Assisted Living in New York (NY)

Costs of Assisted Living in New York

The costs for Assisted Living Care in New York state are about $4,000 per month, (almost $50,000 a year) on average. These costs range from a very low $1100 per month to a very high cost of $11,100 per month. Expenses for assisted living may be on the higher end for New York seniors with dementia or those who are living in New York special care facilities for dementia.  The national average for a month across all states in an Assisted Living Facility is $3,293 per month, and the cost of a month in a facility in New York is $700 higher as New York is a state with a higher cost of living than the national average. Assisted living costs in New York are still much lower than the price of a nursing home, where semi-private rooms carry a cost of more than $131,000 per year, and a private room is approximately $136,000 annually.

Adult Day Health Care in New York is almost $2,000 per month or around $23,500 per year. A Home Health Aide in New York costs, on average $4,500 a month, over $52,600 annually. This is almost $3,000 more than the cost of an Assisted Living Facility. The cost of a New York Home Health Aide is based on a 44-hour-week, whereas Assisted Living provides 24-hour care. To get the same care at home that you would in an Assisted Living Facility you would need 3.8 Home Health Aides per week which would cost around $16,600 every month. Home Health Aides usually do not do housekeeping nor do they come with licensed nurses that you find in Assisted Living Facilities. It is estimated that by the year 2030, Assisted Living in New York will cost over $75,000 per year – an increase of around $25,000.

Within New York itself the costs of Assisted Living Care fluctuate as well, for example, last year these are the approximate costs of a monthly stay in a New York Assisted Living Facility:

• Utica, New York - $2,500 per month;
• Glen Falls, New York - $3,000 per month;
• Brooklyn, New York - $3,300 per month;
• Kingston, New York - $3,400 per month;
• Syracuse, New York - $4,000 per month;
• Bronx, New York - $4,000 per month;
• Buffalo, New York - $4,140 per month;
• Rochester, New York - $4,300 per month;
• Binghamton, New York - $4,400 per month;
• Elmira, New York - $4,450 per month;
• Watertown Area, New York - $4,560 per month;
• Outer New York City, New York - $4,700 per month;
• Ithaca, New York - $5,100 per month;
• Albany, New York - $5,100 per month;
• Queens, New York – $5,500 per month;
• Long Island, New York – $6,500 per month;

The state of New York is a beautiful state with plenty of activities for people of any age. It is well known for the city that never sleeps, New York City, but there is more available in the state than just the crowded island of Manhattan. With all the activities that are available in the Empire State, is New York a wise destination for a senior looking to retire? New York is the 4th most populated state in America, with an estimated 19.8 million people and the 27th largest state with an area of 54,555 square miles. The state density is 4th in the nation with 416.42 people per square mile. New York is the “premier gateway for legal immigration to the United States” and has the second-largest international immigrant population in the country, mainly concentrated in New York City. It also has a relatively low percentage of senior citizens at 14.66%, ranking 29th in the United States. But do not let the low senior percentage fool you - considering the almost 20 million total population, almost 3 million seniors live in New York.

Paying for Assisted Living Care in New York

Most New York Assisted Living care costs are covered by New York seniors or their families. The state of New York Assisted Living Program (ALP) was instituted in 1987. This program was created and designed purposely to provide long-term residential care for five or more eligible adults who are unrelated to the operator of the facility. New York residents who need 24-hour nursing care, are chronically bed-fast, or chair-fast, are not eligible for an ALP.

Because there are no other laws in New York state that can help seniors pay for assisted living expenses, ALP program the only one of its kind that helps New York elderly who have low income to cover assisted living facility costs.

Interestingly, unlike most states, the New York Assisted Living Program (ALP) is available to those who are ineligible for Medicaid, yet most people New Yorkers who participate – close to 90% - are on Medicaid. The number of ALP units is determined through the New York State legislative process, and therefore the number is limited, and waiting lists are common.

There have been some barriers to the development of further ALP facilities, as noted on the New York State’s Aging Website, including:

• Capacity – the development of more ALPs is controlled by the state, and the state simply can’t, or hasn’t, kept up with the demand;
• Community-level problems – due to zoning laws that are outdated or unclear or poor community planning, it is hard for developers to build new ALPs;
• Zoning – as zoning requirement differ from one area to another, it can be time-consuming and costly for developers to find out if a potential location is zoned correctly or needs to be re-zoned;
• Not In My Back Yard (NIMBY) – many people fear congregate housing, particularly for a special-needs population. They fear that it will lower their property values, change the feel of the community, alter the community, and/or increase traffic and noise levels; and
• Funding:
  • There is no construction capital “add-on” or reimbursement for New York ALPs and those who build Assisted Living specifically for the ALP program find it difficult to make their money back with the low cost of SSI/Medicaid reimbursement rate for ALPs;
  • SSI Level III reimbursement is simply inadequate to cover the costs of services provided in an ALP;
  • Medicaid reimbursement rate is less than that for nursing facilities.

It is important to note that while some New York Assisted Living Facilities may accept residents on an ALP waiver program, it would be financially impossible to pay for a facility if you only accepted residents from government funding. More than that, it would also be immoral. Even within assisted living facilities, the employees are not supposed to know what the payment source is for each client.

Helpful Programs for Senior Living in New York

New York has quite a few programs to help seniors, whether they are low-income or not. Many of these programs are coordinated by the local offices for the aging or NY Connects. The other number that senior citizens need to know is that of their local New York Ombudsman. The job of an Ombudsman is to protect the rights of residents in long-term care facilities. They advocate on the residents’ behalf, ensure the development and continuation of resident and family councils, and inform the public and the government if there are issues or concerns affecting residents in long-term care facilities. New York also has the following services for elders:

Nutrition Services:

• Community Dining – offered up to five days a week to New Yorkers over the age of 60 (although they are available to spouses and those with disabilities who live with someone over the age of 60.) They are available at senior locations, town halls and other locations across the state – about 1,000 locations. There are also registered dieticians available to answer any questions;
• Home-Delivered Meals – available up to five days a week for those over the age of 60 (also available for married spouses or those with a disability who are younger than 60) who are unable to make meals themselves. To receive meals, you must go through an interview that shows you are unable to prepare meals for yourself;
• Seniors Farmers Market Nutrition Program (SFMNP) – given to eligible seniors every July, it is $20 of coupons for locally grown fruits and vegetables from participating farmers’ markets in the state;
• Supplemental Nutrition Assistance Program (SNAP) – formerly known as food stamps, SNAP can be used to buy food at authorized stores in the state. Eligibility is determined based on income and numbers of eligible people in your household.

For more active seniors there are programs as well, including:

• Senior Community Service Employment Program (SCSEP) helps older people who are searching for a job improve their skills, get necessary training, and find employment. Eligibility requires the client must be 55 or older and meet income guidelines.
• Retired Senior Volunteer Program (RSVP) – a program that matches local volunteering opportunities with older adults who wish to volunteer. Must be 55 or older, live within the community, and be willing to volunteer on a regular basis.

In-Home Care:

• Care Coordination – a required component of all In-home services that are funded by the Expanded In-home Services for the Elderly Program (EISEP.) The actual coordination is a process that involves the applicant, a care coordinator, and members of the client’s support network if available. It includes an assessment of services needed, development of a care plan, and on-going monitoring to ensure that the plan is sufficient and the client is meeting their goals;
• Adult Day Health Services – provides care to seniors who are frail and/or disabled in a group setting within the community. All services and programs are dependent upon the senior / disabled person and the help that they require, but clients must need help with Activities of Daily Living (ADLs) to be eligible. The cost varies and financial assistance may be available.
• Transportation Services – available for a fee throughout the state. However, many of the public transportation systems offer discounts for those 65 and older with a Reduced Fare Metro Card. In New York City, residents can call 311 for help getting but outside of the city you should contact your local office for the aging;
• Respite Services – a program that gives caregivers a temporary break from caregiving duties. Available to anyone who is a caregiver of an older person, although costs vary.

Miscellaneous – other programs available to New York State seniors:

• Home Energy Assistance Program – a program which offers emergency benefits for households during heat or heat related emergencies. Furnace repairs and/or replacements are also available for households with no heating equipment. Eligibility depends upon household income.
• Senior Medicare Patrol (SMP) – a hotline to report Medicare/Medicaid fraud. They also help advocate for those who have been victims of deceptive health care. The phone number is 1-877-678-4697 or you can contact NY Connect; and
• Adult Protective Services – provides services for elderly adults who are physically and/or mentally impaired. You

Pros and Cons of Senior Living in New York

New York is an expensive state, both to live in and to retire, yet there are parts of the state that are not in New York City which have a lower cost of living and could be more attractive to seniors, especially active seniors.

Here are some things to consider for seniors when choosing where to retire in New York:

• Weather – The state has weather that is described as “humid-continental,” where people see both the good and the bad of all four of the seasons. It’s hot and humid during the summers and cold, snowy, and windy during the winters. Western New York has more severe weather and Long Island has more moderate weather. And, you can’t forget Buffalo, Syracuse, and the other cities that experience lake-effect snow from Lake Erie and Lake Ontario;
• Taxes and Cost of Living – New York is only moderately tax-friendly for seniors and retirees. Furthermore, the cost of living is 26% greater than the national average
• Overall good health – New York ranks 14th in the country for overall health and primary care physicians and home health care providers are more easily accessible;
• Natural beauty – not that New York City is not beautiful in its way, but the smaller towns located in upstate New York like Ithaca and Saratoga Springs are known for their beautiful surroundings as well as the outdoor activities; and
• Location – it’s New York. You can get on a train, bus, subway, plane, or car and go anywhere. It may not be cheap, but it will never be boring.

Financial Information for NY Seniors

Those who live in the state of New York pay taxes, but those who live in New York City pay a rate far higher than those who live outside of the city. New York state imposes a state income tax that ranges from 4% to 8.82% on your taxable income. That is the 8th highest in the country, however only those who make more than $1.06 million annually pay that amount. People who live in New York City pay an additional 2.9%-3.88%. The sales tax is New York in only 4%, but counties are allowed to add on top of that amount.

Property taxes are determined by counties and cities in New York, which means that they vary throughout the state – from less than 1% to around 3.5%. New York City has one of the lower rates with the average being around 0.7% of property values. There is an exemption for seniors in the state of New York for those over 65 who meet income limitations and other requirements.

New York does have a capital gains tax, and it is taxed at the rate of normal income. There is also an estate tax in New York, with the rates ranging from 5% to 16% depending on the size of the estate. The exempted amount will grow until it matches the federal exemption of $5.43 million.

New York is also considered to be only moderately tax-friendly state for seniors, due to the following:

• Income from Social Security is not taxed;
• Withdrawals from retirement accounts are only taxed partially;
• Wages are taxed at rates averaging 5.9%;
• Public pension income is not taxed; and
• Private pensions are only partially taxed.

The purchasing power in New York is lower than the average in the nation. For example, what you could purchase for $100 in New York is what you would expect to spend $86.43 on in another state, The cost of living is higher in New York overall than it is in other states in every category with housing being the biggest difference. However, New York rated higher in every category – overall, grocery, health, housing, transportation, utilities, and miscellaneous.

There is much confusion over the difference between “Medicare” and “Medicaid.” Medicare is a program that is run by the United States Government and it is an entitlement program. This means that every New York resident (as well as other state residents) over the age of 65 is “entitled” to Medicare – after all that is where some of your taxes have been going all of these years. There is no income limit and everyone who lives in New York or any other state and is over 65 is eligible for Medicare. One of the things that Medicare will pay is hospital stays.

“Medicaid,” on the other hand, is a program run by the individual states and it is not an “entitlement program.” No one is owed health-care in this country. However, there are circumstances where the state sees that certain individuals need help. In New York State, where you apply for Medicaid depends on the category you belong to (one of those categories is elderly and/or disabled).

For the purpose of Seniors who need Medicaid, in New York, you should apply with your Local Department of Social Services (LDSS). The following groups can become eligible for Medicaid in NY:

• Seniors who are at least 65 years old, who are not caretaker relatives or parents, and age is a condition of their eligibility;
• Blind or disabled New Yorkers or who have asked to be covered due to community-based long-term care (CBLTC) services. This includes those who require Personal Care Services (PCS) or Consumer-Directed Personal Care Services (CDPAS) right away;
• Medicare Savings Program (MSP);
• Medicaid Buy-in for Working New Yorkers with Disabilities (MBI-WPD);
• Those who are currently in a nursing home or adult home; and
• Community residences and Residential treatment centers that are operated by The Office of Mental Health (OMH).

Most New York seniors would fall into the “Non-MAGI Eligibility Group” (which means your eligibility for this program is determined by something other than your “Modified Adjusted Gross Income.”) These “Non-MAGI-Eligibility Groups” include:

• Those 65 and older, who aren’t a parent or a caretaker relative, and those who suffer from blindness or disability but do not meet the criteria of any of the MAGI groups;
• People who receive COBRA;
• Medicare Savings Program (MSP);
• Medicaid Buy-in for Working People with Disabilities;
• AIDS Health Insurance Program (AHIP);
• Medicaid Cancer Treatment Program; and
• Those who reside in an Adult Home run by LDSS (Local Department of Social Services), OMH Community Residences or Residential Care Centers.

For those that qualify for Medicaid under a “non-MAGI” group, which is where most New York senior citizens who need Medicaid would fall, there are documents that you will need to provide to determine your eligibility, including:

• Proof of U.S. citizenship or, if you are a naturalized citizen, you will need to have proof of naturalization;
• A valid Social Security Number;
• Proof of age (birth certificate);
• Four weeks of recent paycheck stubs if you are currently employed;
• Proof of income from other sources such as Social Security, Veteran’s Benefits, Child Support, and Unemployment Insurance Benefits;
• If you are applying for nursing home care waivers or other community long-term care services, you will need to provide information on your bank accounts, insurance policies, and any other resources that you may have;
• Proof of where you live – rent receipt, a statement from your landlord, or an envelope from mail;
• Insurance benefit card or the policy information if you have other health insurance; and
• Medicare Benefit Card.

If you are currently insured, do NOT cancel your health insurance just because you think you qualify for Medicaid. Wait until you know for sure.

Medicaid eligibility is dependent upon your income and the resources that you have. In New York, the latest rates for those who are over 65 are:

• Individual - $9,900 annual income ($825 monthly) with resources of $14,850;
• Family of 2 - $14,500 annual income ($1,209 monthly) with resources of $21,750;
• Family of 3 - $16,675 annual income ($1,390 monthly);
• Family of 4 - $18,850 annual income ($1,571 monthly).

There are circumstances in which people are eligible for Medicaid if they have “excess” money and the requirements.

Places of Interest for Seniors Living in New York

There are numerous things that might be of interest for senior citizens living in New York State. With 22 national parks, four National Heritage Areas, 262 National Historic Landmarks, and 5,379 listings on the National Register of Historic Places there should always be something for an adventurous senior to see. If that is not enough for you, New York does have an extensive public transportation system of trains, subways, ferries, three airports (in the city alone) and a Port where cruise ships regularly leave.

Some of the more interesting things that seniors may enjoy in New York include:

• Live on the Vine – a four-week wine and art festival that takes place throughout Long Island;
• NYC Broadway Week – purchase 2-for-1 tickets for some of Broadway’s favorite shows;
• Jell-O Gallery and Historic LeRoy House – Did you know Jell-O was developed in New York? In LeRoy, New York – close to Attica – a carpenter developed Jell-O in the late 1890s and there is an entire museum devoted to its history and advertising. Tours are available where you can see the museum, the mansion, the local connection to the Underground Railroad and the New LeRoy Bicentennial barn quilt trail;
• The Dutch Stone Houses of Hurley Village – a 330-year-old Dutch village which includes 25 of the oldest private homes in America. Every July they have tours on “Stone House Day” and there is a Bed & Breakfast located in one of the homes;
• American Red Cross, Clara Barton House Chapter #1 – located in Dansville, New York where Clara Barton established the first American Red Cross in 1881. It is still a working American Red Cross chapter with the third floor dedicated to Clara Barton;
• Roosevelt Island Smallpox Hospital Ruins – from 1856-1875 this hospital treated approximately 7,000 smallpox patients a year. In 1875, it was turned into a nurses’ dormitory and the smallpox hospital was moved to North Brothers Island. By the 1950s Renwick Hospital was falling apart. In 1975, the Landmarks Preservation Commission declared it a city landmark to prevent it from falling apart. It is not open for tours and only the outside walls and foundation are still standing;
• Clausland Mountain Tunnels – originally used to keep World War I soldiers safe, these tunnels near Nyack, New York are now home to graffiti art and, reportedly, Satanic Rituals. There are reportedly miles of tunnels and one can be accessed only by crawling under the roots of a tree;
• Howe Caverns – located in the Catskill Mountains and only $15 for NY senior citizens. These natural caverns were created six million years ago, and are one of a small number of mineral caves in the world. They were found around the 1840s by the Howe family patriarch (although the Native-Americans knew about them long before.) There is a museum on site which seniors can visit that explores mining and geology and visitors to the caverns can tour them with flashlights or hats fitted with headlamps;
• Central Park – the famous 843-acre park located in New York City and the most visited urban park in the world is always available and a great place for seniors to visit and to take visitors. It has walking tracks, bridle paths, a zoo, a wildlife sanctuary, two ice-skating rinks, the Central Park Conservatory Garden, and large wooded areas;
• Lake Placid, New York – home to two Winter Olympics and the 1980 “Miracle on Ice.” New York Elderly can also see the Olympic Speed Skating Oval, and the Olympic Sports Complex has tours of the bobsled, luge, and skeleton track;
• Wine tasting in the Finger Lakes – the area of New York where the most wine is produced. There are tours offered with both a professional driver and a guide, accommodating a couple up to a 34-person bus tour. Watkins Glen State Park is on the southern end of Seneca Lake and should be a stop on your tour because of the beautiful waterfall views; and
• The Museums in New York City – New York City is known for its museums – including The Museum of Natural History, Free, The Met, The Guggenheim, The Museum of Modern Art (MoMA), The Cloisters, and the 9/11 museums and memorials. Almost all New York museums have discounted prices for seniors and/or special days where the admission is discounted.

Some cities to consider for New York Senior Living:

• Mamaroneck, New York – located in Westchester County, the town is divided into three parts: the Village of Larchmont, the Village of Mamaroneck, and an unincorporated area. It was listed as #1 of the top 10 places to live in New York State a few years ago by Movoto. Approximately 15% of the population is over the age of 65, and it is a suburb of New York City. To retire in this area, you must really like people because the population density is 2,100/square mile;
• “Greater” Ithaca, New York – a city in the Southern-Tier Finger Lakes region of New York, this “town” is comprised of an urban area of 24.581 square miles and a metro area of 474.649 square miles. The population density in the urban area is 4,900/square mile, and in the metro area, it is a mere 210/square mile. The term Greater Ithaca includes both the City and Town of Ithaca as well as smaller areas within or near the Town. It is the home of Cornell University, an Ivy League school, as well as Ithaca College. It is home to the “Cayuga Chamber Orchestra,” “Cornell Concert Series,” and the “School of Music” at Ithaca College. About 6.5% of the population are seniors over the age of 65;
• Mattituck, New York – a hamlet in Suffolk County, New York, located near the Town of Southold. The population of this hamlet is less than 5,000 with a population density of 450/square mile. Over 19% of the population are the elderly over the age of 65. Mattituck is in the heart of the Long Island Wine Region and holds an annual Strawberry Festival every year;
• Elmira, New York – located in Chemung County in the Southern Tier of New York State near the Pennsylvania state line. The population is around 30,000 with a density of over 4,250/square mile, and almost 14% of Elmira residents are over 65; and
• Bronxville, New York – a village in Westchester County, Bronxville is about 15 miles north of midtown Manhattan. With an area of 1 square mile and a population of around 6,300, the population density is high in this village. Over 12% of the population are seniors over 65, and the median income is almost $150,000 annually. There are over 70 acres of green areas in Bronxville and the town is known for outdoor activities.

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