1. (a) Assisted living, assisted living residence or ALR means an entity which provides or arranges for housing, on-site monitoring, and personal care services and/or home care services (either directly or indirectly), in a home-like setting to five or more adult residents unrelated to the assisted living provider. An applicant for licensure as assisted living that has been approved in accordance with the provisions of article 46-B of the Public Health Law and this Part must also provide daily food service, 24-hour on-site monitoring, case management services, and the development of an individualized service plan for each resident. An operator of assisted living shall provide each resident with considerate and respectful care and promote the resident's dignity, autonomy, independence and privacy in the least restrictive and most homelike setting commensurate with the resident's preferences and physical and mental status. Assisted living, enhanced assisted living and special needs assisted living shall not include:

   1. (1) residential health care facilities or general hospitals licensed under article 28 of the Public Health Law;
   2. (2) continuing care retirement communities which possess a certificate of authority pursuant to article 46 of this chapter, unless the continuing care retirement is operating an assisted living residence as defined under this section;
   3. (3) residential services for persons that are provided under a license pursuant to article 16, 19, 31 or 32 of the Mental Hygiene Law or other residential services primarily funded by or primarily under the jurisdiction of the Office of Mental Health;
   4. (4) naturally occurring retirement communities, as defined in section 209 of the Elder Law;
   5. (5) assisted living programs approved by the department pursuant to section 461-l of the Social Services Law;
   6. (6) public or publicly assisted multi-family housing projects administered or regulated by the U.S. Department of Housing and Urban Development or the Division of Housing and Community Renewal or funded through the Homeless Housing Assistance Program that were designed for the elderly or persons with disabilities, or homeless persons, provided such entities do not provide or arrange for home care, 24-hour supervision or both, beyond providing periodic coordination or arrangement of such services for residents at no charge to residents. Except, however, such entities that are in receipt of grants for conversion of elderly housing to assisted living facilities pursuant to section 1701-q-2 of the United States Code shall be licensed as an assisted living residence pursuant to article 46-B of the Public Health Law and this Part;
   7. (7) an operating demonstration as such term is defined in paragraph (d) of subdivision (1) of section 4403-f of the Public Health Law;
   8. (8) hospice and hospice residences as defined pursuant to section 4002 of the Public Health Law;
   9. (9) an adult care facility as defined in subdivision (21) of section 2 of the Social Services Law that is not utilizing the term assisted living (or any derivation thereof) or is not required to obtain licensure as assisted living or certification as enhanced assisted living or special needs assisted living; and

   10. (10) independent senior housing, shelters or residences for adults.

       1. (i) For purposes of determining the necessity to become licensed as an assisted living residence, the term independent senior housing shall mean a housing setting serving seniors in which:

          1. (a) no individual or entity provides, arranges for or coordinates long-term housing, on-site monitoring and either personal care or home care services for five or more residents of such housing setting unrelated to the housing provider; and in which
          2. (b) neither the housing setting nor other services provided in such setting are advertised or marketed to the public as assisted living, assistive living or any similar term.
       2. (ii) For purposes of determining the necessity to become licensed as an adult home, enriched housing program or residence for adults, the term independent senior housing shall mean a housing setting serving seniors in which no individual or entity provides, arranges for or coordinates long-term housing and either personal care or supervision for five or more residents of such housing setting unrelated to the housing provider.
       3. (iii) A resident of independent senior housing shall have the ability to obtain, personally and directly, personal care services or home care services from a home care services agency licensed or certified pursuant to article 36 of the Public Health Law.

       4. (iv) The provision, arrangement for or coordination of one or more of the following services shall not, in and of itself, require licensure as an adult care facility or assisted living residence: room, board, laundry, housekeeping, information and referral, security, concierge-like services, or case management services, including assisting tenants with housing issues, providing information to tenants regarding services and activities available in the community and assisting tenants in contacting such services and activities, and contacting appropriate responders in urgent and emergency situations. Case management services in independent senior housing shall not include case management in any setting in which an entity:

          1. (a) provides, arranges for or coordinates housing, on-site monitoring and personal care services and/or home care services to five or more adults unrelated to provider; or
          2. (b) on a continual basis supervises or monitors the health status of five or more adults unrelated to the provider.
       5. (v) An individual or entity that provides housing and either personal care or supervision (either directly or indirectly) to persons unrelated to the operator shall be subject to licensure under the appropriate category as an adult care facility.
       6. (vi) Where a housing entity and a services entity are commonly owned or otherwise subject to the control of one or more entities or principals and work together to provide, arrange or coordinate housing and such services as are set forth in this subdivision or subdivision (b) of this section, such housing and services entities shall be subject to licensure under the appropriate category as an adult care facility and/or assisted living residence.

       7. (vii) Indicators that an entity or individual is providing or arranging for personal care services and/or home care services include, but are not limited to, provision or arrangement for the following:

          1. (a) initiation, implementation or overseeing of a schedule of personal care or home care visits for residents; or
          2. (b) overseeing of the provision of personal care, home care or monitoring services to residents; or
          3. (c) conducting initial and follow up health assessments regarding residents' health needs and functioning; or
          4. (d) having a written contract or otherwise providing a statement under which the entity or individual agrees to provide, arrange for or coordinate the services stated herein.
2. (b) Applicant means the entity which submits an assisted living licensure application with the department pursuant to article 46-B of the Public Health Law and this Part.
3. (c) Adult home means an adult home as defined by subdivision (25) of section 2 of the Social Services Law.
4. (d) Enriched housing program means an enriched housing program, as defined in subdivision (28) of section 2 of the Social Services Law.
5. (e) Assisted living operator or operator means a person, persons or an entity which has obtained the written approval of the department to operate an assisted living residence in accordance with article 46-B of the Public Health Law and this Part.
6. (f) Controlling person means any person who by reason of a direct or indirect ownership interest, whether of record or beneficial, has the ability, acting either alone or in concert with others with ownership interests, to direct or cause the direction of the management or policies of said corporation, partnership or other entity.
7. (g) Resident means an adult not related to the provider, who, pursuant to a residency agreement with a provider resides in an assisted living residence, enhanced assisted living residence, or special needs assisted living residence, as applicable.
8. (h) Resident's representative means a family member or other individual identified in the residency agreement required under section 4658 of the Public Health Law and this Part who is authorized by a resident to communicate with residence employees regarding the health, well-being, needs of and services provided to such resident and to assist the resident in obtaining needed services.
9. (i) Resident's legal representative means a person duly authorized under applicable State law to act on behalf of a resident. Such legal representative could include, but is not necessarily limited to, a court appointed guardian, an attorney in-fact under a durable power of attorney, an agent under a health care proxy or a representative payee, depending upon the action to be taken.
10. (j) Home care services means the services defined in subdivision (1) of section 3602 of the Public Health Law, as provided by a home care services agency which has been approved to operate pursuant to article 36 of such law.
11. (k) Individualized service plan or ISP means a written plan developed pursuant to section 4659 of the Public Health Law and this Part.
12. (l) Monitoring means an ability of the assisted living operator to respond to urgent or emergency needs or requests for assistance with appropriate staff, at any hour of any day or night of the week. Such monitoring must be provided on site.
13. (m) Aging in place means care and services at a facility which possesses an enhanced assisted living certificate which, to the extent practicable, within the scope of services set forth in the written residency agreement executed pursuant to section 4658 of the Public Health Law and this Part, accommodates a resident's changing needs and preferences in order to allow such resident to remain in the residence as long as the residence is able and authorized to accommodate the resident's current and changing needs. A residence that does not possess an enhanced assisted living certificate shall not be deemed able to accommodate a resident's needs if the resident requires or is in need of either enhanced assisted living or 24-hour skilled nursing care or medical care provided by facilities licensed pursuant to article 28 of the Public Health Law, or article 19, 31 or 32 of the Mental Hygiene Law.
14. (n) Enhanced assisted living or enhanced assisted living residence means the care or services provided pursuant to an enhanced assisted living certificate.

15. (o) Enhanced assisted living certificate means a certificate issued by the department which authorizes an assisted living residence to provide aging in place by retaining residents who desire to continue to age in place, including those who:

    1. (1) are chronically chairfast and unable to transfer, or chronically require the physical assistance of one or more persons to transfer;
    2. (2) chronically require the physical assistance of one or more persons in order to walk;
    3. (3) chronically require the physical assistance of one or more persons to climb or descend stairs;
    4. (4) are dependent on medical equipment and require more than intermittent or occasional assistance from medical personnel; or
    5. (5) have chronic unmanaged urinary or bowel incontinence.
16. (p) Enhanced assisted living resident means a resident who is provided care and services pursuant to an enhanced assisted living certificate.
17. (q) Special needs assisted living or special needs assisted living residence means the care and services provided pursuant to a special needs assisted living certificate.
18. (r) Special needs assisted living certificate means a certificate issued by the department which authorizes an assisted living residence to serve persons with special needs in accordance with a special needs plan approved by the department, pursuant to the requirements of this Part.
19. (s) Special needs assisted living resident means a resident who is provided services pursuant to a special needs assisted living certificate.
20. (t) Commissioner means the State Commissioner of Health.
21. (u) Department means the New York State Department of Health.

As used in this Part: