Albany Senior AdvisorWhat is the difference between an ALR and the ALP in New York?
An Assisted Living Residence is a licensed residence paid privately for both rent and care, while the Assisted Living Program is a Medicaid package that pays for care in approved beds inside some adult homes and enriched housing programs.
Per the 2026 Q2 capacity report, 15 Capital Region residences hold Assisted Living Program beds, 774 in total: Promenade at University Place (169), The Eliot at Troy, LLC (95), The Pines at Heartwood (86), The Eliot at Catskill (58), Adirondack Manor HFA D.B.A Adirondack Manor HFA ALP (54), Ghent Assisted Living (49), Home Sweet Home on the Hudson (48), Danforth Adult Care Center (42), The Mansion at South Union (40), Marchand at Sharon Springs (36), Argyle Center for Independent Living (35), Home Sweet Home of Athens (24), Camphill Ghent, Inc. (18), Ingersoll Place (10), Judson Meadows (10).
Who pays for each?
ALR residents pay privately, sometimes with long-term care insurance or VA pension, while ALP residents have their care paid by Medicaid and pay room and board from income, usually at the SSI congregate care rate.
The SSI Congregate Care Level 3 rate is $1,688 a month in 2026.
Who qualifies for each?
Anyone the residence can serve under its license can live in an ALR, but an ALP bed requires Medicaid financial eligibility and a nursing-home level of medical need that can still be met safely in the residence.
The medical test is what surprises families; ALP is not a general Medicaid benefit.
Why does this matter when choosing a residence?
Because a parent who may run out of money is better placed in a residence that holds ALP beds or accepts SSI, where a switch to public payment may be possible without moving.
Ask about the waiting list and whether current residents get priority.
Can a building be both?
Yes: some Capital Region residences hold ALR certification on some beds and ALP approval on others, and the quarterly capacity report shows both counts.
Our assisted living roster shows ALR and ALP beds side by side.
Side by side
| Assisted Living Residence | Assisted Living Program | |
|---|---|---|
| What it is | A license | A Medicaid service package |
| Payment | Private | Medicaid for care, income for room and board |
| Eligibility | Needs the residence can meet | Medicaid plus nursing-home-level need |
| Availability | Many residences | Only approved beds |
Where this page states a rule or a dollar figure, it relies on New York statute or regulation (Social Services Law, Public Health Law, 18 NYCRR and 10 NYCRR), Department of Health GIS messages and directories, CMS, the VA or CareScout, as named in the text. How we source facts: editorial standards.
