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Series: Medicaid—Audit of Health and Safety Standards at Individual Supported Living Facilities

Announced on  | Last Modified on  | Series Number: SRS-A-25-025
Status
Active
Agency
Centers for Medicare and Medicaid Services

OBJECTIVE

State agencies operate home and community-based services programs under a 1915(c) waiver to their respective Medicaid State plans. Some of these waivers allow for providing services to individuals with developmental disabilities. Such waivers include individualized supported living habilitation services, which provide assistance and necessary support to achieve personal outcomes that enhance individuals' ability to live in and participate in their communities. To receive approval for a waiver, State agencies must ensure the health and welfare of the beneficiaries of the service. Recent media coverage throughout the United States of deaths of people with developmental disabilities involving abuse, neglect, or medical errors has led to OIG audits in several States. Our objective is to determine whether State agencies and providers complied with Federal and State health and safety requirements involving Medicaid beneficiaries with developmental disabilities residing in individualized supported living settings, including infection control for conditions such as coronavirus disease 2019 (COVID-19) and other infectious diseases.

There are 4 projects in this series.

Project titles will remain unpublished until projects are complete and reports are posted.

ACTIVE PROJECTS IN THIS SERIES (3)

Project A-04-24-09011 • Announced on Nov 9, 2023

Project A-07-24-04137 • Announced on Apr 18, 2024

Project OAS-25-01-072 • Announced on Apr 25, 2025

COMPLETED PROJECTS IN THIS SERIES (1)

Indiana

Project A-05-24-00013 • Completed on October 9, 2025

TIMELINE

  • November 9, 2023
    Series Number SRS-A-25-025 Assigned
  • November 9, 2023
    Project Announced

    Project A-04-24-09011

  • February 27, 2024
    Project Announced

    Indiana - A-05-24-00013

  • April 18, 2024
    Project Announced

    Project A-07-24-04137

  • April 25, 2025
    Project Announced

    Project OAS-25-01-072

  • October 9, 2025
    Project Complete - A-05-24-00013

    Indiana has been marked as complete. This audit resulted in 3 recommendations.

  • Today
    3 Audits In-Progress
  • Est FY2026
    Estimated Fiscal Year for Series Completion

1 REPORT PUBLISHED

Indiana Did Not Fully Comply With Federal Waiver and State Health, Safety, and Administrative Requirements at 30 Residential Settings (A-05-24-00013)
  • Indiana did not fully comply with Federal waiver and State requirements in overseeing residential providers that serve individuals with developmental disabilities who received supported living services through the HCBS program.
  • Of the 20 residential providers and 30 residential settings we reviewed, we found 246 instances of provider noncompliance with administrative, health, safety, and residential records requirements. Specifically, we identified:
    • 15 residential providers that did not comply with 1 or more administrative requirements, resulting in 46 instances of provider noncompliance, and
    • 29 residential settings that were not in compliance with 1 or more health, safety, and residential records requirements, resulting in 200 instances of provider noncompliance.

26-A-05-002.01 to CMS - Open Unimplemented
Update expected on 04/08/2026
We recommend that the Indiana Family and Social Services Administration work with residential providers to correct the 246 instances of provider noncompliance identified in this report.

26-A-05-002.02 to CMS - Open Unimplemented
Update expected on 04/08/2026
We recommend that the Indiana Family and Social Services Administration improve its oversight and monitoring of residential providers.

26-A-05-002.03 to CMS - Open Unimplemented
Update expected on 04/08/2026
We recommend that the Indiana Family and Social Services Administration work with the residential providers to improve internal controls for health and safety at residential settings, maintenance of records, and training.

View in Recommendation Tracker
Work Plan Type
Office of Audit Services
HHS Agencies
Centers for Medicare and Medicaid Services
Issue Areas
-
Target Groups
-
Financial Groups
Medicaid