What does Independent Living mean?

Independent Living (IL) is age-eligible housing designed for older adults, typically 55+ or 62+. These communities are often apartment style, but are sometimes cottages, condominiums, or patio-style homes.

Residents of IL are older individuals who benefit from convenient services, age-friendly surroundings, and increased social opportunities. IL properties do not provide health care services or assistance with activities of daily living (ADLs) such as medication management or administration, bathing, eating, dressing, toileting and more.

IL residents are permitted to use third-party home health care services to meet additional needs, therefore they don’t technically need to be “independent.” These communities are not overseen or regulated by the New York State Department of Health (NYS DOH).

  • Payment: private, housing subsidies such as Section 8 Housing Choice Voucher (certain affordable housing complexes/HUD subsidized apartments).

 

What is Independent Living with Services?

Some independent living communities offer additional services at an extra cost, such as meals, basic housekeeping, laundry, transportation, and social/recreational activities. Some may also offer emergency alert systems, live-in managers, and amenities like pools, spas, clubhouses, and on-site beauty and barber salons.

  • Payment: private.

 

What is an Adult Care Facility?
Types include:

  • Adult Home

  • Enriched Housing

  • Assisted Living Program

  • Assisted Living Residence

  • Special Needs Assisted Living (Memory Care)

 

What are Family Type Homes for Adults?

 

What is a Skilled Nursing Facility?

Adult Care Facility (ACF) is a general term for a residence that provides long-term care and services for adults who cannot live independently due to physical limitations, mental illness, or cognitive decline. ACFs provide room, board, and other services to five or more adults unrelated to the operator. ACFs are licensed and regulated by the New York State Department of Health (NYS DOH). To be eligible for an ACF, residents cannot have a medical condition that requires 24-hour skilled nursing or medical care and cannot need regular assistance from another person to walk, use a wheelchair, or transfer. Services include meals, some supervision, some personal care, housekeeping, laundry, limited transportation, social/recreational activities, management of self-administered medications, and case management.

Adult Home (AH): Adult homes are long-term, residential, supportive housing settings for adults aged 18 years and older who, to a certain extent, are unable to live independently. AHs can provide care for five to 200 residents. Housing layout varies; some are similar to independent apartments and others have shared rooms and/or bathrooms. Residents are provided with three meals a day, plus snacks. AHs are the lowest level of ACFs provided in NYS.

  • Payment: private, Supplemental Security Income (SSI) (certain facilities), most long-term care insurance plans.

Enriched Housing Program (EHP): The Enriched Housing Program provides long-term, residential care for five or more adults who are primarily 65 years or older (no more than 25% of residents can be under 65 years old and all must be 55 years or older). EHP offers older adults, who may be unable to live on their own, an apartment-style setting that includes a private bathroom and kitchenette. Residents must be provided with at least one meal a day, offered in a group setting.

  • Payment: private, Supplemental Security Income (SSI) (certain facilities), most long-term care insurance plans.

Adult homes and enriched housing programs may have the following additional licenses or certifications for all or part of their facilities:

Assisted Living Program (ALP): The ALP is an additional license by the NYS DOH, available in some AHs and EHPs, designed as an alternative to nursing home residency. It provides services to individuals who are medically eligible for a nursing home, at a lower cost, in a less medically intensive setting. The operator is responsible for providing and arranging additional services, including nursing care, physical therapy, occupational therapy, speech therapy, medical supplies, home health aides, and case management by a registered nurse. An ALP is the only setting in an ACF where Medicaid can be accepted to pay certain fees. Medicaid can cover assisted living care services but won’t cover the cost of room and board. If applicable, Supplemental Security Income (SSI) can supplement one’s income to pay for the room and board portion. ALP participants who do not qualify for SSI can pay privately. While most ALP participants have Medicaid, this program is also open to those who are not eligible for Medicaid.

  • Payment: private, Medicaid, Supplemental Security Income (SSI)

Assisted Living Residence (ALR): An Assisted Living Residence is an AH or EHP with an additional licensure by the New York State Department of Health (NYS DOH). ALRs generally serve the same types of residents as AHs and EHPs and provide the same services, but laws require ALRs to provide additional disclosures and resident rights. ALRs must provide each resident with respectful care to promote the resident's dignity, autonomy, independence, and privacy in the least restrictive and most homelike setting consistent with the resident's preferences and physical and mental status. The philosophy of an ALR emphasizes personal dignity, autonomy, independence, privacy, and freedom of choice.

  • Payment: private, Supplemental Security Income (SSI) (rarely), most long-term care insurance plans.

Assisted living residences may also have the following enhanced certifications for part or all their facility:

• Special Needs Assisted Living Residence (SNALR), known as Memory Care* SNALRs are certified to serve people with special needs, typically dementia or cognitive impairment. They are frequently referred to as memory care assisted living. SNALRs have formal plans for specialized services, environmental features, and staffing levels which must be approved by the New York State Department of Health (NYS DOH). The services offered by these facilities are tailored to the unique needs of the residents they serve. SNALRs must meet specified staffing and training guidelines.

  • Payment: private, most long-term care insurance plans.

Enhanced Assisted Living Residence (EALR): EALRs have a New York State Department of Health (NYS DOH) certification which authorizes them to provide “aging in place” for residents whose needs go beyond what a basic ALR can support. Residents receive a substantially higher level of care, bridging the gap between assisted living and a skilled nursing facility. Unlike a basic ALR, EALRs can support residents who need assistance with walking, transfers, climbing/descending stairs, using complex medical equipment, or managing incontinence.

  • Payment: private, most long-term care insurance plans.

  • * NOTE:
    Regarding facilities, “memory care” typically refers to a SNALR, but there are a few other ways the term is used. Some ACFs may provide services or a secured unit specific for individuals with dementia without specifically being licensed by New York State Department of Health as a SNALR. Additionally, many skilled nursing facilities (nursing homes) have a secured floor which caters specifically to the needs of individuals with dementia. Not all individuals with dementia or memory loss require a “memory care” facility or unit. It is common for facilities to have individuals with dementia residing alongside those without it. Assessments conducted by the individual facility and standardized evaluations will help determine the appropriate setting for individuals with dementia on a person-by-person basis.

Family-Type Homes for Adults (FTHA) provide residential care, personal care, and/or supervision in a private home, for four or fewer adults who are not related to the operator. They are licensed, community-integrated housing alternatives for adults. Residents are adults who cannot safely live independently due to physical limitations, mental illness, or cognitive decline, but do not require skilled medical or nursing services. Some FTHAs may also have up to two additional “boarders,” or individuals who are independent and do not need personal care or supervision. FTHAs are overseen by the New York State Office of Children and Family Services, through the Bureau of Adult Services.

  • Payment: private, Supplemental Security Income (SSI) (certain homes), some long-term care insurance plans.

A Skilled Nursing Facility (SNF), also known as a nursing home, is a residential facility available for individuals who need 24-hour nursing care and supervision due to disability and/or illness. SNFs typically provide both short-term rehabilitation and long-term care. Skilled care, which is usually only for a short period of rehabilitation, is nursing or therapy which can only be performed by skilled or licensed professionals. Some examples of skilled care are physical therapy, speech therapy, wound care, intravenous medication administration, and catheter care. Residents who are considered long-term status at a SNF have continuous care needs which may include both skilled care and assistance with activities of daily living (ADLs), like bathing, dressing, personal hygiene, toileting, walking, etc.

Some facilities have specialized units or floors to meet specific needs of residents. Examples of specialized units include dementia, traumatic brain injury (TBI), ventilator, psychiatric/behavioral, and pediatric.

SNFs are regulated by the Department of Health (DOH) and are governed by both state and federal laws. They must be licensed by the state and certified by the Centers for Medicare & Medicaid Services (CMS).

A Patient Review Instrument (PRI) and Screen is required for admission to any SNF in New York State. A PRI is a professional assessment of selected physical, medical, and cognitive characteristics of an individual which aids in determining their appropriateness for a SNF.

  • Payment: private, Medicare (for certain short-term stays only), Medicaid, most long-term care insurance plans.

Need more help? Call Lifespan 585-244-8400. Our care managers can help you decide the most appropriate housing for your needs.

Revised January 2026 Lifespan of Greater Rochester Inc.