State Health Department Slow To Inspect Violations At Adult Care Facilities, Audit Finds

The state Department of Health (DOH) is not adequately overseeing adult care facilities, risking the health and safety of vulnerable residents, according to an audit released today by New York State Comptroller Thomas P. DiNapoli. The audit found DOH at times failed to con duct timely inspections and often lacked documentation to show critical problems were corrected.

“Adult care facilities across the state have a responsibility to protect residents and deliver quality care,” DiNapoli said. “Regular and routine inspections of these facilities, and correcting problems, ensure residents are not left in unsafe or unsanitary conditions. If the state Department of Health isn’t conducting timely inspections or following up to make sure violations are corrected, then vulnerable residents could be left at risk.”

Adult care facilities are primarily home to the elderly who can no longer live independently, but do not require the care of a nursing home. These facilities provide housing, meals and personal care for individuals who need help with daily activities. All facilities must be licensed, and DOH is required to supervise them through regular inspec tions and complaint investigations. As of 2023, there were 534 adult care facilities operating in New York, serving 37,547 residents.

The audit reviewed DOH’s oversight of these facilities from January 2018 to October 2024. Health and safety issues at facilities can include, but are not limited to, inadequate staffing, call bells not functioning, no clear emergency shelter plans or the presence of mold, mice or bed bugs.

Delayed Inspections

The audit found DOH failed to complete inspections within the required 12- to 18-month timeframe at 70% of the 30 sampled facilities, with some delayed by as much as five years. Three of the state’s four regional oversight offices had inspection backlogs – New York City, Long Island and Western New York – while Central New York had no backlog.

Auditors conducted site vis its at 20 of the sampled adult care facilities across the state and found a range of serious health and safety issues. At one adult care facility that had not received a full inspection in nearly two years, auditors found issues that posed immediate risks to residents’ health and safety. DOH officials were notified and immediately per formed a full inspection of the facility, resulting in a total of 54 violations and 12 findings.

Violations Not Fixed

DOH failed to document whether facilities corrected violations identified in prior inspections. Of the 89 viola tions reviewed in 30 inspec tion reports, auditors found no evidence DOH took corrective action. At 18 of 20 facilities visited, problems cited in ear lier inspection reports were not fixed. In some cases, DOH inaccurately recorded partial inspections as full ones, caus ing further delays in oversight. Without proper follow-up, vio lations may continue for years and facilities may not be held accountable, risking patient safety