Heed report on adult care facilities, improve state oversight

Assisted living and other adult care facilities should be trusted places that provide appropriate care and services for vulnerable adults and seniors who can no longer fully care for themselves.

But a recent audit by the office of the state Comptroller Thomas DiNapoli showed some facilities haven't come close to meeting that seemingly simple standard — and state officials aren't holding them fully accountable.

The audit found some adult care facilities — which do not include nursing homes — had disturbing health and safety deficiencies, including a half-empty bottle of vodka in a medical room, marijuana paraphernalia in an administrator's office, refrigerators that did not adequately chill food and crumbling stairways. On top of that, dozens of previously cited violations were never fixed.

It's bad enough that adult care facilities have such unacceptable practices. Even more dismaying is that the findings emerged only after DiNapoli's auditors found it necessary to inspect these facilities after discovering the state Health department had failed to do so in a timely way.  

Unlike nursing homes, which benefit from additional federal oversight, New York State is solely responsible for many of its adult facilities. If state officials drop the ball, no one picks it up. 

Even the highest-rated complexes are supposed to have inspections every 18 months. But the Health Department was behind schedule by as long as five years. In their official response, state health officials primarily blamed the COVID-19 pandemic for delays, pointing to staffing shortages and other concerns. But the comptroller's analysis covered a period from 2018 through much of 2024. One facility had an inspection in January 2018, making it due for another before the pandemic. As of May 2024, no full inspection was conducted, even though federal guidelines said post-pandemic inspections should have begun in November 2021.

Still, health officials noted that sometimes partial inspections were conducted. They argued that the federal public health emergency lasted until May 2022. These are unfortunate and inadequate excuses. Partial inspections wouldn't have uncovered the vodka, the marijuana, the too-warm refrigerator or the crumbling stairways. And even the Health Department's timeline doesn't change the conclusion: Adult care facilities often have problems and oversight remains insufficient. 

Concerns about adult care aren't new. When state Health officials actually do inspections, they often find poor conditions that need to be remedied. What else is going unnoticed in these truncated, delayed inspection visits?

State health officials claimed they've improved staffing, data collection and policy and procedures. It's not enough. They must heed DiNapoli's recommendations. Follow-up and additional monitoring are critical,. Violations must be corrected, and facilities penalized when they're not. 

Until that happens, area residents in assisted living and similar complexes remain at risk, with residents and their families uncertain whether they are in a safe, healthy home, with staff who care for them, under the watchful eye of the state.