Follow-Up Action and Notification Information

The Follow-Up Action and Notification Information screen is the final screen in the Initial Mortality Review and allows users to capture details about the follow-up actions and notifications identified during the Mortality Review that need to be completed. The Initial Mortality Review is only available when an incident with a primary category of Death is closed in EIM.

 

Note: Mandatory fields are marked with an asterisk. In addition, some fields are conditionally mandatory, or in other words, become mandatory based on the response to a previous field. All mandatory fields (including conditionally mandatory fields) must be completed on a screen.

 

Field Name

Field Description
Are there follow-up actions needed as a result of this Mortality Review? Select whether follow-up actions need to take place as a result of the Mortality Review from the drop-down list.
Please indicate the OLTL follow-up actions If ‘Yes’ is selected in the previous question, indicate the follow-up action or actions needed.
If other, please specify If ‘Other’ is selected as a follow-up action, please explain.
As a result of the Mortality Review, was the Department of Human Services Licensing contacted? Select from the drop-down list whether the Department of Human Services Licensing was contacted as a result of the Mortality Review.

Date Contacted

 Enter the date the Department of Human Services Licensing was contacted.
As a result of the Mortality Review, was the Department of Health Licensing contacted? Select from the drop-down list whether the Department of Health Licensing was contacted as a result of the Mortality Review.
Date Contacted Enter the date the Department of Health Licensing was contacted.
As a result of the Mortality Review, was the Department of Aging contacted? Select from the drop-down list whether the Department of Aging was contacted as a result of the Mortality Review.
Date Contacted Enter the date the Department of Aging was contacted.
As a result of the Mortality Review, was the Department of State contacted?

Select from the drop-down list whether the Department of State was contacted as a result of the Mortality Review.
Date Contacted Enter the date the Department of State was contacted.

Was notification made to local law enforcement and/or the Office of the Attorney General (relating to neglect of a care-dependent person)?

 Select from the drop-down list whether notification was to local law enforcement and/or the Office of the Attorney General (relating to neglect of a care-dependent person).
To which agency was a referral made If notification was made to local law enforcement and/or the Office of the Attorney General (relating to neglect of a care-dependent person), select from the drop-down list which agency or agencies was notified.
Other Relevant Information Document any other relevant information pertaining to follow-up action and notification information in the textbox.