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We're stuck between two communities

The questions that break a tie once the tours all start blurring together.

Quick answer

The questions that break a tie once the tours all start blurring together.

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Home›By Situation›We're stuck between two communities

By this point you have toured enough that the buildings have merged. These are the questions that still separate them.

Short answer

The questions that break a tie once the tours all start blurring together.

What to do, in order

  1. Compare the all-in numbers, not the base rents. Ask each community for the total monthly cost at your parent's assessed care level, in writing.
  2. Compare the rate increase histories. Three years of actual increases from each.
  3. Compare overnight staffing, not daytime. Daytime ratios look similar everywhere. Overnight is where they diverge.
  4. Pull both state inspection records. Read the surveyor narratives rather than counting citations.
  5. Ask the Medicaid waiver question of both. If private funds might run out, a community that does not hold a waiver provider agreement is a future forced move.
  6. Go back unannounced. Same building, evening on a weekday.

Questions families ask

My mom is 68 with a low income - does New York's ACA Medicaid expansion cover her nursing home or home care costs?

No. New York's 2014 ACA Medicaid expansion covers a different population: adults ages 19-64 without dependent children, up to 138% of the federal poverty level, with no asset test. Long-term care Medicaid for seniors is a completely separate eligibility pathway - it is asset and resource-tested, applies to people 65 and older or those needing institutional-level care, and is what actually covers nursing home care, MLTC, the ALP, and NHTD waiver services.

How much money can my spouse keep if I go on Medicaid for nursing home care in New York in 2026?

For 2026, the community spouse may generally keep the greater of the state minimum Community Spouse Resource Allowance ($74,820) or half of the couple's countable resources, up to the federal maximum of $162,660. The community spouse is also entitled to a Minimum Monthly Maintenance Needs Allowance of $4,066.50 per month from the institutionalized spouse's income. These figures come from NYSDOH's GIS 26 MA/03 guidance, effective January 1, 2026.

How much spending money is a Medicaid nursing home resident allowed to keep each month in New York?

New York's Nursing Home Resident Personal Needs Allowance is $50 per month - the amount a Medicaid-funded nursing home resident is permitted to keep from their own income for personal expenses, with the rest going toward the cost of their care. According to the NY State Office for the Aging (NYSOFA), this figure has been unchanged since the 1980s, and NYSOFA notes that 33 other states currently pay a higher PNA, ranging from $52 to $200.

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