245D incident reporting has one master timeline and several branches. Under Minn. Stat. § 245D.06, subd. 1, a home and community-based services (HCBS) license holder must report any incident to the person's legal representative or designated emergency contact and to the case manager within 24 hours. Deaths, serious injuries, suspected maltreatment, and emergency use of manual restraint each add reports to other agencies on their own clocks.
The definition matters as much as the deadline. "Incident" is a defined term in § 245D.02, subd. 11, and it is broader than injuries. A mental health crisis that leads to a 911 call, an unexplained absence, and a maltreatment report are all incidents that start the 24-hour clock.
This guide covers the definitions, the 24-hour report, the manual restraint chain under § 245D.061, maltreatment reporting to the Minnesota Adult Abuse Reporting Center (MAARC), death and serious injury reporting to the Department of Human Services (DHS), and the review duties that follow, as of September 2026.
What counts as an incident under § 245D.02
§ 245D.02, subd. 11 defines an incident as "an occurrence which involves a person and requires the program to make a response that is not a part of the program's ordinary provision of services to that person." The definition then lists what is included:
| Incident type | What it covers |
|---|---|
| Serious injury | Injury as defined in § 245.91, subd. 6 |
| Death | Any death of a person receiving services |
| Medical emergency | Unexpected serious illness or a significant unexpected change in illness or condition that requires calling 911, physician treatment, or hospitalization |
| Mental health crisis | A crisis that requires the program to call 911, a mental health crisis intervention team, or a similar mental health responder |
| Unauthorized or unexplained absence | The person is missing from the program |
| Conduct between persons served | Conduct that substantially interferes with a person's rights or participation in services |
| Sexual activity involving force or coercion | As defined in the criminal sexual conduct statutes |
| Emergency use of manual restraint | Any use under § 245D.061 |
| Maltreatment | A report of alleged or suspected child or vulnerable adult maltreatment |
If your incident policy lists only injuries and hospitalizations, it is narrower than the statute, and staff will miss the 24-hour window without realizing it.
The 24-hour incident report
§ 245D.06, subd. 1(b) sets the baseline. The license holder must "maintain information about and report incidents to the person's legal representative or designated emergency contact and case manager within 24 hours of an incident occurring while services are being provided, within 24 hours of discovery or receipt of information that an incident occurred," unless the license holder has reason to know it was already reported, or unless the person's support plan or addendum directs otherwise.
Two details trip up agencies. Discovery counts: a weekend injury that staff learn about on Monday starts the clock Monday, and the report must say when it was discovered. And under paragraph (c), when more than one person is involved, the report to each person and case manager must not disclose identifying information about any other person without consent.
The report itself should be written even when the notice is given by phone. § 245D.095, subd. 3 requires incident reports to be kept in the service recipient record, and the 245D documentation checklist lists what else belongs there.
Emergency use of manual restraint: the full timeline
An emergency use of manual restraint (EUMR) is allowed only when immediate intervention is needed to protect the person or others from imminent risk of physical harm, using the least restrictive intervention that will achieve safety, and ending as soon as the threat passes (§ 245D.061, subd. 2). Once it happens, the reporting chain in § 245D.061 runs alongside the 24-hour rule.
| Step | Deadline | Who and what | Source |
|---|---|---|---|
| Verbal report | Within 24 hours of the restraint | License holder verbally reports to the legal representative or emergency contact and case manager | § 245D.06, subd. 1(h) |
| Written report | Within 3 calendar days | The staff person who implemented the restraint reports in writing to the designated coordinator | § 245D.061, subd. 5 |
| Internal review | Within 5 working days of the restraint | License holder reviews the report, decides whether plans, policies, or training need to change, and writes a corrective action plan if needed (implemented within 30 days) | § 245D.061, subd. 6 |
| Expanded support team review | Within 5 working days after the internal review | Team defines the antecedent, identifies the function of the behavior, and decides whether the support plan addendum needs revision; written summary kept in the record | § 245D.061, subd. 7 |
| External report | Within 5 working days of the expanded support team review | License holder submits the written report, internal review, corrective action plan, and team summary to DHS and the Office of Ombudsman for Mental Health and Developmental Disabilities | § 245D.061, subd. 8 |
| BIRF | Same external report, on the DHS form | Providers covered by Minn. R. ch. 9544 report the restraint and other restrictive intervention events on the Behavior Intervention Report Form | Minn. R. 9544.0110 |
The written report under subd. 5 must describe the staff and persons involved, the physical and social environment, the less restrictive alternatives attempted and for how long, the condition of everyone involved before, during, and after, any injuries including to staff, and whether a debriefing occurred. Each restraint is reported separately; one that is released and immediately reapplied because the behavior re-escalates counts as a single incident.
Minn. R. 9544.0110 lists other events that also go on the BIRF: a medical emergency caused by a restrictive intervention, a behavioral incident that results in a 911 call, a mental health crisis caused by a restrictive intervention, use of crisis respite because of a restrictive intervention, PRN medication used to intervene in a behavior, and any event a positive support transition plan requires the program to report.
Compliance note: the three 5-working-day steps are sequential, not parallel. Counting from the restraint, the external report is due roughly 15 working days out plus the 3-calendar-day written report. Log each completion date; DHS reads the dates before it reads the narrative. Unreported restraints found in daily log notes are one of the findings described in the common 245D licensing citations guide.
Reporting maltreatment: MAARC and the county
Staff of a 245D program are mandated reporters. Suspected maltreatment of a vulnerable adult is reported immediately under § 626.557 to the Minnesota Adult Abuse Reporting Center (MAARC), which takes reports 24 hours a day at 844-880-1574 and through a web-based system for mandated reporters. MAARC routes the report to the lead investigative agency, which may be county adult protective services, the Department of Health, or DHS. Suspected maltreatment of a child is reported to the local welfare agency or law enforcement under chapter 260E.
§ 245D.06, subd. 1(d) adds a second step for the license holder. Within 24 hours of reporting maltreatment, the license holder must inform the case manager of the report, disclosing the nature of the activity reported and the agency that received it, unless there is reason to believe the case manager is involved in the suspected maltreatment.
Training backs this up. § 245D.09, subd. 4, clause (5) requires orientation on maltreatment reporting within 72 hours of a staff person first providing direct contact services and annually thereafter. The 245D staff training guide covers how to document that.
Death or serious injury: reporting to DHS licensing
§ 245D.06, subd. 1(e) requires the license holder to report the death or serious injury of a person to the DHS Licensing Division and to the Office of Ombudsman for Mental Health and Developmental Disabilities under § 245.94, subd. 2a, within 24 hours of the event or of receiving information that it occurred.
Paragraph (g) then requires an internal review of every death and serious injury that occurred while services were being provided and was not reported as maltreatment. The review must evaluate whether policies and procedures were followed, whether they were adequate, whether staff need more training, whether the event resembles past events with the same persons or services, and whether corrective action is needed. The license holder must develop, document, and implement a corrective action plan based on the results.
Incident review and pattern analysis
Two provisions require the agency to look across incidents rather than at each one alone. § 245D.11, subd. 2 requires a health and welfare policy set that includes emergency and incident reporting procedures and a system for reviewing incidents to identify trends and implement corrective action. § 245D.061, subd. 6 asks the same question for each restraint: is this event similar to past events with the persons, staff, or services involved?
A workable review system has four parts: one incident log across all persons and sites with the § 245D.02, subd. 11 type as a field; a monthly review by the designated manager, whose duties under § 245D.081, subd. 3 include implementing corrective actions from incident reviews; a written corrective action plan with an owner and a date when a pattern appears; and a trail back to the support plan addendum when the fix is a change in supports. The DHS audit preparation checklist shows what licensors pull.
Documenting the incident
The statute does not prescribe a general incident report form, but the elements required for the restraint report in § 245D.061, subd. 5 are a sound template for every incident. A complete report records:
- The person, the date and time the incident occurred, and the date and time it was discovered.
- The incident type using the § 245D.02, subd. 11 categories.
- Who was present, what happened, and what staff did in response.
- Injuries, medical treatment, and any 911 or crisis call.
- Each notification: who was told, by whom, when, and how (phone, in person, written).
- For maltreatment, the receiving agency and when the case manager was told; for a death or serious injury, when DHS Licensing and the Ombudsman were notified.
- The staff person completing the report, the date signed, and dated follow-up entries.
Keep a copy in the service recipient record and in the incident log. Policies under § 245D.061, subd. 9 must spell out the reporting instructions and timelines for staff, so the form and the policy should use the same words. The 245D license guide explains how incident policies fit into the licensing review, and what 245D is explains where the protection standards sit within the chapter.
How Trustora helps
Trustora's 245D module records incidents against the § 245D.02, subd. 11 categories and starts the applicable clocks automatically: the 24-hour notification to the legal representative and case manager, the DHS and Ombudsman report for a death or serious injury, and the full emergency manual restraint chain with its 3-calendar-day, 5-working-day, 5-working-day, and 5-working-day steps. Each notification is logged with who, when, and how, and gap-day alerts fire before a step is late.
Incident reports live in the service recipient record and in an agency-wide log with pattern views by person, site, staff, and incident type, and corrective action plans are tracked to completion. Every entry is written to an append-only, SHA-256-chained audit log, and the one-click DHS audit binder pulls the incident history for any date range. See the platform overview for the incident workflow.