By Robert Cassano · July 20, 2026
Staten Island's three informal regions have very different hospital access, transit, and facility concentration. Here is what that actually means for a family starting a local search.
Staten Island is one county, but not one neighborhood
Richmond County is New York City's smallest borough by population, and it is also the only borough that is its own county -- one coverage area, one Area Agency on Aging (NYC Aging/DFTA), one NY Connects access point (CASC), one ombudsman region (CIDNY). But it is not one neighborhood. Staten Islanders informally divide the island into North Shore, Mid-Island, and South Shore, and those three areas differ meaningfully in hospital access, transit, and where senior care facilities actually cluster.
None of these are official government boundaries -- they are how residents themselves describe the island, and they are useful shorthand for a family trying to orient a search geographically rather than starting from a blank map.
North Shore: the civic core, and the busiest hospital access
The North Shore includes St. George, Tompkinsville, Stapleton, West Brighton, and Port Richmond. St. George is Staten Island's civic and transit seat -- the Staten Island Ferry Terminal, Borough Hall, and the Richmond County Courthouse are all here, which is also where families end up dealing with courts and elder-law attorneys when arranging care. Tompkinsville and West Brighton sit close to Richmond University Medical Center (RUMC), at 355 Bard Avenue, giving North Shore families relatively fast access to that hospital system.
The North Shore also has the heaviest concentration of the verified facilities in this site's directory: communities in St. George, Stapleton, and West Brighton together account for roughly two out of every five facilities we track, including a mix of assisted living, memory care, and skilled nursing options. For a family whose parent lives in or near St. George, Tompkinsville, or West Brighton, a genuinely local option is more often realistic than families elsewhere on the island might assume.
Mid-Island: the geographic middle, and where the largest single cluster sits
Mid-Island includes Willowbrook, Todt Hill, and New Springville. Todt Hill is the highest point on the Eastern Seaboard south of Maine -- an affluent, low-density neighborhood near Staten Island University Hospital's North Campus at 475 Seaview Avenue. New Springville is centered on the Staten Island Mall and functions as a central hub for the middle of the island. Willowbrook is home to the College of Staten Island and Willowbrook Park.
Willowbrook specifically has the single largest concentration of verified facilities on the island in this site's directory -- several skilled nursing and rehabilitation communities, plus assisted living and independent living options, clustered close together. Combined with Todt Hill and New Springville, Mid-Island accounts for roughly as many facilities as the entire North Shore, making it a genuinely strong starting point for a facility search regardless of where on the island a family's parent currently lives.
South Shore: the fastest-growing area, and the thinnest facility concentration
South Shore includes Great Kills, Eltingville, Annadale, Prince's Bay, and Tottenville. Prince's Bay is home to Staten Island University Hospital's South Campus, commonly cited at 375 Seguine Avenue -- giving this end of the island its own major hospital access point, separate from the North Campus near Todt Hill. Great Kills has its own Staten Island Railway station and Great Kills Park, part of the Gateway National Recreation Area. Tottenville, at the island's southernmost tip, sits at the end of the Staten Island Railway line.
Here is the honest gap worth stating plainly: none of the verified facilities in this site's own directory are located in Great Kills, Eltingville, Annadale, Prince's Bay, or Tottenville. That does not mean no senior care options exist in the South Shore -- it means this site has not yet independently verified a facility there against the operator's own website, the same standard applied everywhere else in the directory. A South Shore family should expect to look slightly further north for a verified facility, or should ask us directly if a specific South Shore community should be added to our research queue.
Getting around: the Staten Island Railway and the ferry
The Staten Island Railway (SIR) runs the length of the island, from the St. George Terminal on the North Shore down through Mid-Island and the East Shore to Tottenville on the South Shore -- with stations in Stapleton, Clifton, Great Kills, Eltingville, Annadale, and Tottenville, among others. For a family coordinating visits without a car, or for a home care worker commuting to a client's home, proximity to an SIR station is a genuinely practical factor, not a minor convenience.
The Staten Island Ferry, free and running to and from Manhattan, only serves St. George -- meaning a family coordinating with an out-of-borough sibling, an elder law attorney based in Manhattan, or a specialist appointment off the island will generally find North Shore logistics somewhat simpler than South Shore ones, purely on transit grounds.
Hospital discharge planning differs by region too
Which hospital a parent was admitted to shapes where a family should start looking for post-discharge care. A Richmond University Medical Center discharge points most naturally toward North Shore options, given proximity. A discharge from Staten Island University Hospital's North Campus near Todt Hill points toward Mid-Island options. A discharge from SIUH's South Campus in Prince's Bay leaves a family in the position described above -- searching from a South Shore starting point where this site's verified directory currently has the thinnest coverage, which may mean widening the search radius toward Mid-Island rather than assuming a nearby option exists.
None of this should override the more important factors in a real search -- verified licensing, inspection history, and whether a specific community can actually meet a parent's assessed care level. But geography affects how often family can realistically visit, and that is worth weighing honestly alongside the clinical fit.
Todt Hill: the single highest point, and a quiet Mid-Island pocket
Todt Hill deserves a specific mention beyond its role as a Mid-Island hub. As the highest point on the Eastern Seaboard south of Maine, it is a low-density, largely residential area, and Eger Health Care and Rehabilitation Center -- which also offers hospice care alongside its skilled nursing services -- sits here, close to Staten Island University Hospital's North Campus. For a family whose parent was hospitalized at SIUH North and is exploring both rehabilitation and end-of-life care options in the same search, Todt Hill's proximity to that hospital is a genuinely practical advantage.
A few named examples, region by region
On the North Shore, The Veranda Assisted Living and Silver Lake Specialized Care Center both sit in West Brighton, while Verrazano Nursing and Post-Acute Center and Staten Island Care Center are in St. George itself -- meaning a North Shore family can often find both an assisted-living-style option and a skilled nursing option within the same few square miles.
In Mid-Island, Willowbrook alone is home to The Brielle at Seaview, Clove Lakes Health Care and Rehabilitation, NYC Health + Hospitals/Sea View, and Park Lane at Sea View -- independent living, assisted living, memory care and skilled nursing all within the same neighborhood. Todt Hill and New Springville each add one more nearby option. For the East Shore, Dongan Hills and New Dorp round out the picture with Carmel Richmond Healthcare and Rehabilitation, Sunrise of Staten Island, and Sunrise of New Dorp.
One county, one set of resources, three different starting points
Because Richmond County is Staten Island's only coverage area, every family on the island -- North Shore, Mid-Island, or South Shore -- reaches the same NY Connects access point (CASC, (718) 489-3954), the same NYC Aging (DFTA) Area Agency on Aging, the same CIDNY ombudsman region, and the same NYC HRA Adult Protective Services borough office. Where a family starts geographically changes which facilities are realistically nearby; it does not change which local support systems are available to help sort through the options.
