Accountability: Oversight On $152 Million to Help Rural Seniors

Why It Matters

More than 152 million federal dollars flow each year into programs designed to keep elderly and disabled residents of federally assisted housing out of nursing homes and emergency rooms. The low-income seniors and people with disabilities living in rural affordable housing that those dollars are meant to serve are among the most isolated and medically vulnerable in the country. Rural areas have higher concentrations of older adults and people with disabilities than urban areas, and the services they need, from primary care to transportation to meals, are harder to reach.

The federal government's answer to that problem is rural housing service coordinators: staff hired by housing providers to connect residents with the supportive services they need to remain independent. It sounds straightforward.

A new report from the Government Accountability Office, released June 1, 2026, finds that the Department of Housing and Urban Development (HUD) cannot tell you how well the program is working because the data it collects is a mess and it has not bothered to analyze what it does have.

A Program Flying Blind

HUD administers two service coordinator programs. The Service Coordinators in the Multifamily Housing Program, run by the Office of Multifamily Housing, received $112 million in fiscal year 2025 appropriations. The Resident Opportunity and Self-Sufficiency, or ROSS, Service Coordinator Program, run by the Office of Public and Indian Housing, received $40 million. Together, they represent a $152 million annual federal investment.

In fiscal year 2024, the ROSS program funded 50 service coordinators at 49 public housing authorities or other eligible entities in rural locations. The multifamily program funded approximately 113 grant recipients to employ service coordinators at rural properties the same year.

The GAO found that comprehensive data on how many rural properties actually employ service coordinators, including those funded through USDA rental housing programs and the Low-Income Housing Tax Credit, simply do not exist. USDA and the IRS support affordable rental housing, but do not administer service coordinator programs and collect no data on them.

That gap alone would be troubling. What GAO found inside HUD's own data systems is worse.

The Data Problem Inside HUD's Own System

The multifamily housing program relies on a database called the Integrated Real Estate Management System (iREMS) to track which properties have service coordinators and how those coordinators are funded. GAO found the system is riddled with inconsistencies that make it unreliable for program oversight.

Three of the four HUD regional offices GAO contacted had no written procedures for entering service coordinator data into iREMS. The fourth was working from guidance issued in 2016. The result: information on whether a property even has a service coordinator was, in most cases, between two and 10 years out of date. Funding source data was sometimes contradictory. A single narrative field used at least nine different terms to describe the same condition: the presence of a service coordinator.

HUD has known about these problems for more than a decade. It conducted a data clean-up in 2013. It issued headquarters guidance to regional offices in 2016. It added a new data field for funding sources in 2020. A subsequent planned clean-up was never completed, HUD officials said, due to resource constraints.

The consequence is direct: HUD cannot accurately determine how many properties have service coordinators or whether those properties are complying with program requirements.

Performance Reports

Service coordinators in the multifamily program are required to submit performance reports covering roughly 70 data elements per resident served: information on health outcomes, housing stability, and other measures. HUD collects those reports. It has not conducted a substantive analysis of them since fiscal year 2020.

GAO found that HUD has no routine process for obtaining, preparing, and analyzing the performance data it already requires grantees to submit. The agency is, in effect, asking housing providers to document their work and then file those documents away.

The contrast with the ROSS program is instructive. The Office of Public and Indian Housing annually analyzes performance reports submitted by ROSS grantees and publishes results on a public dashboard, supported by a contractor. HUD even offers training webinars to help grantees understand and use the dashboard. The infrastructure for accountability exists in one arm of HUD. It does not exist in the other.

The Evidence

GAO reviewed five studies on the effectiveness of HUD rural housing programs and service coordination, drawn from an initial pool of 140 potentially relevant studies published between 2015 and 2025. The findings are mixed at best.

A 2015 study of more than 4,300 low-income residents aged 65 and older across nine states found that residents with access to on-site service coordinators had significantly lower odds of an acute inpatient hospital admission. A 2016 study in Portland, Oregon, found that residents who engaged more frequently with service coordinators were more likely to access preventive health care, though only the difference in primary care access was statistically significant.

Two other studies found no evidence of impact. The IWISH interim study, a cluster-randomized control trial involving more than 13,000 residents across 124 properties, found no evidence that the model affected older adults' health care use or housing tenure after three years. A Vermont-based study of the Support and Services at Home program found no evidence of reduced growth in health care expenditures overall, though some subgroups showed slower growth in institutional long-term care costs.

The fifth study, a 2019 ROSS evaluation, surveyed 215 service coordinators and conducted ten site visits, but did not measure resident outcomes, only reported positive resident experiences.

GAO also visited four rural sites in Louisiana, New Hampshire, Washington, and Wisconsin. Local stakeholders told investigators that service coordinators helped residents avoid eviction and navigate Medicaid enrollment. Those accounts are meaningful, but they are not a substitute for systematic data.

Rural Realities

The structural challenges facing rural housing service coordinators go beyond data management. GAO identified six persistent problems reported by local stakeholders and service coordinators in the field.

Coordinators routinely manage multiple funding streams simultaneously, each with its own administrative requirements. Small, rural public housing authorities often lack the staff capacity to navigate competitive grant processes. Service coordination budgets compete with rising insurance costs and other operational expenses. Recruiting and retaining qualified staff is difficult when salaries are low, and service areas can require hours of driving. The rural communities these coordinators serve have fewer service providers to connect residents with. Limited broadband access and low digital literacy among residents complicate the shift toward virtual service delivery.

Federal agencies have taken some steps to address these barriers. HUD revised ROSS policy in fiscal year 2024 to allow grantees to use up to 20 percent of grant funds to provide services directly, up from a previous cap tied to administrative costs. USDA clarified in fiscal year 2022 that service coordination is an eligible expense for Section 515 rural properties. HUD and HHS created a Housing and Services Resource Center in 2021; USDA joined in October 2024. As of February 2026, the center's website included information on service coordination and supportive housing resources.

The Investigation

The report was requested by three House Democrats: Rep. Joyce Beatty of Ohio, Rep. Suzanne Bonamici of Oregon, and Rep. Adam Smith of Washington. None represent exclusively rural districts, but all three have records of sustained engagement on housing affordability and the needs of low-income seniors and people with disabilities.

Bonamici, who represents a suburban Portland district, has been a consistent advocate for affordable housing access and aging-in-place policies. Smith, whose district covers suburban Seattle, has focused on housing stability and social services. Beatty, who represents Columbus-area communities, has worked on housing equity issues throughout her congressional tenure. Their request reflects a concern that has been building in Congress for years: that federal supportive services programs for low-income seniors are underfunded, poorly tracked, and inadequately evaluated.

Data Quality

GAO directed both of its recommendations to HUD's Secretary, specifically to the Assistant Secretary for the Office of Housing.

The first calls on HUD to develop and apply uniform procedures for entering data into iREMS, improving the reliability of information on budget-funded service coordinators. The second calls on HUD to establish a routine process for analyzing the performance data that the multifamily program already collects.

HUD offered no comments on either recommendation. USDA, Treasury's Community Development Financial Institutions Fund, and HHS also had no comments on the draft. Both recommendations remain open.

For a department that has been aware of its iREMS data problems since at least 2013, the absence of any response to recommendations aimed at fixing them is its own kind of answer.