That it took only two years for a group of New York-based investors to run the 5-star Brookside nursing home into the ground should come as no surprise. The system was already blinking red when their acquisition of the 67-bed White River Junction facility from the Rice family, longtime good stewards of Brookside, was approved by Vermont regulators in August 2015.

The Green Mountain Care Board had grave misgivings at the time. In light of low federal quality ratings at two out-of-state facilities with which “one or more of the applicants have been affiliated,” it expressed concern that despite the applicants’ representations to the contrary, the quality of patient care at Brookside would decline. Nonetheless, the board approved the certificate of need required for the sale to go through, in what was perhaps a triumph of hope over experience.

The board’s reservations proved entirely justified. The quality of patient care did indeed drop precipitately at Brookside, as documented in inspections by the Vermont Department of Aging, which found a litany of health and safety deficiencies, and in ratings assigned by the federal Centers for Medicare and Medicaid Services. At the time of the sale, Brookside had a “much-above-average” five-star rating. By late October of this year, the rating had declined to a “below-average” two stars. At that point, CMS pulled the plug, announcing that Brookside would no longer be eligible for Medicaid and Medicare payments. This sanction is “generally a last resort after all other attempts to remedy deficiencies at the facility have been exhausted,” according to CMS. Since the new owners are not commenting, it’s unclear why they did not or could not address the problems. But the result is that they have decided to shutter the facility at the end of this month, leaving the remaining residents and their families to make, on short notice, a most consequential decision about where to relocate.

This debacle raises red flags for a number of reasons, the main one being that it exposes deficiencies in regulation that could have statewide implications. It appears that Vermont, despite its reputation as a nanny state, has insufficient regulatory infrastructure in place to adequately protect some of its most vulnerable residents.

Authority is currently divided between the Green Mountain Care Board and the Department of Disabilities, Aging and Independent Living. The former oversees the certificate of need process, which is designed to assess whether a given service is needed in a given community. But somehow in the case of nursing homes, the board is also tasked with approving transfers of ownership. The Department of Aging is responsible for monitoring health and safety in the state’s nursing homes.

Staff writer Nora Doyle-Burr’s reporting on this subject strongly suggests that neither of the two agencies currently involved believes itself well suited to provide comprehensive oversight: the Green Mountain Care Board because it lacks operational expertise and the authority to hold new owners accountable for the promises they make during the certificate of need process; the Department of Aging because it lacks the resources to undertake sophisticated financial assessment and related tasks of regulatory compliance.

As ownership of family-owned facilities in Vermont increasingly passes to out-of-state entities, stricter scrutiny certainly will be required. That almost certainly implies an overhaul of the regulatory structure. The Legislature and the Scott administration ought to urgently assess the situation and come up with a solution. A single agency, or a department within an agency, dedicated solely to nursing homes and similar facilities appears to be required, one endowed with sufficient authority, expertise and staff to rigorously regulate all aspects of nursing home operation and to hold owners accountable when they fall short.