Report is 'new territory,' GAO director says

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A new report about federal oversight of Medicaid beneficiaries who live in assisted living communities is “new territory” for the Government Accountability Office, the report's author told McKnight's Senior Living.

“No one had really looked at oversight from the standpoint that we looked at it before,” said Katherine Iritani, director of healthcare at the agency. “So it was complicated from the standpoint of, states really have the key responsibility for overseeing assisted living facilities, and they do it in different ways, not only between the states but even within a state, for the different kinds of programs that they can operate and provide assisted living services. So we had to navigate that world, too, in trying to come up with a survey that we could reasonably report on oversight.”

The uncharted territory meant that the research took longer than originally expected, Iritani said.

Four senators — Susan Collins (R-ME), Orrin Hatch (R-UT), Claire McCaskill (D-MO) and Elizabeth Warren (D-MA) — originally requested that the agency research assisted living in mid-2015.

“Given the growth in federal Medicaid spending for long-term care services and expected program growth caused by the aging and expansion of the population and program, information to understand federal and state spending and oversight of care provided in these settings is needed,” they said at the time.

In mid-2016, a spokesman for the GAO, in response to a question from McKnight's Senior Living, estimated that the report would be completed by early 2017, but Iritani said the inquiry came early in the process.

“There is a lot that happens with a request [for a report], depending on the scope of the interest of the clients and the complexity of work, and there oftentimes are unexpected complications,” she said. “In the case of this report, we did a survey of all state Medicaid agencies, and the planning of that survey, given the complexity of Medicaid and how home- and community-based services are provided, took longer than we had initially planned for. And then the execution of the survey and the responses from the state Medicaid agencies, took longer than we had anticipated.”

See the McKnight's Senior Living article about the GAO report, with insights from assisted living industry representatives, lawmakers and consumer advocates, here: “New GAO report focuses on CMS but could have direct effects on assisted living.”

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