Incident Investigations

PCG is the Ohio Department of Medicaid’s (ODM) designee responsible for conducting various provider oversight activities for the state of Ohio. PCG conducts onsite visits, incident investigations, and structural reviews for ODM-Administered Waiver services.

Incidents may include cases of neglect, abuse, exploitation, abandonment, theft, or other events that inhibit the health, welfare, or care of the individual. If an incident occurs that may be detrimental to the care of an individual receiving waiver services, PCG may be asked to investigate this incident on behalf of the state.

It is PCG’s role to determine whether an incident occurred, and, if it did, ensure that measures are taken to prevent such incidents from occurring in the future. During the investigation, PCG may need to speak with family, friends, providers, case managers, or others involved. PCG may review documentation such as provider or case management notes, incident reports, provider billing records, doctor’s orders, Person-Centered Services Plans, or any other documents needed to determine what happened, and how to prevent the incident from happening again.

Interested in learning more about the Incident Management Rule? Review our CE training course Navigating Incident Management: Assuring the Health and Safety of Individuals on the Ohio Home Care Waiver and MyCare Ohio Waiver here.