09-07-2025
Crumbling stairs, bed bugs: Inside NY's adult care facilities deemed unsafe in audit
State health officials failed to conduct required inspections at adult care facilities across New York, leaving thousands of elderly residents exposed to myriad threats, including expired medications, crumbling stairs, bed bugs and uncertified staff, state auditors found.
The unaddressed health and safety risks at adult care facilities stemmed from the fact New York's Health Department at times "failed to conduct timely inspections and often lacked documentation to show critical problems were corrected," according to the state Comptroller's Office report.
Revelations surrounding the newly reported adult care facility inspection backlogs and failures came after USA TODAY Network-New York revealed state health officials failed to properly inspect nursing homes during the pandemic.
State health officials failed to complete adult care facility 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, state auditors reported.
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 visits at 20 of the sampled adult care facilities across the state and found a range of serious health and safety issues, including:
Crumbling stairs and walkways.
Dishwashers that didn't reach safe temperatures.
Refrigerators that weren't cold enough.
A lack of regular fire drills.
Auditors also found additional unresolved problems at adult care facilities, including:
A half-empty vodka bottle in a medical room and marijuana paraphernalia in an administrator's office.
Expired medication present four years after a prior citation.
Staff still uncertified in basic first aid more than 13 months after being cited.
Health officials also failed to document whether facilities corrected violations identified in prior inspections. Of the 89 violations reviewed in 30 inspection reports, auditors found no evidence health officials took corrective action. At 18 of 20 facilities visited, problems cited in earlier inspection reports were not fixed.
Investigation: NY vowed to improve nursing homes after COVID. The pandemic made things worse. Here's how
At the same time, health officials received 7,440 adult care facility complaints and completed 6,498 complaint investigations from 2018 through 2023.
Still, health officials failed to fully investigate some complaints or adequately document its investigations, auditors found, noting in a sample of 130 complaints, 18% of allegations had no evidence they were investigated.
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, auditors noted.
As of 2023, there were 534 adult care facilities operating in New York, serving 37,547 residents, the report added.
More: Unsafe care to lawmaking missteps: Why we keep reporting on NY nursing home failures
The audit reviewed health officials' 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.
In response to the audit findings, health officials acknowledged delays in inspections and correcting violations, citing staffing shortages and the COVID-19 pandemic as major challenges. Health officials said they have increased hiring, improved tracking systems and created a quality assurance committee to strengthen oversight moving forward.
Addressing the stakes of New York's failed oversight of adult care facilities, state Comptroller Thomas DiNapoli asserted proper inspections "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,' he added.
David Robinson is a veteran health reporter for the USA TODAY Network's New York State Team. Reach him at Drobinson@
This article originally appeared on Rockland/Westchester Journal News: NY's adult care facilities deemed unsafe in state audit
