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Okla. Admin. Code § 317:35-17-27 - Incident Reporting (ADvantage Waiver)

OklahomaregulationOklahoma Health Care Authority (OHCA) / Oklahoma Human Services Medicaid Services Unit (MSU)

What this rule requires your agency to do

  • 1The provider must report critical incidents in the ten enumerated categories, including suspected maltreatment, suicide attempts/ideation, unexpected deaths, falls requiring medical attention, missing members, medication errors requiring treatment, use of physical restraint, and PCA/PSA allegations. (OAC 317:35-17-27(b))(Okla. Admin. Code § 317:35-17-27 - Incident Reporting (ADvantage Waiver))
  • 2The provider must report non-critical incidents in the enumerated categories, including falls not requiring medical attention, theft allegations, threatening behavior, substance abuse, serious provider allegations, and law enforcement involvement. (OAC 317:35-17-27(c))(Okla. Admin. Code § 317:35-17-27 - Incident Reporting (ADvantage Waiver))
  • 3The provider must complete and submit an internal investigation report within ten (10) working days. (OAC 317:35-17-27)(Okla. Admin. Code § 317:35-17-27 - Incident Reporting (ADvantage Waiver))
  • 4The provider must document and submit reportable incidents to MSU in the electronic system on the Critical Incident Report (CIR) document within one business day of becoming aware of the incident. (OAC 317:35-17-27)(Okla. Admin. Code § 317:35-17-27 - Incident Reporting (ADvantage Waiver))
  • 5The provider must notify law enforcement, the Office of Client Advocacy, or Adult Protective Services, as applicable, when maltreatment is suspected, per 43A O.S. § 10-103. (OAC 317:35-17-27)(Okla. Admin. Code § 317:35-17-27 - Incident Reporting (ADvantage Waiver))
  • 6The provider must report critical and non-critical incidents involving the health and welfare of ADvantage Waiver members to the Oklahoma Human Services Medicaid Services Unit (MSU). (OAC 317:35-17-27(a))(Okla. Admin. Code § 317:35-17-27 - Incident Reporting (ADvantage Waiver))
  • 7The provider's supervisory staff must conduct monthly reviews of critical incidents. (OAC 317:35-17-27)(Okla. Admin. Code § 317:35-17-27 - Incident Reporting (ADvantage Waiver))

Applies to: home and community-based services (HCBS); personal care / personal services provided to ADvantage Waiver members

Oklahoma's ADvantage HCBS waiver rule requires certified provider staff to report critical and non-critical incidents affecting member health and welfare to the Medicaid Services Unit via an electronic Critical Incident Report, within one business day, with internal investigation reports and supervisory monthly reviews, and to notify law enforcement/APS when maltreatment is suspected.

Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.