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W. Va. Medicaid Provider Manual, Chapter 501 Aged and Disabled Waiver (ADW), Section 501.4 Incident Management / 501.4.1 Reporting Requirements
West Virginiasub-regulatoryWest Virginia Department of Human Services (DHS), Bureau for Medical Services (BMS)
What this rule requires your agency to do
- 1The provider must report all critical incidents (e.g., attempted suicide, injuries requiring medical intervention, medication errors, home fires, and disruptions of planned services that compromise health or safety) by entering them into the West Virginia Incident Management System (WV IMS) within one business day of learning of the incident. (Ch. 501, § 501.4.1)(Ch. 501, § 501.4.1)
- 2The provider must immediately report suspected abuse, neglect, or exploitation to Adult Protective Services (1-800-352-6513) and submit a written report to the local DHHR/DHS office within 48 hours. (Ch. 501, § 501.4.1)(Ch. 501, § 501.4.1)
- 3The provider must initiate an investigation of reported incidents and maintain incident management documentation as specified in the incident management procedures. (Ch. 501, § 501.4)(Ch. 501, § 501.4)
- 4The provider must treat any incident resulting from staff failure to perform assigned responsibilities as neglect and report it accordingly. (Ch. 501, § 501.4.1)(Ch. 501, § 501.4.1)
- 5The provider must complete the written Incident Report within 14 calendar days of learning of the incident. (Ch. 501, § 501.4.1)(Ch. 501, § 501.4.1)
- 6The provider must report incidents involving sexual assault, serious physical abuse, or exploitation to local law enforcement. (Ch. 501, § 501.4.1)(Ch. 501, § 501.4.1)
Applies to: home and community-based services; personal care / home care under the ADW waiver
Chapter 501 of the WV Medicaid Provider Manual (Aged and Disabled Waiver) requires ADW providers to identify, report, document, and investigate critical incidents involving waiver members, using the WV Incident Management System and, where abuse/neglect/exploitation is suspected, Adult Protective Services and law enforcement.
Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.