Office of Risk Management and Patient Safety

Sean Massey, Program Administrator
Risk Management and Patient Safety
Tel: (850) 412-3759
Fax: (850) 922-2217

The Agency for Health Care Administration administers serious patient injury reporting, tracking, trending and problem resolution programs in hospitals, ambulatory surgical centers, assisted living facilities, nursing homes and certain HMOs as directed by Florida Statutes.

Important Notices and Alerts:

Single Sign On Portal - Adverse Incident Reporting (Log-in and Registration)

Annual Report and Liability Claims Access Application

IMPORTANT: The New User Application allows text to be typed directly on the form prior to printing.

Adverse Incident Annual Report

IMPORTANT: This system may time out after 20 minutes if the online reporting is not complete.

Submit Liability Claims Report

Adverse Incident Reporting Resources

Florida Statutes (F.S.):

Florida Administrative Code (F.A.C.):

Helpful Links: