In reviewing the report regarding this program, it does not appear to fit the Home and Community Based Setting.  When the HCBS rule came out there were several organizations that had to make changes. It is concerning that a place like Vanguard Landing would be approved to take Medicaid funds when they don't fit the definition of the rule.  Although Vanguard sounds nice and would probably do well as a private pay setting, it should not be considered as a DD Waiver setting for individuals who are eligible for an institutional setting. Vanguard appears to fit an institutional setting with the size and set up.  If Vanguard Landing is approved to accept the DD Waiver, what message does that give to the organizations that had to downsize their group homes, or ended up closing because they couldn't meet the HCBS rule?