Which fields on the form must be filled out in order to submit a nursing facility report?

The form contains required questions that must be completed in order to submit any Patient Safety Reporting Program (PSRP) report. Depending on the event type selected, there may be additional event-specific questions that must be completed prior to submission. The system will automatically save a partially completed report regardless of whether the required fields are completed.

The following questions are required for any PSRP report:

General Information

Event Summary, Causes, and Action Plans

Harm Category

Event Details

Contributing Factors

Event Review and Analysis