SULLIVAN COUNTY — The Sullivan County Legislature on Nov. 13 approved a resolution authorizing payment of a fine assessed by the Centers for Medicare and Medicaid Services (CMS) against the Sunset Lake adult care center.

A public commenter told the Legislature the penalty stems from “a frail elderly resident of the ACC [adult care center] [who] was body slammed at our county nursing home” and said it was the third penalty since the county contracted with consultant Infinite Care. The commenter also said fines tied to the facility have totaled $46,840 to date.

Legislators spent the bulk of the discussion seeking clarity on the timing and calculation of the fine. Staff said the original CMS notice listed a fine of $14,800, and later discussion in the meeting referenced a reduction to roughly $9,000 through negotiation, but the transcript contains inconsistent references to $14,800 and $14,000; legislators asked for the CMS enforcement letter that documents how the fine amount was determined and how the negotiated reduction was reached.

The administrator of the adult care center identified themself during discussion and provided timeline details, saying the incident in question occurred Feb. 14, 2024, the enforcement cycle was in September 2024, and a revisit occurred Dec. 6, 2024. Legislators noted that another incident earlier in the year remains under review and that the County has not yet received a final fine tied to that other event.

One legislator asked legal staff or the county manager to provide the CMS letter showing the statutory citations and the basis for the fine so the Legislature could see the factual and regulatory basis for the amount. Officials characterized CMS fines as regulatory enforcement that include a maximum fine under agency regulations and said counties have limited ability to contest amounts beyond negotiation.

After the discussion the Legislature voted in favor of the resolution. The transcript records a voice vote in which the presiding officer called for “aye” and no formal roll-call tally appears in the record.

Next steps: Legislators requested that staff circulate the CMS enforcement letter and any documentation of the negotiated reduction; the motion to authorize payment passed and the Legislature moved to other business.