OIG: Assisted living needs to up information, compliance levels on HCBS

Share this article:

Concerns about home- and community-based services (HCBS) at assisted living facilities were raised in a report released Tuesday by the Health and Human Services Office of Inspector General.

The OIG is asking the Centers for Medicare & Medicaid Services to put out more guidance on HCBS compliance with federal requirements. Assisted living programs might not be giving enough information about access to HCBS funds, the agency said. Methods for eligibility include Section 1915 c waivers or Section 115 research and demonstration waivers. The 1915 c waiver allows Medicaid to cover HCBS, but the OIG wants more information about the services, their compliance to the plan and their cost.

In 2009, 35 state Medicaid programs reported that they covered HCBS for more than 54,000 beneficiaries. This involved about 12,000 ALFs at an annual cost of $1.7 billion, according to OIG.

The OIG said it selected seven states with the highest numbers of beneficiaries that did not completely comply with the federal provider standards. In the group, more than three-quarters of beneficiaries received HCBS in ALFs that were cited for noncompliance with at least one state requirement. Nine percent of beneficiaries' records did not include plans of care, and more than 40%  did not include HCBS frequency data, officials said.

CMS agreed with the OIG recommendation to issue more guidance to state Medicaid programs and emphasize compliance with federal requirements. Click here to see the report.

Share this article:

More in News

Long-term care continues to lead in deal volume and value: PwC report

Long-term care continues to lead in deal volume ...

Long-term care bucked healthcare industry trends with strong merger and acquisition activity in the second quarter of 2014, according to newly released data from professional services firm PricewaterhouseCoopers.

Empowering nurse practitioners could reduce hospitalizations from SNFs, study finds

Granting more authority to nurse practitioners is associated with reduced hospitalization of skilled nursing facility residents, according to recently published findings.

Pioneer ACO drops out of program, despite reductions in skilled nursing utilization

A California healthcare system has become the latest dropout from the Pioneer Accountable Care Organization program, despite reducing skilled nursing facility utilization and improving its readmission rates. Sharp HealthCare announced its decision in a quarterly financial statement released Tuesday.