Hudson Valley Senior AdvisorWhich laws govern senior care facilities in Dutchess and Orange counties?
State law does: the Social Services Law and 18 NYCRR Parts 485-494 cover adult homes and enriched housing, Public Health Law Article 46-B and 10 NYCRR Part 1001 cover Assisted Living Residences, and Public Health Law Article 28 and 10 NYCRR Part 415 cover nursing homes, with federal CMS rules for certified homes.
Last verified: November 2026The Department of Health enforces all of it; the state roster places Dutchess and Orange adult care facilities under its Metropolitan Area Regional Office. Counties and towns handle zoning and building codes, never care licenses.
What is distinctive about the Mid-Hudson's licensed residences?
Two things: a large share of assisted living beds belongs to Medicaid's Assisted Living Program, and very few beds carry the SNALR dementia certification, so payment options are broader here than dementia options.
In Dutchess and Orange counties together, the state roster shows 18 licensed adult care facility buildings with 1,664 certified beds: 15 hold an adult home license and 3 an enriched housing license, 7 are certified Assisted Living Residences, and 9 have Medicaid Assisted Living Program beds.
Who takes complaints from Dutchess and Orange families?
The Department of Health takes adult care facility complaints at 1-866-893-6772 and nursing home complaints and discharge appeals at 1-888-201-4563; county Adult Protective Services handles abuse of adults living at home; and the ombudsman advocates for residents at no charge.
The ombudsman for both counties is the Hudson Valley Long Term Care Ombudsman Program, (845) 229-4680. Dutchess APS: (845) 486-3000; Orange APS: (845) 291-2800.
NY Rules: all guides
Who licenses assisted living in Poughkeepsie, Newburgh and Middletown
How New York's Department of Health licenses adult homes, enriched housing and Assisted Living Residences in Dutchess and Orange counties, and what each license allows a building to do.
Read the guide →ALR, EALR and SNALR, for Dutchess and Orange families
What New York's Assisted Living Residence (ALR), Enhanced ALR (EALR) and Special Needs ALR (SNALR, memory care) certifications allow, and which Dutchess and Orange residences hold them.
Read the guide →Admission, retention and discharge rules for Mid-Hudson residences
New York's admission and retention rules for adult homes, enriched housing and Assisted Living Residences, including medical evaluations, written agreements and 30-day discharge notice, for Dutchess and Orange County families.
Read the guide →Nursing home rules and staffing in the Mid-Hudson
How New York regulates nursing homes in Dutchess and Orange counties: 10 NYCRR Part 415, the 3.5-hour staffing law, CMS inspections and star ratings, and residents' discharge protections.
Read the guide →How to check a facility's record before you tour
Step-by-step: how Dutchess and Orange County families can check an adult home's or nursing home's license, inspections and enforcement on NYS Health Profiles and CMS Care Compare.
Read the guide →Complaints, abuse reports and the ombudsman in the Mid-Hudson
Where Dutchess and Orange County families report problems: NYSDOH complaint hotlines, Adult Protective Services, the Dutchess elder abuse hotline and the Hudson Valley Long Term Care Ombudsman Program.
Read the guide →At a glance
| New York's rules | New York's rules do not | |
|---|---|---|
| Assisted living | Build on an adult home or enriched housing license | Offer one generic assisted living license |
| Dementia | Require SNALR certification with an approved plan | Set a single statewide dementia ratio |
| Inspections | Call for unannounced visits at least yearly | Give residences star ratings |
| Nursing homes | Require 3.5 nursing hours per resident a day | Allow discharge for switching to Medicaid |
