Who licenses assisted living in Poughkeepsie, Newburgh and Middletown

Who licenses assisted living in Dutchess and Orange counties?

The New York State Department of Health licenses and inspects every adult care facility in the two counties; neither county, nor any city or town from Beacon to Port Jervis, issues a care license of its own, and the state roster assigns these buildings to the department's Metropolitan Area Regional Office.

So a search for “assisted living near Poughkeepsie” is really a search of one state list. New York sorts that list into adult homes (18 NYCRR Part 487), enriched housing programs (Part 488) and the rare residence for adults (Part 490). Town governments still control zoning and building permits, which is why a new residence goes through a planning board, but once the doors open the only care regulator is Albany.

What is the difference between the base license and the extras?

The base license, adult home or enriched housing, sets the floor: room, meals, housekeeping, supervision and personal care; extras such as Assisted Living Residence, enhanced, special needs or Assisted Living Program beds are added on top, approved one at a time and counted bed by bed in a quarterly state report.

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. A building's marketing name tells you nothing about which extras it holds. The quarterly capacity numbers do, and they are the backbone of our Dutchess and Orange roster.

Source: NYSDOH Adult Care Facility Quarterly Statistical Information Report, 2026 Q2.

Why does the Mid-Hudson have so many Assisted Living Program beds?

Because several of the region's larger residences, in Beacon, Middletown, Poughkeepsie, Port Jervis and Tuxedo among them, were built or converted around Medicaid's Assisted Living Program, which pays for care services in approved beds for people who would otherwise qualify for a nursing home.

The 2026 Q2 capacity report shows 9 of the 18 licensed residences in Dutchess and Orange holding Assisted Living Program beds, 931 of the 1,664 certified beds: Hedgewood Assisted Living (192), Promenade at Middletown (131), The Eliot at Erie Station ALP (120), The Sentinel of Port Jervis (109), Dutchess Care (92), Braemar Living at Wallkill (88), The Avalon Assisted Living and Wellness Center (75), Hyde Park Assisted Living Facility, Inc. (66), Promenade at Tuxedo Place (58). That makes the two counties unusual: a family with modest savings has more realistic assisted living choices here than in many suburban markets, while a family looking for a private-pay dementia unit has fewer. The Assisted Living Program guide explains eligibility.

How often does the state inspect a residence in the Hudson Valley?

Social Services Law 461-a requires at least one unannounced inspection of each adult care facility a year, stretched to every 18 months only for facilities holding the department's highest rating, and complaint investigations come on top of that schedule.

Every report lands on NYS Health Profiles with its date, type, violation count and the regulation topics cited, kept for a rolling four years. Across the two counties the typical residence shows 4 reports and 13 violations in that window. Our facility pages copy each building's list so you can read it beside its bed counts.