Free senior care guidance for Nassau and Suffolk County families. No cost to you, ever.
Call (934) 200-2603
Long Island Senior Advisor

Nursing Home vs. Assisted Living

New York licenses nursing homes under 10 NYCRR Part 415, entirely separate from assisted living's ACF/ALR framework.

Get matched freeCall (934) 200-2603
Home›Comparisons›Nursing Home vs. Assisted Living
Short answer

New York licenses nursing homes under a completely separate rule chapter (10 NYCRR Part 415) from assisted living (10 NYCRR Part 1001 for ALR/EALR/SNALR, 18 NYCRR Parts 487-494 for the base ACF types). Nursing homes carry federal CMS star ratings; assisted living communities in New York do not.

What actually gates the decision

A resident who needs 24-hour licensed nursing care, not just personal-care assistance, generally needs a nursing home rather than assisted living, regardless of how a specific ALR/EALR/SNALR community markets its capabilities. Ask any assisted living community directly what its admission and retention limits are.

Medicare's skilled-nursing benefit only covers a limited rehabilitation stay after a qualifying inpatient hospital admission -- it is not a way to pay for long-term nursing home placement, in New York or anywhere else.

Questions families ask

How much does hourly in-home caregiving cost in New York?

CareScout's 2025 Cost of Care Survey reports a New York State median of $35 per hour for what it now calls non-medical caregiver services, a category that merged the formerly separate homemaker services and home health aide categories in 2025 due to price convergence. Based on a 44-hour week, that works out to roughly $6,673 per month or $80,080 per year. Private duty nursing, a higher-acuity service, runs a New York State median of $120 per hour.

What does adult day care cost in New York, and could it help delay a move to assisted living?

CareScout's 2025 Cost of Care Survey puts New York State's Adult Day Health Care median at $144 per day, or about $3,120 per month based on five days a week, $37,440 per year. That's up from $113 per day in the 2024 survey, an increase of roughly 27 percent year over year, the largest percentage jump among CareScout's surveyed New York categories.

Is there a separate published cost for memory care in New York?

No. CareScout's Cost of Care Survey, the primary published cost benchmark used on this site, does not survey or publish a distinct memory care cost category in either its 2024 or 2025 New York State data tables. CareScout only publishes figures for Assisted Living Community, Nursing Home (semi-private and private), Adult Day Health Care, and in-home care categories.

Is there a Long Island-specific senior care cost figure, or only a statewide number?

Only a statewide figure is published. CareScout confirms that its publicly downloadable National and State Data Tables report, the source for the cost figures cited throughout this site, provides state-level and national medians only. CareScout's underlying survey does collect metro-area (MSA-level) data that feeds its separate interactive online cost calculator, but that breakout is not included in the downloadable state tables.

Not sure where to start?

Answer five questions and a local advisor will come back with senior care options in your area that actually fit your situation and budget. It is free, and there is no obligation.

Find care options
Find senior care — free