Dear Nursing Home Administrator,

Effective Nov 1, 2018, the method of submitting Reportable Events from your facility will change.  The statutory requirement to report with a voice phone call has been changed to require Reportable Events be submitted via DPH FLIS Events web based program within 2 hours of the incident.

To use this web site; each facility must have a registered administrator. This facility administrator will have access to this web based program and also be empowered to create additional users who can submit the reports. Please provide your facility administrator information by completing this survey. This Facility administrator who is authorized for your facility will be able to create new user accounts to submit Reportable Events to the State of Connecticut Department of Public Health.

This information is mandatory in order for DPH FLIS System Administrators to give access to the web based reporting for your facility administrators. The Department suggests that you subscribe at least two administrators to provide coverage depth and serve as a backup for vacations, etc. If a facility administrator requests access to the system and is not on the list provided by your facility (submitted below), the Department will need to follow up with a telephone call to verify your approval for that individual’s access.

The Department of Public Health should be notified as soon as possible when any approved facility administrator resigns or leaves your facility so their account can be deactivated. Thank you for your attention to this important initiative. 

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* 1. Chronic & Convalescent Nursing Home Name (If multiple facilities, please separate by comma)

Please provide at least one facility administrator. Use Questions 3&4 for additional facility administrators

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* 2. Facility Administrator

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* 3. Additional Facility Administrator

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* 4. Additional Facility Administrator

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* 5. Designated Approver from Nursing Home(CEO, Director of Quality, etc)

Please do not hesitate to contact Surjit Sethuraman at with any questions.