An unusual incident, also called a 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.


The Incident Report Form is used to report an unusual incident. Whenever a UI occurs, a provider must submit the Incident Report Form to the County Board.

Every independent and agency provider must maintain a log of unusual incidents that includes:

Information about the incident, including day, time, and notes regarding any injuries

What actions were taken after becoming aware of the incident

What caused or contributed to the incident

Preventative measures

*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. Once the logs have been reviewed, send them to the appropriate County Board.

Providers may use the UI Incident Report Log as a template.


Major unusual incidents, also called MUIs, are alleged, suspected, or actual occurrences of an incident when there is reason to believe the health and welfare of a person may be adversely affected or the person is placed at a likely risk of harm. MUIs are reported so they can be investigated. The investigation will help find out why the incident happened and what can be done to keep it from happening again. The goal is to help people be safe.

To ensure Health and Safety of the individual(s) they serve, providers must:


Take immediate action to protect the health and safety of the person

Notify the person’s legal guardian on the same day of the incident. (Parents who are not the legal guardians may only be notified with approval by the son or daughter or the legal guardian)

Notify the county board immediately and no later than four hours when the allegation is Abuse, Neglect, Misappropriation, Exploitation, Prohibited Sexual, Suspicious or Accidental Death.

Notify the police or children’s services when there is an alleged crime

Send the Incident Report to the county board by 3 PM of the next working day

Annual Reporting

By January 31st of each year, a provider must conduct an in-depth review and analysis of trends and patterns of MUIs occurring during the preceding calendar year. DODD has an annual report template which can assist with your analysis and can be found here:

The completed Annual Report needs to be sent to the County Board by February 28th of each year.