Site Visits

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.

Learn more about site visits conducted by PCG.

Federal and state laws require some providers to have pre- and post-enrollment site visits to ensure they are following Ohio rules and regulations for being a Medicaid provider. In Ohio, PCG conducts these site visits on behalf of ODM. Site visits are conducted at the provider's service location without prior notification or appointment.

When PCG representatives arrive at your office, they will have business cards and a letter of introduction for your verification. Please take a few moments to answer their questions and allow them access to your facility. This will help to complete your site visit smoothly. During your site visit, PCG representatives will review various aspects of your business and will ask to view specific documentation. Failure to answer their questions and cooperate may affect your enrollment or current provider status with Ohio Medicaid.

If providers are out of compliance with rules and regulations, PCG representatives will educate the provider regarding any deficiencies. The provider will have an opportunity to ask follow-up questions or for clarification.

After the site visit, non-compliant providers may receive a letter from ODM further outlining areas where the provider is non-compliant. This notification is called a "Notice of Operational Deficiencies" (NOD). The NOD will clearly outline the areas where deficiencies were found. If you receive a NOD, you must submit a “Plan of Correction” (POC) within 14 days outlining how you have corrected the deficiency and what action has been implemented to ensure no future deficiency. While there is no official format for a POC, it must include the following:

  • An explanation of any actions the provider has initiated in order to correct each deficiency

  • What steps the provider has taken to ensure similar deficiencies will not recur in the future

  • The business name, address, Reg ID, provider’s signature, and date of submittal

The NOD will outline these requirements along with the mailing address for where to send the completed POC.

For additional information about provider screening requirements, see OAC 5160-1-17.8.