New York Department of Health (DOH) regulations provide that an adult home may not admit additional residents with serious mental illness if it has a capacity of 80 or more beds and its resident population is over 25% persons with serious mental illness.  In Oceanview Home for Adults, Inc. v. Zucker, the New York Court of Appeals held that these regulations do not facially discriminate against persons with disabilities. 

In 1999, the United State Supreme Court held that the Americans with Disabilities Act imposes an affirmative obligation on states to prevent the segregation of persons with disabilities in institutionalized settings that are more restrictive than appropriate for their needs.  In October of 2012, New York’s Office of Mental Health (OMH) issued two Clinical Advisories stating that certain large adult homes provided housing experiences for persons with serious mental illness that were not clinically appropriate to their needs and were not conducive to their rehabilitation or recovery.  Shortly thereafter, DOH issued the challenged regulations.