Fields marked with an asterisk * are required.

• Incident date is required.
• Provider is required.
• Type of incident is required.
• Consumer number is required.

*Date of incident:

mm/dd/yyyy

* Time of incident:

hh:mi

AM PM

estimated Check this box if exact date and time of incident is unknown

* Type of incident
Abuse: Type I Choking: Type I Death: Type I Fire department: Type II Hospital admission / emergency room visit: Type I Hospital admission / psychiatric admission: Type I Injury: Type I Medication error: Type I Neglect: Type I Other - not specified: Type II Other / individual committed a crime: Type II Other / outbreak of a communicable disease: Type II Other / suicide attempt: Type II Other / suicide threat: Type II Other / three of a kind: Type II Police: Type II Restraint - chemical intervention: Type II Restraint - unauthorized/ inappropriate use of restraints: Type II Restraint - use of restraints that result in any type of injury: Type II Theft of individual's property or funds: Type II Unexpected or risky absence / (absent >= 4 hours): Type II Unexpected or risky absence / (individual in immediate danger): Type II Abuse - Internally investigated: Type I Choking - Internally investigated: Type I Hospital treatment for chronic condition - Internally investigated: Type II Hospital visits - Internally investigated Injury - Internally investigated: Type I Medication error - Internally investigated: Type I Other internally investigated incident - Internally investigated: Type II Physical aggression - Internally investigated: Type I Planned use of restraints - Internally investigated: Type II Police - Internally investigated: Type II Theft of individual s property or fund - Internally investigated: Type II Unexpected or risky absence / absent less than 4 hours - Internally investigated: Type I    

*Provider   A & C SUPPORT SERVICES, INC. - S082 A & S COMPASSION CARE, INC. - W029 A NEW HORIZON INC - C087 ABILITIES NETWORK - C024 ABLE HEALTH SERVICES, INC. - C188 ABSOLUTE SUPPORT SERVICES INC - S098 ABUNDANT GRACE HEALTH CARE - C113 ACIDD MARYLAND - S396 ADORABLE OPTIONS - W053 AGNES SUPPORT SERVICES, INC. - W048 ALCHERA INC, DBA SAFEINHOME - S096 ALLIANCE - C012 ALOFT HEALTHCARE INC. - C154 ALTERNATIVE DDA HOME CARE, LLC - C186 AMAZING CARE HEALTH SERVICES LLC - C133 AMAZING GRACE HEALTH SERVICES - C156 AMAZING GRACE RESIDENTIAL SERVICES INC - C080 AME HOME CARE, LLC. - C165 AMERICAN CAREGIVERS, INC. - S087 AMERICAN CENTER FOR COMMUNITY INTEGRATION SERVICES INC. - S071 AMIABLE ACCESS HEALTHCARE INC - C126 AMICABLE LIVING INC. - S065 ANCHOR HOME, INC - C107 APEX HOME CARE, INC - S476 APEX NETWORK CONSOLIDATED, INC. - C264 APPALACHIAN PARENT ASSN - W002 ARC OF CARROLL COUNTY INC - W018 ARC OF NORTHERN CHESAPEAKE - C031 ARC OF PRINCE GEORGES CO INC - S011 ARC OF SOUTHERN MARYLAND INC - S002 ARC/WASHINGTON CO. - W011 ARCHWAY STATION - W014 ARDMORE ENTERPRISES - S001 ARVINA CARE GROUP - C132 ASPIRE LIVING AND LEARNING, INC. - C003 ASSOCIATED CATHOLIC CHARITIES DBA GALLAGHER SERVICES - C020 AT PENIEL INC - C192 ATHELAS INSTITUTE - C017 BAY AREA CENTER FOR INDEPENDENT LIVING - E150 BAY COMMUNITY SUPPORT SERVICES, INC. - S043 BAY SHORE SERVICES, INC. - E018 BAYSIDE COMMUNITY NETWORK - E003 BEATRICE LOVING HEART AND HEALTHCARE AGENCY INC. - S597 BELIEVE YOU CAN - E028 BELLO MACHRE - C021 BENCHMARK HUMAN SERVICES - W160 BENEDICTINE SCHOOL - E015 BEST BUDDIES INTERNATIONAL, INC. - C804 BESTCARE NURSING AND RESIDENTIAL SERVICES, INC - C404 BETHEL CARE & SUPPORT, INC. - S092 BRYSON HEALTHCARE SERVICES, INC. - C158 CALMRA, INC. - S033 CALVERT CO. HEALTH DEPT. - S027 CALVERT COUNTY COMMISSIONERS (FORMALLY CC OFFICE OF AGING) - S020 CARAFAP LLC - C137 CAREWITHHEART ANGELS, INC. - C168 CAROLINE CENTER INC - E002 CAROLINE COUNTY HEALTH DEPARTMENT - E050 CARPE DIEM SEMPER, INC - C904 CARROLL CO. BUREAU OF AGING AND DISABILITIES - W019 CBAI/NCIA - C042 CECIL COUNTY HEALTH DEPARTMENT - E051 CENTER FOR COMFORT CARE, INC - C060 CENTER FOR COMMUNITY BALANCE, INC - C664 CENTER FOR COMMUNITY INCLUSION, INC. - C171 CENTER FOR COMMUNITY INTEGRATION, INC - C484 CENTER FOR COMMUNITY SERVICES - C190 CENTER FOR COMPREHENSIVE SERVICES, INC. DBA NEURORESTORATIVE MARYLAND - S216 CENTER FOR PROGRESSIVE LEARNING - C055 CENTER FOR SOCIAL CHANGE - C049 CERENITY HEALTH CARE CORPORATION - S356 CERTIFIED HOME NURSING SOLUTIONS, INC - C083 CHAMLA, INCORPORATED - C114 CHANGING TURN COMMUNITY HEALTHCARE SERVICE, INC. - C002 CHARITY HEARTS - C097 CHARLES CO HARC - S005 CHARLES CO. HEALTH DEPT. - S028 CHERISHED HANDS HEALTHCARE SERVICES, INC. - S094 CHESAPEAKE CARE RESOURCES - E013 CHESAPEAKE CENTER, INC. - E016 CHESAPEAKE DEVELOPMENTAL SUPPORT SERVICES INC - C167 CHESAPEAKE DEVELOPMENTAL UNIT - E011 CHESAPEAKE GROUP HOMES - E004 CHESAPEAKE HEAD INJURY CENTER - E019 CHESTERWYE CENTER - E005 CHIMES INC. - C023 CIS & H INC. - S236 CITADEL OF HEALTHCARE, INC. - C196 CLEAR VISION SOLUTIONS, INC. - C111 CMRO HOLDING PROVIDER - C059 COMMUNITY CARE DEVELOPMENT SERVICES, CORP. - W039 COMMUNITY LIVING INC - W003 COMMUNITY OF INFINITE POSSIBILITIES SUPPORT SERVICES - C170 COMMUNITY OPTIONS, INC - S456 COMMUNITY SUPPORT SERVICES - S034 COMPANIONS, INC. - C344 COMPASS, INC. - S035 COMPASSION CARE INC - C105 COMPASSIONATE HOME HEALTH RESIDENTIAL SERVICE, INC. - C624 CONCEPT FOR COMMUNITY SUPPORTS INC - C159 CONNECT LEARN AND LIVE, INC. - W028 COORDINATING CENTER FOR HOME AND COMMUNITY CARE, INC. DBA THE COORDINATING CENTER - C104 CORE FOUNDATION AT KKI - S048 CORNERSTONE RESEARCH & DEVELOPMENT CENTER, INC - C744 COUNCIL FOR EC&A - W004 COURT INVOLVED RESIDENTIAL PROGRAM (CIRP) - W180 CREATIVE OPTIONS - C047 CREEKSIDE CORPORATION, INC. - S101 CREST MANOR HEALTHCARE SERVICES, INC. - C175 CRYSTAL GREENE - C143 CSAAC - S006 CSSD - C009 DAILY CARE SUPPORT SERVICES - C109 DAYLIGHT HEALTHCARE SERVICES, INC. - C179 DDP HEALTH CARE SERVICES, INC - C095 DEAF INDEPENDENT LIVING ASSOC - E021 DEBOBETH CARE INCORPORATED - C131 DELMARVA COMMUNITY SERVICES - E006 DESIRE OF ALL AGES CARE, INC. - C161 DESTINY'S GROUP HOME, INC - C324 DEVOTION CARE, INC. - S416 DIRECT COMMUNITY SUPPORT INCORPORATED - C130 DIVINE CARE INC. - S051 DIVINE CONNECT CARE, INC - S576 DIVINE HELP HEALTHCARE SERVICES - C160 DIVINE HELP SERVICES, INC. - W049 DIVINE HERITAGE INC. - C106 DIVINE SUPPORT SERVICES INC. - C148 DO NOT USE PRIMUS HEALTH INC - C089 DOCKINGS, INC. - C864 DOMINION RESIDENCE OF MARYLAND, INC - S376 DOMINION RESOURCE CENTER INC - C072 DON'T USE - SOCIAL HEALTH SERVICE GROUP, INC. - C075 DORCHESTER COUNTY HEALTH DEPARTMENT - E052 DOVE POINTE RESIDENTIAL SERVICES - E009 DOVE POINTE, INC - E012 DOVE POINTE, INC (CHILDRENS) - E170 DREAMCATCHERS COMMUNITY IMPROVEMENTS - S058 DYMOND'S QUALITY CARE, INC. - C524 DYNAMIC COMMUNITY CARE INC - E031 EBED COMMUNITY IMPROVEMENT INC. - S036 EBRIGHT SOLUTIONS, INC. - S102 EMERGE - C029 EMMANUEL GROUP HOME & GROUP OF CO, INC - C824 EMPOWERMENT FOR SUCCESS, INC. - W034 EMPOWERMENT OPTIONS INC. - C164 ENRICHING LIVES, LLC - S073 EPIC EMPOWERING PEOPLE WITH INTELLECTUAL CHALLENGES - S019 EROSUN INC. - C070 ESRO HOLDING PROVIDER - E025 ESTHAB HEALTHCARE SERVICES, INC. - S095 EVERGREEN COMMUNITY HOMES INC - C151 EVOLVECARE - W041 EXCEL SUPPORT SERVICES - W045 FAITH CLINICAL CARE INC - C122 FAMILY LIFE FOUNDATION, INCORPORATION - C098 FAMILY SERVICE FOUNDATION INC - S046 FAVORED ANGELS INCORPORATED - C103 FIDELITY RESOURCES INC. - C069 FIRST CHOICE CARE, INC - S076 FIRST PATHFINDER - C150 FLYING COLORS OF SUCCESS - W036 FORTUNE HEALTH CARE SERVICES INC. - C181 FORWARD VISIONS - C039 FOUNTAIN HEALTH SERVICES - C169 FREEDOM ASSOCIATES - C153 FREEDOM TO CHOOSE INC - C100 FRIENDS AWARE, INC. - W007 FRONTLINE COMMUNITY SERVICES, INC - S055 FULL CITIZENSHIP OF MD - S018 GBMG HEALTHCARE INC - C149 GENERATION 5 HEALTHCARE, INC. - C964 GLOBAL HANDS, INC - C764 GLOBAL WELLNESS, INC - C129 GOD'S MERCY AND GRACE GROUP HOME INC. - W052 GOLDEN MEMORY COMMUNITY HEALTH AND SERVICES - C183 GOSHEN HEALTHCARE SERVICES INC. - C117 GRACE EXCEEDING INC - C058 GRACE LINE NURSING, INC. - S083 GRACE RESIDENTIAL SERVICES LLC - C194 GRACIOUS HEALTH INC - C094 GREENER LIFE SOLUTIONS, INC - C013 GT INDEPENDENCE, INC. - C172 GUIDING LITE, INC. - C187 H&H INC. - W050 HAGERSTOWN OR HORIZON GOODWILL INDUSTRIES - W008 HANDS OF HOPE SERVICES, INC - S061 HEAD INJURY REHABILITATION AND REFERRAL SERVICES - S024 HEALTHY LIVES LLC - C108 HEALTHY LIVING OPTION INC - C145 HEART OF GOLD, INC. - S080 HELENA'S HOUSE, INC. - S066 HELIX HEALTHCARE INC - C086 HELPFUL HEARTS HEALTH SERVICES - C199 HELPFUL HEARTS HEALTH SERVICES INC. - C200 HIS KEEPSAKE, INC. - C176 HIZWILL - C110 HOLLY CENTER - E022 HOLY TRINITY CARE, INC. - S089 HOME SWEET HOME-DD, INC - C079 HOME4ME, INC - C082 HORIZON SUPPORT SERVICES, INC - C127 HOWARD COUNTY ARC - C014 HUMANIM - C011 IHCOS CARE ASSOCIATES, INC - S357 IMPACT SUPPORT SERVICES, INC - S059 INCLUSION SERVICES INC. - S156 INDEPENDENCE NOW, INC. - S596 INDIVIDUAL ADVOCACY GROUP, INC. - S100 INNOVATIVE SERVICES,INC. - C063 INSPIRED OPTIONS, INC - C584 INTEGRATIVE CARE - W047 INTERNATIONAL HEALTHCARE SERVICES, INC. - C125 ITINERIS, INC. - C204 JENNIFER NGETHA - W006 JEWISH COMMUNITY SERVICES, INC. - C027 JEWISH SOCIAL SERVICE AGENCY - S025 JOSHUA HOUSE - C065 JPS HEALTH SERVICES, LLC - C134 JUBILEE ASSOCIATION OF MD - S008 JUMOKE COMMUNITY BASED CARE, INC. - C116 KAHAK HEALTH CARE SERVICES - S099 KARINA ASSOCIATION INC - C043 KENNEDY KRIEGER INST. - C051 KENT CENTER INC. - E001 KENT COUNTY HEALTH DEPARTMENT - E053 KINETIC POTENTIAL/DIGITAL NETWORK GROUP LLC - S077 LANGTON GREEN - C019 LATTER RAIN, INC - S516 LIFE - C028 LIFE BEYOND DISABILITIES - C155 LIFE GATE HEALTHCARE SERVICE, INC. - C924 LINWOOD CENTER, INC. - C008 LIVE AGAIN INC - C162 LIVING HOPE, INC. - S063 LIVING OUT LOUD, INC - C424 LIVING SANS FRONTIERES, INC. - C068 LOVING SUPPORT CENTER, INC. - C185 LOWER SHORE ENTERPRISES - E020 LOYAL CARE AND SUPPORT INC - C157 LOYAL HEALTH CARE INC - S075 LOYALTY CARE SERVICES INC. - C136 LT JOSEPH P KENNEDY INSTIT - S017 M3 HEALTHCARE SERVICES INC. - W043 MADI'S PLACE LLC - C118 MAKOM (FORMALLY JFGH) - S007 MARIAN'S MANOR ALTERNATIVE LIVING & COMMUNITY RESOURCES, INC. - C784 MARY T. MARYLAND, LLC - C061 MARYLAND COMMUNITY CONNECTION - S068 MARYLAND INCLUSIVE HOUSING CORPORATION - S079 MARYLAND NEIGHBORLY NETWORKS - S016 MARYLAND SALEM CHILDREN'S TRUST - W033 MARYLAND SUPPORT SERVICES - W032 MAXIM HEALTH CARE SERVS. - C054 MAXIMUM COMMUNITY SUPPORT SERVICES INC. - S074 MAXIMUM SUPPORT SERVICES, INC - C088 MAY HOME CORPORATION - S097 MEDICAL MGMT OF REHABILITATION SERVICES (MMARS RC INC.) - C504 MEDSOURCE COMMUNITY SERVICE - W035 MELWOOD HORTICULTURAL TRAINING CENTER - S009 MERCY HEALTH SYSTEMS, INC. - C182 MERCY HEALTHCARE GROUP, INC. - S084 MERCY HEALTHCARE RESOURCES INC. - C093 METRO HOMES HEALTHCARE MARYLAND INC. - S436 MILLENNIUM RESIDENTIAL INC - C091 MILOUS YOUNG III - C123 MISSY'S CHOICE, INC - S062 MONARCH HEALTH SYSTEMS, INC. - C147 MONT COUNTY DHHS - S021 MOTRAC HEALTH INC. - C178 MULTI-DIMENSIONS RESOURCES INC - C139 MY LIFE LEARNING CENTER - C135 NATIONAL CHILDRENS CENTER - S044 NEW BEGINNINGS, INC - C244 NEW DIRECTIONS, INC. - C189 NEW HORIZONS SUPPORTED SERVICES INC. - S014 NEW START DD, INC. - C944 NEXTGEN HEALTH SERVICES, INC. - S086 NIAS HOUSE INC - C074 NORTHSTAR SPECIAL SERVICES, INC - C121 NOT USED - LIVING HOPE, INC. - S064 NPLH SERVICE GROUP - C084 OBIMEM CARING HAND INC - C152 OMEGA HOME CARE INC - C092 OPPORTUNITIES, INC. (FORMALLY ROI) - S022 OPPORTUNITY BUILDERS - C018 OPTIMAL CASE MANAGEMENT - W044 OPTIMAL HEALTH CARE, INC. - W140 OTIK HEALTH CARE SERVICES, INC - C138 OURCARE, INC. - S536 PACESETTER HEALTH SYSTEMS - C198 PACT:HELPING CHILDREN - C001 PBAL GROUP SERVICES, INC. - S093 PENN MAR ORGANIZATION - C032 PLEASANT OPTIONS COMMUNITY SERVICES INC - C146 POLARVIEW RESOURCES INC - C195 POOL OF BETHESDA COMMUNITY SERVICES, INC. - S116 POSITIVE PATHWAY, INC. - C844 POTOMAC CENTER - W025 POWDER MILL COMMUNITY SERVICES, INC. - S056 PRECISION HEALTH CARE RESOURCES - C224 PRIMUS HEALTH INC - C096 PRISTINE HEALTH SERVICES INC - C124 PROGRESS UNLIMITED - C033 PROVIDENCE OF MARYLAND, INC. - C034 PUBLIC PARTNERSHIPS, LLC - C173 Q-CARE INCORPORATED - S110 QUALITY PROVIDERS - C166 QUANTUM LEAP INC. - C073 QUEEN ANNE'S COUNTY DEPARTMENT OF HEALTH - E070 RADIANT CONSULTING, INC - C724 RAY OF HOPE, INC. - W010 REMED RCCOVERY CARE CENTERS DBA REMED - C191 RENOXX CAREGIVERS, INC - S556 RESIDENTIAL ADVOCACY REACHING EXCELLENCE, INC. - C544 RESOURCE CONNECTIONS, INC. - S112 RICHCROFT - C035 RISING VILLAGE, INC - S078 ROBINSON ENTITIES - C085 ROSEMOUNT MUSIC ACADEMY LLC - S072 SCOTT KEY CENTER - W005 SECOND FAMILY ADULT HOMES, INC - S115 SECOND FAMILY, INC - S336 SECURE EVALUATION AND THERAPEUTIC TREATMENT PROGRAM - W060 SEEC CORPORATION - S026 SERVICE COORDINATION, INC. - W040 SHARED SUPPORT MARYLAND , INC. - C078 SHERONDA'S HOUSE, INC. - C184 SHINING STAR HEALTH SERVICES INC - C177 SHORE COMMUNITY SERVICES, INC. - E024 SHOREHAVEN - E017 SHURA, INC. - C048 SMITH CONSULTANT GROUP - E030 SMRO HOLDING PROVIDER - S047 SOCIAL HEALTH SERVICES GROUP INC - S090 SOMERSET COMMUNITY SERVICES, INC. - E008 SOMERSET COUNTY HEALTH DEPARTMENT - E090 SON-GRACE INC. - C304 SPARKLIGHT SUPPORT SERVICES - S085 SPECTRUM SUPPORT, INC. - W030 SPRING DELL CENTER - S012 ST COLETTA OF GREATER WASHINGTON, INC. - S114 ST. MARY'S CO. HEALTH DEPT. - S029 ST. PATRICK HOMES INC - C102 ST. PETERS ADULT LEARNING - C037 STANDARD INTEGRATED SUPPORTS, INC - C564 STAR COMMUNITY, INC. - W024 STARFLIGHT ENTERPRISE INC - C046 STEIN HOME HEALTH CARE, INC. - C604 STEP BY STEP FOR CHANGE, INC. - C644 STEP BY STEP IN HOME CARE - S091 STERLING HEALTH CORP - C115 SUNRISE CEDARS, INC. - C081 SUNRISE COMMUNITY OF MARYLAND, INC. - S111 TALBOT COUNTY HEALTH DEPARTMENT - E110 TARGET COMMUNITY AND EDUCATIONAL SERVICES - W021 TEASURES, INC. - W051 TELECARE SERVICES, INC. - E033 TEMPORARY - T001 TEST - E032 TESTED - C885 THE ARC BALTIMORE - C022 THE ARC MONTGOMERY COUNTY INC - S010 THE ARC OF FREDERICK COUNTY - W001 THE ARC OF THE CENTRAL CHESAPEAKE REGION, INC. - C053 THE BROTHERHOOD & SISTERHOOD INTERNATIONAL - S276 THE CENTER FOR LIFE ENRICHMENT - S013 THE HARFORD CENTER, INC. - C025 THE LEAGUE FOR PEOPLE WITH DISABILITIES - C062 THE ROCK CREEK FOUNDATION - S045 THE TREASURED HAVEN - W046 THE WHOLE SELF CENTER (NEW GROUND ENTERPRISES) - C120 THERAPEUTIC WELLNESS SERVICES CORP - C064 TIME ORGANIZATION, INC - C057 TOFA ELITE SERVICES, INC. - S088 TOMAJOA HEALTHCARE RESOURCES, INC - C197 TOP CARE RESIDENTIAL INC. - C119 TOTAL CARE CENTERS FOR SUPPORT SERVICES - S296 TOTAL QUALITY RESIDENTIAL SERVICE, INC. - C364 TRACY'S LIFE, INC. - S067 TREASURES, INC. - W042 TREATMENT & LEARNING CTR, INC. - S042 TRINITY CARE INC - C090 TRUE VINE HEALTH SYSTEMS, INC. - C180 TRULIFE HEALTH SERVICES. INC. - C684 UNIFIED COMMUNITY CONNECTIONS (UC2) - C036 UNITED COMMUNITY SUPPORTS OF MARYLAND, INC. (FORMERLY LATONYA'S HOUSE, INC.) - S316 UNITED NEEDS AND ABILITIES, INC. (EPILEPSY ASSOC EAST SHORE) - E007 UNITRUST RESOURCES - W027 UNIVERSAL PRO CARE INC - C128 V & T RESIDENTIAL SERVICES - S136 VIRTUOUS, INC. - C704 VIVA CHOICE INCORPORATED - C163 VOCA CORPORATION - S023 WASHINGTON COUNTY HUMAN DEVELOPMENT COUNCIL - W012 WATERMARK HEALTH SERVICES - C174 WAY STATION, INC. - W038 WEACHIEVE, INC.(FORMALLY CHI CENTERS) - S003 WICOMICO COUNTY HEALTH DEPARTMENT - E111 WINDSOR WOODS HOME CARE, INC. - C112 WISDOM HAVEN INC. - C193 WMRO HOLDING PROVIDER - W037 WORCESTER CO DEVELOPMENTAL CTR - E010 WORCESTER COUNTY HEALTH DEPARTMENT - E130 WORK OPPORTUNITIES UNLIMITED CONTRACTS INC - S069 XX closed XX CARING HANDS, INC. - C041 YOUR CHOICES SUPPORT SERVICES, INC. - W031 YOUR WELLNESS SOURCES - S081 ZITA GROUP OF COMPANY - C984 closed - ABSOLUTE COMM. SERV. - C052 closed - ACE HELPING HANDS, INC. - S054 closed - AMERICAN FOUND. AUTISTIC CHILD - S004 closed - ARTEMIS MISSION INC. - C142 closed - AUTUMN HOMES - C045 closed - BEE HOMES INC - C099 closed - BETHESDA LUTHERAN HOMES - W013 closed - BETHLEHEM HOUSE INC. - S060 closed - BLUEMPLOY, INC - C144 closed - BRANDENBURG CENTER - W026 closed - CENTER FOR COMMUNITY INTEGRATION, INC. - C076 closed - CHANGE, INC. - W020 closed - CHRISHARON'S INC. - S038 closed - COMPREHENSIVE RESIDENTIAL SYSTEMS, INC. - S053 closed - COPE HOMES, INC. - C007 closed - CROSSROADS COMMUNITY - E014 closed - CTR FOR NEURO REHABILITATION - C005 closed - DESCO CHARITIES, INC. - C101 closed - DEVOTION CARE, INC. - WESTERN - W080 closed - DOUGLAS AND FRIENDS, INC - S196 closed - EASTER SEAL SOCIETY CENTRAL MD - C010 closed - EVERSHINE RESIDENTIAL SERVICES - C006 closed - FIRST METROPOLITAN FACILITIES, INC - S176 closed - GOODWILL IND. MONOCACY VALLEY - W009 closed - GRAFTON SCHOOL, INC - S032 closed - HEBRON ASSOCIATION FOR COMMUNITY SERVICES, INC - S050 closed - HOME SWEET HOME, INC. - C077 closed - HOPE HOMES OF MD - W023 closed - HUMANIM/SALISBURY - E027 closed - INTERVALS - C040 closed - JAPEC RESIDENTIAL PROGRAMS INC - C141 closed - JEANNE BUSSARD CENTER - W015 closed - LIFELINE INC. - S256 closed - LIFELINE MD/VA INC. - S113 closed - LOWER SHORE ENTERPRISES - E023 closed - LYCHER, INC. - W016 closed - MATT'S WAY INC. - C066 closed - MATTS WAY - C067 closed - MENTOR MARYLAND INC. - C056 closed - MONOCACY START CENTER, INC. - W120 closed - MULTI THERAPEUTIC SVS - S015 closed - MULTIPLE SCLEROSIS SOCIETY - W022 closed - MY OWN PLACE, INC. - S616 closed - NATIONAL MS SOCIETY, NATIONAL CAPITAL CHAPTER - S070 closed - NATIONAL MULTIPLE SCLEROSIS SOCIETY, MD CHAPTER - C030 closed - NETCON & EARTHKINS, INC. - C050 closed - NOVENA HEALTHCARE, INC. - S496 closed - PR. GEO. CO. DEPT. FAMILY SERV - S030 closed - PROGRESSIVE HORIZONS - C016 closed - PSI SERVICES, INC - S039 closed - RC UPDATE - E000 closed - REM, INC. - C004 closed - RES CARE/OTHER OPTIONS - C026 closed - RESOURCES FOR INDEPENDENCE, INC. - W100 closed - RESPITE CARE ASSOCIATES - S037 closed - ROSEWOOD CENTER - C015 closed - S & G RESIDENTIAL SERVICES, INC. - S049 closed - SACRED CARE, INC - S040 closed - SECOND CHANCE SERVICES UNLIMITED - S057 closed - SELFPRIDE - C044 closed - SERVICE SOURCE - S031 closed - SETON MANOR CARE - S052 closed - SHURA - E026 closed - STEP, INC - C071 closed - TENDER CARE, INC. - E029 closed - UCP OF PG & MONTG COUNTY - S041 closed - WASHINGTON CO. MENTAL HEALTH - W017 closed - WORKFIRST - C038 closed -HEART OF GOLD INC. SMRO PROVIDER - C140

* Service Type: BSS - CONSULTING COMMUNITY COORDINATION COMMUNITY LEARNING SERVICE COMMUNITY PATHWAYS WAIVER : NON-FPS SERVICES COMMUNITY SUPPORT WAIVER CSLA DAY HABILITATION EMPLOYMENT DISCOVERY AND CUSTOMIZATION FAMILY SUPPORT SERVICE FAMILY SUPPORT WAIVER INNOVATIVE SERVICE PROGRAM ISS PERSONAL SUPPORT RESIDENTIAL SELF_DIRECTED/FMS SERVICE SHARED LIVING - IFC STATE ONLY SUPPORTED EMPLOYMENT SUPPORTED EMPLOYMENT-CONTRACT

Individual: