A. The staff of the hospice house shall complete an incident report in accordance with hospice policy within 24 hours of having knowledge that an incident has occurred.
B. All incident reports shall include:
(1) Time, date, place, and individuals present;
(2) Complete description of the incident;
(3) Response of the staff at the time; and
(4) Follow up action, including notification to the:
(a) Patientís primary hospice nurse or hospice nurse on call;
(b) Patientís representative or family;
(c) Patientís attending physician or nurse practitioner;
(d) Hospice medical director; and
(e) Licensing or law enforcement authorities, when appropriate.