Hudson Valley Senior AdvisorWhat is the difference between private-pay assisted living and an ALP bed?
A private-pay resident pays the residence's monthly rate for room, board and care from their own funds, while a resident in an Assisted Living Program bed has care services paid by Medicaid and contributes SSI or other income toward room and board.
The 2026 Q2 capacity report shows 9 of the 18 licensed residences in Dutchess and Orange holding Assisted Living Program beds, 931 of the 1,664 certified beds: Hedgewood Assisted Living (192), Promenade at Middletown (131), The Eliot at Erie Station ALP (120), The Sentinel of Port Jervis (109), Dutchess Care (92), Braemar Living at Wallkill (88), The Avalon Assisted Living and Wellness Center (75), Hyde Park Assisted Living Facility, Inc. (66), Promenade at Tuxedo Place (58). In several Mid-Hudson buildings both kinds of residents live side by side, which is why a family can sometimes plan a private-pay move now and an ALP switch later without changing addresses.
Who qualifies for the Assisted Living Program instead of private pay?
Someone who is financially eligible for Medicaid and medically eligible for nursing home placement, but who does not need continual nursing and can be served safely in the residence.
The medical side surprises families: a parent who is still quite independent may be too well for an ALP bed. Ask the residence's case manager to explain its assessment before you count on the program.
How do the monthly costs compare?
Private-pay assisted living in New York has a 2025 median of about $7,110 a month, while an ALP resident on SSI pays most of the $1,688 Congregate Care Level 3 benefit and keeps $262 for personal needs.
The gap is large, which is why ALP beds have waiting lists. A family planning ahead can file the Medicaid application with the county Department of Social Services months before savings run out.
What should we ask a residence that has both?
Ask how many ALP beds it has and how many are open, whether private-pay residents get priority when they convert, whether the room or level of service changes on conversion, and how long the current wait is.
Get the answers in writing, alongside the admission agreement. Our directory shows each building's ALP bed count from the state report.
At a glance
| Private-pay assisted living | Assisted Living Program bed | |
|---|---|---|
| Who pays for care | The resident or family | Medicaid |
| Room and board | Included in the monthly rate | Paid from SSI or income |
| Eligibility | Needs within the license | Medicaid plus nursing-home-level need |
| Availability | Usually an open room | Often a waiting list |
Rules and dollar amounts on this page come from New York law and regulation (the Social Services Law, Public Health Law, 18 NYCRR and 10 NYCRR), Department of Health GIS messages and directories, CMS, the VA, CareScout or the county agencies named in the text. Our sourcing rules: editorial standards.
