Florida Did Not Comply With Federal Waiver and State Requirements at 18 of 20 Adult Day Care Facilities Reviewed

Why OIG Did This Audit

• The Florida Home and Community-Based Services Waiver program (the program) funds home and community-based services for people 65 and older, or 18 or older and eligible for Florida Medicaid by reason of a disability, who require the level of care provided in a nursing home but choose to live in the community.
• Florida operates the program under a Federal waiver to its Medicaid State plan. The program funds adult day care services for Medicaid beneficiaries who reside at home and attend adult day care facilities (facilities).
• We have conducted various health and safety reviews nationwide and wanted to determine whether adults participating in this program were at risk.
• This audit determined whether Florida complied with Federal waiver and State requirements in overseeing adult day care facilities that serve adults who receive services through the program.

What OIG Found

• Florida did not fully comply with Federal waiver and State requirements in overseeing providers that serve adults receiving adult day care services through the program.
• Of the 20 providers we reviewed, 13 did not comply with 1 or more health and safety requirements, and 17 did not comply with 1 or more administrative requirements.
• We found 120 instances of provider noncompliance including 39 instances of noncompliance with health and safety requirements. The remaining 81 instances related to administrative requirements, some of which could significantly affect the health and safety of recipients.
• Florida did not fully comply with Federal waiver and State requirements because its inspections of facilities were insufficient to ensure a continuously safe and nonhazardous environment.

What OIG Recommends

We recommend that Florida:

1. ensure that providers correct the 120 instances of provider noncompliance identified in this report;
2. improve its oversight and monitoring of providers; and
3. work with providers to improve their facilities, staffing, and training.

Florida disagreed with our findings and did not indicate concurrence or nonconcurrence with our recommendations. However, it detailed steps it has taken and plans to take in response to our recommendations.