The Department of Health and Human Services (HHS) Office of Inspector General (OIG) conducted a study to identify the costs and types of home and community-based services (HCBS) covered under 1915(c) waivers for Medicaid beneficiaries residing in assisted living facilities (ALFs).

Additionally, to determine the extent to which Medicaid programs complied with federal and state requirements for HCBS furnished under the waiver, OIG reviewed state survey agency inspection reports for ALFs in which the beneficiaries from the sample group resided, and reviewed plans of care associated with the sampled beneficiaries.