Indiana Fails to Meet Federal and State Health, Safety, and Administrative Requirements in Residential Settings for Individuals with Developmental Disabilities

Strategic Insights -

The Health and Human Services Inspector General issued a report on October 9, 2025, which found that Indiana did not fully comply with Federal waiver and State requirements in overseeing residential providers serving individuals with developmental disabilities. The report examined 30 residential settings and identified 246 instances of provider noncompliance with administrative, health, safety, and residential records requirements.

Key Takeaways:

  • The audit examined the oversight of Home and Community-Based Services (HCBS) residential providers serving Medicaid enrollees with developmental disabilities in Indiana.
  • The report found that 15 residential providers did not comply with administrative requirements, resulting in 46 instances of provider noncompliance.
  • A total of 29 residential settings were not in compliance with health, safety, and residential records requirements, resulting in 200 instances of provider noncompliance.
  • The auditors identified 246 instances of provider noncompliance with administrative, health, safety, and residential records requirements.
  • The report recommended that Indiana work with residential providers to correct noncompliance, improve oversight and monitoring, and improve internal controls for health and safety, maintenance of records, and training.
  • Indiana did not indicate concurrence or nonconcurrence with the recommendations but detailed steps it has taken or plans to take in response.

Statistics:

  • 246 instances of provider noncompliance with administrative, health, safety, and residential records requirements were identified.
  • 15 residential providers did not comply with administrative requirements, resulting in 46 instances of provider noncompliance.
  • 29 residential settings were not in compliance with health, safety, and residential records requirements, resulting in 200 instances of provider noncompliance.
  • The audit examined 30 residential settings.

Sources:

  • "Indiana Did Not Fully Comply With Federal Waiver and State Health, Safety and Administrative Requirements at 30 Residential Settings". Report No. A-05-24-00013, October 9, 2025, Centers for Medicare and Medicaid Services.