New York Residential Alzheimer’s Care (Memory Care): Rules, Costs & Financial Help

Legal Definition of Assisted Living/Memory Care in New York

In New York, assisted living and memory care residences are referred to as Adult Care Facilities (ACFs) and are licensed and regulated by the New York State Department of Health. ACFs in New York provide long-term, non-medical residential services to adults who are unable to live independently due to physical, mental or other limitations associated with age or other factors. ACF residents must not require the kind of continuous medical services that are normally associated with nursing homes, acute care hospitals, in-patient psychiatric facilities or any other health facilities.

There are three general categories for ACFs in New York:

• Adult Home (AH): A type of ACF that offers long-term residential care, room, board, housekeeping, personal care and supervision to five or more adults unrelated to the operator.
• Enriched Housing Program (EHP): A type of ACF that provides long-term residential care to five or more more adults (usually age 65 or older) in community-integrated settings that resemble independent housing units. These ACFs also provide or arrange for room, board, housekeeping, personal care and supervision.
• Residences for Adults: These types of ACFs provide housing and care for five or more adults (unrelated to the operator) who face substantial obstacles to living independently and they are separated into three sub-categories: Assisted Living Residence, Enhanced Assisted Living Residence and Special Needs Assisted Living. They all provide a higher level of care and supervision than an Adult Home or the Enriched Housing Program. The substantial obstacle to independent living can include Alzheimer’s disease, other dementias or other types of cognitive impairments. New York seniors with Alzheimer’s disease or another dementia can live in any of the three types of Residences for Adults, and which type they reside in will depend on their care needs. Assisted Living Residences are the most homelike; Enhanced Assisted Living provides the most support for people with physical disabilities; Special Needs Assisted Living is the most common for dementia patients and have special plans in place to safely and appropriately meet the needs of their residents.

New York Medicaid also offers an Assisted Living Program, which serves individuals who are medically eligible for nursing home placement but do not actually need that type highly structured and medical environment, and would prefer to live in a less restrictive (and lower cost) setting. These residences are part of an Adult Home or an Enriched Housing Program, and they are required to hold extra certification. So, seniors in the early stages of dementia could potentially live in an Assisted Living Program unit in one of these settings, although they would likely have to move to a Residence for Adults as the disease progressed.

New York Assisted Living Laws & Regulations

Admissions Process & Requirements

To be admitted into a New York Adult Care Facility (ACF) that is designated as an Adult Home (AH), an applicant must undergo a medical evaluation and an interview with residence administrator. If the applicant has a history of chronic mental disability, or the medical evaluation or interview reveals as much, they must also undergo a mental health evaluation.

To be admitted to an Enriched housing Program, applicants must have medical evaluation, interview, mental evaluation when necessary and undergo a functional assessment that evaluates sensory impairments, behavioral characteristics, personality traits, daily habits, and their ability to complete the Activities of Daily Living (mobility, bathing, dressing/grooming, eating, toileting) and the Instrumental Activities of Daily Living (shopping, cooking, cleaning, laundry, medication management, paying bills, etc.)

To be admitted to a Residence for Adults, including an Assisted Living Residence, Enhanced Assisted Living Residence and Special Needs Assisted Living, applicants must undergo all of the above processes. Plus, the residence must create an individualized service plan (ISP) for them that addresses their medical, nutritional, rehabilitation, functional and cognitive needs as soon as they move into the residence.

New York residents cannot be admitted to an ACF if they:

• Require constant medical care
• Are chronically bedfast
• Have impairments (physical, cognitive, or mental) that jeopardize the safety of themselves or others

However, a resident in need of 24-hour skilled nursing care can continue residency in a New York Adult Care Facility (ACF) if the following conditions are met:

• The resident hires appropriate staff to meet their 24-hour needs
• The resident’s physician and home care services agency agree the resident can be safely cared for in the ACF
• The ACF agrees to retain the resident and coordinate care with their providers
• The resident is otherwise eligible to live at the ACF

Staff & Training

Employees working with Alzheimer’s and dementia patients in memory care units must have dementia-appropriate training. This includes education in common behaviors associated with dementia. Emotional, cognitive, and functional changes that occur with the progression of the disease and this offers training in how to best assist people with dementia. The number of training hours required is not specified.

All assisted living residences in New York must be overseen by an administrator who is at least 21 years old. If the administrator does not have a nursing home administrator license from the state of New York, they are required to take 60 hours every 2 years of continuing education courses. In addition, each residence must have a case manager, as well as aides that provide residents assistance with personal care like bathing, personal hygiene and getting dressed.

Evictions & Discharges

New York assisted living homes, including those with memory care, must give 30 days written notice before a resident has to move out. Anyone who is evicted can appeal. The process for appealing should be explained at admission, but one option is to contact New York’s Long Term Care Ombudsman in the Office for the Aging.

New York ACFs are generally allowed to evict when a resident’s personal or medical needs cannot be met there. ACFs will have their own criteria, and it’s important to be clear on eviction rules before agreeing to move in. Can a resident be asked to leave for aggressive behavior? Is non-payment of bills after a certain amount of time enough to get a person evicted? You need to know these answers ahead of time, because unfair evictions can be a problem in assisted living.

If your loved one in memory care has received an eviction notice, and you need to know next steps, click here.

Memory Care Costs in New York

Because of New York’s size, there can be significant differences in the cost of ACFs depending on what part of the state you are in. The table below lists the median monthly cost of ACFs that do not provide dementia care (assisted living) and ACFs that do provide care for dementia patients (memory care) in different regions of the state as of 2025, and it includes the statewide median as well as the median for non-metropolitan areas. Individuals who are in the early to mid stages of dementia may be best suited for assisted living facilities, which are less expensive than memory care, while those with more severe symptoms or who are in the late stages of dementia will likely need memory care.

Financial Assistance and Care Support for New York Memory Care/Assisted Living

There are several sources of financial assistance and care support for qualified New York seniors with Alzheimer’s disease and other dementias who reside in Adult Care Facilities. They include New York Medicaid’s Managed Long Term Care (MLTC) Program, Assisted Living Program and Community First Choice Option, as well as the Program of All-Inclusive Care for the Elderly (PACE), Veterans Affairs (VA) pensions, Supplemental Security Income (SSI), elder loans, tax credits and reverse mortgages.

Medicaid Long-Term Care

New York Medicaid Managed Long Term Care Program
New York’s Managed Long Term Care (MLTC) Program covers long-term care for New York Medicaid beneficiaries who need a Nursing Facility Level of Care (NFLOC), but live in an Adult Care Facility (or there own home or the home of a loved one). The MLTC will not cover benefits if the Adult Care Facility (ACF) is already providing them. MLTC benefits include adult day care, nursing services and personal care assistance with daily activities like bathing, dressing, eating, cooking, cleaning, shopping, etc. The state can assign someone to provide this care, or MLTC beneficiaries can self-direct their care by selecting a caregiver of their choice, including friends and family members, although spouses can not be hired.

Assisted Living Program
As mentioned above, Assisted Living Program units are part of an Adult Home or an Enriched Housing Program residence, but they provide a higher level of care. The program serves New York Medicaid beneficiaries who are medically eligible for a NFLOC, but don’t need the high-level of care or structure of a nursing home. Assisted Living Programs are responsible for providing residents with long-term residential care, room, board, housekeeping, personal care, supervision, and providing or arranging for home health services.

Community First Choice Option
New York’s Community First Choice Option (CFCO) provides extra long-term care services and supports to Disabled, Aged or Blind (DAB) Medicaid beneficiaries who require a NFLOC but live in an Adult Care Facility, as long as that residence does not provide the same long-term care. Just to be clear, CFCO also covers seniors who live in private homes. Program benefits include home health aides, transportation, meal delivery, and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing/grooming, eating, toileting) and the Instrumental Activities of Daily Living (such as shopping, cooking, cleaning, laundry, medication management, etc.). These benefits can be provided by licensed caregivers, and program participants can also self-direct some of their care, like personal care assistance, by hiring caregivers of their choosing, such as relatives or friends. Spouses, however, can not be hired as CFCO caregivers.

To qualify for all three of the New York Medicaid programs described above – MLTC, Assisted Living Program, and CFCO – applicants will be evaluated to see if they require a Nursing Facility Level of Care. They also must meet an asset limit ($33,038 for individual in 2026) and an income limit ($1,836/month for an individual in 2026). MLTC and the Assisted Living Program are part of New York’s Community Medicaid, while CFCO is a Disabled, Aged or Blind (DAB) Medicaid program. All three are entitlements, which means all eligible applicants are guaranteed coverage without wait.

Program of All-Inclusive Care for the Elderly
New York residents age 55 and over who require a NFLOC can have all of their healthcare coverage, including Medicaid and Medicare, streamlined into one plan with the Program of All-Inclusive Care for the Elderly (PACE). PACE also offers vision, dental and hearing care, and PACE day centers provide day-time supervision, meals, social activities and regular health checkups for program participants. Being enrolled in Medicaid and/or Medicare is not a requirement for PACE, but it is free for New York DAB Medicaid beneficiaries. PACE can also be known as LIFE (Living Independence for the Elderly). New York’s PACE/LIFE programs are located in Buffalo (Catholic Health LIFE and Fallon Health Weinberg-PACE), New York City (ArchCare Senior Life and CenterLight Healthcare), Niagara Falls (Complete SeniorCare), Olean (Total Senior Care, Inc), Rochester (ElderONE), Schenectady (Eddy SeniorCare) and Syracuse (PACE CNY).

Nursing Home Medicaid
New York’s Nursing Home Medicaid will cover all nursing home expenses, including room and board, for all eligible applicants. To qualify, applicants must meet an asset limit ($33,038 for an individual in 2026) and an income limit ($1,836/month for an individual in 2026). They also have to meet the medical requirement of needing a Nursing Facility Level of Care (NFLOC), which means they need the type of full-time supervision and care associated with nursing homes. It’s important to note that a diagnosis of Alzheimer’s disease or another dementia does not guarantee a NFLOC designation. However, many people with dementia will meet the requirements.

Special Needs Assisted Living Voucher Demonstration Program for Persons with Dementia

The Special Needs Assisted Living Voucher Demonstration Program is specific to the state of New York. It offers financial assistance in the form of a voucher to help fund the cost of memory care for people with Alzheimer’s disease and other related dementias. Through this New York Department of Health program, 200 assisted living vouchers were available for persons who could no longer afford to privately pay for special needs assisted living, and as a result, would have to be moved to a Medicaid-funded nursing home. The average monthly cost of memory care was considered for the region. Vouchers can pay as much as 75% of the average cost. Please note this program does have a waitlist.

Veterans Affairs (VA)

Traumatic brain injuries and post-traumatic stress disorder lead to a higher probability of developing dementia, so veterans are statistically more likely to develop the condition than non-veterans. The VA offers many benefits for Alzheimer’s and dementia as well as different pension types.

Qualified New York veterans (or their surviving spouses) can also receive financial assistance through a Veterans Affairs (VA) Pension that they could use to pay for assisted living or memory care. There are three levels of VA Pensions – Basic, Aid & Attendance (A&A) and Housebound. To qualify for any of them, veterans or their surviving spouses need to meet a net worth limit of $163,699 (effective Dec. 2025 – Nov. 2026), which is calculated by adding the total of their assets to their annual income. Some assets are exempt, like a primary home, primary vehicle and household furniture and appliances. VA Pension applicants also have to meet an income limit to be eligible – their income must be less than the VA Pension they are applying for in order for them to qualify. And veterans must meet a military service requirement, which includes not having received a dishonorable discharge.

To qualify for A&A, veterans or their surviving spouses must also meet a medical requirement, which is one of the following must be true:

• They need help to perform the Activities of Daily Living (mobility, bathing, dressing/grooming, eating, toileting) OR
• They have to stay in bed for at least a large portion of the day due to illness OR
• They are in a nursing home due to loss of mental or physical abilities OR
• Their eyesight is extremely limited (5/200 or less in both eyes even with glasses or contacts; or concentric contraction of the visual field to 5 degrees or fewer)

To qualify for Housebound, veterans must spend most of their time in their home due to a permanent disability.

There is no medical requirement for VA Basic Pensions.

Qualified veterans or their surviving spouses are entitled to their Maximum Annual Pension Rate (MAPR) minus their annual income. The following MAPRs are effective from Dec. 1, 2025, to Nov. 30, 2026.

VA Basic Pension MAPRs

• Veterans without spouses or children: $17,441
• Veterans with dependent spouses or children: $22,839
• Surviving spouses without dependent children: $11,699
• Surviving spouses with dependent children: $15,311
• Two veterans married to each other: $22,839

VA Aid & Attendance MAPRs

• Veterans without spouses or children: $29,093
• Veterans with dependent spouses or children: $34,488
• Surviving spouses without dependent children a maximum of $18,697
• Surviving spouses with dependent children: $22,304
• Two veterans married to each other and one qualifies for A&A: $34,488
• Two veterans married to each other and one qualifies for A&A and one for Housebound: $38,350
• Two veterans married to each other and both qualify for A&A: $44,886

VA Housebound MAPRs

• Veterans without spouses or children: $21,313
• Veterans with dependent spouses or children: $26,710
• Surviving spouses without dependent children: $14,298
• Surviving spouses with dependent children: $17,902
• Two veterans married to each other and one qualifies for Housebound: $26,710
• Two veterans married to each other and both qualify for Housebound: $30,580
• Two veterans married to each other and one qualifies for A&A and one for Housebound: $38,350

Veterans’ Homes
New York State Veterans Homes are skilled nursing facilities for eligible veterans and their eligible dependents who require skilled nursing care and/or rehabilitative services. There are five New York State Veterans Homes located in Batavia, Oxford, Montrose, Queens and Stony Brook. The first four on that list are operated by the New York State Department of Health, and the fifth is operated by the State University of New York (SUNY) Stony Brook, where it’s located. All of them offer care for Alzheimer’s and dementia patients, including a dedicated “memory care neighborhood” at the New York State Veterans Home at Oxford.

Supplemental Security Income

Dementia patients age 65 and over with limited income and assets may qualify for Supplemental Security Income (SSI). These funds can be used to pay for the cost of assisted living or memory care. As of 2026, the maximum SSI benefit for an individual is $994/month and for a married couple it’s $1,491/month.

To qualify for SSI, applicants must be age 65 and over or have a significant disability, and they must meet an income limit and an asset limit. As of 2026, individuals may meet the SSI income limit if they earn less than $2,073/month OR they get less than $1,014/month from non-work sources, like Social Security benefits or pension payments. They may meet the SSI asset limit if they have $2,000 or less in countable assets. For couples, the income limit is $3,067/month in work income or $1,511/month in non-work income, and the asset limit is $3,000.

Other Options

1) Elder care loans exist for families to cover the costs of moving into memory care while waiting for other financial resources to become available. For example, if one is waiting for Medicaid approval or waiting to sell a home. More on bridge loans for memory care.

2) Some tax credits and deductions can provide financial relief for seniors with dementia and their families. Seniors with limited financial resources can claim the Credit for the Elderly and/or the Disabled, as long as no one can claim them as a dependent. If someone (like an adult child) can claim the senior as a dependent, they can utilize the Child and Dependent Care Credit, and they can deduct any medical or dental expenses they paid for the senior.

3) A reverse mortgage loan can be a viable option for some senior homeowners who are in need of extra income to help pay dementia care. However, reverse mortgages are not recommended for every senior homeowner who needs extra income, so it’s important to consult with a professional before taking out one of these loans.