The Government Accountability Office on Monday urged the Centers for Medicare & Medicaid Services to address a recommendation made in its January 2018 report on assisted living and said it would be monitoring CMS to see what actions it takes.

One of three recommendations made in the GAO’s 2018 report about assisted living remains unaddressed, the GAO noted in a new assessment published Monday.

The 2018 report, “Medicaid Assisted Living Services: Improved Federal Oversight of Beneficiary Health and Welfare is Needed” contained a to-do list for CMS related to state reporting of deficiencies in care and services provided to Medicaid beneficiaries in assisted living communities.

Investigators recommended that CMS Administrator Seema Verma:

  1. Provide guidance and clarify requirements for states regarding their monitoring and reporting of deficiencies in assisted living communities.
  2. Establish standard Medicaid reporting requirements that all states could use to annually report information on critical incidents.
  3. Ensure that all states submit annual reports for home- and community-based services waivers on time, as required.

It’s the second recommendation that remains unaddressed, according to the GAO.

“HHS neither agreed nor disagreed with this recommendation,” noted the report released Monday. “In June 2018, CMS issued a bulletin to states to highlight the importance of critical incident reporting and provide steps states could consider to improve their critical incident reporting systems. To fully implement this recommendation, HHS would need to establish standard Medicaid reporting requirements for all states to annually report key information on critical incidents.”

The GAO said it will continue to monitor actions taken by the Department of Health and Human Services in response to its recommendation, one of 404 “priority recommendations” — 54 of them at HHS — that were open as of April 7. The agency said it sent letters to the heads of the HHS, Veterans Affairs, and Defense departments “urging them to continue focusing on these issues.”

“Our recommendations help congressional and agency leaders prepare for appropriations and oversight activities, as well as help improve government operations,” the GAO said. “Moreover, when implemented, some of our priority recommendations can save large amounts of money, help Congress make decisions on major issues, and substantially improve or transform major government programs or agencies, among other benefits.”

GAO recommendations are considered “open” until they are designated “closed-implemented” or “closed-not implemented.”

Overall, the agency said, 4,769 of its recommendations remain unaddressed.

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