Ohio Did Not Comply With Federal Waiver and State Requirements at 18 of 19 Adult Day Care Facilities Audited

Why OIG Did This Audit

• Under the Ohio Home and Community-Based Services Waiver program (the program), Ohio funds Adult Day Services (ADS) which are regularly scheduled services provided at an adult day center in a non-institutional, community-based setting and consist of activities authorized in an individual's person-centered services plan.
• The Office of Inspector General (OIG) has conducted health and safety reviews of adult day care and foster care homes and regulated childcare facilities. Those reviews identified multiple health and safety issues that put children and adults at risk.
• This audit determined whether Ohio complied with Federal waiver and State requirements in overseeing adult day service facilities that serve adults who receive services through the program.

What OIG Found

The Ohio Department of Medicaid (ODM) did not fully comply with Federal waiver and State requirements in overseeing providers that serve adults receiving ADS through the program because its inspections of facilities were insufficient to ensure a continuously safe and nonhazardous environment. As a result, adults were at risk in numerous instances.

• Of the 19 providers that we reviewed, 18 did not comply with 1 or more health and safety requirements, and 9 did not comply with 1 or more administrative requirements.
• We found 117 instances of provider noncompliance with health, safety, and administrative requirements.
• Providers of ADS did not always meet the needs of program participants or maintain compliance with State requirements.

What OIG Recommends

We made three recommendations to ODM to ensure that providers correct the 117 instances of provider noncompliance identified in this report; improve its oversight and monitoring of all providers; and work with providers to improve their facilities, staffing, and training. The full recommendations are in the report.

In written comments on our draft report, the State agency concurred with our three recommendations and described corrective actions that it had taken or planned to take. These corrective actions included updating Ohio Administrative Code rules, requested remediation actions from providers, developing technical assistance and guidance, and performed site visits.

After reviewing the State agency’s comments and additional information it provided, we modified some of our findings. We maintain that the remaining findings and recommendations are valid.