For generations, as people aged, too many of the frail elderly found themselves placed in nursing homes where many of them stayed for the remainder of their lives. Fortunately, today, there is a medical and social consensus that elderly people should be encouraged to stay in their own homes, and as needed, to receive appropriate support services for as long as they reasonably can. This is not only far more humane to the elderly, but in most cases it is their own clear preference. Moreover, being able to “age in place” can also reduce the sizable expenses associated with long-term nursing home care, particularly for the Medicaid program. For example, a senior citizen who has had a stroke may be hospitalized to receive treatment for the stroke, then spend some time in a skilled nursing facility to receive physical therapy and rehabilitative services, and then be returned home to continue recuperating with the assistance of a home health care services provider.

Even without a serious health episode like a stroke or heart attack, elderly people with the usual health problems associated with advancing age have more options for staying in their own homes. Indeed, as the population ages, particularly the Baby Boom generation, older individuals and their families will increasingly be seeking suitable so-called “supportive housing.” As opposed to an apartment building that happens to have numerous elderly individuals living on their own (see, e.g., “naturally occurring retirement communities” as defined in NY Elder Law §209), supportive housing offers living quarters and makes various levels of assistance available to residents depending upon their physical and mental needs. New York has comprehensive regulatory authority over supportive housing facilities, and this column will explain the various categories of housing and the types of support services they provide.1

Adult Care Facilities

The New York State Department of Health licenses and supervises what are classified as Adult Care Facilities (ACF), which are defined by law as facilities that provide:

… temporary or long-term, residential care and services to adults who, though not requiring continual medical or nursing care as provided by [hospitals, nursing homes or mental health facilities] are by reason of physical or other limitations associated with age, physical or mental disabilities or other factors, unable or substantially unable to live independently.