Assisted living in New York: rules, costs and what families need to know

The short answer

In New York, the license families see for assisted living is "Assisted Living Residence (ALR)", issued by the New York State Department of Health, Division of Adult Care Facility and Assisted Living Surveillance. A physician, physician assistant or nurse practitioner must complete a signed medical evaluation within 30 days before admission, on a Department of Health form or an approved substitute. The operator must give at least 30 days' written notice on a state form, and may end the agreement only for set reasons, such as care the home is not licensed to give, risk of serious harm, late payment, repeated disruptive behavior or loss of license.

Key facts

  • The median monthly cost of assisted living in New York was $7,110 in CareScout's 2025 Cost of Care Survey, or $85,320 a year, $910 above the national median of $6,200 a month. (CareScout, 2026)
  • Medicaid does not pay to live in an assisted living residence, though it may pay for some medical services there. (New York State Department of Health, 2010)
  • The state's Assisted Living Residence Medical Evaluation form (DOH-3122) includes TB screening done within 30 days before first admission, unless medically contraindicated, by skin test or TB blood test. (New York State Department of Health, 2012)
  • Under the adult home rule that assisted living residences follow, staff help residents who need it by giving the proper dose at the set time and watching and recording that they take it. (N.Y. Comp. Codes R. & Regs. tit. 18, 487.7, 2023)
  • A residence that advertises or markets itself as serving people with dementia or cognitive impairment must apply for a special needs assisted living certificate, with a special needs plan. (N.Y. Comp. Codes R. & Regs. tit. 10, 1001.4, 2026)

New York licenses assisted living residences under Public Health Law Article 46-B, and each one must also be licensed as an adult home or an enriched housing program. An ALR may add Enhanced (EALR) or Special Needs (SNALR) certification; the facts below are for the basic ALR license and the adult home rules (18 NYCRR Part 487) it follows.

Rules change and communities can set stricter policies. Before you sign, confirm the details with the community and the New York State Department of Health, Division of Adult Care Facility and Assisted Living Surveillance. This page is general information, not legal advice.

The rules at a glance

Medical assessment before move-inA physician, physician assistant or nurse practitioner must complete a signed medical evaluation within 30 days before admission, on a Department of Health form or an approved substitute. It is repeated whenever a change in the resident's condition calls for it, and at least once every 12 months. [4] More on this
TB testThe state's Assisted Living Residence Medical Evaluation form (DOH-3122) includes TB screening done within 30 days before first admission, unless medically contraindicated, by skin test or TB blood test. The examiner also states whether the person shows signs of a communicable disease that could spread through casual contact. [5] More on this
Notice before a move-outThe operator must give at least 30 days' written notice on a state form, and may end the agreement only for set reasons, such as care the home is not licensed to give, risk of serious harm, late payment, repeated disruptive behavior or loss of license. If the resident objects, the operator must start a court case before discharge. [6] More on this
Who may give medicationsUnder the adult home rule that assisted living residences follow, staff help residents who need it by giving the proper dose at the set time and watching and recording that they take it. Staff may not give injections, such as insulin, unless they hold a New York license that allows it, though a nurse may prefill insulin syringes. [7] More on this
Memory care and dementiaA residence that advertises or markets itself as serving people with dementia or cognitive impairment must apply for a special needs assisted living certificate, with a special needs plan. It may not market these services until the Department of Health approves it. [8]
Long-term care ombudsmanThe New York State Long Term Care Ombudsman Program helps people who live in nursing homes, assisted living and other licensed adult care homes; call 1-855-582-6769 to reach your ombudsman. [9] Official page More on this
Medicaid helpMedicaid does not pay to live in an assisted living residence, though it may pay for some medical services there. The Assisted Living Program (ALP), offered in some adult homes and enriched housing programs as an alternative to nursing home placement, is Medicaid funded. [10][11] Official page More on this

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What assisted living costs in New York

The median monthly cost of assisted living in New York was $7,110 in CareScout's 2025 Cost of Care Survey, or $85,320 a year, $910 above the national median of $6,200 a month. [12]

A median is the middle of the rates communities reported, so many charge more or less. Rates differ between regions and by the care a resident needs, so ask each community for its full fee list in writing. More: assisted living costs in every state, a monthly budget and the costs that aren't in the base rate.

How to check a community in New York

NYS Health Profiles lets families search adult care facilities by name, county or type, including assisted living, enhanced and special needs residences. Each facility's Inspections tab lists citations from recent inspections and any enforcement actions. Search New York's records. [3]

The licensing agency: New York State Department of Health, Division of Adult Care Facility and Assisted Living Surveillance. [2] Our guide on how to read an inspection report explains what to look for.

Put New York's paperwork on a date

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Frequently asked questions

How much does assisted living cost in New York?

The median monthly cost of assisted living in New York was $7,110 in CareScout's 2025 Cost of Care Survey, or $85,320 a year, $910 above the national median of $6,200 a month. A median is the middle of the rates communities reported, so many charge more or less, and rates differ between regions and by the care a resident needs.

What medical assessment does New York require before moving into assisted living?

A physician, physician assistant or nurse practitioner must complete a signed medical evaluation within 30 days before admission, on a Department of Health form or an approved substitute. It is repeated whenever a change in the resident's condition calls for it, and at least once every 12 months.

Does New York require a TB test for assisted living?

The state's Assisted Living Residence Medical Evaluation form (DOH-3122) includes TB screening done within 30 days before first admission, unless medically contraindicated, by skin test or TB blood test. The examiner also states whether the person shows signs of a communicable disease that could spread through casual contact.

How much notice must an assisted living community in New York give before a move-out?

The operator must give at least 30 days' written notice on a state form, and may end the agreement only for set reasons, such as care the home is not licensed to give, risk of serious harm, late payment, repeated disruptive behavior or loss of license. If the resident objects, the operator must start a court case before discharge.

Who can give medications in assisted living in New York?

Under the adult home rule that assisted living residences follow, staff help residents who need it by giving the proper dose at the set time and watching and recording that they take it. Staff may not give injections, such as insulin, unless they hold a New York license that allows it, though a nurse may prefill insulin syringes.

Who can help with a complaint about assisted living in New York?

The New York State Long Term Care Ombudsman Program helps people who live in nursing homes, assisted living and other licensed adult care homes; call 1-855-582-6769 to reach your ombudsman.

Does Medicaid pay for assisted living in New York?

Medicaid does not pay to live in an assisted living residence, though it may pay for some medical services there. The Assisted Living Program (ALP), offered in some adult homes and enriched housing programs as an alternative to nursing home placement, is Medicaid funded.

Sources

  1. New York State Department of Health: Adult Care Facility Services (revised September 2026) (checked October 22, 2026)
  2. New York State Department of Health: 2025 Adult Care Facilities Annual Legislative Report (2026) (checked October 22, 2026)
  3. New York State Department of Health: NYS Health Profiles, Adult Care Facilities (2026) (checked October 22, 2026)
  4. N.Y. Comp. Codes R. & Regs. tit. 10, 1001.7(h), Admission and retention standards, medical evaluation (via Cornell LII), 2014 (checked October 22, 2026)
  5. New York State Department of Health: DOH-3122, Assisted Living Residence Medical Evaluation (Rev. 5/12), 2012 (checked October 22, 2026)
  6. N.Y. Comp. Codes R. & Regs. tit. 18, 487.5(f), Termination of admission agreements, applied to assisted living by 10 NYCRR 1001.8(f) (via Cornell LII), 2023 (checked October 22, 2026)
  7. N.Y. Comp. Codes R. & Regs. tit. 18, 487.7(f), Medication management, applied to assisted living by 10 NYCRR 1001.10(l) (via Cornell LII), 2023 (checked October 22, 2026)
  8. N.Y. Comp. Codes R. & Regs. tit. 10, 1001.4(p), Special needs assisted living certification (via Cornell LII), accessed 2026 (checked October 22, 2026)
  9. New York State Long Term Care Ombudsman Program: home page (2026) (checked October 22, 2026)
  10. New York State Department of Health: Consumer Information Guide, Assisted Living Residence, publication 1505 (12/10), 2010 (checked October 22, 2026)
  11. New York State Department of Health: Assisted Living Program (ALP) (revised August 2014) (checked October 22, 2026)
  12. CareScout: Cost of Care Survey 2025, Ranked Median Costs by State (2026) (checked October 22, 2026)

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Other states: assisted living rules by state. A word you don't know? See assisted living terms, explained.