Escalation
Protocols

 Recognition and safe response across physical, sexual, and financial abuse, neglect, abandonment, self-neglect, isolation, and mental suffering — including how to act without ever alerting a suspected abuser. inHealth policy is that every coach reports: every state, every time, on reasonable suspicion, without waiting for proof. That duty is personal. Telling a supervisor does not satisfy it, and no inHealth supervisor may tell a coach not to report. 

 Covers medical emergency, falls and injury, mental health crisis, suicide risk, substance use and overdose, and disordered eating red flags. Coaches ask about suicide directly, stay on the line through a 988 handoff, and confirm the participant's current address before dialing — because a coach calling from another state will otherwise route to the wrong dispatch. If a participant declines help, the referring provider is notified anyway. A refusal does not close an incident. 

 Begins with measurement technique, because a reading taken wrong isn't worth escalating. Categorization requires averaged readings across multiple occasions, then tiers from Stage 1 hypertension (routine lifestyle coaching) up to hypertensive emergency (911 first, provider within the hour). It also runs the opposite direction: participants losing weight on antihypertensives may find a once-correct dose is now too strong, so symptomatic low readings trigger same-day provider contact and a medication review flag. 

 Separates two questions that are easy to conflate — how many hours the device is worn, the payer-facing adherence metric, and how well the therapy works when it is. A participant can be fully adherent and still undertreated. Below-standard usage gets a named barrier documented (mask leak, pressure intolerance, nasal congestion, claustrophobia), not a generic "low adherence" note. Drowsy driving is a same-day escalation because the risk extends to third parties, and 10% weight loss since the last titration triggers a sleep physician referral.