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Independent Living vs. Assisted Living

Independent living in New York is typically unlicensed housing. Assisted living requires an Adult Care Facility base license plus, usually, ALR certification.

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Short answer

Independent living in New York is typically unlicensed housing, since no personal care is provided. Assisted living requires an Adult Care Facility base license (Adult Home, Enriched Housing Program, or Residence for Adults) plus, usually, Assisted Living Residence (ALR) certification from NYSDOH under 10 NYCRR Part 1001.

The practical dividing line

If a Long Island community only provides an apartment, meals, housekeeping and activities, with no help with bathing, dressing or medication management, it is very likely independent living and unlicensed as a care facility. The moment personal care support is added, New York generally requires ACF/ALR licensure.

Several Long Island campuses -- Jefferson's Ferry (South Setauket) and Peconic Landing (Greenport) among them -- combine independent living with assisted living, memory care and nursing on one site through a Life Plan Community (CCRC) model, letting a resident move between levels without changing communities.

Questions families ask

What state regulations govern nursing homes on Long Island?

Nursing homes in New York are licensed and regulated by NYSDOH under 10 NYCRR Part 415, Nursing Homes - Minimum Standards, a completely separate rule set from the Adult Care Facility regulations that govern assisted living. Families can search and compare Nassau and Suffolk nursing homes through the NYS Health Profiles Nursing Home Profiles tool. Note that as of mid-2025, CMS's migration to a new federal inspection database (iQIES) temporarily affected how current some posted inspection data is, so it's worth confirming a record's date.

What is an Enhanced Assisted Living Residence (EALR) and when would my parent need one?

An Enhanced Assisted Living Residence (EALR) is an additional certification an Assisted Living Residence can obtain to let residents age in place despite higher physical needs, specifically those who chronically need physical help walking or using stairs, depend on medical equipment requiring frequent professional assistance, or have chronic, unmanaged bowel or bladder incontinence. EALR care is delivered per an Individualized Service Plan and is regulated under the same 10 NYCRR Part 1001 rules as standard ALR and SNALR certifications.

Is there a local New York State office that oversees senior care facilities specifically on Long Island?

Yes. Long Island Adult Care Facilities fall under NYSDOH's Metropolitan Area Regional Office - Long Island (MARO-LI), located at 320 Carleton Avenue, Suite 5000, Central Islip, NY 11722, phone 631-851-3098. This regional office handles licensing oversight and inspections for Nassau and Suffolk County facilities rather than families needing to go through a statewide-only office.

Do I have to enroll in an MLTC plan for home care in Nassau or Suffolk County?

Yes - Managed Long Term Care (MLTC) enrollment is mandatory in both Nassau and Suffolk counties for dual-eligible Medicaid recipients age 21 and older who need community-based long-term care services for more than 120 days. NYSDOH extended mandatory MLTC enrollment to Nassau, Suffolk, and Westchester counties beginning in the 2013 transition period, and that mandatory enrollment structure remains in effect. MLTC plans coordinate home care, adult day care, nursing home care, and related services through a single managed care plan rather than fee-for-service Medicaid.

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