As part of its comprehensive law enforcement approach, the Lexington Medical Center Department of Public Safety has an investigative function to research reported unlawful activities, solve cases and seek prosecution in criminal court. The cases investigated range from misdemeanor crimes to serious felonies. Casework is generated in response to patrol officers, self-generated investigations and referrals from other sources.

Investigators receive extensive training in criminal investigations, evidence recovery and seizure, interview techniques and victimology. They are also the primary investigators for sexual assaults and domestic violence cases. The investigators’ work focuses on the solvability of casework, the application of warrants and the needs of the victims. The investigators also function as the department's court officers by representing the department in most Magistrate and General Sessions court cases.