OIG: Home, community patients get inadequate care

Amid a growing trend of in-home and community-based care, the U.S Department of Health & Human Services' Office of Inspector General released a report Friday that revealed seven out of 25 reviewed states did not have adequate systems to ensure quality care to home and community-based services (HCBS) beneficiaries.

The report notes that ensuring the quality of care is a key objective for the OIG, and based on the report findings, also a cause for concern. Typically, states provide care through HCBS waiver programs, however, the OIG noted that HCBS patients were most likely to receive inadequate care because their caregivers often are friends and family members who are untrained in medical care. The report also expressed concern that patients who remain in their homes lose the benefit of interacting with and being observed by trained professionals.

The OIG insisted that the Centers for Medicare & Medicaid Services take a more active role in solving gaps in care. In the report summary, the OIG suggested CMS did not adequately monitor states to ensure quality care to HCBS patients and recommended increased oversight.

The OIG provided several other recommendations for CMS, including requiring patients to receive an on-sight visit to renew the waiver program, CMS assisting states to help ensure they meet assurances and requiring states that do not meet all assurances to implement action plans that will help correct quality care problems.

To learn more:
- read the summary and  report (.pdf)