Complaint and Incident Reporting / Tracking

Complaint Tracking Tool

Complaints must be documented by the CMA separately from the chart in Netsmart CareManager.  While not required, we recommend using the CHHUNY Complaint Tracking Tool to document complaints managed at your agency for the Health Home program, as it contains fields for all of the key information. For the first 60 days as a Care Management Agency, all complaint documentation should sent via secure/encrypted email to HHUNY’s Complaint/Incident Manager for review: LSpas@hhuny.org.

Download the Complaint Tracking Tool Here (.doc)

Incident Reporting Forms

These document must be completed by the CMA and sent via secure/encrypted email to the HHUNY Complaint/Incident Manager within the appropriate timeframe listed on the reports. These are required documents for Incident Tracking and Reporting and was created based on DOH guidance. 

Initial Incident Report Form

Download the Initial Incident Reporting Form (Fillable .pdf) Updated 4/24/2017