NEW YORK STATE — Adult care centers in New York—such as Sullivan County’s Sunset Lake Adult Care Center—have received inadequate state oversight since the COVID-19 pandemic, according to a new audit from the New York State Comptroller. 

The audit found that the Department of Health (DOH) failed to inspect adult care centers within the required time frame. Additionally, it found that the DOH did not properly follow up on issues found during those inspections, or properly investigate all of the complaints it received about issues at adult care facilities.

“Regular and routine inspections of these facilities, and correcting problems, ensure residents are not left in unsafe or unsanitary conditions,” said comptroller Thomas DiNapoli. “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.”

The audit does not identify any specific facility by name, and it only studied 30 of the state’s 534 adult care facilities. 

However, the audit’s findings are in line with the issues raised by local health care advocates, who have repeatedly brought up issues with oversight at the county-owned adult care center, Sunset Lake. 

Lise Kennedy, county resident and member of the Senior Legislative Action Committee, told the River Reporter there are “absolutely” issues with DOH oversight.

“It’s something you can’t really appreciate until you try to report,” Kennedy said. 

A recent example involved the care center’s dishwasher. 

Kennedy said she called the DOH Nursing Home Complaints Hotline on June 18 to report the fact that the dishwasher was broken. At that point, the dishwasher had already been broken for a month, she said. 

When she got though to someone, the person she reached said her complaint was “very serious,” and that he would transfer her to the right department to take a complaint, and that she should leave a message if nobody answered. She left a message, but didn’t get a call back until July 2, two weeks later. 

“Of course, the dishwasher had been fixed already, so I didn’t even call them back,” said Kennedy. “Still, some hotline!”

A statewide issue

The comptroller’s audit covered the period between January 2018 and October 2024. 

The DOH stated in its response that the comptroller’s office had chosen the facilities to include in the study, rather than taking a random sample. Because of that, the audit results were not representative of the state’s entire adult care center population, it said. 

The comptroller’s office said it chose facilities to focus audit resources on likely spots of non-compliance. “This targeted approach allowed us to obtain evidence most likely to impact the health and safety of residents,” it said. 

The audit found that the number of care-center full investigations the DOH carried out dropped by 76% when the pandemic hit, and did not recover thereafter. 

“In 2018 and 2019, prior to the COVID-19 pandemic, DOH completed 376 and 458 inspections, respectively. Since 2021, DOH has conducted between 104 and 207 full inspections each year, or less than half the number per year prior to COVID,” reads the audit. 

DOH officials said the issues arose from staff shortages and high turnover, according to the audit. “However,” reads the audit, “we also found that DOH lacks high-quality, accurate information to manage its limited staffing resources and evaluate its facility inspection program.”

Of the 30 facilities examined over the course of the audit, the comptroller’s office determined that 21 did not have a full investigation conducted within the required time frame. 

The DOH is supposed to conduct regular investigations of care centers on either a 12- or an 18-month cycle, depending on the status of the facility. Investigations for eight of the facilities audited were between three and five years late. 

“When DOH does not conduct inspections in a timely manner, it cannot ensure facilities are complying with statutory and regulatory requirements, which ultimately may impact quality of care and resident safety,” reads the audit.

Auditors visited 20 out of the 30 sites in the study, and found concerning conditions at nine of these facilities. These conditions included crumbling stairs or walkways as well as kitchen appliances that did not operate at the correct temperatures. 

“Many of these issues, such as incorrectly operating refrigerators, were noted in prior inspections several years earlier,” reads the audit.

The audit also found that complaints were not always fully investigated or documented, and that investigation reports were not properly and promptly issued. 

To read the full audit, visit bit.ly/RR-2025-care-centers-audit.