was impacted by the staff member feeling rushed. It was towards the end of the shift and staff was behind in cleanup. The way the staff member manages the time and tasks such as when to begin cleaning and the time to dispense medications of the shift contributed to her being behind and feeling rushed as she waited until the end of the shift to complete many of her duties.  Another factor contributing to feeling rushed was when an individual approached the staff asking for his\\/her medications. The staff prioritized the medication administration over her other duties to which she was attending to accommodate the request. When the individual asked for their medications this impacted how staff chose to manage their time and tasks. The staff\'s being rushed influenced their decision not to follow the medication protocol having observed other staff members distribute all medications at one time for the residents. The staff member distributed all four medications at once and did not ask the individuals to verify the medications given. Both of these areas influenced the staff administering the wrong medications to the two individuals. The managing of time and tasks is influenced by the medication protocol and the houses having different schedules. The different schedules are impacted by the staff ratio, which is derived from the 6790 and the CSSP, as well as the expectation that there is person centered choice within the home. This choice allows for the schedule of the home to be more fluid adapting for the individuals that live in the home. Person Centered Choice is impacted by 245D licensing and the Home and Community Based Services (HCBS). \\r\\nAn additional factor in administering the wrong medication was that the staff feeling pressured to complete all her duties before the end of the shift, which contributed to the staff feeling rushed. Staff felt pressure because they were previously written up due to not meeting shift responsibilities\\/tasks. The provider\\u2019s expectations of staff impacted both the house responsibilities that each staff member must complete and writing up staff who don\'t follow through on their responsibilities. These house responsibilities influenced the staff feeling rushed. The provider\'s house responsibilities and staff expectations were influenced by the Community Services and Support Plan (CSSP). The CSSP is impacted by 245D licensing and the 6790 that identifies how staffing should be conducted.\\r\\n\\r\\n\\r\\nThe medication protocol was another influence of how the staff chose to manage the time and tasks. The protocol outlines the time frame that medications can be given and the procedure in distributing the medications. The medication protocol has a reciprocal impact with the medication protocol training. It is also impacted by the pharmacy consultation and sign off, 245D licensing and liability that exists for the provider. Medication administration errors can result in licensing violations, maltreatment investigations and even civil lawsuits. This Liability results in the provider creating medication protocols implementing a number of safeguards to reduce the likelihood of committing a med error, but those safeguards also increase the complexity of administering medications. This complexity can increase the amount of time it takes to administer medications, so when staff are rushed they are likely to weight efficiency over thoroughness.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37493}','68.53.115.247','2021-05-26 21:38:32'),(25894,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37494,'{\"report_id\":209,\"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\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37494}','68.53.115.247','2021-05-26 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21:38:32'),(25909,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37509,'{\"report_id\":209,\"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\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37509}','68.53.115.247','2021-05-26 21:38:32'),(25910,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37510,'{\"report_id\":209,\"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\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37510}','68.53.115.247','2021-05-26 21:38:32'),(25911,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37511,'{\"report_id\":209,\"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\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37511}','68.53.115.247','2021-05-26 21:38:32'),(25912,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37512,'{\"report_id\":209,\"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\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37512}','68.53.115.247','2021-05-26 21:38:32'),(25913,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37513,'{\"report_id\":209,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"115\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37513}','68.53.115.247','2021-05-26 21:38:32'),(25914,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37514,'{\"report_id\":209,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"116\",\"question_type\":\"Free_Text\",\"text_answer\":\"This Liability results in the provider creating medication protocols implementing a number of safeguards to reduce the likelihood of committing a med error, but those safeguards also increase the complexity of administering medications. This complexity can increase the amount of time it takes to administer medications, so when staff are rushed they are likely to weight efficiency over thoroughness. The different schedules are impacted by the staff ratio, which is derived from the 6790 and the CSSP, as well as the expectation that there is person centered choice within the home.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37514}','68.53.115.247','2021-05-26 21:38:32'),(25915,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37515,'{\"report_id\":209,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"117\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37515}','68.53.115.247','2021-05-26 21:38:32'),(25916,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37516,'{\"report_id\":209,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"118\",\"question_type\":\"Free_Text\",\"text_answer\":\"The staff administering the wrong medications to two individuals was impacted by the staff member feeling rushed. It was towards the end of the shift and staff was behind in cleanup. The way the staff member manages the time and tasks such as when to begin cleaning and the time to dispense medications of the shift contributed to her being behind and feeling rushed as she waited until the end of the shift to complete many of her duties.  Another factor contributing to feeling rushed was when an individual approached the staff asking for his\\/her medications. The staff prioritized the medication administration over her other duties to which she was attending to accommodate the request. When the individual asked for their medications this impacted how staff chose to manage their time and tasks.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37516}','68.53.115.247','2021-05-26 21:38:32'),(25917,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37517,'{\"report_id\":209,\"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\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37517}','68.53.115.247','2021-05-26 21:38:32'),(25918,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37518,'{\"report_id\":209,\"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\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37518}','68.53.115.247','2021-05-26 21:38:32'),(25919,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37519,'{\"report_id\":209,\"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\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37519}','68.53.115.247','2021-05-26 21:38:32'),(25920,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37520,'{\"report_id\":209,\"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\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37520}','68.53.115.247','2021-05-26 21:38:32'),(25921,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37521,'{\"report_id\":209,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"123\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37521}','68.53.115.247','2021-05-26 21:38:32'),(25922,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37522,'{\"report_id\":209,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"124\",\"question_type\":\"Free_Text\",\"text_answer\":\"This choice allows for the schedule of the home to be more fluid adapting for the individuals that live in the home. Person Centered Choice is impacted by 245D licensing and the Home and Community Based Services (HCBS).\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37522}','68.53.115.247','2021-05-26 21:38:32'),(25923,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37523,'{\"report_id\":209,\"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\":\"5\\/26\\/2021 4:38:32 pm\",\"created_at\":\"5\\/26\\/2021 4:38:32 pm\",\"id\":37523}','68.53.115.247','2021-05-26 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21:40:01'),(25991,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37591,'{\"report_id\":211,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"06\\/16\\/2020\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:40:01 pm\",\"created_at\":\"5\\/26\\/2021 4:40:01 pm\",\"id\":37591}','68.53.115.247','2021-05-26 21:40:01'),(25992,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37592,'{\"report_id\":211,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"Kira was training in staff to the Springvale Program. Staff reported that Kira told her that there isn\'t anything that\\r\\nneeds to be done on overnights and that she sleeps. She then took her blanket into the tv room and slept the overnight shift leaving\\r\\nsomeone untrained along with 3 individuals.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:40:01 pm\",\"created_at\":\"5\\/26\\/2021 4:40:01 pm\",\"id\":37592}','68.53.115.247','2021-05-26 21:40:01'),(25993,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37593,'{\"report_id\":211,\"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\":\"5\\/26\\/2021 4:40:01 pm\",\"created_at\":\"5\\/26\\/2021 4:40:01 pm\",\"id\":37593}','68.53.115.247','2021-05-26 21:40:01'),(25994,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37594,'{\"report_id\":211,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Staff was asleep during overnight awake shift\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:40:01 pm\",\"created_at\":\"5\\/26\\/2021 4:40:01 pm\",\"id\":37594}','68.53.115.247','2021-05-26 21:40:01'),(25995,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37595,'{\"report_id\":211,\"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\":\"5\\/26\\/2021 4:40:01 pm\",\"created_at\":\"5\\/26\\/2021 4:40:01 pm\",\"id\":37595}','68.53.115.247','2021-05-26 21:40:01'),(25996,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37596,'{\"report_id\":211,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"09\\/18\\/2020\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:40:01 pm\",\"created_at\":\"5\\/26\\/2021 4:40:01 pm\",\"id\":37596}','68.53.115.247','2021-05-26 21:40:01'),(25997,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37597,'{\"report_id\":211,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"REM Springvale is an adult foster home that has four ladies who reside there. The women in the home consists of one with sever autism who requires frequent cares, one who tends to remain in her room for much of the day and two women who are in wheelchairs and require assistance for transfers. The home is typically staffed with at least two staff members during awake times to accommodate these transfer assists but may also have three staff members working during the busier times to support functions and appointments. Overnight is typically staffed with one awake staff since the one resident will tend to get up every few hours throughout the night. \\r\\n\\r\\n\\r\\nThis was a fairly new job for the staff member, explaining she had previously worked in a nursing facility and came to this position approximately two months prior to the incident. The hours she worked were overnight shifts, 4 on and 10 off. The hours tended up to either 11 or 12 hour days depending on whether it was a weekend or weekday. The day of the incident, she believed this to be her second or third day of the 4 days she\\u2019d work in a row. The night prior she had another person during the entire overnight shift with her. This was not normal since she started working and she stated she believed they may have done this out of concern that she wouldn\\u2019t show up. The night of the incident, she came in at 9:00 p.m. for her shift and realized that she would be cross-training another staff member for the overnight shift. She wasn\\u2019t aware of this and recalled being \\u201cthrown off\\u201d by this as she still saw herself as a fairly new person to the agency. She decided that she would have the training staff shadow her as she went through and explained what she was doing and why she was doing it. She explained on a typical night shift she would start putting the ladies to bed once she arrived. She would clean the house but often times would spread this out throughout the night. She would take care of any \\u201ccares\\u201d that the residents required such as going to the bathroom. During the breaks in between cleaning, she would sit in the living room and watch tv. She explained she always brought a blanket as the house would get cold and she would use this while sitting in the living room.\\r\\n\\r\\nThe staff explained during that night she had a headache. She stated she was talking throughout the night with the staff who was training and mentioned having a headache. Around 3:30 in the morning, she decided to go into the other room where she could sit back and close her eyes. She states she realizes now that she could have been more direct in communicating that she was going to \\u201cclose her eyes\\u201d, but at the time didn\\u2019t think to. She further explained thinking, \\u201cthere\\u2019s another person here, I\\u2019m just going to close my eyes.\\u201d When she got up, she realized she dosed off for approximately 15-20 minutes. She then mentioned to the trainee that she had just dosed off and then resumed work. She stated there was no other discussion on this as the work continued into the morning.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:40:01 pm\",\"created_at\":\"5\\/26\\/2021 4:40:01 pm\",\"id\":37597}','68.53.115.247','2021-05-26 21:40:01'),(25998,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37598,'{\"report_id\":211,\"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\":\"5\\/26\\/2021 4:40:01 pm\",\"created_at\":\"5\\/26\\/2021 4:40:01 pm\",\"id\":37598}','68.53.115.247','2021-05-26 21:40:01'),(25999,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37599,'{\"report_id\":211,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"Staff sleeping during an overnight awake shift was impacted by the staff member laying down. Staff lying down was directly influenced by the staff member having a headache and that there was another awake staff present. The other awake staff present was due to a second staff member being scheduled for the shift. The second staff member being present was impacted by the provider lining up a second staff in case the first staff member couldn\\u2019t work. The lining up a second staff member was influenced due to the concern by the provider that the staff was potentially unable to make it to work. The staff member was having issues with their driver\\u2019s license and there was concern that this may have prevented them from working. A valid picture ID is required for employment. \\r\\n\\r\\nWhen staff laid down, this created a situation where the conditions were conducive for sleeping. Having the conditions conducive for sleeping was established by a multitude of influences such as there was another awake staff present (thus the people in the home\\u2019s supervision requirements were met), the house was quiet (all residents were asleep), the staff member laid down, and the staff member covered themself with a blanket. The staff member regularly brought a blanket to use when taking breaks due to the house being cold at night. The house being quiet and the home having natural downtime built into the night shift had a reciprocal effect on one another. Having the extra staff on shift impacted the natural downtime at the home since no major cares were needed during that time. One resident would wake up every couple of hours that did end up requiring some engagement by staff to redirect them back to bed. This need directly impacts the need for the provider to require an awake staff at night and this being calculated into the rate of care for that client through the 6790 process which sets the rate based on individual cares for the persons living in the home. 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The second staff member being present was impacted by the provider lining up a second staff in case the first staff member couldn\\u2019t work. The lining up a second staff member was influenced due to the concern by the provider that the staff was potentially unable to make it to work. Having the extra staff on shift impacted the natural downtime at the home since no major cares were needed during that time.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:40:01 pm\",\"created_at\":\"5\\/26\\/2021 4:40:01 pm\",\"id\":37614}','68.53.115.247','2021-05-26 21:40:01'),(26015,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37615,'{\"report_id\":211,\"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\":\"5\\/26\\/2021 4:40:01 pm\",\"created_at\":\"5\\/26\\/2021 4:40:01 pm\",\"id\":37615}','68.53.115.247','2021-05-26 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21:44:24'),(26042,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37642,'{\"report_id\":212,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"sheila.fetters@residentialservices.org\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:44:24 pm\",\"created_at\":\"5\\/26\\/2021 4:44:24 pm\",\"id\":37642}','68.53.115.247','2021-05-26 21:44:24'),(26043,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37643,'{\"report_id\":212,\"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\":\"5\\/26\\/2021 4:44:24 pm\",\"created_at\":\"5\\/26\\/2021 4:44:24 pm\",\"id\":37643}','68.53.115.247','2021-05-26 21:44:24'),(26044,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37644,'{\"report_id\":212,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"84\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Wheelchair Safety\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:44:24 pm\",\"created_at\":\"5\\/26\\/2021 4:44:24 pm\",\"id\":37644}','68.53.115.247','2021-05-26 21:44:24'),(26045,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37645,'{\"report_id\":212,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"St. Louis County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:44:24 pm\",\"created_at\":\"5\\/26\\/2021 4:44:24 pm\",\"id\":37645}','68.53.115.247','2021-05-26 21:44:24'),(26046,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37646,'{\"report_id\":212,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"06\\/10\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:44:24 pm\",\"created_at\":\"5\\/26\\/2021 4:44:24 pm\",\"id\":37646}','68.53.115.247','2021-05-26 21:44:24'),(26047,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37647,'{\"report_id\":212,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"Staff was transporting supported person to an appointment. She had secured the wheelchair to the four point restraints. This was a standard wheelchair and the supported person does not use a lap belt due to being able to transfer. While driving, the staff report that Denise fell out of the wheelchair and fell onto the floor of the van. Other staff came to assist and noticed the seat belt in the van was not being used. Staff later clarified that she didn\\u2019t have the lap belt on correctly and that it was down around the individual\\u2019s ankles at the time of the fall.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:44:24 pm\",\"created_at\":\"5\\/26\\/2021 4:44:24 pm\",\"id\":37647}','68.53.115.247','2021-05-26 21:44:24'),(26048,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37648,'{\"report_id\":212,\"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\":\"5\\/26\\/2021 4:44:24 pm\",\"created_at\":\"5\\/26\\/2021 4:44:24 pm\",\"id\":37648}','68.53.115.247','2021-05-26 21:44:24'),(26049,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37649,'{\"report_id\":212,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Staff was not able to secure seat belt at waist.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:44:24 pm\",\"created_at\":\"5\\/26\\/2021 4:44:24 pm\",\"id\":37649}','68.53.115.247','2021-05-26 21:44:24'),(26050,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37650,'{\"report_id\":212,\"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\":\"5\\/26\\/2021 4:44:24 pm\",\"created_at\":\"5\\/26\\/2021 4:44:24 pm\",\"id\":37650}','68.53.115.247','2021-05-26 21:44:24'),(26051,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37651,'{\"report_id\":212,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"08\\/23\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:44:24 pm\",\"created_at\":\"5\\/26\\/2021 4:44:24 pm\",\"id\":37651}','68.53.115.247','2021-05-26 21:44:24'),(26052,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37652,'{\"report_id\":212,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"Staff has worked at the agency for approximately one year. She reported having some past experience in nursing home settings, which allowed her to feel comfortable working in a \\u201cmedical home\\u201d. The medical home was described as having individuals who were higher medical needs than some other homes. She reported that some staff members would come into the home and leave, not understanding the level of work that was done in the home. \\r\\n\\r\\nAt the time of the incident, the home was staffed with three staff members. This was recently increased as they admitted their fourth resident in the home a week to two weeks prior of the incident. She described that the individual involved in the incident was verbal, but had some limitations with speaking. She used a wheelchair, but staff described this as a hospital\\/standard wheelchair with no lap belt.\\r\\n\\r\\nThe day of the incident, the staff was bringing the individual to get labs drawn at the local clinic. However, once she got to the clinic, unloaded the wheelchair and went in; it was discovered that staff were at the wrong clinic. At this time the individual begun yelling and screaming in the wait area. Staff identified feeling increased anxiety as others were looking at them. She attempted to speak with the individual to calm her, but this did not help. She stated feeling \\u201cthe crunch\\u201d at the time because she knew how important it is to get the individuals to appointments when they have them. She proceeded to load the individual in the van. She placed the wheelchair in the harnesses and was attempting to place the seat belt on. The staff identified difficulties with the seat belt, stating it was difficult to pull. [It wasn\\u2019t until further conversation with the supervisors following the debriefing that the seat belt was explained to be an airplane style seat belt that latched in front and would be pulled to tighten.] During this time, the staff stated that the individual was leaning forward and would not sit up properly. She believes the individual was able to scoot down out of her wheelchair and fell out. She stated the seat belt was at the ankles of the individual when they had fallen. Once she realized what happened, she pulled into a nearby parking lot and attempted to lift her; however, when that was unsuccessful, she called the house staff and explained what happened. They sent an employee over to assist with transferring the individual into the wheelchair and returned her to the foster home.\\r\\n\\r\\nThe staff stated she received VOC (vehicle orientation class) prior to being able to drive, but also following the incident. She states she tends to be the main driver in the mornings and feels she is a very safe staff, often double checking and taking her time to make sure mistakes don\\u2019t happen. She explained in the VOC training, they don\\u2019t use the hospital model wheelchair that this individual has but instead a different one. She further explained that it is difficult because each person is different and transporting each person has its own struggles, but the training doesn\\u2019t account for this.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:44:24 pm\",\"created_at\":\"5\\/26\\/2021 4:44:24 pm\",\"id\":37652}','68.53.115.247','2021-05-26 21:44:24'),(26053,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37653,'{\"report_id\":212,\"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\":\"5\\/26\\/2021 4:44:24 pm\",\"created_at\":\"5\\/26\\/2021 4:44:24 pm\",\"id\":37653}','68.53.115.247','2021-05-26 21:44:24'),(26054,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37654,'{\"report_id\":212,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The staff being unable to secure the seat belt was impacted by the staff member identifying increased anxiety and struggling with the seat belt. The struggle with the seat belt and staff\\u2019s increased anxiety had a reciprocal impact to one another. The staff member was feeling rushed which was impacted by the staff going to the wrong clinic for the appointment. Once it was realized that they were at the wrong clinic, the individual served started to yell and scream which impacted the staff\\u2019s increased anxiety and the attention this was drawing from the community members nearby. The increased anxiety was further complicated by the staff being inexperienced with such behaviors. The individual being supported was new in the program and the staff member had limited experience and knowledge with their individual needs. Most of the staff\\u2019s training was focused on medical needs rather than behavior management. The agency develops the training based on what the county shares with them on the individual\\u2019s needs when they are moving into the home. With the individual being upset, yelling and screaming, the person was subsequently bent at the waist level. The person\\u2019s position directly impacted staff\\u2019s difficulty with the seat belt. \\r\\n\\r\\nFurther impacting the staff\\u2019s increased anxiety was the staff\\u2019s fear of repercussions of being late to the doctor\\u2019s appointment. There is a history of reprimands for late appointments within the agency. It is required in 245D licensing that the individuals attend appointments. Further complicating the pressure on the agencies, if appointments are not made, there could be maltreatment reports made for failure to provide care. Another contributing factor is the rigidity of the healthcare system influences the pressure on the agencies because of limited time options for appointments, it may be difficult to reschedule in a timely manner or the healthcare provider may discontinue seeing that individual due to missed appointments.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:44:24 pm\",\"created_at\":\"5\\/26\\/2021 4:44:24 pm\",\"id\":37654}','68.53.115.247','2021-05-26 21:44:24'),(26055,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37655,'{\"report_id\":212,\"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\":\"5\\/26\\/2021 4:44:24 pm\",\"created_at\":\"5\\/26\\/2021 4:44:24 pm\",\"id\":37655}','68.53.115.247','2021-05-26 21:44:24'),(26056,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37656,'{\"report_id\":212,\"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\":\"5\\/26\\/2021 4:44:24 pm\",\"created_at\":\"5\\/26\\/2021 4:44:24 pm\",\"id\":37656}','68.53.115.247','2021-05-26 21:44:24'),(26057,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37657,'{\"report_id\":212,\"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\":\"5\\/26\\/2021 4:44:24 pm\",\"created_at\":\"5\\/26\\/2021 4:44:24 pm\",\"id\":37657}','68.53.115.247','2021-05-26 21:44:24'),(26058,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37658,'{\"report_id\":212,\"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\":\"5\\/26\\/2021 4:44:24 pm\",\"created_at\":\"5\\/26\\/2021 4:44:24 pm\",\"id\":37658}','68.53.115.247','2021-05-26 21:44:24'),(26059,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37659,'{\"report_id\":212,\"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\":\"5\\/26\\/2021 4:44:24 pm\",\"created_at\":\"5\\/26\\/2021 4:44:24 pm\",\"id\":37659}','68.53.115.247','2021-05-26 21:44:24'),(26060,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37660,'{\"report_id\":212,\"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\":\"5\\/26\\/2021 4:44:24 pm\",\"created_at\":\"5\\/26\\/2021 4:44:24 pm\",\"id\":37660}','68.53.115.247','2021-05-26 21:44:24'),(26061,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37661,'{\"report_id\":212,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":\"The staff being unable to secure the seat belt was impacted by the staff member identifying increased anxiety and struggling with the seat belt. The struggle with the seat belt and staff\\u2019s increased anxiety had a reciprocal impact to one another.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:44:25 pm\",\"created_at\":\"5\\/26\\/2021 4:44:25 pm\",\"id\":37661}','68.53.115.247','2021-05-26 21:44:25'),(26062,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37662,'{\"report_id\":212,\"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\":\"5\\/26\\/2021 4:44:25 pm\",\"created_at\":\"5\\/26\\/2021 4:44:25 pm\",\"id\":37662}','68.53.115.247','2021-05-26 21:44:25'),(26063,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37663,'{\"report_id\":212,\"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\":\"5\\/26\\/2021 4:44:25 pm\",\"created_at\":\"5\\/26\\/2021 4:44:25 pm\",\"id\":37663}','68.53.115.247','2021-05-26 21:44:25'),(26064,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37664,'{\"report_id\":212,\"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\":\"5\\/26\\/2021 4:44:25 pm\",\"created_at\":\"5\\/26\\/2021 4:44:25 pm\",\"id\":37664}','68.53.115.247','2021-05-26 21:44:25'),(26065,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37665,'{\"report_id\":212,\"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\":\"5\\/26\\/2021 4:44:25 pm\",\"created_at\":\"5\\/26\\/2021 4:44:25 pm\",\"id\":37665}','68.53.115.247','2021-05-26 21:44:25'),(26066,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37666,'{\"report_id\":212,\"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\":\"5\\/26\\/2021 4:44:25 pm\",\"created_at\":\"5\\/26\\/2021 4:44:25 pm\",\"id\":37666}','68.53.115.247','2021-05-26 21:44:25'),(26067,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37667,'{\"report_id\":212,\"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\":\"5\\/26\\/2021 4:44:25 pm\",\"created_at\":\"5\\/26\\/2021 4:44:25 pm\",\"id\":37667}','68.53.115.247','2021-05-26 21:44:25'),(26068,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37668,'{\"report_id\":212,\"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\":\"5\\/26\\/2021 4:44:25 pm\",\"created_at\":\"5\\/26\\/2021 4:44:25 pm\",\"id\":37668}','68.53.115.247','2021-05-26 21:44:25'),(26069,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37669,'{\"report_id\":212,\"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\":\"5\\/26\\/2021 4:44:25 pm\",\"created_at\":\"5\\/26\\/2021 4:44:25 pm\",\"id\":37669}','68.53.115.247','2021-05-26 21:44:25'),(26070,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37670,'{\"report_id\":212,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"111\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:44:25 pm\",\"created_at\":\"5\\/26\\/2021 4:44:25 pm\",\"id\":37670}','68.53.115.247','2021-05-26 21:44:25'),(26071,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37671,'{\"report_id\":212,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"112\",\"question_type\":\"Free_Text\",\"text_answer\":\"The increased anxiety was further complicated by the staff being inexperienced with such behaviors. The individual being supported was new in the program and the staff member had limited experience and knowledge with their individual needs. 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safety for Dominic and others. \\r\\n- Dominic requires a minimum of 2:1 staffing which is not possible with banded rates nor does RLE have the ability to provider additional staffing for this purpose\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:46:01 pm\",\"created_at\":\"5\\/26\\/2021 4:46:01 pm\",\"id\":37700}','68.53.115.247','2021-05-26 21:46:01'),(26101,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37701,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:01 pm\",\"created_at\":\"5\\/26\\/2021 4:46:01 pm\",\"id\":37701}','68.53.115.247','2021-05-26 21:46:01'),(26102,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37702,'{\"report_id\":213,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Services terminated due to concerns for staff safety.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:46:01 pm\",\"created_at\":\"5\\/26\\/2021 4:46:01 pm\",\"id\":37702}','68.53.115.247','2021-05-26 21:46:01'),(26103,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37703,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:01 pm\",\"created_at\":\"5\\/26\\/2021 4:46:01 pm\",\"id\":37703}','68.53.115.247','2021-05-26 21:46:01'),(26104,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37704,'{\"report_id\":213,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"02\\/04\\/2020\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:46:01 pm\",\"created_at\":\"5\\/26\\/2021 4:46:01 pm\",\"id\":37704}','68.53.115.247','2021-05-26 21:46:01'),(26105,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37705,'{\"report_id\":213,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"Debriefing 1 \\r\\nThe home was created in 2007 and licensed for 3 beds. Referrals were in from other counties; however, at the same time 2 MSOCS homes were being closed in the county and St. Louis County needed those beds. Host county concurrence from St. Louis County was denied on the 3 out of county individuals. Administration felt that they were forced into taking the three people who eventually moved in. All three had 1:1 staffing ratios when they came in. Even at that time, staff felt that the one individual should have been a 2:1; however, this was not approved by the county. He would bite himself, bite others, hit things which often resulted in daily restraints. He was on a Rule 40 program that created a plan for these restraints. Through the years adjustments were made to the home, attempting to reinforce walls, replacing toilets, industrial sheetrock, etc. \\r\\n\\r\\nIn 2017, one of the individuals in the home passed away. The home then went from 3 licensed beds to 2 licensed beds, subsequently only now having 2 staff members in the home where prior to 2017 there were 3. Through the next few years, the individual\\u2019s behaviors continued to be present but with the loss of the one staff member, it made it more difficult to intervene. This even resulted in a 60 day termination notice being issued in April 2018; however, no alternative housing option was ever found so the individual never did move from the home .The county was approached about developing a specialized home for the one individual; however, due to banding, which is when rates are locked only allowing incremental increases, they were told this couldn\\u2019t happen. In 2019, the banding was frozen so there was no slight increase they saw on their rate. They realize they could have put in 2:1 staffing, but they would have \\u201cate the cost\\u201d for this as they would not be reimbursed for the extra staffing. \\r\\nThrough the years, the individual worked with one staff member who he tended to do better with. This was helpful in having to bring the individual places because they would try to schedule it with the one staff member. However, the staff member resigned in the fall of 2019. With the staff member\\u2019s departure, it appeared that the individual\\u2019s behaviors started to increase. They attempted various things, some even being quite non-conventional such as getting \\u201cgay man pheromones\\u201d. At the time of the notice, 911 was called 2 days in a row. They eventually brought him to the Duluth ER where once there, he was restrained by 8 hospital staff.\\r\\n\\r\\nWhen asked about other impacts of the situation they found themselves in, the quality of employees was quickly brought up. There continues to be a staffing shortage and it is difficult to find staff, let alone finding staff with any experience or other qualifications. There is also a concern that our state is missing a part of the continuum of care, specifically that there is little to no institutional care option that would allow individuals a longer period of stabilization. \\r\\n\\r\\nDebriefing 2 \\r\\nStaff members were at a point where they were no longer being effective in managing the individual\\u2019s behaviors. He went to the annual assessment meeting and saw the extremely high number of PRN\\u2019s being given. He realized they were using that as a means to control and \\u201cif we\\u2019re doing that something is wrong.\\u201d In further looking at this, he discovered that the documentation wasn\\u2019t always consistent depending on what staff member was documenting. Many behaviors were not being reported in the documentation or if they were, it wasn\\u2019t consistent amongst staff on how they were recorded. He felt that they weren\\u2019t training staff right. It was difficult to get staff to recognize what they were seeing. The house manager did not experience the same behaviors as the other staff; therefore, what he was reporting was not consistent with what staff experienced. The individual tended to treat certain staff differently, being particularly worse for women.\\r\\n\\r\\nAbout three years ago, the number of injuries that staff were sustaining started to rise consistently. Many workman\\u2019s comp claims, particularly with concerns about staff being bit. It came down to the realization that they did not have the right house for him and the concerns for staff\\u2019s safety. He felt strongly that staff did not fail the individual but rather the individual needed different suppor\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:46:01 pm\",\"created_at\":\"5\\/26\\/2021 4:46:01 pm\",\"id\":37705}','68.53.115.247','2021-05-26 21:46:01'),(26106,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37706,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:01 pm\",\"created_at\":\"5\\/26\\/2021 4:46:01 pm\",\"id\":37706}','68.53.115.247','2021-05-26 21:46:01'),(26107,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37707,'{\"report_id\":213,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The services being terminated for a person due to concerns for staff safety were impacted by increased staff injuries. The physical aggression displayed by the person was increasing, which led to the increased staff injuries and the person damaging the house. Staff were not always able to be consistent when redirecting behavior with just one staff which impacted the increased staff injuries. The pressure from the worker\\u2019s compensation agency influenced the services terminated due to the concerns for staff safety. The number of workman\\u2019s comp claims influenced the pressure from this agency, which was impacted by the increased injuries to staff.\\r\\n\\r\\nStaff injuries was also influenced by the staff being unable to consistently redirect behaviors with one staff. One of the impacts to the inconsistency in redirecting behaviors, which included physical aggression, property distruction and self injurious, was the physical layout of the house due to narrow hallways and bathroom made it difficult to give space or intervene so the way staff chose to intervene was dependent on where the staff and individual were physically at in the home at the time of the behavior.The physical layout of the house not only impacted the consistency of redirecting these behaviors, but this also directly impacted the increased staff injuries and the requests to develop a new site around the person\\u2019s sensory needs. This request was subsequently denied by the county due to the county being unaware of available funds for modification for new development and that the county had limited foster care development. The limited foster care development was influenced by the county having a high number of foster care homes serving individuals from other counties along with a statewide moratorium on the creation of foster care beds, which in essence was a hold in developing further beds. This moratorium not only limited the foster care development in the county, but it also impacted the elimination of institutions in the state and left few alternative housing options. Other influences of the elimination of institutions was the Jensen Settlement and the Minnesota Olmstead Plan which found that individuals with disabilities were unconstitutionally secluded and the plan detailed a way to ensure that individuals with disabilities live in the most integrated setting appropriate for their needs. Another impact of staff being unable to consistently redirect behaviors with one staff was the staffing level dropped in the home in 2017 after a roommate passed away. When the person passed away, the home reduced their staff level to coincide with the reduced reimbursement that came from that person\\u2019s residence in the home. The staff attached to the roommate who passed away would often intervene in de-escalating and responding to the person\\u2019s physically aggressive behavior. When the roommate passed away, the provider inquired about adding a staff but were told that 2:1 staff couldn\\u2019t be reimbursed. This was impacted by the county not moving forward with the rate exception due to the needs of the person not changing, which in turn was influenced by the banding for the state rate allowing limited rate increase for service intensity. The Disability Waiver Rate System (DWRS) has impacted the banding requirements. The last impact to the staff being unable to consistently redirect behavior with one staff was the difficulty in matching staff to the needs of the people in the home. The difficulty in matching staff was influenced by the person tending to work best with male staff (2 particular staff) but also the low applicant pool fitting the person\\u2019s preference.  The low applicant pool was influenced by the current workforce shortage in the community and state. \\r\\n\\r\\nThe attempts and barriers to create the right service environment were also an influence to the terminating the person\\u2019s services due to concerns for staff safety. This was due to the 2:1 staff not being able to be reimbursed as previously mentioned because the staffing in the home changed but not the person\\u2019s needs. It also was influenced by county\\u2019s denial of the request to develop a new site around the person\\u2019s sensory needs. Subsequently, previous attempts to terminate service were not followed through on due to lack of providers which was impacted by the view that a part of the continuum of care for people with challenging behaviors statewide is missing. This missing part of the continuum is influenced by the lack of crisis respite providers, a lack of service availability between crisis residential services and hospitals, and few services for adults with autism. The effort to eliminate institutions and the DWRS has impacted the missing part of the continuum. The goal of the elimination of institutions to promote community living is generally seen as good; however, the lack of alternatives is what is most problematic to serve this population.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:46:01 pm\",\"created_at\":\"5\\/26\\/2021 4:46:01 pm\",\"id\":37707}','68.53.115.247','2021-05-26 21:46:01'),(26108,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37708,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:01 pm\",\"created_at\":\"5\\/26\\/2021 4:46:01 pm\",\"id\":37708}','68.53.115.247','2021-05-26 21:46:01'),(26109,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37709,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:01 pm\",\"created_at\":\"5\\/26\\/2021 4:46:01 pm\",\"id\":37709}','68.53.115.247','2021-05-26 21:46:01'),(26110,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37710,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:01 pm\",\"created_at\":\"5\\/26\\/2021 4:46:01 pm\",\"id\":37710}','68.53.115.247','2021-05-26 21:46:02'),(26111,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37711,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37711}','68.53.115.247','2021-05-26 21:46:02'),(26112,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37712,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37712}','68.53.115.247','2021-05-26 21:46:02'),(26113,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37713,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37713}','68.53.115.247','2021-05-26 21:46:02'),(26114,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37714,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37714}','68.53.115.247','2021-05-26 21:46:02'),(26115,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37715,'{\"report_id\":213,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"103\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37715}','68.53.115.247','2021-05-26 21:46:02'),(26116,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37716,'{\"report_id\":213,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"104\",\"question_type\":\"Free_Text\",\"text_answer\":\"Staff injuries was also influenced by the staff being unable to consistently redirect behaviors with one staff. One of the impacts to the inconsistency in redirecting behaviors, which included physical aggression, property destruction and self injurious, was the physical layout of the house due to narrow hallways and bathroom made it difficult to give space or intervene so the way staff chose to intervene was dependent on where the staff and individual were physically at in the home at the time of the behavior.The physical layout of the house not only impacted the consistency of redirecting these behaviors, but this also directly impacted the increased staff injuries and the requests to develop a new site around the person\\u2019s sensory needs. \\r\\n\\r\\nThe last impact to the staff being unable to consistently redirect behavior with one staff was the difficulty in matching staff to the needs of the people in the home. The difficulty in matching staff was influenced by the person tending to work best with male staff (2 particular staff) but also the low applicant pool fitting the person\\u2019s preference.  The low applicant pool was influenced by the current workforce shortage in the community and state.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37716}','68.53.115.247','2021-05-26 21:46:02'),(26117,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37717,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37717}','68.53.115.247','2021-05-26 21:46:02'),(26118,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37718,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37718}','68.53.115.247','2021-05-26 21:46:02'),(26119,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37719,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37719}','68.53.115.247','2021-05-26 21:46:02'),(26120,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37720,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37720}','68.53.115.247','2021-05-26 21:46:02'),(26121,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37721,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37721}','68.53.115.247','2021-05-26 21:46:02'),(26122,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37722,'{\"report_id\":213,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"110\",\"question_type\":\"Free_Text\",\"text_answer\":\"The examples of Demand Resource Mismatch & Prescribed Practice (policies, resource constraints, etc.) influenced the ability to have \\\"success\\\" working as a team. \\r\\n\\r\\nThis request was subsequently denied by the county due to the county being unaware of available funds for modification for new development and that the county had limited foster care development. The limited foster care development was influenced by the county having a high number of foster care homes serving individuals from other counties along with a statewide moratorium on the creation of foster care beds, which in essence was a hold in developing further beds. This moratorium not only limited the foster care development in the county, but it also impacted the elimination of institutions in the state and left few alternative housing options. Other influences of the elimination of institutions was the Jensen Settlement and the Minnesota Olmstead Plan which found that individuals with disabilities were unconstitutionally secluded and the plan detailed a way to ensure that individuals with disabilities live in the most integrated setting appropriate for their needs.\\r\\n\\r\\nWhen the roommate passed away, the provider inquired about adding a staff but were told that 2:1 staff couldn\\u2019t be reimbursed. This was impacted by the county not moving forward with the rate exception due to the needs of the person not changing, which in turn was influenced by the banding for the state rate allowing limited rate increase for service intensity.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37722}','68.53.115.247','2021-05-26 21:46:02'),(26123,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37723,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37723}','68.53.115.247','2021-05-26 21:46:02'),(26124,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37724,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37724}','68.53.115.247','2021-05-26 21:46:02'),(26125,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37725,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37725}','68.53.115.247','2021-05-26 21:46:02'),(26126,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37726,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37726}','68.53.115.247','2021-05-26 21:46:02'),(26127,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37727,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37727}','68.53.115.247','2021-05-26 21:46:02'),(26128,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37728,'{\"report_id\":213,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"116\",\"question_type\":\"Free_Text\",\"text_answer\":\"The services being terminated for a person due to concerns for staff safety were impacted by increased staff injuries. The physical aggression displayed by the person was increasing, which led to the increased staff injuries and the person damaging the house. Staff were not always able to be consistent when redirecting behavior with just one staff which impacted the increased staff injuries. The pressure from the worker\\u2019s compensation agency influenced the services terminated due to the concerns for staff safety. The number of workman\\u2019s comp claims influenced the pressure from this agency, which was impacted by the increased injuries to staff.\\r\\n\\r\\nThe attempts and barriers to create the right service environment were also an influence to the terminating the person\\u2019s services due to concerns for staff safety. This was due to the 2:1 staff not being able to be reimbursed as previously mentioned because the staffing in the home changed but not the person\\u2019s needs. It also was influenced by county\\u2019s denial of the request to develop a new site around the person\\u2019s sensory needs. Subsequently, previous attempts to terminate service were not followed through on due to lack of providers which was impacted by the view that a part of the continuum of care for people with challenging behaviors statewide is missing. This missing part of the continuum is influenced by the lack of crisis respite providers, a lack of service availability between crisis residential services and hospitals, and few services for adults with autism. The effort to eliminate institutions and the DWRS has impacted the missing part of the continuum. The goal of the elimination of institutions to promote community living is generally seen as good; however, the lack of alternatives is what is most problematic to serve this population.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37728}','68.53.115.247','2021-05-26 21:46:02'),(26129,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37729,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37729}','68.53.115.247','2021-05-26 21:46:02'),(26130,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37730,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37730}','68.53.115.247','2021-05-26 21:46:02'),(26131,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37731,'{\"report_id\":213,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"119\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37731}','68.53.115.247','2021-05-26 21:46:02'),(26132,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37732,'{\"report_id\":213,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"120\",\"question_type\":\"Free_Text\",\"text_answer\":\"This missing part of the continuum is influenced by the lack of crisis respite providers, a lack of service availability between crisis residential services and hospitals, and few services for adults with autism. The effort to eliminate institutions and the DWRS has impacted the missing part of the continuum. The goal of the elimination of institutions to promote community living is generally seen as good; however, the lack of alternatives is what is most problematic to serve this population.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37732}','68.53.115.247','2021-05-26 21:46:02'),(26133,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37733,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37733}','68.53.115.247','2021-05-26 21:46:02'),(26134,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37734,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37734}','68.53.115.247','2021-05-26 21:46:02'),(26135,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37735,'{\"report_id\":213,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"123\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37735}','68.53.115.247','2021-05-26 21:46:02'),(26136,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37736,'{\"report_id\":213,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"124\",\"question_type\":\"Free_Text\",\"text_answer\":\"\\\"Note: a key part of the example of drift stems out of this...The staff attached to the roommate who passed away would often intervene in de-escalating and responding to the person\\u2019s physically aggressive behavior...then additional system constraints with DWRS impacted not being able to change the staff ratio to 2:1.\\\"\\r\\n\\r\\nAnother impact of staff being unable to consistently redirect behaviors with one staff was the staffing level dropped in the home in 2017 after a roommate passed away. When the person passed away, the home reduced their staff level to coincide with the reduced reimbursement that came from that person\\u2019s residence in the home. The staff attached to the roommate who passed away would often intervene in de-escalating and responding to the person\\u2019s physically aggressive behavior. When the roommate passed away, the provider inquired about adding a staff but were told that 2:1 staff couldn\\u2019t be reimbursed. This was impacted by the county not moving forward with the rate exception due to the needs of the person not changing, which in turn was influenced by the banding for the state rate allowing limited rate increase for service intensity.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37736}','68.53.115.247','2021-05-26 21:46:02'),(26137,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37737,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37737}','68.53.115.247','2021-05-26 21:46:02'),(26138,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37738,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37738}','68.53.115.247','2021-05-26 21:46:02'),(26139,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37739,'{\"report_id\":213,\"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\":\"5\\/26\\/2021 4:46:02 pm\",\"created_at\":\"5\\/26\\/2021 4:46:02 pm\",\"id\":37739}','68.53.115.247','2021-05-26 21:46:02'),(26140,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37740,'{\"report_id\":214,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"03\\/12\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:02:51 pm\",\"created_at\":\"5\\/26\\/2021 5:02:51 pm\",\"id\":37740}','68.53.115.247','2021-05-26 22:02:51'),(26141,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37741,'{\"report_id\":214,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"201901897\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37741}','68.53.115.247','2021-05-26 22:02:59'),(26142,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37742,'{\"report_id\":214,\"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\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37742}','68.53.115.247','2021-05-26 22:02:59'),(26143,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37743,'{\"report_id\":214,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"78\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Kelly Sather\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37743}','68.53.115.247','2021-05-26 22:02:59'),(26144,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37744,'{\"report_id\":214,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"David Vukelich\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37744}','68.53.115.247','2021-05-26 22:02:59'),(26145,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37745,'{\"report_id\":214,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Westview Services\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37745}','68.53.115.247','2021-05-26 22:02:59'),(26146,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37746,'{\"report_id\":214,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"David Birkhofer JR\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37746}','68.53.115.247','2021-05-26 22:02:59'),(26147,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37747,'{\"report_id\":214,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"dbirkhofer@westview-services.com\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37747}','68.53.115.247','2021-05-26 22:02:59'),(26148,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37748,'{\"report_id\":214,\"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\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37748}','68.53.115.247','2021-05-26 22:02:59'),(26149,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37749,'{\"report_id\":214,\"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\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37749}','68.53.115.247','2021-05-26 22:02:59'),(26150,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37750,'{\"report_id\":214,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"St. Louis County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37750}','68.53.115.247','2021-05-26 22:02:59'),(26151,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37751,'{\"report_id\":214,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"03\\/12\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37751}','68.53.115.247','2021-05-26 22:02:59'),(26152,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37752,'{\"report_id\":214,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"Staff was doing shift change on overnight shift and became distracted, leaving a card of a controlled medication (lorazepam) on the counter. Isaiah saw the med card, took in and brought it to his room. In the morning it was discovered after doing controlled medication counts that a sheet of the bubble wrapped Ativan was missing. The medication card was found in Isaiah\\u2019s possession and there were 12 tablets missing. Isaiah reported that he had taken 12 tablets of the medication. Once discovered, staff called nurse immediately to report. Nurse instructed staff to bring Isaiah to the emergency room. Isaiah was able to be aroused but groggy. After the emergency room evaluation, it was determined that Isaiah could return to the foster care home. No hospitalization required.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37752}','68.53.115.247','2021-05-26 22:02:59'),(26153,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37753,'{\"report_id\":214,\"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\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37753}','68.53.115.247','2021-05-26 22:02:59'),(26154,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37754,'{\"report_id\":214,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Individual had access to medications.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37754}','68.53.115.247','2021-05-26 22:02:59'),(26155,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37755,'{\"report_id\":214,\"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\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37755}','68.53.115.247','2021-05-26 22:02:59'),(26156,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37756,'{\"report_id\":214,\"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\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37756}','68.53.115.247','2021-05-26 22:02:59'),(26157,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37757,'{\"report_id\":214,\"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\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37757}','68.53.115.247','2021-05-26 22:02:59'),(26158,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37758,'{\"report_id\":214,\"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\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37758}','68.53.115.247','2021-05-26 22:02:59'),(26159,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37759,'{\"report_id\":214,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The individual\\u2019s access to medication was impacted by the staff\\u2019s shift change and set up of the office. Staff was focused on completing a shift change task, of medication reconciling and money reconciling. The medication reconciling and money reconciling are necessary by M.S. 245 licensing requirements and reflected the provider\\u2019s attempts to maintain compliance. The staff\\u2019s focus of attention to the tasks was impacted as the staff had limited time during shift change. Often times, overlap of staff is only a few minutes, which is why staff adapted to combine the reconciliation processes to complete it quickly. \\r\\n\\r\\nImpacting the limited amount of time for shift changes was that the provider could not schedule much overlap between staff during shift changes. Contributing to the limited time was that routine staffing patterns do not allow for staff overlap at shift change. Labor laws can influence staffing patterns by dictating the number of hours individuals can work and the requirement to receive compensation for time worked, including overtime pay. The staffing patterns are both impacted by and impacting the fiscal constraints of the provider. These patterns dictate the level of staffing required for individuals in the home and does not allow for the provider to hire additional staff.  The Rate Management Worksheet (6790) identifies the staffing need of the individual, but does not account for the needs of the provider to support the individual; therefore this impacts the staffing patterns of the home. The MnCHOICES assessment which is completed by the county influences the 6790 by determining the level of care \\u2013 including staff hours \\u2013 a person may need. The Rate Management System (RMS) which calculates rates based on information received in the 6790 has a reciprocating impact with the 6790 in that RMS factors in legislative constraints to rates as well as the flexible components negotiated during the 6790 process. The RMS is influenced by both the Disability Waiver Rate System (DWRS) and The Center for Medicare and Medicaid Services (CMS) defined services for indirect and direct care. Only direct service time as defined by CMS and the waiver plan can be included on a 6790 for this service, and as staff coordination is indirect time, this time cannot be added to the worksheet. Therefore, there is no compensation to the provider for overlap in staffing to allow for a shift change because this is considered to be indirect time. 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The staff\\u2019s focus of attention to the tasks was impacted as the staff had limited time during shift change.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37766}','68.53.115.247','2021-05-26 22:02:59'),(26167,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37767,'{\"report_id\":214,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"103\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37767}','68.53.115.247','2021-05-26 22:02:59'),(26168,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37768,'{\"report_id\":214,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"104\",\"question_type\":\"Free_Text\",\"text_answer\":\"The staffing patterns are both impacted by and impacting the fiscal constraints of the provider. These patterns dictate the level of staffing required for individuals in the home and does not allow for the provider to hire additional staff.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37768}','68.53.115.247','2021-05-26 22:02:59'),(26169,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37769,'{\"report_id\":214,\"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\":\"5\\/26\\/2021 5:02:59 pm\",\"created_at\":\"5\\/26\\/2021 5:02:59 pm\",\"id\":37769}','68.53.115.247','2021-05-26 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Also our water scalds us here!\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:05:02 pm\",\"created_at\":\"5\\/26\\/2021 5:05:02 pm\",\"id\":37805}','68.53.115.247','2021-05-26 22:05:02'),(26206,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37806,'{\"report_id\":215,\"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\":\"5\\/26\\/2021 5:05:02 pm\",\"created_at\":\"5\\/26\\/2021 5:05:02 pm\",\"id\":37806}','68.53.115.247','2021-05-26 22:05:02'),(26207,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37807,'{\"report_id\":215,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Barriers to supporting people while implementing COVID policies\\/protocols.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:05:02 pm\",\"created_at\":\"5\\/26\\/2021 5:05:02 pm\",\"id\":37807}','68.53.115.247','2021-05-26 22:05:02'),(26208,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37808,'{\"report_id\":215,\"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\":\"5\\/26\\/2021 5:05:02 pm\",\"created_at\":\"5\\/26\\/2021 5:05:02 pm\",\"id\":37808}','68.53.115.247','2021-05-26 22:05:02'),(26209,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37809,'{\"report_id\":215,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"03\\/11\\/2021\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:05:02 pm\",\"created_at\":\"5\\/26\\/2021 5:05:02 pm\",\"id\":37809}','68.53.115.247','2021-05-26 22:05:02'),(26210,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37810,'{\"report_id\":215,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"Westview has 6 homes in total with 4 residents living at each home. The staffing patterns typically consist of two workers from 7:00 a.m. to 11:30 p.m. and one awake overnight. The homes tend to be fairly active with trying to do outings and activities such as ball games, bowling, going for drives, etc.\\r\\n\\r\\nWhen the CDC and Department of Health set out instructions for individuals to not go anywhere if they don\\u2019t have to, residents who were working were pulled back from work and remained in their home. Activities that the workers typically brought people to were pulled back as well. Consequently, there ended up being a sense of fear from the residents. Many of them watch the news and that seemed to be all they were seeing and hearing. There was some increased frustration with some residents as they were unable to do the things they typically do, particularly as these delays went on for so long.\\r\\n\\r\\nWhen a home needed to quarantine, it tended to feel like a crazy two weeks. Each time a staff member needed to quarantine or residents ended up positive, there were a core group of staff members who tended to pull together to ensure coverage was provided. While they saw some staff members leave when the $600 unemployment went into effect and people felt they could remain at home and be safe while getting paid. There were attempts made to ensure that sanitizing and safety protocols were in place to minimize risk, but when staff chose to participate in non-work activities that were outside of their work schedule which presented risks, this created a greater burden. Supervisors reminded them to keep the individuals they support in mind when they choose to do certain activities. Individual texts would get sent out to provide those reminders as well. If traveling, quarantining for 3 days (unpaid) and negative COVID test were required.\\r\\n\\r\\nThere was some concern of decompensation that was noticed in residents. Some remained fearful to the point where there was concern noted that some may be developing agoraphobia. Many residents did in fact choose to get vaccinated with only one declining. They are hopeful to get back to normal for the majority, but there remain a handful of individuals who will require work and time to get back to where they were at prior to COVID. There are some concerns that pressures will occur from social workers to work on goals where some individuals will simply need time to slowly acclimate back into society again. Some residents really struggled with the mask wearing by staff members. They were unable to recognize the staff members and this frightened them. Many staff members learned that they would need to greet the resident with their mask pulled down so the resident could identify them prior to beginning their work day. \\r\\n\\r\\nThere are some things that were identified during this that go against the work that has tried to be done. One of those is having a person centered organization. They\\u2019ve worked hard to keep people\\u2019s choices in mind, but in the last year found them minimizing these choices and at times telling someone no, they couldn\\u2019t do something. The other concern is that staff have lost confidence in making decisions as this time has created some uncertainty for them in their day to day work and the quick changes that have occurred. The impact on staff can be notable for some. Since there are not as many outings and activities happening, they have found increased down time with some staff members. They anticipate losing some staff members as the work changes because expectations will be higher and the work will inadvertently become busier as they resume activities.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:05:02 pm\",\"created_at\":\"5\\/26\\/2021 5:05:02 pm\",\"id\":37810}','68.53.115.247','2021-05-26 22:05:02'),(26211,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37811,'{\"report_id\":215,\"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\":\"5\\/26\\/2021 5:05:02 pm\",\"created_at\":\"5\\/26\\/2021 5:05:02 pm\",\"id\":37811}','68.53.115.247','2021-05-26 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22:05:03'),(26240,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37840,'{\"report_id\":215,\"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\":\"5\\/26\\/2021 5:05:03 pm\",\"created_at\":\"5\\/26\\/2021 5:05:03 pm\",\"id\":37840}','68.53.115.247','2021-05-26 22:05:03'),(26241,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37841,'{\"report_id\":215,\"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\":\"5\\/26\\/2021 5:05:03 pm\",\"created_at\":\"5\\/26\\/2021 5:05:03 pm\",\"id\":37841}','68.53.115.247','2021-05-26 22:05:03'),(26242,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37842,'{\"report_id\":215,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"125\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:05:03 pm\",\"created_at\":\"5\\/26\\/2021 5:05:03 pm\",\"id\":37842}','68.53.115.247','2021-05-26 22:05:03'),(26243,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37843,'{\"report_id\":215,\"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\":\"5\\/26\\/2021 5:05:03 pm\",\"created_at\":\"5\\/26\\/2021 5:05:03 pm\",\"id\":37843}','68.53.115.247','2021-05-26 22:05:03'),(26244,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37844,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"04\\/07\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:06:34 pm\",\"created_at\":\"5\\/26\\/2021 5:06:34 pm\",\"id\":37844}','68.53.115.247','2021-05-26 22:06:34'),(26245,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37845,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"201904881\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:04 pm\",\"created_at\":\"5\\/26\\/2021 5:07:04 pm\",\"id\":37845}','68.53.115.247','2021-05-26 22:07:05'),(26246,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37846,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"08\\/15\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37846}','68.53.115.247','2021-05-26 22:07:05'),(26247,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37847,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"78\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Marilee Bengtson\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37847}','68.53.115.247','2021-05-26 22:07:05'),(26248,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37848,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Tim Sullivan\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37848}','68.53.115.247','2021-05-26 22:07:05'),(26249,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37849,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Accessible Spaces - Silver Lake\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37849}','68.53.115.247','2021-05-26 22:07:05'),(26250,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37850,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Stephen Vander Schaaf\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37850}','68.53.115.247','2021-05-26 22:07:05'),(26251,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37851,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"svanderschaaf@accessiblespace.org\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37851}','68.53.115.247','2021-05-26 22:07:05'),(26252,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37852,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"83\",\"question_type\":\"Short_Answer\",\"text_answer\":\"6516457271\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37852}','68.53.115.247','2021-05-26 22:07:05'),(26253,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37853,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37853}','68.53.115.247','2021-05-26 22:07:05'),(26254,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37854,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Hennepin County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37854}','68.53.115.247','2021-05-26 22:07:05'),(26255,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37855,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"04\\/07\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37855}','68.53.115.247','2021-05-26 22:07:05'),(26256,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37856,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"Reporter heard from staff at VA\'s group home today that VA left sometime between mid day on 7\\/3\\/2019 and early morning 7\\/4\\/2019. VA\\r\\ntold one staff member on 7\\/3\\/2019, \\\"I\'m moving out.\\\" and when the staff asked where VA told him \\\"I\'m not going to tell you.\\\" and VA was\\r\\nnoticed gone early in the morning of 7\\/4\\/2019. VA\'s Case manager has received a voice message from VA saying that she is ok and\\r\\neverything is fine but has not spoken with VA yet. Reporter has tried contacting VA but after ringing a few times VA\'s phone goes to voice\\r\\nmail and VA\'s voice mail is currently full.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37856}','68.53.115.247','2021-05-26 22:07:05'),(26257,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37857,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37857}','68.53.115.247','2021-05-26 22:07:05'),(26258,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37858,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Staff did not report Individual\'s absence for 5 days.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37858}','68.53.115.247','2021-05-26 22:07:05'),(26259,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37859,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37859}','68.53.115.247','2021-05-26 22:07:05'),(26260,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37860,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37860}','68.53.115.247','2021-05-26 22:07:05'),(26261,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37861,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"Incident report description\\r\\nIncident date:\\t07\\/04\\/2019\\r\\nIt was reported to CEP, that the individual left her group home, which was noted the early morning of 7-4-19, and has not returned for 5 days.  The reporter of the incident had been told by group home staff that the individual had told staff \\u201cI\\u2019m moving out\\u201d.   When staff asked where, the individual stated, \\u201cI\\u2019m not going to tell you\\u201d.  The individual\\u2019s case manager reportedly tried calling the individual, but her phone goes to voicemail and message states it is full.\\r\\n\\r\\nDebriefing information for Learning Point \\r\\nDebriefing date: November 18, 2019\\r\\nPerson debriefed: Home Supervisor\\r\\nIndividual is her own guardian and has an ongoing medical condition which requires her to attend numerous and frequent medical appointments and at times hospitalizations.  There is only one staff on site at the 4-person group home at a time.  This individual makes and attends her medical appointments by herself and is allowed to be in the community unsupervised.  \\r\\n\\r\\nDuring the time of the incident, the home supervisor was on vacation.  Several days prior to the incident, the individual reported to staff that she was moving out of the group home.  The individual reportedly stated she was not going to tell staff where.  One staff emailed the home supervisor (who was on vacation) a day after the incident asking the supervisor if she was aware the individual was moving out of the group home.  \\r\\n\\r\\nThe morning of the incident, the individual reported to early morning staff she was moving and would not say where to.  At the time she left the group home, she told a different staff she was going to the hospital.  The individual had unspecified alone time in the community, so staff did not follow her. It was typical for her to leave to do what she wanted without telling staff where she was going. Staff also believed the individual was going to the hospital and did not follow elopement protocol. \\r\\n\\r\\nThe individual did not come back to the group home the evening she left.  Staff did not follow up with trying to call the individual, or the covering supervisor, case manager of individual or 911.  Staff believed the individual had either moved out of the home or was hospitalized and due to individual being her own guardian, did not consider this an elopement.   \\r\\n\\r\\nWhen the supervisor returned from vacation, she followed up by calling case manager, individual, and reporting the incident.  The individual did go to the hospital and was hospitalized inpatient.  She returned to the group home.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37861}','68.53.115.247','2021-05-26 22:07:05'),(26262,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37862,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37862}','68.53.115.247','2021-05-26 22:07:05'),(26263,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37863,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"Narrative\\r\\nElopement\\r\\nDecember 12, 2019 Mapping\\r\\n\\r\\n\\r\\nLearning Point:  Staff did not report individual\\u2019s absence for 5 days.\\r\\n\\r\\nStaff not following-up about where the individual was for 5 days after she left the group home was influenced by the staff believing the notification policy wasn\' t applicable TO this individual AND situation.Several factors influenced staff believing the policy wasn \'t applicable including the staff and the individual being newer to the home and the individual being her own guardian.  The two newer staff were less familiar with the support needs of this individual.  As her own guardian, the individual made her own healthcare decisions and did not have to share the information with staff. The individual had a history of being admitted to a hospital without staff knowledge.  The individual had a history of hospitalizations lasting several days which further contributed to staff not believing the policy was applicable.  The provider did have a policy that emergency contacts should be notified if an individual who is their own guardian is hospitalized which was not followed because staff did not know the individual went to the hospital. \\r\\nOther contributing factors to staff believing the notification policy wasn\'t applicable was the individual was her own guardian and allowed to be in the community unsupervised for an indeterminate amount of time.  The individual\\u2019s Community Support Plan (CSP) and Community Support Service Plan (CSSP), which is completed by the individual and a county case manager, did not indicate how much time the individual could have.  Staff would have to follow the consented to CSP and CSSP.  Case Manager\\u2019s comply with 245D for how and what is written in an individual\\u2019s CSP and CSSP.  The individual approved what was included in the plans.  The individual having unspecified time in the community influenced staff\'s decision that documenting when the individual left was sufficient. The individual regularly was in the community unsupervised so staff felt like it was okay to not notify anyone beyond the logging of their activity in the individual\\u2019s logbook. It was noted that staff didn\\u2019t have much time to communicate between shifts, so communication often took place in the logbooks instead of staff communication directly with one another regarding the individual.  The individual was admitted to this home directly from a discharge from a hospital and this home was one of only two choices.\\r\\n\\r\\nAnother influencing factor affecting staff not following-up to individual\\u2019s whereabouts was the staff being worried about calling their supervisor or manager when it wasn\'t necessary due to being of a culture that deffers to authority figures.   Staff were not of the dominant culture and may have felt intimidated by calling a supervisor with questions.\\r\\n\\r\\n\\r\\nAdditionally, staff not following up on the individual was influenced by the house supervisor being on vacation.  At the time, the provider was short staffed and some of the shifts at this residence were covered by non-routine or fill-in staff.  A lack of cross-training on the individuals supports needs and plan of care could influence staff not reporting the individual\\u2019s whereabouts.  The provider\'s overall staff shortage, and not just this residence, contributed to having non-routine staff supporting individuals and not having enough time to train non-routine staff on all the support needs of individuals in the group home.  Staff shortage is influenced by the state and national wide direct support professional workforce shortage. \\r\\n\\r\\nStaff not following up on their individual\\u2019s whereabouts was influenced by the individual keeping an irregular schedule and would often not tell staff where she was going or would tell different information to different staff about where she was going or would be. The individual was described as having much different support needs than the three other individuals living in the group home.  The decision to place the individual in a four person home was impacted by an overall lack of community residential settings in Minnesota.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37863}','68.53.115.247','2021-05-26 22:07:05'),(26264,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37864,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37864}','68.53.115.247','2021-05-26 22:07:05'),(26265,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37865,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37865}','68.53.115.247','2021-05-26 22:07:05'),(26266,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37866,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37866}','68.53.115.247','2021-05-26 22:07:05'),(26267,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37867,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37867}','68.53.115.247','2021-05-26 22:07:05'),(26268,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37868,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37868}','68.53.115.247','2021-05-26 22:07:05'),(26269,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37869,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"101\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"1\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37869}','68.53.115.247','2021-05-26 22:07:05'),(26270,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37870,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37870}','68.53.115.247','2021-05-26 22:07:05'),(26271,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37871,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"103\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37871}','68.53.115.247','2021-05-26 22:07:05'),(26272,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37872,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"104\",\"question_type\":\"Free_Text\",\"text_answer\":\"The individual was admitted to this home directly from a discharge from a hospital and this home was one of only two choices. The individual was admitted to this home directly from a discharge from a hospital and this home was one of only two choices.\\r\\n\\r\\nThe individual was described as having much different support needs than the three other individuals living in the group home.  The decision to place the individual in a home was impacted by an overall lack of community residential settings in Minnesota.  \\r\\n\\r\\nThe two newer staff were less familiar with the support needs of this individual.\\r\\n\\r\\nAt the time, the provider was short staffed and some of the shifts at this residence were covered by non-routine or fill-in staff.  A lack of cross-training on the individuals supports needs and plan of care could influence staff not reporting the individual\\u2019s whereabouts.  The provider\'s overall staff shortage, and not just this residence, contributed to having non-routine staff supporting individuals and not having enough time to train non-routine staff on all the support needs of individuals in the group home.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37872}','68.53.115.247','2021-05-26 22:07:05'),(26273,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37873,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"105\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37873}','68.53.115.247','2021-05-26 22:07:05'),(26274,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37874,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"106\",\"question_type\":\"Free_Text\",\"text_answer\":\"The individual\\u2019s Community Support Plan (CSP) and Community Support Service Plan (CSSP), which is completed by the individual and a county case manager, did not indicate how much time the individual could have.  Staff would have to follow the consented to CSP and CSSP.  Case Manager\\u2019s comply with 245D for how and what is written in an individual\\u2019s CSP and CSSP.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37874}','68.53.115.247','2021-05-26 22:07:05'),(26275,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37875,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37875}','68.53.115.247','2021-05-26 22:07:05'),(26276,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37876,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37876}','68.53.115.247','2021-05-26 22:07:05'),(26277,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37877,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"109\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37877}','68.53.115.247','2021-05-26 22:07:05'),(26278,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37878,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37878}','68.53.115.247','2021-05-26 22:07:05'),(26279,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37879,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"111\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37879}','68.53.115.247','2021-05-26 22:07:05'),(26280,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37880,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"112\",\"question_type\":\"Free_Text\",\"text_answer\":\"Staff not following-up about where the individual was for 5 days after she left the group home was influenced by the staff believing the notification policy wasn\'t applicable to this individual and situation. Several factors influenced staff believing the policy wasn\'t applicable including the staff and the individual being newer to the home and the individual being her own guardian.  \\r\\n\\r\\nThe individual having unspecified time in the community influenced staff\'s decision that documenting when the individual left was sufficient. The individual regularly was in the community unsupervised so staff felt like it was okay to not notify anyone beyond the logging of their activity in the individual\\u2019s logbook. \\r\\n\\r\\n As her own guardian, the individual made her own healthcare decisions and did not have to share the information with staff. The individual had a history of being admitted to a hospital without staff knowledge.  The individual had a history of hospitalizations lasting several days which further contributed to staff not believing the policy was applicable.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37880}','68.53.115.247','2021-05-26 22:07:05'),(26281,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37881,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37881}','68.53.115.247','2021-05-26 22:07:05'),(26282,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37882,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37882}','68.53.115.247','2021-05-26 22:07:05'),(26283,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37883,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"115\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37883}','68.53.115.247','2021-05-26 22:07:05'),(26284,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37884,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37884}','68.53.115.247','2021-05-26 22:07:05'),(26285,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37885,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37885}','68.53.115.247','2021-05-26 22:07:05'),(26286,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37886,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37886}','68.53.115.247','2021-05-26 22:07:05'),(26287,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37887,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"119\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37887}','68.53.115.247','2021-05-26 22:07:05'),(26288,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37888,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"120\",\"question_type\":\"Free_Text\",\"text_answer\":\"The individual was described as having much different support needs than the three other individuals living in the group home.  The decision to place the individual in a four person home was impacted by an overall lack of community residential settings in Minnesota.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37888}','68.53.115.247','2021-05-26 22:07:05'),(26289,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37889,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37889}','68.53.115.247','2021-05-26 22:07:05'),(26290,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37890,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37890}','68.53.115.247','2021-05-26 22:07:05'),(26291,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37891,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37891}','68.53.115.247','2021-05-26 22:07:05'),(26292,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37892,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37892}','68.53.115.247','2021-05-26 22:07:05'),(26293,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37893,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"125\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37893}','68.53.115.247','2021-05-26 22:07:05'),(26294,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37894,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37894}','68.53.115.247','2021-05-26 22:07:05'),(26295,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37895,'{\"report_id\":216,\"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\":\"5\\/26\\/2021 5:07:05 pm\",\"created_at\":\"5\\/26\\/2021 5:07:05 pm\",\"id\":37895}','68.53.115.247','2021-05-26 22:07:05'),(26296,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37896,'{\"report_id\":217,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"02\\/24\\/2020\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:40 pm\",\"created_at\":\"5\\/26\\/2021 5:07:40 pm\",\"id\":37896}','68.53.115.247','2021-05-26 22:07:40'),(26297,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37897,'{\"report_id\":217,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"02\\/24\\/2020\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:07:41 pm\",\"created_at\":\"5\\/26\\/2021 5:07:41 pm\",\"id\":37897}','68.53.115.247','2021-05-26 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22:08:55'),(26350,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37950,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"78\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Marilee Bengtson\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:08:55 pm\",\"created_at\":\"5\\/26\\/2021 5:08:55 pm\",\"id\":37950}','68.53.115.247','2021-05-26 22:08:55'),(26351,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37951,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Sara Beauchene\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:08:55 pm\",\"created_at\":\"5\\/26\\/2021 5:08:55 pm\",\"id\":37951}','68.53.115.247','2021-05-26 22:08:55'),(26352,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37952,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Meridian Services, Inc - Kentucky\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:08:55 pm\",\"created_at\":\"5\\/26\\/2021 5:08:55 pm\",\"id\":37952}','68.53.115.247','2021-05-26 22:08:55'),(26353,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37953,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Ginny Benson\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:08:55 pm\",\"created_at\":\"5\\/26\\/2021 5:08:55 pm\",\"id\":37953}','68.53.115.247','2021-05-26 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22:08:55'),(26356,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37956,'{\"report_id\":218,\"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\":\"5\\/26\\/2021 5:08:55 pm\",\"created_at\":\"5\\/26\\/2021 5:08:55 pm\",\"id\":37956}','68.53.115.247','2021-05-26 22:08:55'),(26357,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37957,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Hennepin County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:08:55 pm\",\"created_at\":\"5\\/26\\/2021 5:08:55 pm\",\"id\":37957}','68.53.115.247','2021-05-26 22:08:55'),(26358,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37958,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"08\\/09\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:08:55 pm\",\"created_at\":\"5\\/26\\/2021 5:08:55 pm\",\"id\":37958}','68.53.115.247','2021-05-26 22:08:55'),(26359,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37959,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"Vincent was released from the hospital on 8\\/9\\/2019 at approximately 10:30am to Meridian Services-Kentucky site.\\r\\nThis is a short term transition\\/crisis home home until permanent placement can be found. On Vincent\'s discharge orders he was\\r\\nprescribed Depakote 500mg each morning and 2000mg each evening for mood irritability. This order was not put on Vincent\'s medication\\r\\nadministration record at the Meridian site. Due to not being on the MAR, Vincent was not administered this medication. The error was\\r\\ndiscovered today at approximately 3:50pm. After consulting with our LPN, the medication will be started tonight as ordered. Vincent\'s last\\r\\ndose of administration would have been on Friday, August 9th 8:00am at the hospital before discharge.\\r\\n\\r\\nThe MAR was created by Alan Sloan, Program Manager at Kentucky. He also did the initial set-up in the medi-set. Stephanie Hughes did\\r\\nthe double check on the medi-set prior to being made available to staff for administration.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:08:55 pm\",\"created_at\":\"5\\/26\\/2021 5:08:55 pm\",\"id\":37959}','68.53.115.247','2021-05-26 22:08:55'),(26360,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37960,'{\"report_id\":218,\"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\":\"5\\/26\\/2021 5:08:55 pm\",\"created_at\":\"5\\/26\\/2021 5:08:55 pm\",\"id\":37960}','68.53.115.247','2021-05-26 22:08:55'),(26361,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37961,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Individual\'s Medication Administration Record (MAR) listed a daily medication as a PRN (as needed) medication.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:08:55 pm\",\"created_at\":\"5\\/26\\/2021 5:08:55 pm\",\"id\":37961}','68.53.115.247','2021-05-26 22:08:55'),(26362,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37962,'{\"report_id\":218,\"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\":\"5\\/26\\/2021 5:08:55 pm\",\"created_at\":\"5\\/26\\/2021 5:08:55 pm\",\"id\":37962}','68.53.115.247','2021-05-26 22:08:55'),(26363,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37963,'{\"report_id\":218,\"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\":\"5\\/26\\/2021 5:08:55 pm\",\"created_at\":\"5\\/26\\/2021 5:08:55 pm\",\"id\":37963}','68.53.115.247','2021-05-26 22:08:55'),(26364,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37964,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"Incident report description\\r\\nIndividual was discharged directly from the hospital to Meridian Kentucky, a Transition Home for adults.  Individual was prescribed Depakote 500 mg in the morning and 2000 mg in the evening every day for mood irritability per his discharge medication order.  Depakote was not put on the Medication Administration Record (MAR) at Meridian Kentucky as a daily medication, but as a PRN.  Due to not being on the MAR as a daily medication, the individual was not administered his medication for 8 administrations from 8\\/9 to 8\\/13.  The error was discovered mid-afternoon on 8\\/13 and the Meridian LPN called and who recommended medication be started again at individual\\u2019s night administration. \\r\\n\\r\\nDebriefing Information for Learning Point \\r\\nDebriefing date:\\tNovember 18, 2019\\r\\nPerson debriefed:\\tProgram Administrator\\r\\nMeridian staff, including the Program Manager of Kentucky went to the hospital to pick up individual to transport to Meridian Kentucky.  The Program Manager was given the individual\\u2019s Medication Orders signed by a physician, a Discharge Summary and the individual\\u2019s medication in prescription bottles.   At Meridian Kentucky, the Program Manager then completed the Medication Administration Record from the Discharge Summary which listed all the individual\\u2019s prescribed medications.  The MAR\\u2019s is used for staff to follow when administering the individual\\u2019s medication.  Then a lead staff reviewed\\/checked the MARS completed by the Program Manager for accuracy.  The lead staff signed off on the correctness of MARS.  \\r\\n\\r\\nThe Program Manager who completed the MARS no longer works for Meridian, not due to this incident but leaving state and was not available to be debriefed.  The Program Administrator (PA) of Meridian Kentucky was debriefed.  PA explained there are several checks and double checks documented in the process of completing a MARS.  The first was that when an individual is admitted directly from being discharged at hospital, that the actual signed Medication Order and the prescription bottles are to be reviewed to assure they match at the hospital.  Then the Program Manager should review the Medication Orders, and prescription bottles at the group home to again insure the match and then complete the MARS.  The PA stated that this was the first time the Program Manager had completed the MARS without supervision.  Then the process is the double checker, Lead Staff in this case, who was recently promoted and was her first time being a double checker, was to compare the signed order Medication Order, with the completed MARS, then compare the MARS to the created \\u201cmedi-set\\u201d of prescribed medications, then the completed medi-set back to the prescribed bottles. \\r\\n\\r\\nThe PA explained that the Program Manager was a newer employee to Meridian Services, had worked at this job for about 8 months, and again, it was the first time completing an intake and MARS independently.  The PA also stated the Program Manager developed the MARS with medication information from the Discharge Summary which also listed the prescribed medications.  The individual had an over the counter PRN listed on the Discharge Summary, and right below this PRN, Depakote was listed so it appeared it was also a PRN.  As stated previously, this was also the first time the Lead Staff, recently promoted, was responsible for double checking a MARS.  The Lead Staff noted the error around 4 days later.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37964}','68.53.115.247','2021-05-26 22:08:56'),(26365,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37965,'{\"report_id\":218,\"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\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37965}','68.53.115.247','2021-05-26 22:08:56'),(26366,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37966,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The Program Manager (PM) listing the daily medication as a PRN medication in the Medication Administration Record (MAR) was influenced by it being the PM\'s first time creating a MAR for a new admission of a person that was coming from a hospital discharge. The PM was working in an unfamiliar environment coordinating a discharge from the hospital and had never completed the forms related to both a hospital discharge and new admission to the provider. Further complicating this process was that PM felt pressure from the hospital to complete the discharge quickly. In turn, the PM felt rushed to complete the discharge process which includes creating a MARS due to hospital beds are in high demand due to a very low availability of psychiatric beds. This is influenced by the state regulating the number of hospital beds that need to be available as psychiatric beds.   \\r\\n\\r\\nOn the hospital discharge summary report the medications were in a list. The daily medication was listed right below the PRN category which influenced the PM\'s decision to list it as a PRN. The confusing layout of the discharge summary was influenced by the hospital\'s lack of understanding of licensed crisis homes.\\r\\n\\r\\nAdditionally, the PM listing the daily medication as a PRN medication was influenced by it being their first time creating a MAR without the house supervisor. The PM didn\'t typically work with PRNs and when they did, the house supervisor was leading the process in creating the MAR. \\r\\n\\r\\nAfter the MAR was completed, the home\\u2019s House Supervisor double checked the MAR for accuracy. Further contributing to the daily medication being incorrectly listed in the MAR is that the House Supervisor that completed the double check didn\'t catch the error on the MAR. The House Supervisor not identifying the error was influenced by her being new to the position and it was the first time they completed a double check of a MAR after a hospital discharge.   The double checker  may have been hesitant to correct her direct supervisor.\\r\\n\\r\\nAn additional factor influencing the PM listing the daily med as a PRN was that the MAR is created by the provider. Staff felt like the provider staff are not as knowledgeable about medications as a hospital or pharmacy would be. It was the provider\'s responsibility to create the MAR when the person was discharged from the hospital. The provider had a practice of signing and preparing medication orders 24-48 hours before admission to the provider\\u2019s residence. Confirming medication regimen prior to admission was a practice developed to decrease medication errors and ensure continuity between settings. However, sometimes there are medication changes at the hospital during that 24-48 hour window and that information may not be shared or updated within the MAR. While this practice of preparing the medication order in advance wasn\\u2019t required, it was influenced by licensing and liability laws for providers and the medication administration policies the provider created.  The provider\\u2019s medication administration policies were influenced by the county assigning the responsibility to providers and 245D licensing requirements.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37966}','68.53.115.247','2021-05-26 22:08:56'),(26367,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37967,'{\"report_id\":218,\"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\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37967}','68.53.115.247','2021-05-26 22:08:56'),(26368,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37968,'{\"report_id\":218,\"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\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37968}','68.53.115.247','2021-05-26 22:08:56'),(26369,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37969,'{\"report_id\":218,\"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\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37969}','68.53.115.247','2021-05-26 22:08:56'),(26370,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37970,'{\"report_id\":218,\"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\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37970}','68.53.115.247','2021-05-26 22:08:56'),(26371,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37971,'{\"report_id\":218,\"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\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37971}','68.53.115.247','2021-05-26 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22:08:56'),(26376,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37976,'{\"report_id\":218,\"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\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37976}','68.53.115.247','2021-05-26 22:08:56'),(26377,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37977,'{\"report_id\":218,\"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\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37977}','68.53.115.247','2021-05-26 22:08:56'),(26378,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37978,'{\"report_id\":218,\"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\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37978}','68.53.115.247','2021-05-26 22:08:56'),(26379,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37979,'{\"report_id\":218,\"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\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37979}','68.53.115.247','2021-05-26 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The daily medication was listed right below the PRN category which influenced the PM\'s decision to list it as a PRN. The confusing layout of the discharge summary was influenced by the hospital\'s lack of understanding of licensed crisis homes.\\r\\n\\r\\nThe provider had a practice of signing and preparing medication orders 24-48 hours before admission to the provider\\u2019s residence. Confirming medication regimen prior to admission was a practice developed to decrease medication errors and ensure continuity between settings. However, sometimes there are medication changes at the hospital during that 24-48 hour window and that information may not be shared or updated within the MAR. While this practice of preparing the medication order in advance wasn\\u2019t required, it was influenced by licensing and liability laws for providers and the medication administration policies the provider created.  The provider\\u2019s medication administration policies were influenced by the county assigning the responsibility to providers and 245D licensing requirements.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37981}','68.53.115.247','2021-05-26 22:08:56'),(26382,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37982,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"111\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37982}','68.53.115.247','2021-05-26 22:08:56'),(26383,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37983,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"112\",\"question_type\":\"Free_Text\",\"text_answer\":\"The Program Manager (PM) listing the daily medication as a PRN medication in the Medication Administration Record (MAR) was influenced by it being the PM\'s first time creating a MAR for a new admission of a person that was coming from a hospital discharge.  The PM was working in an unfamiliar environment coordinating a discharge from the hospital and had never completed the forms related to both a hospital discharge and new admission to the provider.\\r\\n\\r\\nAdditionally, the PM listing the daily medication as a PRN medication was influenced by it being their first time creating a MAR without the house supervisor. The PM didn\'t typically work with PRNs and when they did, the house supervisor was leading the process in creating the MAR. \\r\\n\\r\\nFurther contributing to the daily medication being incorrectly listed in the MAR is that the House Supervisor that completed the double check didn\'t catch the error on the MAR. The House Supervisor not identifying the error was influenced by her being new to their position and it was the first time they completed a double check of a MAR after a hospital discharge.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37983}','68.53.115.247','2021-05-26 22:08:56'),(26384,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37984,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"113\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"3\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37984}','68.53.115.247','2021-05-26 22:08:56'),(26385,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37985,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"114\",\"question_type\":\"Free_Text\",\"text_answer\":\"On the hospital discharge summary report the medications were in a list. The daily medication was listed right below the PRN category which influenced the PM\'s decision to list it as a PRN. The confusing layout of the discharge summary was influenced by the hospital\'s lack of understanding of licensed crisis homes.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37985}','68.53.115.247','2021-05-26 22:08:56'),(26386,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37986,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"115\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37986}','68.53.115.247','2021-05-26 22:08:56'),(26387,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37987,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"116\",\"question_type\":\"Free_Text\",\"text_answer\":\"The provider had a practice of signing and preparing medication orders 24-48 hours before admission to the provider\\u2019s residence. Confirming medication regimen prior to admission was a practice developed to decrease medication errors and ensure continuity between settings. However, sometimes there are medication changes at the hospital during that 24-48 hour window and that information may not be shared or updated within the MAR. While this practice of preparing the medication order in advance wasn\\u2019t required, it was influenced by licensing and liability laws for providers and the medication administration policies the provider created.  The provider\\u2019s medication administration policies were influenced by the county assigning the responsibility to providers and 245D licensing requirements.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37987}','68.53.115.247','2021-05-26 22:08:56'),(26388,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37988,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"117\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"2\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37988}','68.53.115.247','2021-05-26 22:08:56'),(26389,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37989,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"118\",\"question_type\":\"Free_Text\",\"text_answer\":\"Further complicating this process was that PM felt pressure from the hospital to complete the discharge quickly. In turn, the PM felt rushed to complete the discharge process which includes creating a MARS due to hospital beds are in high demand due to a very low availability of psychiatric beds\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37989}','68.53.115.247','2021-05-26 22:08:56'),(26390,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',37990,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"119\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"1\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:08:56 pm\",\"created_at\":\"5\\/26\\/2021 5:08:56 pm\",\"id\":37990}','68.53.115.247','2021-05-26 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22:11:46'),(26401,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',38001,'{\"report_id\":219,\"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\":\"5\\/26\\/2021 5:15:40 pm\",\"created_at\":\"5\\/26\\/2021 5:15:40 pm\",\"id\":38001}','68.53.115.247','2021-05-26 22:15:40'),(26402,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',38002,'{\"report_id\":219,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"01\\/28\\/2020\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:15:40 pm\",\"created_at\":\"5\\/26\\/2021 5:15:40 pm\",\"id\":38002}','68.53.115.247','2021-05-26 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22:15:40'),(26405,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',38005,'{\"report_id\":219,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Options Residential\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:15:40 pm\",\"created_at\":\"5\\/26\\/2021 5:15:40 pm\",\"id\":38005}','68.53.115.247','2021-05-26 22:15:40'),(26406,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',38006,'{\"report_id\":219,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Chantal Kraemer\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:15:40 pm\",\"created_at\":\"5\\/26\\/2021 5:15:40 pm\",\"id\":38006}','68.53.115.247','2021-05-26 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22:15:41'),(26411,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',38011,'{\"report_id\":219,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"11\\/05\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:15:41 pm\",\"created_at\":\"5\\/26\\/2021 5:15:41 pm\",\"id\":38011}','68.53.115.247','2021-05-26 22:15:41'),(26412,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',38012,'{\"report_id\":219,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"Individual\\u2019s DD Waiver residential services were terminated.  The provider stated that the termination was \\u201cnecessary for your welfare and your needs cannot be met in this facility\\u201d, the \\u201csafety of you or others in the program is endangered and positive strategies were attempted and have not achieved and effectively maintained safety of you and others\\u201d and lastly that the \\u201chealth of you and others in the program would otherwise be endangered\\u201d.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:15:41 pm\",\"created_at\":\"5\\/26\\/2021 5:15:41 pm\",\"id\":38012}','68.53.115.247','2021-05-26 22:15:41'),(26413,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',38013,'{\"report_id\":219,\"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\":\"5\\/26\\/2021 5:15:41 pm\",\"created_at\":\"5\\/26\\/2021 5:15:41 pm\",\"id\":38013}','68.53.115.247','2021-05-26 22:15:41'),(26414,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',38014,'{\"report_id\":219,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Service Termination due to individual\\u2019s needs not being able to be met in the group home.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:15:41 pm\",\"created_at\":\"5\\/26\\/2021 5:15:41 pm\",\"id\":38014}','68.53.115.247','2021-05-26 22:15:41'),(26415,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',38015,'{\"report_id\":219,\"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\":\"5\\/26\\/2021 5:15:41 pm\",\"created_at\":\"5\\/26\\/2021 5:15:41 pm\",\"id\":38015}','68.53.115.247','2021-05-26 22:15:41'),(26416,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',38016,'{\"report_id\":219,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"05\\/01\\/2020\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:15:41 pm\",\"created_at\":\"5\\/26\\/2021 5:15:41 pm\",\"id\":38016}','68.53.115.247','2021-05-26 22:15:41'),(26417,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',38017,'{\"report_id\":219,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"The individual was admitted to this home in 2015 directly from the hospital.  He is diagnosed with Autism Spectrum Disorder and Other Intellectual Disability.  At the time of his admission the individual was described as only communicating in 2-3 word utterances and by pointing.  Those debriefed made the comment he is very smart.  The individual was admitted directly from a psychiatric hospital discharge and described as very medicated.  The individual\\u2019s parents are his guardians.\\r\\nAt the beginning, the individual had significant interfering behavioral issues including aggression towards others and significant property destruction.  The provider implemented positive behavioral support strategies and with a decrease in medications, notice the individual gained communication abilities.\\r\\nThere was a time period where the individual had a decrease in behavioral issues, was better able to express his wants and needs and advocate for himself, developed relationships with his peers in the home and became more independent and needing less support.   The provider described using the positive support strategies of using a punching bag and speed bag to provide the individual with needed physical activity he found rewarding, used white noise in his room to help with his sensitivity to sounds his housemates made and he was able to go to his favorite activity Comacon.  \\r\\nUnfortunately, a housemate the individual was very close to in the home, described more like a sibling, passed away.  A new resident was eventually admitted, who was smaller in stature, cognitively functioned lower and made loud verbalizations.  \\r\\nThe individual began aggressing towards the new peer and had an increase in behaviors, again including significant property destruction.  The provider enlisted the services of a Behavior Analyst who found clear antecedents to the individual\\u2019s interfering behaviors which were his housemates waking earlier than he would like and making noise or peers doing an activity he did not want them to do. \\r\\nBeing aware the antecedents couldn\\u2019t be changed; the provider advocated the individual have a Person-Centered Plan completed.  The individual was very clear that he wanted to live on his own where he could control the environment. The provider also agreed this would be an appropriate setting with supports and even offered a residential setting where this could happen.  The individual\\u2019s guardians did not agree with this plan as they felt the individual required 24 hour support.\\r\\nThe provider decided to demit the individual as the setting he was in was not meeting his needs, nor was it the environment the client wanted to live in.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:15:41 pm\",\"created_at\":\"5\\/26\\/2021 5:15:41 pm\",\"id\":38017}','68.53.115.247','2021-05-26 22:15:41'),(26418,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',38018,'{\"report_id\":219,\"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\":\"5\\/26\\/2021 5:15:41 pm\",\"created_at\":\"5\\/26\\/2021 5:15:41 pm\",\"id\":38018}','68.53.115.247','2021-05-26 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22:15:41'),(26433,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',38033,'{\"report_id\":219,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"109\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:15:41 pm\",\"created_at\":\"5\\/26\\/2021 5:15:41 pm\",\"id\":38033}','68.53.115.247','2021-05-26 22:15:41'),(26434,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',38034,'{\"report_id\":219,\"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\":\"5\\/26\\/2021 5:15:41 pm\",\"created_at\":\"5\\/26\\/2021 5:15:41 pm\",\"id\":38034}','68.53.115.247','2021-05-26 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22:16:33'),(26459,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',38059,'{\"report_id\":220,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"paul.mcdowell@pathwaystocommunity.com\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:16:33 pm\",\"created_at\":\"5\\/26\\/2021 5:16:33 pm\",\"id\":38059}','68.53.115.247','2021-05-26 22:16:33'),(26460,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',38060,'{\"report_id\":220,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"83\",\"question_type\":\"Short_Answer\",\"text_answer\":\"651-641-4009\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:16:33 pm\",\"created_at\":\"5\\/26\\/2021 5:16:33 pm\",\"id\":38060}','68.53.115.247','2021-05-26 22:16:33'),(26461,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',38061,'{\"report_id\":220,\"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\":\"5\\/26\\/2021 5:16:33 pm\",\"created_at\":\"5\\/26\\/2021 5:16:33 pm\",\"id\":38061}','68.53.115.247','2021-05-26 22:16:33'),(26462,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',38062,'{\"report_id\":220,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Hennepin County\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:16:33 pm\",\"created_at\":\"5\\/26\\/2021 5:16:33 pm\",\"id\":38062}','68.53.115.247','2021-05-26 22:16:33'),(26463,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',38063,'{\"report_id\":220,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"03\\/30\\/2020\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:16:33 pm\",\"created_at\":\"5\\/26\\/2021 5:16:33 pm\",\"id\":38063}','68.53.115.247','2021-05-26 22:16:33'),(26464,'e6VDpcj7xuKlFWAHFjzCyIpYOvCCmp44Bbf6JqMy',81,'reports_answer','create',38064,'{\"report_id\":220,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"Arron eloped out of sight of Pathways staff, resulting in him being missing for nearly 24 hours at the time of this report\'s submission (3\\/31\\/21, 3:00pm).  reported that staff were following Arron engaging in fast walking in the community to deescalate, that he was at a bus stop at the time staff no longer could see him, and that it is unknown whether he boarded a bus or not. \\r\\nEmergency services, including police departments of Minneapolis, St. Paul, and Bloomington, have reportedly been notified and are assisting in the search, and a missing person\'s report was reportedly completed as soon as supervisor was aware that he was gone from staff\'s sight. have been looking for Arron since 4:00am 3\\/31 and that Arron\'s mom, Linda Huber, has been looking for him all day 3\\/31 as well. reported the concern that if Arron liked an initial bus ride, he may have ridden several busses and now be out of range of the police departments searching for him.  \\r\\nArron has an autism diagnosis and a history of police-related trauma and severe aggression. He has limited verbal skills and little to no awareness of whether something is safe or dangerous, who is safe to seek assistance from, or how to keep himself safe. \\r\\nIt is unknown at this point if Arron is still alive, the timeline in which he will be found, if has sustained physical and\\/or emotional injury at this point as the result of the lack of supervision. He has for sure missed medication, supervision, access to food, and access to shelter.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/26\\/2021 5:16:33 pm\",\"created_at\":\"5\\/26\\/2021 5:16:33 pm\",\"id\":38064}','68.53.115.247','2021-05-26 22:16:33');
