NEW YORK STATE DEPARTMENT OF HEALTH
OFFICE OF LONG TERM CARE
DIVISION OF RESIDENTIAL SERVICES ADULT CARE FACILITY
There are five types of adult care facilities and up until 1997 all were under the jurisdiction of the Department of Social Services until we moved to the Department of Health. New York State, through the NYS Department of Health, licenses and supervises three types of adult care facilities; adult homes, enriched housing and residences. The other two types are Family Type homes which are under the jurisdiction of The Office of Children and Family Services and shelters which are under the jurisdiction of The Office of Temporary and Disability Assistance. At this time there are no residences and there are 378 adult homes and 102 enriched housing statewide.
- An adult home is 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. Adult homes may be either proprietary (operated for profit), public or not-for-profit.
- An enriched housing program is 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.
- A Residence For Adults is established and operated for the purpose of providing long-term residential care, room, board; housekeeping and supervision to five or more adults, unrelated to the operator.
- A family-type home for adults is established and operated for the purpose of providing long-term residential care, room, board, housekeeping, personal care and/or supervision to four or fewer adult persons unrelated to the operator. These homes are operated by a person in his/her own home. Neither proprietary nor not-for-profit corporations are permitted to operate a family-type home. Information on family-type homes may be obtained from your local county Department of Social Services office.
- Shelters: A Family shelter provides shelter and services to 10 or more homeless families. Services include: private rooms, access to three nutritional meals a day, supervision, assessment services, permanent housing preparation services, recreational services, information and referral services access to health services and child care services. Shelters for single adults provide temporary residential care, room, board, supervision, information and referral and social rehabilitation services to adults who need temporary accommodates, supervision and services.
- An assisted living program is available in some adult homes and enriched housing programs that combine residential and home care services. It is designed as an alternative to nursing home placement for individuals who historically have been admitted to nursing facilities for reasons that are primarily social, rather than medical in nature. The operator of the assisted living program is responsible for providing or arranging for resident services that must include room, board, housekeeping, supervision, personal care, case management and home health services. Facilities approved for this program receive Medicaid dollars for additional personal care and services. The facilities employ an RN and home health aide (HHA) through a Licensed Home Care Service Agency (LHCSA).
On October 26, 2004 Governor Pataki signed The Assisted Living Reform Act as Chapter 2 of the Laws of 2004. The Assisted Living Reform Act created several new certification categories and allowed facilities to call themselves “Assisted Living”. Once a facility is an adult care facility they can apply to be an Assisted Living Residence (ALR). The ALR level is viewed as a basic level of care with operator responsibilities and services must like those in adult homes or enriched housing program with the same admission/retention standards with some variations, higher case management staffing, an Individualized Service Plan (ISP) coordinating all service providers, new residency agreements and additional resident rights.
- An assisted living residence (ALR) is an extension of an adult home or enriched housing program. The ALR will provide long-term residential care, room, board, housekeeping, personal care and supervision to five or more adults unrelated to the operator. Adult homes/enriched housing programs may be proprietary (operated for profit), public or not-for-profit. An ALR must develop an individual service plan (ISP) for each resident.
If a facility is an adult home/enriched housing program and an Assisted Living Residence, they can opt for two additional licenses:
Special Needs Assisted Living Residence (SNALR) This level was developed from the concept to serve individuals with special needs, including but not limited to dementia or cognitive impairments. The only model seen to date are those developed for dementia.
Enhanced Assisted Living Residence. This level was developed from the concept of “aging in place”. Each facility will decide to what extent they will retain residents, i.e., what their own retention standards will be. Some facilities have indicated that they will only keep residents for 1 or 2 person transfer while other facilities have indicated they will provide more skilled services.
Requirements were promulgated in March 2008, however, two lawsuits were filed in July 2008 and decisions rendered in September 2009 nullified certain sections of these regulations, i.e. nursing requirements, architectural requirements and other sections. Next steps are not decided as yet.
Under State Law, no person or organization may operate an adult care facility without an operating certificate from the New York State Department of Health. Operating certificates are issued only to operators who satisfactorily demonstrate good character, competency and the ability to operate facilities in compliance with law and regulations. Facilities are subject to periodic inspection by state staff, except family-type homes which are inspected by staff of local social services districts, to determine if the facility is being operated in a manner that protects the health, safety and well-being of residents. Failure of an operator to comply with regulations may result in fines or action to revoke or suspend the operating certificate.
The regulations for straight adult homes and enriched housing programs are found under Social Services Law and Regulation 18 NYCRR 487 and 488 while the assisted living residences are found under Public Health Law and Regulation 10 NYCRR 1001.