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15:17:25'),(12297,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15387,'{\"report_id\":209,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"2019-08-13 00:00:00\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15387}','68.53.115.247','2021-05-25 15:17:25'),(12298,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15388,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15388}','68.53.115.247','2021-05-25 15:17:25'),(12299,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15389,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15389}','68.53.115.247','2021-05-25 15:17:25'),(12300,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15390,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15390}','68.53.115.247','2021-05-25 15:17:25'),(12301,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15391,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15391}','68.53.115.247','2021-05-25 15:17:25'),(12302,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15392,'{\"report_id\":209,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"2019-10-22 00:00:00\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15392}','68.53.115.247','2021-05-25 15:17:25'),(12303,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15393,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15393}','68.53.115.247','2021-05-25 15:17:25'),(12304,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15394,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15394}','68.53.115.247','2021-05-25 15:17:25'),(12305,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15395,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15395}','68.53.115.247','2021-05-25 15:17:25'),(12306,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15396,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15396}','68.53.115.247','2021-05-25 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15:17:25'),(12321,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15411,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15411}','68.53.115.247','2021-05-25 15:17:25'),(12322,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15412,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15412}','68.53.115.247','2021-05-25 15:17:25'),(12323,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15413,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15413}','68.53.115.247','2021-05-25 15:17:25'),(12324,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15414,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15414}','68.53.115.247','2021-05-25 15:17:25'),(12325,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15415,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15415}','68.53.115.247','2021-05-25 15:17:25'),(12326,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15416,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15416}','68.53.115.247','2021-05-25 15:17:25'),(12327,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15417,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15417}','68.53.115.247','2021-05-25 15:17:25'),(12328,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15418,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15418}','68.53.115.247','2021-05-25 15:17:25'),(12329,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15419,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15419}','68.53.115.247','2021-05-25 15:17:25'),(12330,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15420,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15420}','68.53.115.247','2021-05-25 15:17:25'),(12331,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15421,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15421}','68.53.115.247','2021-05-25 15:17:25'),(12332,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15422,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15422}','68.53.115.247','2021-05-25 15:17:25'),(12333,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15423,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15423}','68.53.115.247','2021-05-25 15:17:25'),(12334,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15424,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15424}','68.53.115.247','2021-05-25 15:17:25'),(12335,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15425,'{\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15425}','68.53.115.247','2021-05-25 15:17:25'),(12336,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15426,'{\"report_id\":209,\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15426}','68.53.115.247','2021-05-25 15:17:25'),(12337,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15427,'{\"report_id\":209,\"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\\/25\\/2021 10:17:25 am\",\"created_at\":\"5\\/25\\/2021 10:17:25 am\",\"id\":15427}','68.53.115.247','2021-05-25 15:17:25'),(12338,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15428,'{\"report_id\":239,\"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\\/25\\/2021 10:18:29 am\",\"created_at\":\"5\\/25\\/2021 10:18:29 am\",\"id\":15428}','68.53.115.247','2021-05-25 15:18:29'),(12339,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15429,'{\"report_id\":239,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"201900069\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:18:32 am\",\"created_at\":\"5\\/25\\/2021 10:18:32 am\",\"id\":15429}','68.53.115.247','2021-05-25 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15:18:32'),(12342,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15432,'{\"report_id\":239,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Tony Gantenbein\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:18:32 am\",\"created_at\":\"5\\/25\\/2021 10:18:32 am\",\"id\":15432}','68.53.115.247','2021-05-25 15:18:32'),(12343,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15433,'{\"report_id\":239,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Howry Southside\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:18:32 am\",\"created_at\":\"5\\/25\\/2021 10:18:32 am\",\"id\":15433}','68.53.115.247','2021-05-25 15:18:32'),(12344,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15434,'{\"report_id\":239,\"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\\/25\\/2021 10:18:32 am\",\"created_at\":\"5\\/25\\/2021 10:18:32 am\",\"id\":15434}','68.53.115.247','2021-05-25 15:18:32'),(12345,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15435,'{\"report_id\":239,\"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\\/25\\/2021 10:18:32 am\",\"created_at\":\"5\\/25\\/2021 10:18:32 am\",\"id\":15435}','68.53.115.247','2021-05-25 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15:18:32'),(12348,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15438,'{\"report_id\":239,\"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\\/25\\/2021 10:18:32 am\",\"created_at\":\"5\\/25\\/2021 10:18:32 am\",\"id\":15438}','68.53.115.247','2021-05-25 15:18:32'),(12349,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15439,'{\"report_id\":239,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"2019-01-02 00:00:00\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:18:32 am\",\"created_at\":\"5\\/25\\/2021 10:18:32 am\",\"id\":15439}','68.53.115.247','2021-05-25 15:18:32'),(12350,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15440,'{\"report_id\":239,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"VA is describing increasing frustration and low mood as a result of these incidents. He does not feel comfortable with staff assistance and therefore isolates himself in his room.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:18:32 am\",\"created_at\":\"5\\/25\\/2021 10:18:32 am\",\"id\":15440}','68.53.115.247','2021-05-25 15:18:32'),(12351,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15441,'{\"report_id\":239,\"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\\/25\\/2021 10:18:32 am\",\"created_at\":\"5\\/25\\/2021 10:18:32 am\",\"id\":15441}','68.53.115.247','2021-05-25 15:18:32'),(12352,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15442,'{\"report_id\":239,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Staff did not hear person call for assistance after falling\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:18:32 am\",\"created_at\":\"5\\/25\\/2021 10:18:32 am\",\"id\":15442}','68.53.115.247','2021-05-25 15:18:32'),(12353,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15443,'{\"report_id\":239,\"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\\/25\\/2021 10:18:32 am\",\"created_at\":\"5\\/25\\/2021 10:18:32 am\",\"id\":15443}','68.53.115.247','2021-05-25 15:18:32'),(12354,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15444,'{\"report_id\":239,\"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\\/25\\/2021 10:18:32 am\",\"created_at\":\"5\\/25\\/2021 10:18:32 am\",\"id\":15444}','68.53.115.247','2021-05-25 15:18:32'),(12355,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15445,'{\"report_id\":239,\"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\\/25\\/2021 10:18:32 am\",\"created_at\":\"5\\/25\\/2021 10:18:32 am\",\"id\":15445}','68.53.115.247','2021-05-25 15:18:32'),(12356,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15446,'{\"report_id\":239,\"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\\/25\\/2021 10:18:32 am\",\"created_at\":\"5\\/25\\/2021 10:18:32 am\",\"id\":15446}','68.53.115.247','2021-05-25 15:18:32'),(12357,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15447,'{\"report_id\":239,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The overnight asleep direct service provider\\u2019s ability to hear the vulnerable adult\\u2019s calls for assistance was impacted by the VA being a soft spoken individual and the existence of routine overnight \\u201cwhite\\u201d noise in the home from roommates (TV, radio, electronics, etc.).  \\r\\nThe direct service provider\\u2019s ability to hear the vulnerable adult\\u2019s call for assistance was impacted by the fact that the provider only provides overnight asleep staff at this site.  This decision was made by the provider based on the support needs of the other three residents in the home which reflected the information provided in their assessments and service plans and the information provided by the vulnerable adult\\u2019s CM before admission\\r\\nThe pre-admission information the case manager provides to the provider varies by person and may have been impacted by a lack of resources and options due to the current moratorium on new adult foster (CRS) beds.  Based on the information provided the case manager and provider discussed these needs prior to the VA moving into the home and all agreed that the provider could meet the needs of the VA with an asleep overnight staff person.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:18:32 am\",\"created_at\":\"5\\/25\\/2021 10:18:32 am\",\"id\":15447}','68.53.115.247','2021-05-25 15:18:32'),(12358,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15448,'{\"report_id\":239,\"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\\/25\\/2021 10:18:32 am\",\"created_at\":\"5\\/25\\/2021 10:18:32 am\",\"id\":15448}','68.53.115.247','2021-05-25 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15:18:33'),(12361,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15451,'{\"report_id\":239,\"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\\/25\\/2021 10:18:33 am\",\"created_at\":\"5\\/25\\/2021 10:18:33 am\",\"id\":15451}','68.53.115.247','2021-05-25 15:18:33'),(12362,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15452,'{\"report_id\":239,\"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\\/25\\/2021 10:18:33 am\",\"created_at\":\"5\\/25\\/2021 10:18:33 am\",\"id\":15452}','68.53.115.247','2021-05-25 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15:18:57'),(12400,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15490,'{\"report_id\":209,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"2019-08-13 00:00:00\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:18:58 am\",\"created_at\":\"5\\/25\\/2021 10:18:58 am\",\"id\":15490}','68.53.115.247','2021-05-25 15:18:58'),(12401,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15491,'{\"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\\/25\\/2021 10:18:58 am\",\"created_at\":\"5\\/25\\/2021 10:18:58 am\",\"id\":15491}','68.53.115.247','2021-05-25 15:18:58'),(12402,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15492,'{\"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\\/25\\/2021 10:18:58 am\",\"created_at\":\"5\\/25\\/2021 10:18:58 am\",\"id\":15492}','68.53.115.247','2021-05-25 15:18:58'),(12403,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15493,'{\"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\\/25\\/2021 10:18:58 am\",\"created_at\":\"5\\/25\\/2021 10:18:58 am\",\"id\":15493}','68.53.115.247','2021-05-25 15:18:58'),(12404,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15494,'{\"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\\/25\\/2021 10:18:58 am\",\"created_at\":\"5\\/25\\/2021 10:18:58 am\",\"id\":15494}','68.53.115.247','2021-05-25 15:18:58'),(12405,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15495,'{\"report_id\":209,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"2019-10-22 00:00:00\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:18:58 am\",\"created_at\":\"5\\/25\\/2021 10:18:58 am\",\"id\":15495}','68.53.115.247','2021-05-25 15:18:58'),(12406,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15496,'{\"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\\/25\\/2021 10:18:58 am\",\"created_at\":\"5\\/25\\/2021 10:18:58 am\",\"id\":15496}','68.53.115.247','2021-05-25 15:18:58'),(12407,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15497,'{\"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\\/25\\/2021 10:18:58 am\",\"created_at\":\"5\\/25\\/2021 10:18:58 am\",\"id\":15497}','68.53.115.247','2021-05-25 15:18:58'),(12408,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15498,'{\"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\\/25\\/2021 10:18:58 am\",\"created_at\":\"5\\/25\\/2021 10:18:58 am\",\"id\":15498}','68.53.115.247','2021-05-25 15:18:58'),(12409,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15499,'{\"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\\/25\\/2021 10:18:58 am\",\"created_at\":\"5\\/25\\/2021 10:18:58 am\",\"id\":15499}','68.53.115.247','2021-05-25 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15:18:59'),(12424,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15514,'{\"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\\/25\\/2021 10:18:59 am\",\"created_at\":\"5\\/25\\/2021 10:18:59 am\",\"id\":15514}','68.53.115.247','2021-05-25 15:18:59'),(12425,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15515,'{\"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\\/25\\/2021 10:18:59 am\",\"created_at\":\"5\\/25\\/2021 10:18:59 am\",\"id\":15515}','68.53.115.247','2021-05-25 15:18:59'),(12426,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15516,'{\"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\\/25\\/2021 10:18:59 am\",\"created_at\":\"5\\/25\\/2021 10:18:59 am\",\"id\":15516}','68.53.115.247','2021-05-25 15:18:59'),(12427,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15517,'{\"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\\/25\\/2021 10:18:59 am\",\"created_at\":\"5\\/25\\/2021 10:18:59 am\",\"id\":15517}','68.53.115.247','2021-05-25 15:18:59'),(12428,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15518,'{\"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\\/25\\/2021 10:18:59 am\",\"created_at\":\"5\\/25\\/2021 10:18:59 am\",\"id\":15518}','68.53.115.247','2021-05-25 15:18:59'),(12429,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15519,'{\"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\\/25\\/2021 10:18:59 am\",\"created_at\":\"5\\/25\\/2021 10:18:59 am\",\"id\":15519}','68.53.115.247','2021-05-25 15:18:59'),(12430,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15520,'{\"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\\/25\\/2021 10:18:59 am\",\"created_at\":\"5\\/25\\/2021 10:18:59 am\",\"id\":15520}','68.53.115.247','2021-05-25 15:18:59'),(12431,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15521,'{\"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\\/25\\/2021 10:18:59 am\",\"created_at\":\"5\\/25\\/2021 10:18:59 am\",\"id\":15521}','68.53.115.247','2021-05-25 15:18:59'),(12432,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15522,'{\"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\\/25\\/2021 10:18:59 am\",\"created_at\":\"5\\/25\\/2021 10:18:59 am\",\"id\":15522}','68.53.115.247','2021-05-25 15:18:59'),(12433,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15523,'{\"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\\/25\\/2021 10:18:59 am\",\"created_at\":\"5\\/25\\/2021 10:18:59 am\",\"id\":15523}','68.53.115.247','2021-05-25 15:18:59'),(12434,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15524,'{\"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\\/25\\/2021 10:19:00 am\",\"created_at\":\"5\\/25\\/2021 10:19:00 am\",\"id\":15524}','68.53.115.247','2021-05-25 15:19:00'),(12435,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15525,'{\"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\\/25\\/2021 10:19:00 am\",\"created_at\":\"5\\/25\\/2021 10:19:00 am\",\"id\":15525}','68.53.115.247','2021-05-25 15:19:00'),(12436,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15526,'{\"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\\/25\\/2021 10:19:00 am\",\"created_at\":\"5\\/25\\/2021 10:19:00 am\",\"id\":15526}','68.53.115.247','2021-05-25 15:19:00'),(12437,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15527,'{\"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\\/25\\/2021 10:19:00 am\",\"created_at\":\"5\\/25\\/2021 10:19:00 am\",\"id\":15527}','68.53.115.247','2021-05-25 15:19:00'),(12438,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15528,'{\"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\\/25\\/2021 10:19:00 am\",\"created_at\":\"5\\/25\\/2021 10:19:00 am\",\"id\":15528}','68.53.115.247','2021-05-25 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15:19:18'),(12447,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15537,'{\"report_id\":210,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Jennifer Klaas\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:19:18 am\",\"created_at\":\"5\\/25\\/2021 10:19:18 am\",\"id\":15537}','68.53.115.247','2021-05-25 15:19:18'),(12448,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15538,'{\"report_id\":210,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"82\",\"question_type\":\"Short_Answer\",\"text_answer\":\"heartlandhomes.jk34@outlook.com\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:19:18 am\",\"created_at\":\"5\\/25\\/2021 10:19:18 am\",\"id\":15538}','68.53.115.247','2021-05-25 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15:19:18'),(12451,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15541,'{\"report_id\":210,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:19:18 am\",\"created_at\":\"5\\/25\\/2021 10:19:18 am\",\"id\":15541}','68.53.115.247','2021-05-25 15:19:18'),(12452,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15542,'{\"report_id\":210,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"2021-02-08 00:00:00\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:19:18 am\",\"created_at\":\"5\\/25\\/2021 10:19:18 am\",\"id\":15542}','68.53.115.247','2021-05-25 15:19:18'),(12453,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15543,'{\"report_id\":210,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"Monday, 2\\/8\\/21 11:15am. Darryl had left our facility to use independence. Darryl told the staff he would return home at 5pm. Darryl did not return on Monday 2\\/8\\/21.  \\r\\n\\r\\nTuesday 2\\/9\\/21, Darryl still had still not returned to our facility. We called 911 at 11am to report a missing person. Darryl called our facility at 2pm and stated he would be returning home in the evening. Darryl did not return home.  \\r\\n\\r\\nWednesday, 2\\/10\\/21. He called our facility at 8am and stated he would be returning home. A female grabbed the phone and started speaking to the house staff, and stated she took care of him and made sure he did his blood sugar tests. She used someone else\'s needles to do blood checks.  \\r\\n\\r\\nDarryl just returned to the facility at 10:45am.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:19:18 am\",\"created_at\":\"5\\/25\\/2021 10:19:18 am\",\"id\":15543}','68.53.115.247','2021-05-25 15:19:18'),(12454,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15544,'{\"report_id\":210,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"96\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:19:18 am\",\"created_at\":\"5\\/25\\/2021 10:19:18 am\",\"id\":15544}','68.53.115.247','2021-05-25 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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\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15593}','68.53.115.247','2021-05-25 15:19:54'),(12504,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15594,'{\"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\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15594}','68.53.115.247','2021-05-25 15:19:54'),(12505,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15595,'{\"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\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15595}','68.53.115.247','2021-05-25 15:19:54'),(12506,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15596,'{\"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\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15596}','68.53.115.247','2021-05-25 15:19:54'),(12507,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15597,'{\"report_id\":211,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"2020-09-18 00:00:00\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15597}','68.53.115.247','2021-05-25 15:19:54'),(12508,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15598,'{\"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\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15598}','68.53.115.247','2021-05-25 15:19:54'),(12509,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15599,'{\"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\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15599}','68.53.115.247','2021-05-25 15:19:54'),(12510,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15600,'{\"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. The 6790 is impacted by the Community Services and Support Plan that outlines the supervision level based upon the MnCHOICES assessment.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15600}','68.53.115.247','2021-05-25 15:19:54'),(12511,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15601,'{\"report_id\":211,\"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\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15601}','68.53.115.247','2021-05-25 15:19:54'),(12512,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15602,'{\"report_id\":211,\"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\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15602}','68.53.115.247','2021-05-25 15:19:54'),(12513,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15603,'{\"report_id\":211,\"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\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15603}','68.53.115.247','2021-05-25 15:19:54'),(12514,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15604,'{\"report_id\":211,\"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\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15604}','68.53.115.247','2021-05-25 15:19:54'),(12515,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15605,'{\"report_id\":211,\"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\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15605}','68.53.115.247','2021-05-25 15:19:54'),(12516,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15606,'{\"report_id\":211,\"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\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15606}','68.53.115.247','2021-05-25 15:19:54'),(12517,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15607,'{\"report_id\":211,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":\"Staff lying down was directly influenced by the staff member having a headache and that there was another awake staff present. 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).\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15607}','68.53.115.247','2021-05-25 15:19:54'),(12518,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15608,'{\"report_id\":211,\"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\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15608}','68.53.115.247','2021-05-25 15:19:54'),(12519,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15609,'{\"report_id\":211,\"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\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15609}','68.53.115.247','2021-05-25 15:19:54'),(12520,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15610,'{\"report_id\":211,\"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\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15610}','68.53.115.247','2021-05-25 15:19:54'),(12521,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15611,'{\"report_id\":211,\"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\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15611}','68.53.115.247','2021-05-25 15:19:54'),(12522,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15612,'{\"report_id\":211,\"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\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15612}','68.53.115.247','2021-05-25 15:19:54'),(12523,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15613,'{\"report_id\":211,\"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\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15613}','68.53.115.247','2021-05-25 15:19:54'),(12524,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15614,'{\"report_id\":211,\"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\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15614}','68.53.115.247','2021-05-25 15:19:54'),(12525,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15615,'{\"report_id\":211,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"110\",\"question_type\":\"Free_Text\",\"text_answer\":\"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. 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\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15615}','68.53.115.247','2021-05-25 15:19:54'),(12526,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15616,'{\"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\\/25\\/2021 10:19:54 am\",\"created_at\":\"5\\/25\\/2021 10:19:54 am\",\"id\":15616}','68.53.115.247','2021-05-25 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15:20:27'),(12545,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15635,'{\"report_id\":211,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"78\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Kelly Slather\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:20:27 am\",\"created_at\":\"5\\/25\\/2021 10:20:27 am\",\"id\":15635}','68.53.115.247','2021-05-25 15:20:27'),(12546,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15636,'{\"report_id\":211,\"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\\/25\\/2021 10:20:27 am\",\"created_at\":\"5\\/25\\/2021 10:20:27 am\",\"id\":15636}','68.53.115.247','2021-05-25 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15:20:27'),(12551,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15641,'{\"report_id\":211,\"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\\/25\\/2021 10:20:27 am\",\"created_at\":\"5\\/25\\/2021 10:20:27 am\",\"id\":15641}','68.53.115.247','2021-05-25 15:20:27'),(12552,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15642,'{\"report_id\":211,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:20:27 am\",\"created_at\":\"5\\/25\\/2021 10:20:27 am\",\"id\":15642}','68.53.115.247','2021-05-25 15:20:27'),(12553,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15643,'{\"report_id\":211,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"2020-06-16 00:00:00\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:20:27 am\",\"created_at\":\"5\\/25\\/2021 10:20:27 am\",\"id\":15643}','68.53.115.247','2021-05-25 15:20:27'),(12554,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15644,'{\"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\\/25\\/2021 10:20:27 am\",\"created_at\":\"5\\/25\\/2021 10:20:27 am\",\"id\":15644}','68.53.115.247','2021-05-25 15:20:27'),(12555,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15645,'{\"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\\/25\\/2021 10:20:27 am\",\"created_at\":\"5\\/25\\/2021 10:20:27 am\",\"id\":15645}','68.53.115.247','2021-05-25 15:20:27'),(12556,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15646,'{\"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\\/25\\/2021 10:20:27 am\",\"created_at\":\"5\\/25\\/2021 10:20:27 am\",\"id\":15646}','68.53.115.247','2021-05-25 15:20:27'),(12557,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15647,'{\"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\\/25\\/2021 10:20:27 am\",\"created_at\":\"5\\/25\\/2021 10:20:27 am\",\"id\":15647}','68.53.115.247','2021-05-25 15:20:27'),(12558,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15648,'{\"report_id\":211,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"2020-09-18 00:00:00\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:20:27 am\",\"created_at\":\"5\\/25\\/2021 10:20:27 am\",\"id\":15648}','68.53.115.247','2021-05-25 15:20:27'),(12559,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15649,'{\"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\\/25\\/2021 10:20:27 am\",\"created_at\":\"5\\/25\\/2021 10:20:27 am\",\"id\":15649}','68.53.115.247','2021-05-25 15:20:27'),(12560,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15650,'{\"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\\/25\\/2021 10:20:27 am\",\"created_at\":\"5\\/25\\/2021 10:20:27 am\",\"id\":15650}','68.53.115.247','2021-05-25 15:20:27'),(12561,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15651,'{\"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. The 6790 is impacted by the Community Services and Support Plan that outlines the supervision level based upon the MnCHOICES assessment.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:20:27 am\",\"created_at\":\"5\\/25\\/2021 10:20:27 am\",\"id\":15651}','68.53.115.247','2021-05-25 15:20:27'),(12562,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15652,'{\"report_id\":211,\"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\\/25\\/2021 10:20:27 am\",\"created_at\":\"5\\/25\\/2021 10:20:27 am\",\"id\":15652}','68.53.115.247','2021-05-25 15:20:27'),(12563,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15653,'{\"report_id\":211,\"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\\/25\\/2021 10:20:27 am\",\"created_at\":\"5\\/25\\/2021 10:20:27 am\",\"id\":15653}','68.53.115.247','2021-05-25 15:20:27'),(12564,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15654,'{\"report_id\":211,\"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\\/25\\/2021 10:20:27 am\",\"created_at\":\"5\\/25\\/2021 10:20:27 am\",\"id\":15654}','68.53.115.247','2021-05-25 15:20:27'),(12565,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15655,'{\"report_id\":211,\"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\\/25\\/2021 10:20:27 am\",\"created_at\":\"5\\/25\\/2021 10:20:27 am\",\"id\":15655}','68.53.115.247','2021-05-25 15:20:27'),(12566,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15656,'{\"report_id\":211,\"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\\/25\\/2021 10:20:27 am\",\"created_at\":\"5\\/25\\/2021 10:20:27 am\",\"id\":15656}','68.53.115.247','2021-05-25 15:20:27'),(12567,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15657,'{\"report_id\":211,\"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\\/25\\/2021 10:20:27 am\",\"created_at\":\"5\\/25\\/2021 10:20:27 am\",\"id\":15657}','68.53.115.247','2021-05-25 15:20:27'),(12568,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15658,'{\"report_id\":211,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":\"Staff lying down was directly influenced by the staff member having a headache and that there was another awake staff present. 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15:21:19'),(12602,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15692,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15692}','68.53.115.247','2021-05-25 15:21:19'),(12603,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15693,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15693}','68.53.115.247','2021-05-25 15:21:19'),(12604,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15694,'{\"report_id\":212,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15694}','68.53.115.247','2021-05-25 15:21:19'),(12605,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15695,'{\"report_id\":212,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"2019-06-10 00:00:00\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15695}','68.53.115.247','2021-05-25 15:21:19'),(12606,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15696,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15696}','68.53.115.247','2021-05-25 15:21:19'),(12607,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15697,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15697}','68.53.115.247','2021-05-25 15:21:19'),(12608,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15698,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15698}','68.53.115.247','2021-05-25 15:21:19'),(12609,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15699,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15699}','68.53.115.247','2021-05-25 15:21:19'),(12610,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15700,'{\"report_id\":212,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"2019-08-23 00:00:00\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15700}','68.53.115.247','2021-05-25 15:21:19'),(12611,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15701,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15701}','68.53.115.247','2021-05-25 15:21:19'),(12612,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15702,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15702}','68.53.115.247','2021-05-25 15:21:19'),(12613,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15703,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15703}','68.53.115.247','2021-05-25 15:21:19'),(12614,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15704,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15704}','68.53.115.247','2021-05-25 15:21:19'),(12615,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15705,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15705}','68.53.115.247','2021-05-25 15:21:19'),(12616,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15706,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15706}','68.53.115.247','2021-05-25 15:21:19'),(12617,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15707,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15707}','68.53.115.247','2021-05-25 15:21:19'),(12618,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15708,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15708}','68.53.115.247','2021-05-25 15:21:19'),(12619,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15709,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15709}','68.53.115.247','2021-05-25 15:21:19'),(12620,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15710,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15710}','68.53.115.247','2021-05-25 15:21:19'),(12621,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15711,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15711}','68.53.115.247','2021-05-25 15:21:19'),(12622,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15712,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15712}','68.53.115.247','2021-05-25 15:21:19'),(12623,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15713,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15713}','68.53.115.247','2021-05-25 15:21:19'),(12624,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15714,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15714}','68.53.115.247','2021-05-25 15:21:19'),(12625,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15715,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15715}','68.53.115.247','2021-05-25 15:21:19'),(12626,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15716,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15716}','68.53.115.247','2021-05-25 15:21:19'),(12627,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15717,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15717}','68.53.115.247','2021-05-25 15:21:19'),(12628,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15718,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15718}','68.53.115.247','2021-05-25 15:21:19'),(12629,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15719,'{\"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\\/25\\/2021 10:21:19 am\",\"created_at\":\"5\\/25\\/2021 10:21:19 am\",\"id\":15719}','68.53.115.247','2021-05-25 15:21:19'),(12630,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15720,'{\"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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15:22:02'),(12658,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15748,'{\"report_id\":213,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"The reason for the service termination is: \\r\\n- the termination is necessary for Dominic\'s welfare and his needs cannot be met in our programs\\r\\n- Dominic\'s safety and that of his housemate and staff is endangered and positive support strategies that have been attempted have not achieved and effectively maintained 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\\/25\\/2021 10:22:02 am\",\"created_at\":\"5\\/25\\/2021 10:22:02 am\",\"id\":15748}','68.53.115.247','2021-05-25 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15:22:02'),(12661,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15751,'{\"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\\/25\\/2021 10:22:02 am\",\"created_at\":\"5\\/25\\/2021 10:22:02 am\",\"id\":15751}','68.53.115.247','2021-05-25 15:22:02'),(12662,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15752,'{\"report_id\":213,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"2020-02-04 00:00:00\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:22:02 am\",\"created_at\":\"5\\/25\\/2021 10:22:02 am\",\"id\":15752}','68.53.115.247','2021-05-25 15:22:02'),(12663,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15753,'{\"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\\/25\\/2021 10:22:02 am\",\"created_at\":\"5\\/25\\/2021 10:22:02 am\",\"id\":15753}','68.53.115.247','2021-05-25 15:22:02'),(12664,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15754,'{\"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\\/25\\/2021 10:22:02 am\",\"created_at\":\"5\\/25\\/2021 10:22:02 am\",\"id\":15754}','68.53.115.247','2021-05-25 15:22:02'),(12665,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15755,'{\"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\\/25\\/2021 10:22:02 am\",\"created_at\":\"5\\/25\\/2021 10:22:02 am\",\"id\":15755}','68.53.115.247','2021-05-25 15:22:02'),(12666,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15756,'{\"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\\/25\\/2021 10:22:02 am\",\"created_at\":\"5\\/25\\/2021 10:22:02 am\",\"id\":15756}','68.53.115.247','2021-05-25 15:22:02'),(12667,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15757,'{\"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\\/25\\/2021 10:22:02 am\",\"created_at\":\"5\\/25\\/2021 10:22:02 am\",\"id\":15757}','68.53.115.247','2021-05-25 15:22:02'),(12668,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15758,'{\"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\\/25\\/2021 10:22:02 am\",\"created_at\":\"5\\/25\\/2021 10:22:02 am\",\"id\":15758}','68.53.115.247','2021-05-25 15:22:02'),(12669,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15759,'{\"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\\/25\\/2021 10:22:02 am\",\"created_at\":\"5\\/25\\/2021 10:22:02 am\",\"id\":15759}','68.53.115.247','2021-05-25 15:22:02'),(12670,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15760,'{\"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\\/25\\/2021 10:22:02 am\",\"created_at\":\"5\\/25\\/2021 10:22:02 am\",\"id\":15760}','68.53.115.247','2021-05-25 15:22:02'),(12671,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15761,'{\"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\\/25\\/2021 10:22:02 am\",\"created_at\":\"5\\/25\\/2021 10:22:02 am\",\"id\":15761}','68.53.115.247','2021-05-25 15:22:02'),(12672,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15762,'{\"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\\/25\\/2021 10:22:02 am\",\"created_at\":\"5\\/25\\/2021 10:22:02 am\",\"id\":15762}','68.53.115.247','2021-05-25 15:22:02'),(12673,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15763,'{\"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\\/25\\/2021 10:22:02 am\",\"created_at\":\"5\\/25\\/2021 10:22:02 am\",\"id\":15763}','68.53.115.247','2021-05-25 15:22:02'),(12674,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15764,'{\"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\\/25\\/2021 10:22:02 am\",\"created_at\":\"5\\/25\\/2021 10:22:02 am\",\"id\":15764}','68.53.115.247','2021-05-25 15:22:02'),(12675,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15765,'{\"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\\/25\\/2021 10:22:02 am\",\"created_at\":\"5\\/25\\/2021 10:22:02 am\",\"id\":15765}','68.53.115.247','2021-05-25 15:22:02'),(12676,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15766,'{\"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\\/25\\/2021 10:22:02 am\",\"created_at\":\"5\\/25\\/2021 10:22:02 am\",\"id\":15766}','68.53.115.247','2021-05-25 15:22:02'),(12677,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15767,'{\"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\\/25\\/2021 10:22:02 am\",\"created_at\":\"5\\/25\\/2021 10:22:02 am\",\"id\":15767}','68.53.115.247','2021-05-25 15:22:02'),(12678,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15768,'{\"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\\/25\\/2021 10:22:03 am\",\"created_at\":\"5\\/25\\/2021 10:22:03 am\",\"id\":15768}','68.53.115.247','2021-05-25 15:22:03'),(12679,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15769,'{\"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\\/25\\/2021 10:22:03 am\",\"created_at\":\"5\\/25\\/2021 10:22:03 am\",\"id\":15769}','68.53.115.247','2021-05-25 15:22:03'),(12680,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15770,'{\"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\\/25\\/2021 10:22:03 am\",\"created_at\":\"5\\/25\\/2021 10:22:03 am\",\"id\":15770}','68.53.115.247','2021-05-25 15:22:03'),(12681,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15771,'{\"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\\/25\\/2021 10:22:03 am\",\"created_at\":\"5\\/25\\/2021 10:22:03 am\",\"id\":15771}','68.53.115.247','2021-05-25 15:22:03'),(12682,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15772,'{\"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\\/25\\/2021 10:22:03 am\",\"created_at\":\"5\\/25\\/2021 10:22:03 am\",\"id\":15772}','68.53.115.247','2021-05-25 15:22:03'),(12683,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15773,'{\"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\\/25\\/2021 10:22:03 am\",\"created_at\":\"5\\/25\\/2021 10:22:03 am\",\"id\":15773}','68.53.115.247','2021-05-25 15:22:03'),(12684,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15774,'{\"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\\/25\\/2021 10:22:03 am\",\"created_at\":\"5\\/25\\/2021 10:22:03 am\",\"id\":15774}','68.53.115.247','2021-05-25 15:22:03'),(12685,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15775,'{\"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\\/25\\/2021 10:22:03 am\",\"created_at\":\"5\\/25\\/2021 10:22:03 am\",\"id\":15775}','68.53.115.247','2021-05-25 15:22:03'),(12686,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15776,'{\"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\\/25\\/2021 10:22:03 am\",\"created_at\":\"5\\/25\\/2021 10:22:03 am\",\"id\":15776}','68.53.115.247','2021-05-25 15:22:03'),(12687,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15777,'{\"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\\/25\\/2021 10:22:03 am\",\"created_at\":\"5\\/25\\/2021 10:22:03 am\",\"id\":15777}','68.53.115.247','2021-05-25 15:22:03'),(12688,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15778,'{\"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\\/25\\/2021 10:22:03 am\",\"created_at\":\"5\\/25\\/2021 10:22:03 am\",\"id\":15778}','68.53.115.247','2021-05-25 15:22:03'),(12689,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15779,'{\"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\\/25\\/2021 10:22:03 am\",\"created_at\":\"5\\/25\\/2021 10:22:03 am\",\"id\":15779}','68.53.115.247','2021-05-25 15:22:03'),(12690,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15780,'{\"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\\/25\\/2021 10:22:03 am\",\"created_at\":\"5\\/25\\/2021 10:22:03 am\",\"id\":15780}','68.53.115.247','2021-05-25 15:22:03'),(12691,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15781,'{\"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\\/25\\/2021 10:22:03 am\",\"created_at\":\"5\\/25\\/2021 10:22:03 am\",\"id\":15781}','68.53.115.247','2021-05-25 15:22:03'),(12692,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15782,'{\"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\\/25\\/2021 10:22:03 am\",\"created_at\":\"5\\/25\\/2021 10:22:03 am\",\"id\":15782}','68.53.115.247','2021-05-25 15:22:03'),(12693,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15783,'{\"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\\/25\\/2021 10:22:03 am\",\"created_at\":\"5\\/25\\/2021 10:22:03 am\",\"id\":15783}','68.53.115.247','2021-05-25 15:22:03'),(12694,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15784,'{\"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\\/25\\/2021 10:22:03 am\",\"created_at\":\"5\\/25\\/2021 10:22:03 am\",\"id\":15784}','68.53.115.247','2021-05-25 15:22:03'),(12695,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15785,'{\"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\\/25\\/2021 10:22:03 am\",\"created_at\":\"5\\/25\\/2021 10:22:03 am\",\"id\":15785}','68.53.115.247','2021-05-25 15:22:03'),(12696,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15786,'{\"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\\/25\\/2021 10:22:03 am\",\"created_at\":\"5\\/25\\/2021 10:22:03 am\",\"id\":15786}','68.53.115.247','2021-05-25 15:22:03'),(12697,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15787,'{\"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\\/25\\/2021 10:22:03 am\",\"created_at\":\"5\\/25\\/2021 10:22:03 am\",\"id\":15787}','68.53.115.247','2021-05-25 15:22:03'),(12698,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15788,'{\"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\\/25\\/2021 10:23:03 am\",\"created_at\":\"5\\/25\\/2021 10:23:03 am\",\"id\":15788}','68.53.115.247','2021-05-25 15:23:03'),(12699,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15789,'{\"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\\/25\\/2021 10:23:06 am\",\"created_at\":\"5\\/25\\/2021 10:23:06 am\",\"id\":15789}','68.53.115.247','2021-05-25 15:23:06'),(12700,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15790,'{\"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\\/25\\/2021 10:23:06 am\",\"created_at\":\"5\\/25\\/2021 10:23:06 am\",\"id\":15790}','68.53.115.247','2021-05-25 15:23:06'),(12701,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15791,'{\"report_id\":214,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"78\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Kelly Slather\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:23:06 am\",\"created_at\":\"5\\/25\\/2021 10:23:06 am\",\"id\":15791}','68.53.115.247','2021-05-25 15:23:06'),(12702,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15792,'{\"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\\/25\\/2021 10:23:06 am\",\"created_at\":\"5\\/25\\/2021 10:23:06 am\",\"id\":15792}','68.53.115.247','2021-05-25 15:23:06'),(12703,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15793,'{\"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\\/25\\/2021 10:23:06 am\",\"created_at\":\"5\\/25\\/2021 10:23:06 am\",\"id\":15793}','68.53.115.247','2021-05-25 15:23:06'),(12704,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15794,'{\"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\\/25\\/2021 10:23:06 am\",\"created_at\":\"5\\/25\\/2021 10:23:06 am\",\"id\":15794}','68.53.115.247','2021-05-25 15:23:06'),(12705,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15795,'{\"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\\/25\\/2021 10:23:06 am\",\"created_at\":\"5\\/25\\/2021 10:23:06 am\",\"id\":15795}','68.53.115.247','2021-05-25 15:23:06'),(12706,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15796,'{\"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\\/25\\/2021 10:23:06 am\",\"created_at\":\"5\\/25\\/2021 10:23:06 am\",\"id\":15796}','68.53.115.247','2021-05-25 15:23:06'),(12707,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15797,'{\"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\\/25\\/2021 10:23:06 am\",\"created_at\":\"5\\/25\\/2021 10:23:06 am\",\"id\":15797}','68.53.115.247','2021-05-25 15:23:06'),(12708,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15798,'{\"report_id\":214,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:23:06 am\",\"created_at\":\"5\\/25\\/2021 10:23:06 am\",\"id\":15798}','68.53.115.247','2021-05-25 15:23:06'),(12709,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15799,'{\"report_id\":214,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"2019-03-12 00:00:00\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:23:06 am\",\"created_at\":\"5\\/25\\/2021 10:23:06 am\",\"id\":15799}','68.53.115.247','2021-05-25 15:23:06'),(12710,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15800,'{\"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\\/25\\/2021 10:23:06 am\",\"created_at\":\"5\\/25\\/2021 10:23:06 am\",\"id\":15800}','68.53.115.247','2021-05-25 15:23:06'),(12711,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15801,'{\"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\\/25\\/2021 10:23:06 am\",\"created_at\":\"5\\/25\\/2021 10:23:06 am\",\"id\":15801}','68.53.115.247','2021-05-25 15:23:06'),(12712,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15802,'{\"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\\/25\\/2021 10:23:06 am\",\"created_at\":\"5\\/25\\/2021 10:23:06 am\",\"id\":15802}','68.53.115.247','2021-05-25 15:23:06'),(12713,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15803,'{\"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\\/25\\/2021 10:23:06 am\",\"created_at\":\"5\\/25\\/2021 10:23:06 am\",\"id\":15803}','68.53.115.247','2021-05-25 15:23:06'),(12714,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15804,'{\"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\\/25\\/2021 10:23:06 am\",\"created_at\":\"5\\/25\\/2021 10:23:06 am\",\"id\":15804}','68.53.115.247','2021-05-25 15:23:07'),(12715,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15805,'{\"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\\/25\\/2021 10:23:07 am\",\"created_at\":\"5\\/25\\/2021 10:23:07 am\",\"id\":15805}','68.53.115.247','2021-05-25 15:23:07'),(12716,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15806,'{\"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\\/25\\/2021 10:23:07 am\",\"created_at\":\"5\\/25\\/2021 10:23:07 am\",\"id\":15806}','68.53.115.247','2021-05-25 15:23:07'),(12717,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15807,'{\"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. The Legislative decisions also impact the DWRS as the legislature creates and amends the rate components set in Minnesota statutes (256B) which directly impacts the rates providers receive to staff homes.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:23:07 am\",\"created_at\":\"5\\/25\\/2021 10:23:07 am\",\"id\":15807}','68.53.115.247','2021-05-25 15:23:07'),(12718,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15808,'{\"report_id\":214,\"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\\/25\\/2021 10:23:07 am\",\"created_at\":\"5\\/25\\/2021 10:23:07 am\",\"id\":15808}','68.53.115.247','2021-05-25 15:23:07'),(12719,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15809,'{\"report_id\":214,\"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\\/25\\/2021 10:23:07 am\",\"created_at\":\"5\\/25\\/2021 10:23:07 am\",\"id\":15809}','68.53.115.247','2021-05-25 15:23:07'),(12720,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15810,'{\"report_id\":214,\"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\\/25\\/2021 10:23:07 am\",\"created_at\":\"5\\/25\\/2021 10:23:07 am\",\"id\":15810}','68.53.115.247','2021-05-25 15:23:07'),(12721,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15811,'{\"report_id\":214,\"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\\/25\\/2021 10:23:07 am\",\"created_at\":\"5\\/25\\/2021 10:23:07 am\",\"id\":15811}','68.53.115.247','2021-05-25 15:23:07'),(12722,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15812,'{\"report_id\":214,\"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\\/25\\/2021 10:23:07 am\",\"created_at\":\"5\\/25\\/2021 10:23:07 am\",\"id\":15812}','68.53.115.247','2021-05-25 15:23:07'),(12723,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15813,'{\"report_id\":214,\"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\\/25\\/2021 10:23:07 am\",\"created_at\":\"5\\/25\\/2021 10:23:07 am\",\"id\":15813}','68.53.115.247','2021-05-25 15:23:07'),(12724,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15814,'{\"report_id\":214,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":\"Staff was focused on completing a shift change task, of medication reconciling and money reconciling. 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\\/25\\/2021 10:23:07 am\",\"created_at\":\"5\\/25\\/2021 10:23:07 am\",\"id\":15814}','68.53.115.247','2021-05-25 15:23:07'),(12725,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15815,'{\"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\\/25\\/2021 10:23:07 am\",\"created_at\":\"5\\/25\\/2021 10:23:07 am\",\"id\":15815}','68.53.115.247','2021-05-25 15:23:07'),(12726,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15816,'{\"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\\/25\\/2021 10:23:07 am\",\"created_at\":\"5\\/25\\/2021 10:23:07 am\",\"id\":15816}','68.53.115.247','2021-05-25 15:23:07'),(12727,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15817,'{\"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\\/25\\/2021 10:23:07 am\",\"created_at\":\"5\\/25\\/2021 10:23:07 am\",\"id\":15817}','68.53.115.247','2021-05-25 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15:23:48'),(12797,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15887,'{\"report_id\":210,\"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\\/25\\/2021 10:23:48 am\",\"created_at\":\"5\\/25\\/2021 10:23:48 am\",\"id\":15887}','68.53.115.247','2021-05-25 15:23:48'),(12798,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15888,'{\"report_id\":210,\"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\\/25\\/2021 10:23:48 am\",\"created_at\":\"5\\/25\\/2021 10:23:48 am\",\"id\":15888}','68.53.115.247','2021-05-25 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15:25:17'),(12801,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15891,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15891}','68.53.115.247','2021-05-25 15:25:22'),(12802,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15892,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15892}','68.53.115.247','2021-05-25 15:25:22'),(12803,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15893,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15893}','68.53.115.247','2021-05-25 15:25:22'),(12804,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15894,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15894}','68.53.115.247','2021-05-25 15:25:22'),(12805,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15895,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15895}','68.53.115.247','2021-05-25 15:25:22'),(12806,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15896,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15896}','68.53.115.247','2021-05-25 15:25:22'),(12807,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15897,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15897}','68.53.115.247','2021-05-25 15:25:22'),(12808,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15898,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15898}','68.53.115.247','2021-05-25 15:25:22'),(12809,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15899,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15899}','68.53.115.247','2021-05-25 15:25:22'),(12810,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15900,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15900}','68.53.115.247','2021-05-25 15:25:22'),(12811,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15901,'{\"report_id\":216,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"2019-07-04 00:00:00\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15901}','68.53.115.247','2021-05-25 15:25:22'),(12812,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15902,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15902}','68.53.115.247','2021-05-25 15:25:22'),(12813,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15903,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15903}','68.53.115.247','2021-05-25 15:25:22'),(12814,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15904,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15904}','68.53.115.247','2021-05-25 15:25:22'),(12815,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15905,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15905}','68.53.115.247','2021-05-25 15:25:22'),(12816,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15906,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15906}','68.53.115.247','2021-05-25 15:25:22'),(12817,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15907,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15907}','68.53.115.247','2021-05-25 15:25:22'),(12818,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15908,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15908}','68.53.115.247','2021-05-25 15:25:22'),(12819,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15909,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15909}','68.53.115.247','2021-05-25 15:25:22'),(12820,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15910,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15910}','68.53.115.247','2021-05-25 15:25:22'),(12821,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15911,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15911}','68.53.115.247','2021-05-25 15:25:22'),(12822,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15912,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15912}','68.53.115.247','2021-05-25 15:25:22'),(12823,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15913,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15913}','68.53.115.247','2021-05-25 15:25:22'),(12824,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15914,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15914}','68.53.115.247','2021-05-25 15:25:22'),(12825,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15915,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15915}','68.53.115.247','2021-05-25 15:25:22'),(12826,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15916,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15916}','68.53.115.247','2021-05-25 15:25:22'),(12827,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15917,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15917}','68.53.115.247','2021-05-25 15:25:22'),(12828,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15918,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15918}','68.53.115.247','2021-05-25 15:25:22'),(12829,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15919,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15919}','68.53.115.247','2021-05-25 15:25:22'),(12830,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15920,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15920}','68.53.115.247','2021-05-25 15:25:22'),(12831,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15921,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15921}','68.53.115.247','2021-05-25 15:25:22'),(12832,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15922,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15922}','68.53.115.247','2021-05-25 15:25:22'),(12833,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15923,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15923}','68.53.115.247','2021-05-25 15:25:22'),(12834,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15924,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15924}','68.53.115.247','2021-05-25 15:25:22'),(12835,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15925,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15925}','68.53.115.247','2021-05-25 15:25:22'),(12836,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15926,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15926}','68.53.115.247','2021-05-25 15:25:22'),(12837,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15927,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15927}','68.53.115.247','2021-05-25 15:25:22'),(12838,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15928,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15928}','68.53.115.247','2021-05-25 15:25:22'),(12839,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15929,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15929}','68.53.115.247','2021-05-25 15:25:22'),(12840,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15930,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15930}','68.53.115.247','2021-05-25 15:25:22'),(12841,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15931,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15931}','68.53.115.247','2021-05-25 15:25:22'),(12842,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15932,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15932}','68.53.115.247','2021-05-25 15:25:22'),(12843,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15933,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15933}','68.53.115.247','2021-05-25 15:25:22'),(12844,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15934,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15934}','68.53.115.247','2021-05-25 15:25:22'),(12845,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15935,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15935}','68.53.115.247','2021-05-25 15:25:22'),(12846,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15936,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15936}','68.53.115.247','2021-05-25 15:25:22'),(12847,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15937,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15937}','68.53.115.247','2021-05-25 15:25:22'),(12848,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15938,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15938}','68.53.115.247','2021-05-25 15:25:22'),(12849,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15939,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15939}','68.53.115.247','2021-05-25 15:25:22'),(12850,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15940,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15940}','68.53.115.247','2021-05-25 15:25:22'),(12851,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15941,'{\"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\\/25\\/2021 10:25:22 am\",\"created_at\":\"5\\/25\\/2021 10:25:22 am\",\"id\":15941}','68.53.115.247','2021-05-25 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15:26:22'),(12900,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15990,'{\"report_id\":217,\"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\\/25\\/2021 10:26:22 am\",\"created_at\":\"5\\/25\\/2021 10:26:22 am\",\"id\":15990}','68.53.115.247','2021-05-25 15:26:22'),(12901,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15991,'{\"report_id\":217,\"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\\/25\\/2021 10:26:22 am\",\"created_at\":\"5\\/25\\/2021 10:26:22 am\",\"id\":15991}','68.53.115.247','2021-05-25 15:26:22'),(12902,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15992,'{\"report_id\":218,\"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\\/25\\/2021 10:26:47 am\",\"created_at\":\"5\\/25\\/2021 10:26:47 am\",\"id\":15992}','68.53.115.247','2021-05-25 15:26:47'),(12903,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15993,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"201905859\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:26:51 am\",\"created_at\":\"5\\/25\\/2021 10:26:51 am\",\"id\":15993}','68.53.115.247','2021-05-25 15:26:51'),(12904,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15994,'{\"report_id\":218,\"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\\/25\\/2021 10:26:51 am\",\"created_at\":\"5\\/25\\/2021 10:26:51 am\",\"id\":15994}','68.53.115.247','2021-05-25 15:26:51'),(12905,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15995,'{\"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\\/25\\/2021 10:26:51 am\",\"created_at\":\"5\\/25\\/2021 10:26:51 am\",\"id\":15995}','68.53.115.247','2021-05-25 15:26:51'),(12906,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15996,'{\"report_id\":218,\"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\\/25\\/2021 10:26:51 am\",\"created_at\":\"5\\/25\\/2021 10:26:51 am\",\"id\":15996}','68.53.115.247','2021-05-25 15:26:52'),(12907,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15997,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":15997}','68.53.115.247','2021-05-25 15:26:52'),(12908,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15998,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":15998}','68.53.115.247','2021-05-25 15:26:52'),(12909,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',15999,'{\"report_id\":218,\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":15999}','68.53.115.247','2021-05-25 15:26:52'),(12910,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16000,'{\"report_id\":218,\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16000}','68.53.115.247','2021-05-25 15:26:52'),(12911,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16001,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16001}','68.53.115.247','2021-05-25 15:26:52'),(12912,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16002,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16002}','68.53.115.247','2021-05-25 15:26:52'),(12913,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16003,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"2019-08-09 00:00:00\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16003}','68.53.115.247','2021-05-25 15:26:52'),(12914,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16004,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16004}','68.53.115.247','2021-05-25 15:26:52'),(12915,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16005,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16005}','68.53.115.247','2021-05-25 15:26:52'),(12916,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16006,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16006}','68.53.115.247','2021-05-25 15:26:52'),(12917,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16007,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16007}','68.53.115.247','2021-05-25 15:26:52'),(12918,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16008,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16008}','68.53.115.247','2021-05-25 15:26:52'),(12919,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16009,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16009}','68.53.115.247','2021-05-25 15:26:52'),(12920,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16010,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16010}','68.53.115.247','2021-05-25 15:26:52'),(12921,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16011,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16011}','68.53.115.247','2021-05-25 15:26:52'),(12922,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16012,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16012}','68.53.115.247','2021-05-25 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15:26:52'),(12933,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16023,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16023}','68.53.115.247','2021-05-25 15:26:52'),(12934,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16024,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16024}','68.53.115.247','2021-05-25 15:26:52'),(12935,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16025,'{\"report_id\":218,\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16025}','68.53.115.247','2021-05-25 15:26:52'),(12936,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16026,'{\"report_id\":218,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"110\",\"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.\\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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16026}','68.53.115.247','2021-05-25 15:26:52'),(12937,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16027,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16027}','68.53.115.247','2021-05-25 15:26:52'),(12938,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16028,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16028}','68.53.115.247','2021-05-25 15:26:52'),(12939,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16029,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16029}','68.53.115.247','2021-05-25 15:26:52'),(12940,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16030,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16030}','68.53.115.247','2021-05-25 15:26:52'),(12941,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16031,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16031}','68.53.115.247','2021-05-25 15:26:52'),(12942,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16032,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16032}','68.53.115.247','2021-05-25 15:26:52'),(12943,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16033,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16033}','68.53.115.247','2021-05-25 15:26:52'),(12944,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16034,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16034}','68.53.115.247','2021-05-25 15:26:52'),(12945,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16035,'{\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16035}','68.53.115.247','2021-05-25 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15:26:52'),(12950,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16040,'{\"report_id\":218,\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16040}','68.53.115.247','2021-05-25 15:26:52'),(12951,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16041,'{\"report_id\":218,\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16041}','68.53.115.247','2021-05-25 15:26:52'),(12952,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16042,'{\"report_id\":218,\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16042}','68.53.115.247','2021-05-25 15:26:52'),(12953,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16043,'{\"report_id\":218,\"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\\/25\\/2021 10:26:52 am\",\"created_at\":\"5\\/25\\/2021 10:26:52 am\",\"id\":16043}','68.53.115.247','2021-05-25 15:26:52'),(12954,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16044,'{\"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\\/25\\/2021 10:27:22 am\",\"created_at\":\"5\\/25\\/2021 10:27:22 am\",\"id\":16044}','68.53.115.247','2021-05-25 15:27:22'),(12955,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16045,'{\"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\\/25\\/2021 10:27:38 am\",\"created_at\":\"5\\/25\\/2021 10:27:38 am\",\"id\":16045}','68.53.115.247','2021-05-25 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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\\/25\\/2021 10:27:38 am\",\"created_at\":\"5\\/25\\/2021 10:27:38 am\",\"id\":16056}','68.53.115.247','2021-05-25 15:27:38'),(12967,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16057,'{\"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\\/25\\/2021 10:27:38 am\",\"created_at\":\"5\\/25\\/2021 10:27:38 am\",\"id\":16057}','68.53.115.247','2021-05-25 15:27:38'),(12968,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16058,'{\"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\\/25\\/2021 10:27:38 am\",\"created_at\":\"5\\/25\\/2021 10:27:38 am\",\"id\":16058}','68.53.115.247','2021-05-25 15:27:38'),(12969,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16059,'{\"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\\/25\\/2021 10:27:38 am\",\"created_at\":\"5\\/25\\/2021 10:27:38 am\",\"id\":16059}','68.53.115.247','2021-05-25 15:27:38'),(12970,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16060,'{\"report_id\":219,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"2020-05-01 00:00:00\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:27:38 am\",\"created_at\":\"5\\/25\\/2021 10:27:38 am\",\"id\":16060}','68.53.115.247','2021-05-25 15:27:38'),(12971,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16061,'{\"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\\/25\\/2021 10:27:38 am\",\"created_at\":\"5\\/25\\/2021 10:27:38 am\",\"id\":16061}','68.53.115.247','2021-05-25 15:27:38'),(12972,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16062,'{\"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\\/25\\/2021 10:27:38 am\",\"created_at\":\"5\\/25\\/2021 10:27:38 am\",\"id\":16062}','68.53.115.247','2021-05-25 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15:28:06'),(13015,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16105,'{\"report_id\":238,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"85\",\"question_type\":\"Multiple_Choice\",\"text_answer\":null,\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:28:06 am\",\"created_at\":\"5\\/25\\/2021 10:28:06 am\",\"id\":16105}','68.53.115.247','2021-05-25 15:28:06'),(13016,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16106,'{\"report_id\":238,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"2019-03-20 00:00:00\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:28:06 am\",\"created_at\":\"5\\/25\\/2021 10:28:06 am\",\"id\":16106}','68.53.115.247','2021-05-25 15:28:06'),(13017,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16107,'{\"report_id\":238,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"TBI Crisis Float was at the Alder home at 5:45pm on Friday, March 20th talking with Dwayne. Crisis Float and\\r\\nDwayne were outside during the conversation. Dwayne asked if he was able to get his hair done soon and Crisis Float explained that due\\r\\nto the pandemic the salon was closed until further notice. Dwayne was disappointed that he could not get his hair done. After the\\r\\nconversation Dwayne walked inside and Crisis Float left the Alder home. At 6:00pm Khun (staff) went to check on Dwayne and he was not\\r\\nin his bedroom. Khun checked the inside of the house then walked around the outside of the house and could not locate Dwayne. Khun\\r\\nthen called the Crisis Float to notify them of the situation. Crisis Float began driving around the area looking for Dwayne. At 7:00pm Crisis\\r\\nFloat notified the Sheriff and completed an Attempt to Locate for Dwayne. Crisis Float continued to search for Dwayne. At 8:30pm the Crisis\\r\\nFloat asked that the Attempt to Locate be changed to a Missing Persons report. At 4:00am on Saturday, March 21st the TBI Crisis Float\\r\\nreceived a call from the Duluth Police Department saying that Dwayne had approached them looking for a ride home. Dwayne reported to\\r\\nthe police and TBI Crisis Float that he eloped from the Alder house and walked to the Kwik Trip where he was able to catch a bus to\\r\\ndowntown Duluth. Dwayne reported he walked around downtown for several hours before finding a police officer at CVS Pharmacy in\\r\\ndowntown Duluth. Dwayne returned home at 5:00am and went to bed.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:28:06 am\",\"created_at\":\"5\\/25\\/2021 10:28:06 am\",\"id\":16107}','68.53.115.247','2021-05-25 15:28:06'),(13018,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16108,'{\"report_id\":238,\"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\\/25\\/2021 10:28:06 am\",\"created_at\":\"5\\/25\\/2021 10:28:06 am\",\"id\":16108}','68.53.115.247','2021-05-25 15:28:06'),(13019,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16109,'{\"report_id\":238,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Float staff waited four hours to contact their supervisor about an elopement\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:28:06 am\",\"created_at\":\"5\\/25\\/2021 10:28:06 am\",\"id\":16109}','68.53.115.247','2021-05-25 15:28:06'),(13020,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16110,'{\"report_id\":238,\"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\\/25\\/2021 10:28:06 am\",\"created_at\":\"5\\/25\\/2021 10:28:06 am\",\"id\":16110}','68.53.115.247','2021-05-25 15:28:06'),(13021,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16111,'{\"report_id\":238,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"2020-08-27 00:00:00\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:28:06 am\",\"created_at\":\"5\\/25\\/2021 10:28:06 am\",\"id\":16111}','68.53.115.247','2021-05-25 15:28:06'),(13022,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16112,'{\"report_id\":238,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"Person was talking with (Alder House staff) about going downtown Duluth to get a haircut. The salons were closed due to the Governor\\u2019s Executive Order about COVID 19. DSP went to cook food for dinner. The DSP was the only staff working, normally two staff. SP was attending to the other residents who were asking questions while the SP was cooking food. The SP knocked on bedroom door and there was no answer. The room was empty. The SP began to search the house for 10-15 minutes and then called the crisis float for direction and next steps. The SP immediately began to write up report, Incident Report Internal Review (IRIR). The Alder House DSP worked alone most of March. Quote: \\u201cIf two staff were working this elopement could have been avoided because the other staff could drive person downtown Duluth\\u201d.\\r\\nCrisis float takes over the elopement incident and the decision to call 911. Arrives at home and begins the attempt to locate. Drives and searches streets and downtown Duluth for 4 hours. It is protocol to search for 1-2 hours before contacting a supervisor. The Program manager makes the decision to call 911 and report a missing person. The call 911 was to report a non-emergency and provide a description of the person. The role of the crisis float is to fill in gaps as needed in the residential setting. The Crisis float needs to be available to respond to other crisis. The night of the incident the crisis float was moving from a crisis, de-escalating attention seeking behaviors, and then came to Alder House. Priority goes to situations that require hospitalization. During the attempt to locate the Crisis float communicates with the Alder house DSP with updates as needed, about every 15-20 minutes.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:28:06 am\",\"created_at\":\"5\\/25\\/2021 10:28:06 am\",\"id\":16112}','68.53.115.247','2021-05-25 15:28:06'),(13023,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16113,'{\"report_id\":238,\"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\\/25\\/2021 10:28:06 am\",\"created_at\":\"5\\/25\\/2021 10:28:06 am\",\"id\":16113}','68.53.115.247','2021-05-25 15:28:06'),(13024,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16114,'{\"report_id\":238,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"The float staff waiting 4 hours (instead of the policy of 1 hour) to contact their supervisor about an individual eloping, was impacted by the staff not seeing it as an emergency . Staff had ideas of where the person would go and that they\\u2019d be able to find them. The float staff\\u2019s ideas were impacted by their familiarity with the person, they knew their favorite places to go, that they had no previous elopements, and the person mentioned wanting to get a haircut. The staff feeling like they could find the person was also influenced by the empty streets in Duluth due to the Governor\\u2019s Stay at Home order. The Governor\\u2019s Stay At Home Order was issued due to COVID-19 in an attempt to slow the curve of the virus spreading. The Order required people to stay in their home unless they were conducting essential business. This influenced the streets of Duluth to be empty, businesses to be closed and the staff feeling as though the person should have been easier to spot. Other contributing factors to not seeing this elopement as an emergency and waiting to call the supervisor was that the staff maintained constant communication with the house staff about search strategies and updates and they knew the person had the ability to navigate the community independently .  \\r\\nAdditional influences to waiting 4 hours to call the supervisor may have been the staff\\u2019s desire to avoid the 245D\\/Positive Support Rule reporting requirements because the process can be very time consuming . Additionally, staff waited to call the supervisor because it is provider practice is not to contact supervisors if the elopement is supervised or the person\\u2019s whereabouts are known and they were confident they would be able to find the person .  St. Louis County had a recent history of attempting to decrease 911 calls, and had brought together HCBS providers, Law Enforcement Officers, County staff and Healthcare staff to work on this issue and created a Person Centered Incident Matrix to help provider\\u2019s parse out when 911 should be called and how to avoid overusing the 911 relay. The staff noted they were aware of the Person-Centered Matrix and this influenced the staff to exhaust all known places the person might go before contacting the supervisor about the elopement .\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:28:06 am\",\"created_at\":\"5\\/25\\/2021 10:28:06 am\",\"id\":16114}','68.53.115.247','2021-05-25 15:28:06'),(13025,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16115,'{\"report_id\":238,\"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\\/25\\/2021 10:28:06 am\",\"created_at\":\"5\\/25\\/2021 10:28:06 am\",\"id\":16115}','68.53.115.247','2021-05-25 15:28:06'),(13026,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16116,'{\"report_id\":238,\"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\\/25\\/2021 10:28:06 am\",\"created_at\":\"5\\/25\\/2021 10:28:06 am\",\"id\":16116}','68.53.115.247','2021-05-25 15:28:06'),(13027,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16117,'{\"report_id\":238,\"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\\/25\\/2021 10:28:06 am\",\"created_at\":\"5\\/25\\/2021 10:28:06 am\",\"id\":16117}','68.53.115.247','2021-05-25 15:28:06'),(13028,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16118,'{\"report_id\":238,\"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\\/25\\/2021 10:28:06 am\",\"created_at\":\"5\\/25\\/2021 10:28:06 am\",\"id\":16118}','68.53.115.247','2021-05-25 15:28:06'),(13029,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16119,'{\"report_id\":238,\"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\\/25\\/2021 10:28:06 am\",\"created_at\":\"5\\/25\\/2021 10:28:06 am\",\"id\":16119}','68.53.115.247','2021-05-25 15:28:06'),(13030,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16120,'{\"report_id\":238,\"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\\/25\\/2021 10:28:06 am\",\"created_at\":\"5\\/25\\/2021 10:28:06 am\",\"id\":16120}','68.53.115.247','2021-05-25 15:28:06'),(13031,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16121,'{\"report_id\":238,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"102\",\"question_type\":\"Free_Text\",\"text_answer\":\"The float staff waiting 4 hours (instead of the policy of 1 hour) to contact their supervisor about an individual eloping, was impacted by the staff not seeing it as an emergency.\\r\\n\\r\\nOther contributing factors to not seeing this elopement as an emergency and waiting to call the supervisor was that the staff maintained constant communication with the house staff about search strategies and updates and they knew the person had the ability to navigate the community independently . \\r\\n\\r\\n  St. Louis County had a recent history of attempting to decrease 911 calls, and had brought together HCBS providers, Law Enforcement Officers, County staff and Healthcare staff to work on this issue and created a Person Centered Incident Matrix to help provider\\u2019s parse out when 911 should be called and how to avoid overusing the 911 relay. 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15:28:28'),(13100,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16190,'{\"report_id\":220,\"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\\/25\\/2021 10:28:28 am\",\"created_at\":\"5\\/25\\/2021 10:28:28 am\",\"id\":16190}','68.53.115.247','2021-05-25 15:28:28'),(13101,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16191,'{\"report_id\":220,\"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\\/25\\/2021 10:28:28 am\",\"created_at\":\"5\\/25\\/2021 10:28:28 am\",\"id\":16191}','68.53.115.247','2021-05-25 15:28:28'),(13102,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16192,'{\"report_id\":220,\"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\\/25\\/2021 10:28:28 am\",\"created_at\":\"5\\/25\\/2021 10:28:28 am\",\"id\":16192}','68.53.115.247','2021-05-25 15:28:28'),(13103,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16193,'{\"report_id\":220,\"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\\/25\\/2021 10:28:28 am\",\"created_at\":\"5\\/25\\/2021 10:28:28 am\",\"id\":16193}','68.53.115.247','2021-05-25 15:28:28'),(13104,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16194,'{\"report_id\":220,\"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\\/25\\/2021 10:28:28 am\",\"created_at\":\"5\\/25\\/2021 10:28:28 am\",\"id\":16194}','68.53.115.247','2021-05-25 15:28:28'),(13105,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16195,'{\"report_id\":220,\"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\\/25\\/2021 10:28:28 am\",\"created_at\":\"5\\/25\\/2021 10:28:28 am\",\"id\":16195}','68.53.115.247','2021-05-25 15:28:28'),(13106,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16196,'{\"report_id\":220,\"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\\/25\\/2021 10:28:28 am\",\"created_at\":\"5\\/25\\/2021 10:28:28 am\",\"id\":16196}','68.53.115.247','2021-05-25 15:28:28'),(13107,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16197,'{\"report_id\":221,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"05\\/16\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:28:52 am\",\"created_at\":\"5\\/25\\/2021 10:28:52 am\",\"id\":16197}','68.53.115.247','2021-05-25 15:28:52'),(13108,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16198,'{\"report_id\":221,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"76\",\"question_type\":\"Short_Answer\",\"text_answer\":\"201900883\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16198}','68.53.115.247','2021-05-25 15:28:56'),(13109,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16199,'{\"report_id\":221,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"77\",\"question_type\":\"Date\",\"text_answer\":\"05\\/16\\/2019\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16199}','68.53.115.247','2021-05-25 15:28:56'),(13110,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16200,'{\"report_id\":221,\"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\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16200}','68.53.115.247','2021-05-25 15:28:56'),(13111,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16201,'{\"report_id\":221,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"79\",\"question_type\":\"Multiple_Choice\",\"text_answer\":\"Scott Schifsky\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16201}','68.53.115.247','2021-05-25 15:28:56'),(13112,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16202,'{\"report_id\":221,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"80\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Residential Transitions\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16202}','68.53.115.247','2021-05-25 15:28:56'),(13113,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16203,'{\"report_id\":221,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"81\",\"question_type\":\"Short_Answer\",\"text_answer\":\"Chrysa Reichel\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16203}','68.53.115.247','2021-05-25 15:28:56'),(13114,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16204,'{\"report_id\":221,\"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\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16204}','68.53.115.247','2021-05-25 15:28:56'),(13115,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16205,'{\"report_id\":221,\"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\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16205}','68.53.115.247','2021-05-25 15:28:56'),(13116,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16206,'{\"report_id\":221,\"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\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16206}','68.53.115.247','2021-05-25 15:28:56'),(13117,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16207,'{\"report_id\":221,\"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\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16207}','68.53.115.247','2021-05-25 15:28:56'),(13118,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16208,'{\"report_id\":221,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"86\",\"question_type\":\"Date\",\"text_answer\":\"2019-02-02 00:00:00\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16208}','68.53.115.247','2021-05-25 15:28:56'),(13119,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16209,'{\"report_id\":221,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"87\",\"question_type\":\"Free_Text\",\"text_answer\":\"Individual is a 25 year old woman who lives in a 1 bedroom 245D group home in a residential area in Maple Grove.  It was reported in the CEP Intake Form that the individual was agitated around 12:00 am due to being told she could not call friends as it was too late.  An on call staff was called to help support the individual to understand it was too late to call friends.  The individual went to bed around 1:30 and locked her bedroom door.\\r\\n\\r\\nMorning staff arrived at 8:00 and knocked on individual\\u2019s door as medications needed to be administered.  Staff heard no response.  Being the door was locked, the staff obtained the key and it was then discovered the individual was not in her room.  Staff followed elopement protocol and notified on-call staff and non-emergency police.  Staff and police searched local area and found individual walking near the home and she was taken back home.\\r\\n\\r\\nIndividual stated she waited until overnight staff were in bathroom and then left the home.  She reported she walked to local Walmart, called a friend and then walked to his apartment as he was going call her an Uber.  Her friend came down to meet her, called her an Uber, she instructed the driver to drop her off at park near her group home vs her group home as she wanted to swing.  Originally the individual stated she left at 12:30 am but then stated she wasn\\u2019t sure when she left the home.\\r\\n\\r\\nIndividual complained of back and foot pain but refused to go to Urgent Care but opted to sleep.  The next morning she was willing to go and was diagnosed with First Degree Frostbite.  Doctor prescribed over the counter medication for blistering and pain.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16209}','68.53.115.247','2021-05-25 15:28:56'),(13120,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16210,'{\"report_id\":221,\"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\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16210}','68.53.115.247','2021-05-25 15:28:56'),(13121,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16211,'{\"report_id\":221,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"91\",\"question_type\":\"Short_Answer\",\"text_answer\":\"The individual\\u2019s plan was to have one awake and one asleep staff on overnight shift. There was no asleep staff.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16211}','68.53.115.247','2021-05-25 15:28:56'),(13122,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16212,'{\"report_id\":221,\"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\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16212}','68.53.115.247','2021-05-25 15:28:56'),(13123,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16213,'{\"report_id\":221,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"97\",\"question_type\":\"Date\",\"text_answer\":\"2019-06-10 00:00:00\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16213}','68.53.115.247','2021-05-25 15:28:56'),(13124,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16214,'{\"report_id\":221,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"98\",\"question_type\":\"Free_Text\",\"text_answer\":\"orning staff arrived at 8:00 and knocked on individual\\u2019s door as medications needed to be administered.  Staff heard no response.  Being the door was locked, the staff obtained the key and it was then discovered the individual was not in her room.  Staff followed elopement protocol and notified on-call staff and non-emergency police.  Staff and police searched local area and found individual walking near the home and she was taken back home.\\r\\n\\r\\nIndividual stated she waited until overnight staff were in bathroom and then left the home.  She reported she walked to local Walmart, called friend and then walked to his apartment as he was going call her an Uber.  Her friend came down to meet her, called her an Uber, she instructed the driver to drop her off at park near her group home vs her group home as she wanted to swing.  Originally the individual stated she left at 12:30 am but then stated she wasn\\u2019t sure when she left the home.\\r\\n\\r\\nIndividual complained of back and foot pain but refused to go to Urgent Care but opted to sleep.  The next morning she was willing to go and was diagnosed with First Degree Frostbite.  Doctor prescribed over the counter medication for blistering and pain.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16214}','68.53.115.247','2021-05-25 15:28:56'),(13125,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16215,'{\"report_id\":221,\"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\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16215}','68.53.115.247','2021-05-25 15:28:56'),(13126,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16216,'{\"report_id\":221,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"100\",\"question_type\":\"Free_Text\",\"text_answer\":\"No asleep staff for the overnight shift was influenced by the staff who was scheduled being ill and no one else available to cover the shift. Other staff were unwilling to cover this shift because the home is further away than most of the provider\\u2019s other homes. Also, the asleep shift was likely to be awake because the person was known for having challenging behaviors.  Further supporting staff\\u2019s unwillingness to cover this shift was that they would only receive $10\\/hour.\\r\\n\\r\\nAn additional factor that influenced the shift to go unfilled was that the provider didn\\u2019t feel pressure to fill the shift. The individual\\u2019s team, including the case manager at Hennepin County, had previously agreed that due to known staffing shortages with the provider, when an overnight asleep was not available the individual\\u2019s plan would allow for only the one awake overnight staff.\\r\\n\\r\\nMinnesota\\u2019s Rate Management System (RMS) determines a reimbursement rate for an individuals required supports (staffing pattern), which is agreed upon by the provider and case manager at the county per the DHS 6790 form.  This RMS rate then affects the provider determining they could pay overnight staff $10\\/hour for asleep shifts.  \\r\\n\\r\\nAnother influence was the Minnesota State Legislature, who creates laws governing provider rates, enforcing a 7% decrease in reimbursement rates to providers in July of 2018.  This impacted the provider\\u2019s ability to give an annual raises to staff and in turn influenced the provider having a staff shortage.  This was influenced by Federal (CMS) action determining Minnesota\\u2019s reimbursement rates were increased too much in recent years, and the Minnesota Department of Human Services\\u2019 decision to determine which rates needed to be cut and by how much to come into compliance with the CMS decision.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16216}','68.53.115.247','2021-05-25 15:28:56'),(13127,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16217,'{\"report_id\":221,\"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\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16217}','68.53.115.247','2021-05-25 15:28:56'),(13128,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16218,'{\"report_id\":221,\"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\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16218}','68.53.115.247','2021-05-25 15:28:56'),(13129,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16219,'{\"report_id\":221,\"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\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16219}','68.53.115.247','2021-05-25 15:28:56'),(13130,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16220,'{\"report_id\":221,\"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\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16220}','68.53.115.247','2021-05-25 15:28:56'),(13131,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16221,'{\"report_id\":221,\"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\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16221}','68.53.115.247','2021-05-25 15:28:56'),(13132,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16222,'{\"report_id\":221,\"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\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16222}','68.53.115.247','2021-05-25 15:28:56'),(13133,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16223,'{\"report_id\":221,\"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\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16223}','68.53.115.247','2021-05-25 15:28:56'),(13134,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16224,'{\"report_id\":221,\"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\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16224}','68.53.115.247','2021-05-25 15:28:56'),(13135,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16225,'{\"report_id\":221,\"form_id\":\"23\",\"user_id\":81,\"organization_id\":10,\"question_id\":\"104\",\"question_type\":\"Free_Text\",\"text_answer\":\"Other staff were unwilling to cover this shift because the home is further away than most of the provider\\u2019s other homes. Also, the asleep shift was likely to be awake because the person was known for having challenging behaviors.  Further supporting staff\\u2019s unwillingness to cover this shift was that they would only receive $10\\/hour.\\r\\n\\r\\nThis RMS rate then affects the provider determining they could pay overnight staff $10\\/hour for asleep shifts.  \\r\\n\\r\\nAnother influence was the Minnesota State Legislature, who creates laws governing provider rates, enforcing a 7% decrease in reimbursement rates to providers in July of 2018.  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The individual\\u2019s team, including the case manager at Hennepin County, had previously agreed that due to known staffing shortages with the provider, when an overnight asleep was not available the individual\\u2019s plan would allow for only the one awake overnight staff.\",\"created_by\":81,\"updated_by\":81,\"updated_at\":\"5\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16237}','68.53.115.247','2021-05-25 15:28:56'),(13148,'lzuJ7a81axZMw1m4QSDwOdwq1njTbHplExHV7qwq',81,'reports_answer','create',16238,'{\"report_id\":221,\"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\\/25\\/2021 10:28:56 am\",\"created_at\":\"5\\/25\\/2021 10:28:56 am\",\"id\":16238}','68.53.115.247','2021-05-25 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