Reportable Event Record/Report
Form Template
Use the Reportable Event Record/Report mobile app with your smartphone or tablet to document reportable events that happen at your facility.
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Once the app is filled out it can easily be submitted to multiple individuals simultaneously. The app generates a PDF that is also stored in your account securely. If the event is an allegation of abuse, neglect, or misappropriation of resident funds by a nurse aide, please provide the certification number and certificate expiration date.
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