14 Revised 12/5/2024 - New Board Members Handbook Where do complaints come from? People n Consumers n Licensees n Consultants, Experts, and Attorneys n Other Agency investigators (Department of Children and Families, Medical Fraud Control Unit, Agency for Health Care Administration) n Hospital Staff, Ambulatory Surgical Centers, Long Term Care Facilities n Inspections and other internal sources n Good Samaritans, researchers, and activists n Media Analysts Reports n Closed Medical Malpractice Claims n Adverse Incident Reports (Nursing Home, Assisted Living Facilities) n Hospital Discipline Reports (Peer Review) n Other Agency mandates (State and Federal) n Fingerprint Hits n Special Emergency Actions n Internal Error Audits n Insurance Agencies How are complaints assigned? n Complaints go through an intake process where they are triaged for priority, assigned to an investigator or analyst based upon board assignment and rotation, and entered through the MQA online complaint portal. Deciding Complaint Priority Priority 1: n Over-prescribing n Practice related arrests n Sexual assault/sexual misconduct n Assault/battery on a patient n Impairment in a practice setting n Substandard care leading to serious patient injury or death n High media attention n Practicing on a suspended license Priority 2: n Malpractice involving multiple patients n Impairment, including IPN/PRN referrals n Fraud n Convictions with underlying facts relating to practice or ability to practice Priority 3: n Pre-employment and for-cause positive drug screens n Statutorily defined felony convictions
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