“Memory Care” Is Not a License in New York. Ask for the SNALR Number Instead.

By Long Island Senior Advisor Care Team · October 31, 2026

The five words that decide whether it is really a memory care unit

You tour a Long Island assisted living community on a Tuesday afternoon. Somebody walks you down a corridor with a keypad at the end, points out the enclosed garden, the smaller dining room, the activity board, and says the words you came to hear: we do memory care here. The brochure calls it a neighborhood, or a suite, or a program named after a bird. You leave feeling better than you did when you arrived.

Here is what nobody said on the tour. In New York, “memory care” is not a license, not a license class, and not a thing the state issues. The certification that actually authorizes a community to run a dementia program is called a Special Needs Assisted Living Residence certificate — SNALR — and the state regulation that creates it contains five words that decide everything about whether your parent can live in that corridor you just walked:

“either all or a portion.” The exact sentence, from 10 NYCRR 1001.5(c)(1), reads: “Assisted living residences may apply for enhanced and/or special needs assisted living certification for either all or a portion of their licensed beds.” A portion. Which means a community with 155 licensed beds can hold special needs certification on 32 of them and legally, accurately describe itself as offering memory care — while 123 of its beds are not certified for it at all.

That is not a loophole. It is the design. But it means the only question that gets you a real answer on a tour is numerical, and most families never ask it: how many of your beds carry the SNALR certificate, and is one of them open? Everything below is how to get that number before you sign anything, using records New York publishes for free.

SNALR is a certificate, and the Department says you cannot advertise a dementia unit without it

New York's Department of Health publishes a guidance document for operators called the Special Needs Assisted Living Plan Overview and Requirements. Its opening line states the purpose plainly: to guide operators “in developing proposals to serve persons with dementia in special needs assisted living residences (SNALRs).” Dementia is the population the certificate exists for — the Department says so in its own operator guidance, even though the regulation's definition uses the broader phrase “persons with special needs.”

The same document contains a sentence worth reading twice: “No adult home, enriched housing program, or ALR may advertise the operation of a dementia unit unless such program has been approved by the Department and the residence issued a special needs assisted living residence certificate.” Approved, then issued. Not described, not branded — approved by the state after it reviews a written plan.

Marketing language and certification are different things, and the gap between them is where families get hurt. A community can have excellent dementia-aware staff, a genuinely secure layout and a lovely activity program without holding the certificate. It can also hold the certificate on a small fraction of its beds and advertise accordingly. Neither situation is dishonest. Both are invisible unless you look up the certificate. Our page on New York's memory care certification covers how SNALR sits on top of the underlying license.

New York layers its licenses rather than issuing one flat assisted living permit, which is why this gets confusing. The base layer is an Adult Care Facility license — Adult Home, Enriched Housing Program or Residence for Adults, under 18 NYCRR Parts 487, 488 and 490. On top of that, an operator may be licensed as an Assisted Living Residence (ALR) under 10 NYCRR Part 1001. Only then can it add EALR (enhanced) or SNALR (special needs) certification. The regulation is explicit at 1001.5(b): “In order to operate an assisted living residence, an operator must be licensed as an adult home or enriched housing program.” Nursing homes are a separate world entirely, licensed under 10 NYCRR Part 415. There is no Type A / Type B split here the way there is in some states, and no single certificate that covers everything.

The practical consequence of the layering: a base-licensed Adult Home with no ALR license cannot hold SNALR certification at all, because SNALR is an add-on to a license it does not have. Across Nassau and Suffolk, that describes a meaningful share of the beds families tour. Our licensing framework page walks the full ladder.

What the Long Island numbers actually look like

New York publishes the underlying data. The state's facility roster and its Adult Care Facility Quarterly Statistical Information report together give an operating certificate number, a license type, a total licensed capacity and separate certified bed counts for ALR, EALR, SNALR and the Medicaid-funded Assisted Living Program for every adult care facility in the state. Pulled for Nassau and Suffolk at the 2026 second-quarter reporting period, the picture looks like this.

Read the bottom row against the second one. Of 11,685 licensed adult care facility beds across both counties, 2,123 carry special needs certification — about 18 percent. Fifty-three of the 105 operating certificates carry any SNALR beds at all; the other 52 carry none. Thirty-eight of the 105 hold no ALR license whatsoever, which puts SNALR out of reach for them by regulation rather than by choice.

The county split is the part that surprises people. Suffolk has 1,262 more adult care facility beds than Nassau overall, but only 21 more certified special needs beds — 1,072 against 1,051. Suffolk covers far more ground. If your parent lives in Riverhead or Mastic and you are looking for a certified dementia bed, you are drawing from almost exactly the same pool as a family in Garden City, spread across far more miles.

One more number, because it reframes what a “memory care community” usually is. Of those 53 certificates carrying SNALR beds, only three have special needs certification on every licensed bed they hold: Artis Senior Living of Commack (64 beds), Esplanade of Woodmere (76), and The Bristal at Lake Success (110). Those are dedicated buildings. The other 50 are general assisted living communities with a certified portion inside them — which is a perfectly legitimate model, and a completely different thing to be shopping for.

Seven Long Island buildings hold two state licenses, and the memory care is on only one

Here is the finding that should change how you read an address. Across the 105 Long Island operating certificates, there are only 98 distinct street addresses. Seven buildings hold two separate operating certificates each — two different licenses, two different certificate numbers, two different certified bed counts, one front door.

That is entirely lawful. An operator can hold an Adult Home certificate and an Enriched Housing Program certificate at the same site, and 1001.5(b)(1) expressly allows an ALR application to be filed simultaneously with the underlying license application. What matters to a family is the pattern inside those seven buildings. In every single one, the special needs beds sit on exactly one of the two certificates, and the other certificate has none.

Look at North Hills. Sixty beds on the Adult Home certificate, 32 of them special needs certified; 140 beds on the Enriched Housing certificate, none. A family touring that building hears one brand name, sees one lobby, and is quoted one set of prices. Whether the room they are offered sits on 400-F-310 or 400-S-309 determines whether the state has authorized dementia care in it. Same for the Gurwin residence in Commack: 14 certified beds out of 265 across the two certificates.

Maple Pointe in Rockville Centre adds a second wrinkle. Its Enriched Housing certificate carries 36 Assisted Living Program beds — the Medicaid-funded program under 18 NYCRR Part 494 — while the 45 special needs beds sit on the Adult Home certificate. So at one address, the Medicaid-payable beds and the dementia-certified beds are on different licenses. If you need both at once, that building may not be able to give you both, and the answer depends on paperwork no one will volunteer. We explain the program itself in our walkthrough of New York's Assisted Living Program.

Why special needs beds cannot move, and enhanced beds can

The regulation treats the two certifications very differently once they exist, and the difference is physical. 10 NYCRR 1001.5(c)(2): “Certified special needs assisted living beds must be located in a fixed area within a building. They cannot ‘float’, i.e. be designated within the building as the need arises.”

Fixed means fixed. The certified beds are a specific set of rooms in a specific part of the building, approved by the Department as part of the operator's special needs plan. If all 32 are occupied, the thirty-third resident with dementia cannot be accommodated by relabeling a room down the hall. That is what makes the bed count a hard constraint rather than a soft target, and why “we'll find a way to make it work” is not something the facility can actually promise you on a Tuesday afternoon tour.

Enhanced beds are the opposite. 1001.5(c)(3) says enhanced assisted living beds “may float,” subject to a ceiling: the number designated and the number of residents receiving enhanced services “may not exceed the number of such beds on the facility's operating certificate.” So an enhanced bed is a count, and a special needs bed is a place.

There is one narrow escape valve, and it is worth knowing because it is routinely misdescribed as flexibility. Under 1001.5(k), an operator already certified for enhanced or special needs assisted living may apply on an expedited basis for Department approval of up to five additional beds to serve current residents. Current residents. It is a mechanism for keeping someone who is already living there as their needs change — not a way to admit your parent into a full unit next week.

This is the single most useful thing to carry into a tour. Ask where the certified area is, and walk it. Ask how many of its beds are occupied today. Ask what the wait has looked like over the past year. A community that holds the certificate will know all three answers immediately, because the state made them write it down.

The other certificate families mistake for memory care

Dementia rarely arrives alone. It arrives alongside a walking problem, or incontinence, or a transfer that now takes two people. That is where the enhanced certificate comes in, and where families most often end up with the wrong one.

EALR is defined at 1001.2(o) as a certificate authorizing a residence “to provide aging in place by retaining residents who desire to continue to age in place,” including those who are chronically chairfast and unable to transfer or who chronically need one or more people to help them transfer; who chronically need physical assistance to walk; who chronically need physical assistance to climb or descend stairs; who are dependent on medical equipment and need more than intermittent or occasional assistance from medical personnel; or who have chronic unmanaged urinary or bowel incontinence.

Read that list as a checklist against your own parent, because 1001.2(m) is blunt about what happens without it: a residence that does not hold an enhanced certificate “shall not be deemed able to accommodate a resident's needs” if the resident requires enhanced assisted living or round-the-clock skilled nursing. That is not a judgment call the facility gets to make generously. It is a regulatory ceiling.

And the two certificates do not substitute for each other. The Department's own guidance states that an operator running a special needs program who wants to provide aging-in-place services, or retain residents who need enhanced services, “must be approved for both Special Needs and Enhanced services.” Both. So the real question for a parent with mid-stage dementia who also needs help transferring is not “do you do memory care” but “do you hold both SNALR and EALR, and are the beds the same beds?”

Look back at the Long Island table and you can see how often they are not. Across both counties there are 4,147 enhanced-certified beds and 2,123 special needs beds. The Bristal at Massapequa's Adult Home certificate carries 40 of each; its Enriched Housing certificate carries 15 enhanced and zero special needs. Brandywine at Huntington Terrace in Melville carries 54 enhanced and 34 special needs on one certificate, and 110 enhanced with no special needs on the other. These are not errors. They are two different products in one building.

What New York actually requires inside a certified dementia program

If a community does hold the certificate, the Department's guidance describes what it signed up for — and some of it will surprise you, in both directions. The clearest surprise: “Fully locked units are prohibited.” If a Long Island community tells you its memory care wing is locked, that is worth a follow-up question, because what the guidance contemplates instead is a delayed-egress system on exit doors, releasing in not more than 15 seconds, with a sign reading “PUSH UNTIL ALARM SOUNDS. DOOR CAN BE OPENED IN 15 [30] SECONDS.”

On the physical plant, the guidance is specific in ways that are easy to verify with your own eyes on a tour. Windows are to be fitted with mechanisms limiting the opening to a maximum of four inches. Outdoor space is to have fencing or barriers designed so as not to be easily climbable, no less than 72 inches high. In a Type 5 building taller than one story, areas designated for the care of people with Alzheimer's disease, dementia or memory impairment “must be restricted to the grade level and one level above grade level.” The unit should be self-contained enough that staff and visitors are not routinely walking through it to get somewhere else.

On staffing, the guidance sets expectations rather than a hard floor: direct care staffing in a ratio of one staff member for every six to eight residents during day and evening shifts, and one for every 12 to 15 at night, unless the operator demonstrates otherwise — with licensed RN or LPN personnel on staff on both day and evening shifts and available for consultation at other times. It also calls for a minimum of half an hour of case management per resident per week, half an hour of activities planning per resident per week, and activities planned and available for each resident for a minimum of 10 hours per week.

Two caveats you should hold onto, because they matter if you ever need to push. First, much of this document is written in “should” and “recommended,” not “must” — it is guidance on what a proposal needs to address, and the binding language lives in the regulations. Second, the regulation does impose a real admission and retention standard: an operator shall admit, retain and care for only those individuals whose needs can be met by the facility's program and who do not require services beyond what the operator is permitted to provide. Reassessment runs at least every six months.

What this adds up to for a tour: ask to see the approved special needs plan. It is a real document, submitted to the Department and approved, and it has to specify the number of beds in the program, the staffing schedule at full capacity, the training program, the resident profile and pre-admission screening, and the evacuation plan. A community that holds the certificate has that document. Asking for it is a reasonable request, and how they respond tells you something either way.

Look it up before the tour, then ask four questions

You do not need to take anyone's word for any of this. New York publishes it at profiles.health.ny.gov/acf, free, no account. The search page lists providers by type, and the type names are the certificate names: Adult Home (AH), Enriched Housing Program (EHP), Assisted Living Residence (ALR), Enhanced Assisted Living Residence (EALR), Special Needs Assisted Living Residence (SNALR), Assisted Living Program (ALP). Searching by SNALR gives you the Long Island communities that actually hold it.

An individual facility's page carries a Bed Types table with a separate line for each certification, and an Administrative section with the field “Operating Certificate Number (DOH license number for this facility).” Pull up Sunrise of Smithtown as a worked example and you will see certificate 700-F-927, operated by SZR New York LH, Inc., with 104 beds of overall capacity, 104 certified as ALR, 104 as EALR — and 43 as SNALR. Forty-three of 104. That is the number you are looking for, and it took about ninety seconds to find. Our guide to checking a facility's record covers the rest of the lookup, including the nursing home tool, which is separate.

Then, on the tour, four questions in this order. One: what is your operating certificate number, and do you hold more than one at this address? Two: how many of your beds are SNALR certified, and is the room you are offering me one of them? Three: do you also hold EALR, and does it cover the same beds? Four: what in your approved special needs plan would require my parent to move out, and where would they go? That last one is the admission and retention standard restated as a question, and it is the one that saves families a second move eighteen months later.

On cost, be careful about what anyone quotes you as a local number. CareScout's 2025 Cost of Care Survey publishes a New York state assisted living median of $7,110 a month, and no primary source publishes a Nassau, Suffolk or Long Island-specific figure. There is no published memory care median anywhere — it is not surveyed as a category. Long Island pricing plausibly runs at or above the state median, but a specific local memory care number quoted to you is a quote, not a benchmark. Compare it against our cost page and against the in-home alternative.

If something about a certified unit does not look right once your parent is living there, the complaint path runs through NYSDOH's Metropolitan Area Regional Office – Long Island at 631-851-3098. For an advocate who can sit in on a care conference with you, Long Island splits into two separate Long-Term Care Ombudsman regions: Nassau at 516-466-9718, Suffolk at 631-470-6755. And for help assembling the whole picture before you tour, each county runs its own Office for the Aging — Nassau at 516-227-8900, Suffolk at 631-853-8200. They are genuinely separate agencies; the county line decides which one answers, as we covered in our piece on the county line.

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