The US Department of Health and Human Services (HHS) Office of Inspector General (OIG) posted a new report on October 30, 2025, which found that South Carolina did not comply with federal waiver and state requirements at 19 of 20 adult day care facilities reviewed.
The audit examined whether the South Carolina Department of Health and Human Services ensured that adults participating in the state’s Home and Community-Based Services (HCBS) waiver program received services in safe and properly monitored adult day care settings. OIG found that oversight and inspection processes were insufficient to ensure a continuously safe and nonhazardous environment, leaving participants at potential risk.
Among the 20 providers reviewed, OIG identified 204 instances of noncompliance with health, safety, and administrative requirements. Seventeen providers failed to meet one or more health and safety requirements, and 18 failed to meet one or more administrative requirements.
OIG recommended that the South Carolina Department of Health and Human Services work with the South Carolina Department of Public Health to correct the identified deficiencies, strengthen oversight and monitoring of providers, and help improve facility conditions, staffing, and training.
In response, the State agency concurred with all three recommendations.
The full report can be accessed here.
Compliance Perspective
Issue
Healthcare organizations are responsible for maintaining safe, compliant environments that protect individuals receiving care and ensure adherence to all applicable regulatory requirements. When oversight and monitoring systems are inconsistent or when policies are not fully implemented, safety, quality, and compliance can be compromised. Effective coordination of policies, staff training, and internal review processes helps promote accountability and ongoing compliance.
Discussion Points
- Review and, if necessary, update policies and procedures related to health, safety, and administrative compliance. Policies should clearly outline staff responsibilities, reporting expectations, and follow-up processes when deficiencies are identified. Engaging an experienced consultant to assist with policy review or to conduct a focused operational assessment can help ensure that written procedures are both comprehensive and practically implemented in daily operations.
- Provide ongoing education to ensure staff understand how to maintain a safe, clean, and comfortable environment for all individuals receiving care. Training should reinforce the importance of maintaining an orderly, sanitary, and homelike setting that promotes dignity and person-centered care. Med-Net Academy offers the course Safe Environment, which reviews how to provide a safe, clean, comfortable, and homelike setting; the importance of adequate lighting, temperature, and sound levels; and how to create an environment that supports person-centered care.
- Audit regularly to identify risks, verify compliance, and improve overall quality. These audits should evaluate whether policies are being followed and whether corrective actions are effective. Organizations may benefit from collaborating with a qualified consultant to perform mock surveys or targeted compliance audits, providing an objective assessment of readiness and helping leadership strengthen oversight through the QAPI process.
*This news alert has been prepared by Med-Net Concepts, Inc. for informational purposes only and is not intended to provide legal advice.*