Critical Incidents

What is a critical incident?

A critical incident is when a health care provider suspects the person in their care has been harmed through physical, mental, or sexual abuse, neglect, theft or financial harm, inappropriate or unprofessional behavior, or unexpected death.

Here’s how to help.

• For elderly adults, refer to the Elder Abuse Suspicion Index (EASI) when you suspect a critical incident has occurred.
• Be an advocate.
• Be honest, open, up-front, and supportive.
• Find a private place to talk.
• Listen to the patient.
• Remain calm.
• Report the situation immediately.

See a critical incident? Report it.

If you observe or have knowledge of a critical incident, you are responsible for reporting it the same day by calling Highmark Health Options at 1-844-325-6251.

A report should also be made to the appropriate investigative state agency:

^{Contact Information by Department}

West Virginia Department of Human Services

Local line: 304-558-0684

For benefit questions: 877-716-1212

For complaints: 800-642-8589​​

Office of Constituent Services Client Services

Toll free: 800-642-8589
Email: osaclientservices@wv.gov

Office of Maternal Child and Family Health

Local line: 304-558-5388

Toll free: 800-642-8522 or 800-642-9704

West Virginia Bureau for Social Services

Local line: 304-558-0628

Centralized Intake for Abuse and Neglect (Adult/Child)

Toll free: 800-352-6513 (Children: Option 2, Adults: Option 3)

CPS Online Intake Form here, for children not in imminent danger. 

Adult Protective Services Mandatory Reporting Form here.

The Office of Health Facility Licensure & Certification (OHFLAC)

Healthcare facility complaints: 304-558-0050
Home health hotline: 800-442-2888
Online Complaint Form here.

Long-term Care Ombudsman (Operates under Legal Aid of WV)

Ombudsman Program Director Ed Hopple

Remote office line: 304-449-4755

Toll free: 1-800-834-0598, ext. 3912 (Voicemail only)