Barclay Damon
Barclay Damon

Assisted Living Services

About 10 years ago, New York decided to license assisted living facilities. Assisted living facilities are generally operated to provide long-term residential care, room, board, housekeeping, personal care and supervision to five or more adults unrelated to the operator.

New York is one of the more complex states in which to operate an assisted living residence, with multiple layers of regulations, a significant approval process and a strict enforcement landscape.

New York State Assisted Living License Approval Process

The approval process involves a review of character and competence of the operator, financial feasibility, legal requirements, operational components (such as staffing schedules and policies and procedures) and architectural review. In addition, there are opportunities for providers in New York to provide enhanced (the ability to increase staffing to allow residents to receive more care and “age in place”) or special needs (for example, dementia) services through application to the Department of Health.

Assisted Living Programs

Licensed Assisted Living Programs (ALPs) are established and operated for individuals who need more care than that provided by an adult home but less than that provided by a nursing home. ALPs provide long-term residential care, room, board, housekeeping, personal care, supervision, and home health services to five or more eligible adults.

ALP programs attached to adult homes provide continuity for residents who, were it not for the ALP, would have to leave the adult home upon deterioration of health. They are duly licensed as an adult care facility and a home care company. The Social Services Law and Regulations govern the licensure and regulation of ALPs.

Unlike the adult home application process which is done on a rolling basis, ALP applications are processed in batches. The Department of Health, upon determining that a public need exists for such programs, sets an application period for submission of applications. Applications are reviewed comparatively by geographic region. This is the only opportunity to receive Medicaid payments for assisted living services. New York State has provided for a limited number of assisted living beds. The Department has some of these beds available and an Opportunity for Development for these beds is issued sporadically.

We have had success in representing our clients in applying for ALPs. Our attorneys recently prepared, submitted and prosecuted our client’s application to the New York State Department of Health for an Assisted Living Program (ALP) in Brooklyn. Our client prevailed in the first round of a competitive bidding process and received approval to build the ALP facility, which will be a 128-bed assisted living facility.

Assisted Living Team Members

Our attorneys are well versed in all aspects of the assisted living licensing process. In addition to understanding and successfully guiding clients through the licensing process, our attorneys are playing an active role in improving the licensing process. Melissa Zambri, Head of our Health Care & Human Services Practice Area, was a member of the New York State Department of Health workgroup that is revamped the application and approval process for assisted living.

Assisted Living Services


  • Policies and procedures 
  • Admission agreements 
  • Responses to Department of Health surveys


  • Approval process for adult homes, assisted living, enriched housing, special needs and enhanced services

Real Estate 

  • Land acquisition 
  • Site approvals 
  • Bank financing 
  • Tax exempt bond financing


  • Transactional services


  • Not-for-profit tax advice 
  • Tax exemption applications

Labor and Employment

  • Division of Human Rights matters 
  • Employee Discipline matters 
  • Policy and Procedure Matters


  • Defense of suits by residents 
  • Contract disputes