Rochester Senior AdvisorWhich New York counties does Rochester Senior Advisor cover?
We cover five counties of the Rochester area: Monroe (the City of Rochester and its towns), Ontario, Wayne, Livingston and Orleans, which share one long-term care ombudsman program at Lifespan and the Department of Health's Rochester-area office.
| County | Population | 65+ | 85+ | Median age | Licensed residences | Nursing homes |
|---|---|---|---|---|---|---|
| Monroe County | 750,506 | 158,814 | 19,453 | 40.4 | 34 | 32 |
| Ontario County | 113,130 | 28,437 | 3,190 | 45.1 | 7 | 6 |
| Wayne County | 91,250 | 21,206 | 2,125 | 44.1 | 2 | 4 |
| Livingston County | 61,438 | 14,253 | 1,501 | 42.5 | 2 | 4 |
| Orleans County | 39,825 | 8,935 | 839 | 43.5 | 1 | 3 |
U.S. Census Bureau, Vintage 2025 county population estimates by age (July 1, 2025); NYSDOH roster, 2026 Q2.
Why group these five counties together?
Because families cross the county lines constantly: Ontario and Wayne residents use Rochester hospitals, Orleans and Livingston families tour residences in Monroe County, and the same ombudsman program and many of the same home care agencies serve all five.
Each county still has its own Office for the Aging, its own Department of Social Services for Medicaid and Adult Protective Services, and in Orleans County's case a different Medicaid region for transfer penalties.
Which county has the oldest population?
Ontario County: 25.1% of its residents were 65 or older in 2025 Census estimates, with a median age of 45.1, compared with 21.2% in Monroe County.
Monroe County holds by far the most older residents in absolute numbers, but the outer counties have higher shares and fewer licensed beds per older resident, which is why so many families there compare local options with Monroe County residences.
Where is most of the region's licensed senior care?
Overwhelmingly in Monroe County, which holds most of the region's licensed residences, nursing homes and home care agencies, while Ontario County is the second hub, centered on Canandaigua and Geneva, and Wayne, Livingston and Orleans each have a few.
Each county page lists every licensed facility and the straight-line distance from the county seat to the nearest hospitals and to downtown Rochester.
How fast is the older population growing in the five counties?
Census Bureau estimates put 231,645 residents aged 65 and older in the five counties on July 1, 2025, up from 202,064 in 2020, including 27,108 aged 85 and older, the group most likely to need help with daily activities.
Every county's older population grew by double digits in five years while total population was flat or falling, so demand for care is rising faster than the population.
At a glance
| Shared across all five counties | Different county to county | |
|---|---|---|
| Rules | New York State licensing and Medicaid rules | Medicaid's transfer-penalty region (Orleans is Western) |
| Advocacy | Lifespan's long-term care ombudsman program | Office for the Aging and APS phone numbers |
| Costs | The same New York CareScout medians | Actual local quotes |
| PACE | ElderONE in Monroe, Ontario and Wayne | No PACE in Livingston or Orleans |
