Several adult day activity centers in New York City were raided by federal law enforcement on the 20th of this month, sparking shock and discussions within the industry about the current regulatory system.
Industry insiders pointed out that the day care centers for adults involve various aspects of regulation such as the use of premises, approved occupancy, service records, and actual operators. Some anomalies could easily be detected if the relevant agencies cross-checked data. The issue lies in the involvement of multiple parties including city and state governments, and medical insurance plans in regulation, which doesn’t necessarily guarantee effective oversight. If each party holds partial information without coordinated efforts and follow-up, vulnerabilities may persist.
For instance, the “Jiale Adult Day Activity Center” at 4022 Eighth Avenue in Brooklyn that was raided had discrepancies in its actual use and approved occupancy as per the Department of Buildings (DOB) historical complaints and inspection records.
Records show that in November 2019, the DOB received a complaint and conducted an inspection at the center. The inspection mentioned that the first floor was being used as an adult day activity center with 15 tables, each with 6 chairs, totaling 90 seats. However, the official records indicated the first floor was designated as a store with a maximum capacity of 55 people, and the basement was listed as a community center with a capacity of 13.
Opening an adult day care center in New York requires strict compliance with building usage permits (CO), space and zoning regulations. While operating directly in residential areas is generally prohibited, categorizing them as “Community Facilities” allows for establishment in specific areas. However, many centers have not completed the necessary usage changes or compliance procedures.
Interviewees suggested that instead of completely shutting down adult day care centers, the government could enhance on-site supervision. By cross-referencing “approved occupancy” with “daily attendance records” and “service declaration data,” discrepancies in premises usage, potential undersized facilities or overcapacity issues, and inconsistencies between service records and actual operations could be identified early on.
Concerns were raised about the discrepancy between the registered responsible persons in center documents and the actual operators, making it difficult to trace the real beneficiaries and ensure accountability.
It was recommended that regulatory authorities not only verify registration data but also look into the actual management structure, including who gives instructions to staff, is responsible for finances and payments, and makes decisions on the center’s daily operations. If the designated responsible person on paper differs from the actual controller, supervisory agencies should clarify their relationship and responsibilities to avoid difficulties in accountability in case of incidents or situations where the actual operators controlling the operations are not investigated.
Interviewees stressed that adult day care centers are not lacking in regulatory mechanisms, as oversight includes Medicaid supervision or investigation departments, on-site inspections by agencies overseeing elderly services, Management Long-Term Care Plans (MLTC), and insurance company audits, which involve verifying member numbers, actual attendance, and service declaration data. However, the effectiveness of current regulations is still limited, with on-site inspections sometimes being conducted by only one personnel, which may not fully grasp the center’s actual operations. Some insurance companies also lack proactive oversight, raising concerns about the effectiveness of multi-party participation in ensuring adequate supervision.
The audit report released in February 2026 by the New York State Comptroller’s Office pointed out regulatory gaps in social adult day care centers and related Managed Long-Term Care Plans, including insufficient service records, issues with premises use permits, and some centers declaring numbers exceeding approved capacities. The report indicated that the problems extended beyond individual institutions to whether regulatory and payment audit mechanisms were effectively aligned.
Recommendations were made that adult day care centers with more than 50 members could consider arranging full-time government supervisors to directly verify member visits and service records. Compared to monthly payments for supervisory personnel, preventing centers from falsely reporting dozens of non-existent patients to misappropriate public funds would be more cost-effective and help plug regulatory loopholes.
It was emphasized that the value of day care should not be overshadowed by regulatory loopholes, which could unfairly impact the entire industry. For some elderly individuals with cognitive impairments, mobility issues, or who cannot go out alone, adult day care not only provides a place for activities but also undertakes daytime care, social interactions, and alleviates family caregiving stress. If enforcement focuses solely on closing centers without evaluating the actual needs of members and arranging suitable referrals, vulnerable seniors may lose the support they rely on.