Evidence record
Maryland Did Not Comply With Federal Waiver and State Requirements at 20 Adult Day Care Facilities Audited
- Jurisdiction
- Maryland
- Publication date
- May 2025
- Source record
- Original document linked
Findings
1
Recommendations
3
Overall conclusion
The Maryland Department of Health did not fully comply with Federal waiver and State requirements in overseeing adult day care facilities; 253 noncompliance instances were identified across health and safety and administrative areas, with inspections insufficient to detect violations; the OIG recommends corrective actions and oversight improvements.
Scope
The audit examined Maryland’s Home and Community-Based Services (HCBS) 1915(c) waiver program and the operation and oversight of adult day care facilities that serve adults enrolled in the program. Of the 141 adult day care providers in Maryland as of November 16, 2023, a nonstatistical sample of 20 providers was selected for unannounced site visits conducted between January 9 and June 27, 2024, across 14 counties (Allegany, Anne Arundel, Baltimore, Baltimore City, Caroline, Dorchester, Frederick, Harford, Howard, Kent, Montgomery, Prince George’s, Washington, and Wicomico). In 2023, Maryland claimed $106.7 million for services at these 141 facilities, with the 20 reviewed providers reimbursed $20,732,903. The audit focused on provider compliance with health and safety requirements and state administrative requirements, and on the Maryland State agency’s oversight and monitoring of these providers; it did not assess the overall internal controls of the State agency or the Medicaid program beyond those areas relevant to the objective.
Findings (1)
Each finding has a stable link.
- F-445
Maryland did not fully comply with Federal waiver and State requirements in overseeing providers that serve adults receiving adult day care services; of 20 facilities visited, 18 did not comply with health and safety requirements and all 20 failed to meet at least one administrative requirement; total 253 noncompliance instances.
Recommendations (3)
- R-417
Collaborate with providers to enhance their facilities, staffing, and training.
Related finding F-445 - R-415
Verify that providers correct the 253 instances of provider noncompliance identified in this report.
Related finding F-445 - R-416
Improve oversight and monitoring of providers.
Related finding F-445