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.
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:
For suspected abuse, neglect, disruptive behavior, or exploitation.
For adult members in a long-term facility and for child members in a pediatric nursing facility.
For residents in long-term care facilities who have a complaint about their rights.