CMS issued guidance today on health and welfare of HCBS participants. This guidance is in response to the the Joint Report made to CMS regarding oversight of group homes for people with developmental disabilities. This guidance is expected to be the first in a series on the topic of health and welfare. CMS expects to highlight promising practices in putting in place the suggestions in the joint report in future guidance.  This document focuses on incident management, including investigations and auditing. Importantly it includes suggestions on transparency and stakeholder involvement. Getting better reporting and transparency of these incidents for waiver participants is important to health and welfare and should also help provide information about adequacy of services if critical incidents are tied back to training, staffing, or other similar issues.