> ## Documentation Index
> Fetch the complete documentation index at: https://docs.officeridge.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Member safeguards

> Complaint tracking, incident reporting, and member rights documentation.

These tabs protect the people you serve: complaints raised, incidents that occurred, and the rights
each member has been told about.

## Complaints

Complaint tracking with category, priority, investigation status, and resolution dates.

**Columns:** Member · Date · Category · Priority · Status · Resolved

**Category** is what makes complaints useful beyond the individual case. Categories that recur point
at a systemic problem worth a [QAPI](/compliance/qapi) initiative.

<Warning>
  A complaint with no **Resolved** date is still open, regardless of what status says. Members and
  families notice unresolved complaints long before surveyors do.
</Warning>

## Incident Reports

Incident reports with type classification, severity levels, and regulatory reporting status.

**Columns:** Member · Date · Type · Severity · Status · Reported

| Field        | What it tracks                             |
| ------------ | ------------------------------------------ |
| **Type**     | The kind of incident                       |
| **Severity** | How serious it was                         |
| **Status**   | `OPEN`, `UNDER_INVESTIGATION`, or `CLOSED` |
| **Reported** | Whether it was reported to the regulator   |

<Warning>
  **Reported** is a regulatory field, not an internal one. Certain incident types must be reported to
  the state within defined timeframes. Escalate to your compliance officer rather than deciding
  reportability yourself.
</Warning>

## Member Rights

Member rights documentation including acknowledgement, DNR status, and privacy notices.

**Columns:** Member · Provided · Acknowledged · DNR Status · Privacy Notice

| Field              | What it confirms                           |
| ------------------ | ------------------------------------------ |
| **Provided**       | Rights information was given to the member |
| **Acknowledged**   | The member confirmed receipt               |
| **DNR Status**     | The member's do-not-resuscitate status     |
| **Privacy Notice** | The HIPAA privacy notice was provided      |

<Warning>
  **Provided** is not **Acknowledged**. Handing over rights information does not evidence that the
  member received and understood it. Filter on a blank **Acknowledged** to find gaps.
</Warning>

<Warning>
  **DNR Status** is clinical information that affects care delivery in an emergency. Confirm it is
  accurate and current on every member record — not just recorded once at admission.
</Warning>

## Handling a complaint

<Steps>
  <Step title="Record it the day it arrives">
    Set the member, date, category, and priority.
  </Step>

  <Step title="Investigate">
    Move the status forward as you work. Keep the member informed.
  </Step>

  <Step title="Resolve and record the date">
    **Resolved** is what closes the loop.
  </Step>

  <Step title="Look for a pattern">
    Group by **Category**. A recurring category needs a QAPI initiative, not another individual fix.
  </Step>
</Steps>

## Handling an incident

<Steps>
  <Step title="Record the incident immediately">
    Set member, date, type, and severity.
  </Step>

  <Step title="Escalate for reportability assessment">
    Your compliance officer determines whether the state must be notified, and by when.
  </Step>

  <Step title="Investigate">
    Move status to `UNDER_INVESTIGATION`.
  </Step>

  <Step title="Record the regulatory report">
    Set **Reported** if notification was made.
  </Step>

  <Step title="Close with findings">
    Move to `CLOSED` once the investigation concludes.
  </Step>
</Steps>

## Completing member rights at admission

<Steps>
  <Step title="Provide the rights information and privacy notice">
    Set **Provided** and **Privacy Notice**.
  </Step>

  <Step title="Obtain acknowledgement">
    Set **Acknowledged**. This is the field that evidences compliance.
  </Step>

  <Step title="Record DNR status">
    Confirm it with the member and their physician.
  </Step>

  <Step title="Review periodically">
    DNR status and contact preferences change.
  </Step>
</Steps>

## Troubleshooting

| Problem                                                  | What to check                                                           |
| -------------------------------------------------------- | ----------------------------------------------------------------------- |
| A complaint shows closed but the member is still unhappy | Check **Resolved** has a date and that the resolution was communicated. |
| An incident was not reported in time                     | Escalate immediately. Reporting timeframes are regulatory.              |
| Member rights show incomplete                            | **Acknowledged** or **Privacy Notice** is unset.                        |
| Complaints in one category keep recurring                | This is a systemic problem. Open a [QAPI](/compliance/qapi) initiative. |

## Related

<CardGroup cols={2}>
  <Card title="QAPI" icon="trending-up" href="/compliance/qapi">
    Turn complaint patterns into improvement work.
  </Card>

  <Card title="Members" icon="users" href="/members">
    Member records and assessments.
  </Card>
</CardGroup>