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Colorado Department of Public Health and Environment | Health Facilities

Occurrences (Facility Self-Reported Incidents)

Medical Staff Discussing Medical Report

All healthcare entities licensed by the department are required to report occurrences (facility self-reported incidents) to the Health Facilities and Emergency Medical Services Division. Statutory citations for this can be found at 25-1-124 (CRS) and 25-3-109 (1),(3),(7),(8) and the regulations can be found in 6 CCR 1011-1, Chapter II, Licensing: 3.2 Occurrence Reporting.


Reportable occurrences include unexplained deaths, brain injuries, spinal cord injuries, life-threatening complications of anesthesia, life-threatening transfusion errors/reactions, severe burns, missing persons, physical abuse, verbal abuse, sexual abuse, neglect, misappropriation of property, diverted drugs and malfunction/misuse of equipment.

Facilities must report these occurrences within one business day. The division will investigate the occurrence and determine if appropriate facility action has been taken, and then write a summary of the occurrence for public viewing. The summaries respect confidentiality and do not reflect the names of the persons involved.


If necessary, following the investigation of the occurrence, the division will cite a deficiency if it finds that state or federal regulations have been violated. As well, division staff review occurrence reports prior to conducting annual surveys in facilities and prior to reissuing a facility's license. Occurrence reports may also be reviewed as part of a complaint investigation.

Reporting Manual, Example Sets and Updates

A Note to Consumers:


When comparing facilities in terms of quality, consumers must keep in mind that the number of occurrences that a facility has does not necessarily mean that it has failed to act appropriately or is experiencing negative trends in delivery of healthcare. Instead, facilities that appear to have a higher number of reported occurrences may simply be doing a better job of reporting those occurrences.


Consumers are encouraged to review a facility’s occurrence history in order to evaluate how it responds to certain types of events, keeping in mind that the occurrence reports do not reflect such factors as facility size or the complexity of healthcare needs of its patients.