How Connecticut licenses assisted living in Fairfield County

Who licenses assisted living in Stamford and the rest of Fairfield County?

The Connecticut Department of Public Health licenses the assisted living services agency (ALSA) that delivers personal care and nursing oversight; the apartment community itself is a managed residential community (MRC) that registers with DPH and must contract with a licensed ALSA.

This split is the single most important thing to understand about assisted living in Connecticut. A community on High Ridge Road in Stamford or Route 7 in Wilton may look like one business to a family, but legally it is two: the MRC that owns or runs the building and provides housing and core services, and the ALSA that sends aides and nurses into residents' apartments. Sometimes the same company holds both roles, sometimes not. Neither the towns nor any county body licenses care; Fairfield County has had no county government since 1960.

The state auditors put it bluntly in their 2023 follow-up report: Connecticut is the only state that does not fully license assisted living facilities. That is why the license number families should verify is the ALSA's.

What does an assisted living services agency do, and what may it not do?

An ALSA provides assisted living services, meaning help with daily activities, medication administration and nursing oversight, to MRC residents whose conditions are chronic and stable, which can include medical, physical, mental health and cognitive conditions (Regs. Conn. State Agencies 19-13-D105(e)).

Its nurse handles admissions, writes each resident's service program, reassesses residents at least every 120 days, coordinates care, plans transitions, makes referrals, provides 24-hour nursing oversight and administers medications (19-13-D105(h)). Assisted living aides work under a licensed nurse's supervision, helping with personal care, exercise and mobility and routine household tasks, and with limits may supervise residents who take their own medications (19-13-D105(i)).

An ALSA is not a nursing home. When a resident's needs stop being chronic and stable, the agency may arrange ancillary services, but a resident who needs continuous skilled nursing will usually have to move. An ALSA's admission and discharge criteria must be written down and may not unreasonably exclude people whose needs it can meet.

What staffing does Connecticut require from an ALSA?

Connecticut requires each ALSA to name a registered nurse as assisted living supervisor with a second RN as backup, to keep an RN on call 24 hours a day, and to provide at least 10 hours a week of licensed nurse time for every 10 or fewer full-time-equivalent aides, but it sets no staff-to-resident ratio.

• An assisted living supervisor who is a registered nurse, plus a second RN to cover for the supervisor (19-13-D105(j))
• At least 10 hours a week of licensed nurse time for each 10 or fewer full-time-equivalent aides
• A registered nurse on call 24 hours a day
• No required staff-to-resident ratio
• ALSAs providing dementia special care unit services must have adequate staff and file staffing plans with DPH (CGS 19a-564)

Because there is no ratio, two communities with the same number of residents can staff very differently. The useful questions are concrete: how many aides are awake in the building overnight, how long the supervisor has been in the job, and whether the nurse on call is reached directly or through an answering service.

How many assisted living agencies are licensed in Fairfield County?

DPH's eLicense export (retrieved October 31, 2026) shows 43 active assisted living services agency licenses in Fairfield County's 23 towns, most of them in Stamford (7), Darien (3) and Newtown (3).

Statewide, DPH reports 123 licensed ALSAs serving 142 MRCs, and the 2023 auditors counted nearly 8,000 assisted living units. About 60% of Connecticut communities belong to national or regional chains and 18% are independently owned. Our assisted living roster lists every active Fairfield County license with its issue date, expiration date and any earlier licenses recorded at the same address.

What does DPH publish about assisted living, and what doesn't it?

DPH publishes each ALSA's license number, status, licensee, address and issue and expiration dates through the state eLicense system and CT Open Data, but it does not post ALSA inspection reports online or publish a list of approved dementia special care units.

The auditors' 2023 follow-up found that DPH does not always report inspection and complaint results promptly, that its ALSA licensure inspection procedures dated from 1995 and were being updated, and that DPH does not tell MRCs the results of the ALSA inspections in their buildings. They recommended a searchable public resource that would include ALSA inspection reports. Until that exists, families should ask each agency for its most recent DPH inspection letter and plan of correction. See how to check a license yourself.