DAL 17-20: Cold Weather Advisory

November 01, 2017

DAL 17-20: Cold Weather Advisory

Dear Administrator/Operator:

During extended periods of cold temperatures, you are expected to provide your residents with a comfortable and safe environment throughout the winter months and to take the necessary precautions to prevent cold-related conditions. Section 461-q of Social Services Law requires the New York State Department of Health (Department) to set allowable temperatures for resident-occupied areas of the facility. Compliance with this regulation requires you to maintain your facility at a safe and comfortable temperature level.

During the winter months residents may be at risk for cold-related conditions. Elderly residents and those with chronic medical conditions such as diabetes, circulatory or thyroid disease are at increased risk for hypothermia and frostbite. The following information summarizes both conditions.

Cold-Related Conditions:


A drop in one's core body temperature below 95 degrees. This may occur when exposure to the cold causes a person's body to lose heat faster than it can be produced. Hypothermia can occur with air temperatures of 60 to 65 degrees Fahrenheit (15-18 degrees Celsius).


Symptoms of hypothermia vary depending on how long the individual has been exposed to the cold temperatures.

  • Early Symptoms: Shivering, fatigue, loss of coordination, confusion and disorientation.
  • Late Symptoms: No shivering, blue skin, dilated pupils, slowed pulse and breathing and loss of consciousness.


Move the person into a warm room and warm their body with a blanket. Seek medical attention to determine if further treatment is needed.


A decrease in blood flow to an individual's extremities due to exposure to extreme cold resulting in freezing of the skin. Frostbite causes a loss of feeling and color in the affected areas. In extremely cold temperatures, the risk of frostbite is increased in residents with reduced blood circulation and those who are not properly dressed.


Symptoms of frostbite include reduced blood flow to hands and feet, numbness, tingling or stinging, aching, bluish or pale, waxy skin.


Move the person into a warm room. Immerse the affected area in warm (not hot) water (the temperature should be comfortable to the touch for unaffected parts of the body). Do not rub or massage the frostbitten area; doing so may cause more damage. Do not use a heating pad, or the heat of a stove, or radiator for warming. Affected areas are numb and can be easily burned. Seek medical attention to determine if further treatment is needed.

When the outside temperature is 65 degrees Fahrenheit or less (18 degrees Celsius or less), you must maintain the inside temperature in residents' bedrooms and all common areas at the following temperatures as required by regulation:

  • Adult Care Facility: 487.11(m) a minimum temperature of 68 degrees Fahrenheit (20 degrees Celsius)
  • Residences for Adults: 490.11(n) a minimum temperature of 68 degrees Fahrenheit (20 degrees Celsius)
  • Enriched Housing: 488.11(i) a minimum temperature of 72 degrees Fahrenheit (20 degrees Celsius) unless the Operator can demonstrate that the building is in compliance with local heating requirements which are lower and that the Operator does not have control of the building.

Additional information regarding steps to be taken by adult care facilities in cold weather, steps to prevent hypothermia and frostbite and symptoms of cold exposure and treatment are attached. This information is to be posted in a conspicuous area in your facility that is accessible to both staff and residents. Please be advised that this letter and attachments will be available on the Department's website at:

Thank you in advance for your efforts to provide our residents with a safe environment that allows them to enjoy a meaningful and satisfying quality of life. If you have any questions regarding the information in this letter or its attachments, please contact your appropriate Regional Office.


Valerie A. Deetz, Director
Division of ACF and Assisted Living Surveillance