North Carolina Could Better Ensure That Intermediate Care Facilities for Individuals With Intellectual Disabilities Comply With Federal Requirements for Life Safety and Infection Control

Why OIG Did This Audit

• Intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs) that participate in Medicaid are required by CMS to comply with requirements intended to protect residents. This includes requirements related to life safety and emergency preparedness plans. Facilities are also required to develop infection control programs.
• In North Carolina, the State’s Department of Health and Human Services (State agency) conducts surveys of ICF/IIDs for compliance with federal requirements.
• This audit is part of a series of audits that assesses compliance with CMS’s life safety, emergency preparedness, and infection control requirements for ICF/IIDs.

What OIG Found

We identified 14 deficiencies related to life safety and infection control at the 3 ICF/IIDs operated by North Carolina. We did not identify any deficiencies related to emergency preparedness.

These deficiencies put the health and safety of residents, staff, and visitors at an increased risk of injury or death during a fire or other emergency.

What OIG Recommends

We recommend that North Carolina:

1. verify that the three ICF/IIDs we inspected have taken corrective actions on the life safety and infection control deficiencies identified during the audit,
2. work with the applicable ICF/IID to determine whether mold exists, and
3. work with CMS to develop standardized life safety training for staff at ICF/IIDs.

The State agency concurred with two of our recommendations and detailed steps it has taken in response to our recommendations. For our third recommendation, the State agency did not indicate concurrence or nonconcurrence.