What are common types of elder housing?

Low to Moderate Medical Assistance.

Assisted Living facilities, Enriched Housing and Adult Homes offer housing for elders who need some assistance with daily activities, (for example, bathing, dressing or taking medication) but do not require skilled nursing care.  

Residences may be single or shared apartments or rooms.  Support services available vary depending on the mission of the facility.

Cost varies depending on location and scope of services needed.  Payment may be by private payor Medicaid, if accepted. 

Long term care insurance and Medicare do not cover assisted living.  

Low Medical Assistance.

Supported independent housing facilities offer housing for elders able to live independently with few support services.The availability of support services varies depending on the facility’s mission.

Residences are single apartments. 

Cost varies depending on location and scope of services needed. Payment may be by private pay, long term care insurance benefits or Medicaid, if accepted. 

Medicare does not cover supported independent housing. 

No Medical Assistance. Low Income only.

Government subsidized senior housing facilities, often referred to as HUD housing, offer apartment style housing for very low-income seniors who do not require skilled nursing care.  Generally, residents must arrange for their own supportive services, though some have a service coordinator to assist tenants.

There are long waiting lists for subsidized housing, and lotteries for placement in new buildings. Rent is determined by calculating 30% of eligible seniors’ income.

Neither Medicaid or Medicare covers this type of housing.

High Level of Medical Assistance.

Nursing homes offer single and double occupancy rooms for seniors requiring short stay rehabilitation or long term nursing care.  All support services, including 24 hour skilled nursing care, are available to residents depending on individual needs. 

Cost of care varies dramatically depending on location.  Medicare may pay for some or all of a short-term rehabilitation stay at a nursing home, which is usually less than 100 days, but not for long term stays. Payment options for long term care at a nursing home may include private pay, Medicaid and long term care insurance.

High Level of Medical Assistance.

Alzheimer’s Disease Special Care Communities offer housing designed to accommodate the special needs of those with Alzheimer’s Disease. All support services are available, including 24 hour medical staff trained in understanding Alzheimer’s Disease and its progression. 

Residences are usually private or semi private rooms.  Payment is usually by private pay, Medicaid or Medicare.   

All Levels of Medical Assistance.

A Continuing Care Retirement Community (CCRC) offers three different levels of care for residents: independent living, assisted living, and skilled nursing care.  As residents’ needs change over time, the level of care they receive does, as well.   

Cost is determined by the type of contract purchased. A lifecare contract, the only type available in New York State, declares that you pay the same monthly maintenance cost regardless of the level of care received. A modified contract includes a set number of skilled nursing facility days and home health aide hours. A fee-for-service contract charges the resident a pre-set daily rate for each skilled nursing facility day or assisted living day used. 

There is usually a hefty entrance fee or purchase price to participate (often hundreds of thousands of dollars), and a monthly fee that varies according to contract type.  CCRCs are private pay. 

Limited assistance available when community receives government funding.

Naturally Occurring Retirement Communities (NORCs) are housing complexes in which a large number of older residents live, commonly because they have “aged-in-place ”as a community. Rather than requiring elders move when supportive services become necessary, the complex arranges for services to be brought in.