01/22/2026
UNDERSTANDING SENIOR HOUSING, ASSISTED LIVING, AND LONG-TERM CARE IN NEW YORK STATE
Navigating senior housing and care options in New York can feel overwhelming for families suddenly faced with deciding where an older loved one should live and how their care will be paid for. Today, older adults have far more choices than the traditional assumption of eventually entering a “nursing home.” New York offers a continuum of settings tailored to different levels of independence, support, and medical need. These options fall into four major categories:
1. Independent Senior Housing
2. Adult Care Facilities and Assisted Living Residences
3. The Assisted Living Program (ALP)
4. Skilled Nursing Facilities (Long-Term Care/Nursing Homes)
Independent senior housing—often called 55+ or senior apartments—is designed for adults who can live on their own but value accessibility, amenities, and community. These communities do not provide hands-on care. Payment is typically private, though some apartments are income-restricted or subsidized. Medicare and Medicaid do not cover rent in this setting.
When individuals begin to need daily support, they may move to an Adult Care Facility or Assisted Living Residence. These settings offer meals, activities, supervision, and personal care such as bathing, dressing, and medication assistance. New York licenses assisted living closely, with varying levels of certification based on the care a residence can provide. Most residents pay privately unless they qualify for limited assistance, and traditional Medicaid does not fully pay for standard assisted living, which often surprises families.
The Assisted Living Program (ALP) is a unique New York model that blends assisted living with home-care services for individuals who meet nursing home criteria but do not require 24-hour skilled care. In ALP, Medicaid may cover care services, while residents use income or Supplemental Security Income for room and board. ALP availability is limited, and not all assisted living communities offer it.
At the highest level of care are Skilled Nursing Facilities, or nursing homes. These provide 24-hour nursing oversight, medical management, and rehabilitation services for individuals whose medical or cognitive needs can no longer be supported in the community. Medicare may cover short-term rehabilitation after a hospital stay, but it does not pay for long-term custodial care. Many residents start as private pay and then transition to Medicaid after spending down assets.
Understanding the differences among these settings helps families plan before a crisis occurs. Health needs, safety, personal preference, and financial resources all influence the right choice. Because eligibility requirements and payment rules differ by county and can change over time, contacting local resources—such as NY Connects, Offices for the Aging, elder law attorneys, or healthcare professionals—can be an important first step.
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Julie Chetney has more than 30 years of experience in senior housing and adult care, with a strong background in assisted living operations and dementia services. She currently serves as the Vice President of Admissions and Marketing for Elemental Management Group, which oversees multiple senior living communities and local programs across the region, including The Maples, The Gardens, and Morningstar Residential Care Community.
Name: Julie Chetney
Organization: Elemental Management Group
Phone: 315-592-8622
Email: jchetney@elementalmgt.com
