Why OIG Did This Audit

• OIG has conducted health and safety audits of adult day care and foster care homes in various States. Those audits identified multiple health and safety issues that put children and adults at risk.
• This audit examined whether adults participating in South Carolina's Home and Community-Based Services waiver program were at risk.
• This audit determined whether South Carolina 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

South Carolina did not fully comply with Federal waiver and State requirements in overseeing providers that serve adults receiving adult day care services because of insufficient inspections that did not ensure a continuously safe and nonhazardous environment. As a result, adults were at risk in numerous instances.

• We found 204 instances of noncompliance with health, safety, and administrative requirements among 19 of the 20 providers we reviewed.
• Of the 20 providers, 17 did not comply with 1 or more health and safety requirements and 18 did not comply with 1 or more administrative requirements.

What OIG Recommends

We recommend that the South Carolina Department of Health and Human Services:

• work with the South Carolina Department of Public Health to ensure that providers correct the 204 instances of provider noncompliance identified in this report;
• improve its oversight and monitoring of providers; and
• work with providers to improve their facilities, staffing, and training.

In written comments on our draft report, the State agency concurred with all three recommendations.