The state comptroller’s onsite audits of adult care facilities turned up a half-empty vodka bottle, a glass hand pipe, and deep concerns for the New York Department of Health’s (DOH) oversight of assisted-living housing for more than 37,000 people. A report published on July 9 delineated these findings, which were investigated from January 2018 to October 2024.
“Regular and routine inspections of these facilities, and correcting problems, ensure residents are not left in unsafe or unsanitary conditions,” said state Comptroller Tom DiNapoli in a statement. “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 house people who do not live independently due to factors like age and disability status. They should not be conflated with the more regulated nursing homes, which provide more intensive care. Not all residents are seniors, but many are. DOH licenses and regulates the state’s 500+ adult care facilities through inspections every 12 to 18 months and investigations of resident complaints.
“One really important distinction between nursing homes and adult care facilities is that there are no federal safety standards for adult care facilities at all,” said Richard Mollot, executive director of the Long Term Care Community Coalition. “This is of concern to the public, because more and more people who, in the past, would go to a nursing home are now going into these adult care facilities.”
DOH did not promptly inspect 21 out of the 30 sites sampled by the audit. Some inspections were three to five years late. Follow-ups are mandated for violations and potential endangerment found during full inspections. However, DOH could not provide evidence that it followed up on any of the required citations in the sampled facilities. The state comptroller also observed “uncorrected issues” from earlier inspections, such as expired medications and lack of basic first aid training among staff.
Investigations also struggled to keep pace with agency standards. The audit found DOH could not provide evidence of investigations for 101 of 569 allegations stemming from 38 complaints. Results from such investigations must be reported to the corresponding facility within 30 days, but the state comptroller found many reports missed the deadline and seven reports were not issued at all. More than half of the late reports investigated substantiated allegations, including resident-on-resident abuse.
“You need to have regular inspections,” said Tina Kim, deputy comptroller for state government accountability. “When a complaint is lodged, people need to be listened to, so you need to actually do appropriate investigations, and when those investigations and inspections are complete, you need to basically properly provide that information to the facility so they can fix it, and then you need to follow up to make sure that it’s actually done.
“It is important if you want the people to follow the rules and the regulations when they’re not doing that. That needs to be pointed out, and it needs to be followed up upon to make sure that, basically, residents are not being placed at risk.”
Elder care stands as a priority for the state comptroller as the New York City population gets older at an unprecedented rate, said Kim. Communities of color primarily fuel the city’s aging growth: The population of older Black adults grew by 68% from 2000 to 2023. Older Asian and Hispanic populations saw even larger gains in the city.
Mollot said the audit’s findings, unfortunately, do not surprise him, but they remain upsetting and depressing. However, the state comptroller’s office could not interview residents, enter private rooms, or review medical records. With no federal oversight, personal accounts probably paint the most complete picture.
“What I’ve heard over and over again is people living in fear,” said Mollot. “Not everyone, because there are good facilities out there that are well run, but in the absence of good rules and enforcement of those rules, it’s really voluntary.”
“I wish people would … have a little bit more compassion and empathy toward the elderly and disabled, instead of treating [them as] prisoners and cash money [as a] billion-dollar business,” said Open Doors reality poet Shannon Nelson.
DOH pointed to COVID-19–related setbacks in the department’s “normal surveillance timelines” and said oversight is making progress toward getting back up to speed. A tracking system for monitoring compliance launched in 2024.
“Especially on critical audits like this one, they are required to give us a response in 180 days to tell us what the status of the recommendations [is],” said Kim. “But more importantly than that, a year after the audit was issued, we come back and we check to see what the status of recommendations [is], and we do some testing.”
So glad that Comptroller DiNapoli is taking on these issues and auditing NYCHA there should be higher standards and accountability. NYCHA disregards the residents as do many of the “slumlords” in NYC. If the penalties and fines were higher for violations and non-repairs, perhaps the owners and management companies would respond with urgency!
In reference to supportive living and long term care facilities. I cannot understand why there’s no oversight. These facilities care for our elderly, youth, the disabled and our families. The facilities do what they want when they want and the state Medicaid/?Medicare system continues to pay the facilities to provide less than adequate care and supports. It is my sincere hope and belief that these issues will be resolved and the standards for which these facilities exist will drastically improve. It is imperative that our loved ones can have the care that they need and live in a safe environment with dignity.
Thank you,
Sandra Killett
We All Rise!
Greetings,
I experienced a troubling and unbelieveable deficient unethical/illegal Quality of Care experience and l wish to tell my story in (OBH) Interfaith Medical Center..