Adult Programs
Misconduct Complaints

All entities regulated by the Division of Quality Assurance (DQA) must:

• Immediately protect clients from subsequent incidents of misconduct (abuse, neglect, misappropriation and injury of unknown source).

• Investigate all allegations of misconduct

• Document the results of their investigation

• Report allegations/incidents to DQA as appropriate

For allegations involving all staff (noncredentialed and credentialed) or other perpetrators (family member, friend, visitor, resident, etc.) submit the Incident Report to DQA at:

Department of Health Services
Division of Quality Assurance
Office of Caregiver Quality
PO Box 2969
Madison, WI 53701-2969
Fax: 608-264-6340
Email: DHSCaregiverIntake@wi.gov

All incident reports, regardless of perpetrator, must be submitted to the DQA Office of Caregiver Quality.  OCQ will review reports involving noncredentialed staff (nurse aides, caregivers, housekeepers, etc.) for possible investigation and refer reports involving credentialed staff (doctors, RNs, LPNs, social workers, etc.) to the Department of Safety & Professional Services (DSPS) for review.  OCQ will also refer reports to other agencies including the Department of Justice, county departments, adult-at-risk agencies, local law enforcement agencies, and others, as appropriate.  One or more of these agencies may also respond to an allegation investigated by DQA.

All Entities except nursing homes:

DQA Memo 04-028, Revised Caregiver Misconduct Reporting Requirements for DQA Entities

• Use the Worksheet or Flow Chart to assist in making the reporting determination.

• Use the F-62447 Incident Report form to report misconduct allegations.

Nursing Homes Only:

DQA memo 11-032, Guidance for Investigating & Reporting Alleged Violations in Nursing Homes

• Injury of Unknown Source Flowchart P-00362

• Resident-to-Resident Altercation Flowchart P-00361

DQA memo 10-008, Update: Nursing Home Reporting Requirements for Alleged Incidents of Abuse, Neglect and Misappropriation

• Effective immediately, completion of the online form at http://4.selectsurvey.net/DHS/TakeSurvey.aspx?SurveyID=96MI3ml4 is required to meet the requirements in Federal regulation 42 CRF 483.13 (c)(2).

• Use the F-62447 Incident Report form to report misconduct allegations investigations.

Nursing Homes, Hospices and FDDs

DQA Memo 11-021 CMS S&C Memo 11-30 Reporting Reasonable Suspicion of a Crime

All Entities: 

OQA Memo 06--028 Adult at Risk, including Elder Adult at Risk Reporting Requirements for entities regulated by DQA

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Last Revised: May 07, 2013