By Patricia K. Ruiz, J.D.
Mississippi failed to fully comply with federal Medicaid waiver and state requirements in overseeing providers providing adult day care services through the Mississippi Elderly and Disabled Waiver Program. The Office of Inspector General (OIG) found that budgeting and staffing issues limited oversight to monitoring of provider facilities, staffing, and training, and the lack of state licensing requirements also contributed to provider noncompliance (OIG Report, A-04-17-00116, August 23, 2018).
Review of adult day care facilities. The Mississippi Elderly and Disabled Waiver Program funds home- and community-based services for people age 65 and older, as well as individuals with disabilities between 21 and 64. Mississippi operates the program, which provides adult day care services for Medicaid beneficiaries, under a federal waiver to its state Medicaid plan. The OIG conducted a review to determine whether Mississippi complied with its federal waiver and state requirements in overseeing facilities serving vulnerable adults who receive services through the program. In conducting its review, the OIG selected 20 out of 133 facilities providing services to program participants. The OIG conducted unannounced site visits at the 20 facilities between September 11 and September 22, 2017.
Findings. The OIG found that Mississippi did not fully comply with the federal waiver and with state requirements in overseeing providers serving vulnerable adults receiving adult day care services through the program. Of the 20 facilities reviewed, each did not comply with one or more state requirements, for a total of 564 instances of provider noncompliance, including 194 regarding health and safety requirements. Instances of noncompliance found included unsecured toxic chemicals, water damage and mold, unclean facilities, exposed electrical wiring, a dead rodent in a participant bathroom, and an unsecured knife on an outdoor activity lawn.
Further, the OIG found that Mississippi did not fully comply with federal waiver and state requirements because its annual inspections of the facilities did not ensure a continuously safe and nonhazardous requirement, as budgeting and staffing limited oversight to monitoring of provider facilities, staffing, and training. The lack of state licensing requirements also contributed to provider noncompliance.
Recommendations. The OIG recommended that Mississippi ensure that providers correct the 564 instances of provider noncompliance identified, improve its oversight on provider monitoring, and work with providers to improve facilities, staffing, and training. Mississippi agreed with both the finding and recommendations and provided descriptions of corrective actions it will take.
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