Adult Care Facility Services

Adult Care Facilities (ACF) provide long-term, non-medical residential services to adults who are substantially unable to live independently due to physical, mental, or other limitations associated with age or other factors. Residents must not require the continual medical or nursing services provided in acute care hospitals, in-patient psychiatric facilities, skilled nursing homes, or other health related facilities, as Adult Care Facilities are not licensed to provide for such nursing or medical care.

The New York State Department of Health licenses and regulates three types of Adult Care Facilities:

  • Adult Homes (AH): Established and operated for the purpose of providing long-term residential care, room, board, housekeeping, personal care, and supervision to five or more adults unrelated to the operator.
  • Enriched Housing Programs (EHP): Established and operated for the purpose of providing long-term residential care to five or more adults primarily persons sixty-five years of age or older, in community-integrated settings resembling independent housing units. The program provides or arranges for the provision of room, board, housekeeping, personal care, and supervision.
  • Residences for Adults: Established and operated for the purpose of providing long-term residential care, room, board, housekeeping, case management, activities and supervision to five or more adults, unrelated to the operator, who are unable or substantially unable to live independently.

An Adult Care Facility may choose to seek licensure as an Assisted Living Residence (ALR) and apply for additional certification as:

  • Enhanced Assisted Living Residence (EALR): Provides services that may enable a resident to age in place by admitting or retaining residents who (1) chronically require the physical assistance of another person to walk; (2) chronically require the physical assistance of another person to climb or descend stairs; (3) are dependent on medical equipment and require frequent assistance from medical personnel; or (4) have chronic unmanaged urinary or bowel incontinence. Care and services are provided in accordance with an Individualized Service Plan.
  • Special Needs Assisted Living Residence (SNALR): Provides services to individuals with special needs, including individuals with dementia or cognitive impairments in accordance with an Individualized Service Plan.

An Adult Home or Enriched Housing Program may also offer services through an:

  • Assisted Living Program (ALP): Provides services to persons who are medically eligible for nursing home placement but in a less medically intensive, lower cost setting. The ALP provides personal care, room, board, housekeeping, supervision, home health aides, personal emergency response services, nursing, physical therapy, occupational therapy, speech therapy, medical supplies and equipment, adult day health care, home health services, and the case management services of a registered professional nurse.

The operator of an ACF shall provide an organized, twenty-four (24) hour a day program of supervision, care, and services, which include personal care, case management, and activities as described below:

  • Supervision: Knowledge of general whereabouts of each resident, monitoring to identify changes in behavior, assistance in performing basic activities of daily living, including attendance and meals, participation in facility and community programs, and performance of basic money management.
  • Personal Care: Provide personal care as necessary to enable the resident to maintain good hygiene including assistance with grooming, dressing, bathing, toileting, self-administration of medications, and eating.
  • Case Management: Initial and periodic evaluation of the needs of the resident including establishing linkages with and arranging for services from public and private sources for income, health, mental health, and social services.

For laws and regulations pertaining to the rules and responsibilities of the above-mentioned entities, please refer to the “Laws & Regulations” hyperlink at the bottom left of this page.

For regulations pertaining to Adult Homes, Enriched Housing Programs, and Residences for Adults, search Title 18 (Social Services). Specifically, 18 NYCRR 487 for Adult Homes; 18 NYCRR 488 for Enriched Housing Programs; 18 NYCRR 490 for Residences for Adults; and 18 NYCRR 494 for Assisted Living Program.

For regulations pertaining to Assisted Living, Enhanced Assisted Living, and Special Needs Assisted Living, search Title 10 (Public Health). Specifically, 10 NYCRR 1001.

If you have any questions, contact your Regional Office:

Capital District Regional Office (CDRO) Central New York Regional Office (CNYRO) Metropolitan Area Regional Office – New York City (MARO) Metropolitan Area Regional Office – Long Island (MARO) Western Regional Office
875 Central Avenue,
Albany, NY 12206
217 South Salina Street, 4th Floor,
Syracuse, NY 13202
90 Church Street, 15th Floor,
New York, NY 10007
320 Carleton Avenue, Suite 5000,
Central Islip, NY 11722
1565 Jefferson Road, Suite 120,
Rochester, NY 14623
Phone: 518.408.5287 Phone: 315.477.8472 Phone: 212.417.4440 Phone: 631.851.3098 Phone: 585.423.8185
Fax: 518.408.5309 Fax: 315.477.8583 Fax: 212.417.2119 Fax: 631.851.4323 Fax: 585.423.8171