Rochester Senior AdvisorWhat laws govern senior care facilities in Rochester, NY?
New York State law governs them: the Social Services Law and 18 NYCRR Parts 485-494 for adult homes and enriched housing, Public Health Law Article 46-B and 10 NYCRR Part 1001 for assisted living residences, and Public Health Law Article 28 with 10 NYCRR Part 415 for nursing homes, with federal CMS rules on certified nursing homes.
Last verified: October 2026The Department of Health licenses and inspects all of them. The City of Rochester, Monroe County and the towns do not license care settings, though zoning and fire codes apply to the buildings.
How is New York's approach different from other states?
New York layers certifications on two base licenses rather than issuing one assisted living license: a building is an adult home or enriched housing program first, then may add ALR, EALR, SNALR or Assisted Living Program beds, each counted and published quarterly.
The Department of Health's roster lists 46 licensed adult care facility buildings in Monroe, Ontario, Wayne, Livingston and Orleans counties, with 3,632 certified beds: 31 hold an adult home license and 16 an enriched housing license (a few hold both), and 31 are certified as Assisted Living Residences.
Where do Rochester families report problems?
Adult care facility complaints go to the Department of Health at 1-866-893-6772, nursing home complaints and discharge appeals to 1-888-201-4563, suspected abuse of someone living at home to the county's Adult Protective Services (Monroe: 585-753-6532), and residents can get free advocacy from Lifespan's ombudsman program at 585-244-8400 ext. 114.
The guides below explain each step, with the rule behind it.
NY Rules guides
How New York licenses assisted living around Rochester
New York licenses assisted living through the Department of Health as adult homes and enriched housing programs, with ALR, EALR, SNALR and ALP certifications layered on top. How it works for Rochester families.
Read →ALR, EALR and SNALR, in plain language
What New York's Assisted Living Residence, Enhanced ALR and Special Needs ALR certifications allow, how many beds each Rochester-area residence holds, and what to ask.
Read →How New York regulates memory care
How New York's Special Needs Assisted Living Residence (SNALR) certification works for dementia care in Rochester, what it requires, how many beds exist, and where nursing homes fit.
Read →Who can move into, and stay in, a New York adult care facility
New York's admission and retention standards for adult homes, enriched housing and assisted living residences, the residency agreement, discharge notice and resident rights, for Rochester families.
Read →Who handles medications and nursing in New York assisted living
How medications are handled in New York adult homes and assisted living residences, when a licensed nurse is needed, and how home health agencies and hospice serve residents around Rochester.
Read →How New York regulates nursing homes
New York nursing home rules (10 NYCRR Part 415), the 3.5-hour minimum staffing law, inspections, CMS ratings and how Rochester families read them.
Read →How to check a facility's record yourself
How Rochester families check a New York adult home, assisted living residence or nursing home on NYS Health Profiles, health.data.ny.gov and CMS Care Compare before touring.
Read →Where to report a problem with senior care around Rochester
NYSDOH complaint hotlines for adult care facilities and nursing homes, Adult Protective Services by county, and Lifespan's long-term care ombudsman program for the Rochester area.
Read →At a glance
| New York's rules do | New York's rules do not | |
|---|---|---|
| Assisted living | License adult homes and enriched housing, with ALR add-ons | Issue a single 'assisted living' license |
| Memory care | Require SNALR certification and an approved plan | Set one statewide memory care ratio |
| Inspections | Require yearly unannounced inspections (18 months for top-rated) | Rate residences with stars |
| Nursing homes | Require 3.5 nursing hours per resident per day | Allow discharge for switching to Medicaid |
