Assisted Living
Adult Home operators and Enriched Housing operators are eligible to be licensed by the New York State Department of Health to provide additional levels of care as Assisted Living operators. Assisted Living service and care may be paid for with private resources or, for income-eligible residents, residential services (rent, housekeeping, meals, transportation) are eligible for funding through the federal and state Supplemental Security Income Programs. There are four levels of assisted living in New York:
- Basic Assisted Living: Operators may provide or arrange for housing, supportive services, case management, medication management, monitoring (24-hour response by on-site staff for urgent or emergency needs), supervision, personal care, and health-related care to adult residents. All housing, services, and care must be coordinated and provided according to each resident's Individualized Service Plan, and the plan must be fully described in a written residency agreement and in a consumer disclosure document. A resident who requires intermittent short-term skilled nursing care can remain in an Assisted Living facility, but a facility cannot accommodate residents who require 24-hour skilled nursing care or prolonged chronic nursing care. Housing, services, and care provided by the facility are included in one monthly charge, and charges may be paid with private resources or publicly subsidized through the Supplemental Security Income Program.
- Enhanced Assisted Living: An operator licensed to provide Basic Assisted Living is eligible to be certified by the New York State Health Department to provide Enhanced Assisted Living. This certificate allows the operator to provide the housing, services, and care provided in Basic Assisted Living, as well as additional levels of services and care for residents who are chair-fast and unable to transfer; who chronically require assistance to transfer, walk, or climb stairs; who are dependent upon medical equipment; who require more than intermittent assistance from medical personnel; or who have chronic and unmanaged incontinence. Monthly charges may be paid with private resources or publicly subsidized through the Supplemental Security Income Program. An Enhanced Assisted Living facility cannot accommodate residents who require 24-hour skilled nursing care. With agreement by the resident's physician and the facility operator, a resident requiring 24-hour skilled nursing care or medical care may privately hire appropriate nursing, medical, or hospice staff to meet increased needs.
- Special Needs Assisted Living: An operator licensed to provide Basic Assisted Living is eligible to be certified by the New York State Health Department to provide Special Needs Assisted Living. This certificate allows the facility to provide the housing, services, and care provided in Basic Assisted Living, as well as the specialized services and environmental modifications appropriate for serving residents with special needs, including those with Alzheimer's and other dementia conditions. The operator must demonstrate appropriate staffing levels, staff training and qualifications, pertinent work experience, professional affiliations, and special characteristics relevant to serving residents with special needs. Monthly charges may be paid with private resources or publicly subsidized through the Supplemental Security Income Program.
- Assisted Living Program (ALP): Adult Home operators and Enriched Housing operators are eligible to be licensed by the New York State Department of Health to provide, housing, supportive services, personal care, health-related care, physical/speech/occupational therapies, and intermittent skilled nursing care to residents who, through a formal assessment process, are deemed to be nursing-home-eligible (that is, eligible for the level of care provided in a Skilled Nursing Facility). However, residents requiring 24-hour skilled nursing care are not eligible for the ALP Program. Rent and all services and care may be paid for with private resources or, for residents who are income-eligible, rent and residential services may be funded through the federal and state Supplemental Security Program, and personal care and health-related services may be funded through the Medicaid Program.
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