The New York state Department of Health is not adequately overseeing adult care facilities, failing to conduct timely inspections and provide documentation showing critical problems were addressed, according to an audit released Wednesday by state Comptroller Tom DiNapoli.

The audit reviewed adult care facilities from January 2018 to October 2024 and found the 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. Central New York had no backlog.

The audit also found a range of issues including crumbling stairs and walkways; dishwashers that didn’t reach safe temperatures; refrigerators that weren’t cold enough and a lack of regular fire drills. Also found, according to the audit, were expired medication present four years after a prior citation; staff still uncertified in basic first aid more than 13 months after being cited; and a half-empty vodka bottle in a medical room and marijuana paraphernalia in an administrator’s office.

“Adult care facilities across the state have a responsibility to protect residents and deliver quality care,” DiNapoli said in a statement. “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.”

The audit recommends the DOH improve procedures to ensure timely inspections, follow up on violations, complete and document complaint investigations and communicate findings promptly. It also calls on DOH to improve the accuracy of its data by regularly reviewing and updating information in its tracking systems and ensuring inspection records are complete and categorized correctly.

In response, the DOH acknowledged delays in inspections and correcting violations, citing staffing shortages and the COVID-19 pandemic as major challenges. Officials there said they have increased hiring, improved tracking systems and created a quality assurance committee to strengthen oversight moving forward.

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. As of 2023, there were 534 adult care facilities operating in New York, serving 37,547 residents, according to the state comptroller’s office.