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Every independent and agency provider must maintain a log of Unusual Incidents or UIs. Both independent and agency providers must review UI logs at least once per month to ensure appropriate preventive measures were implemented and to identify patterns or trends.

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The log shall contain only unusual incidents as defined in paragraph (C)(25) of this rule and shall include, but is not limited to, the name of the of the individual, a brief description of the unusual incident, any injuries, time, date, location, cause and …

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Use this form to report and track usual or major unusual incidents. An unusual incident or UI, is an event or occurrence involving a person that is not consistent with routine operations, policies, and procedures, or the person's care or service plan, but is not a major unusual incident.