Department Info

Residential Care Facilities and Options

Office For The Aging
Todd N. Tancredi, Director


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Adult Homes provide a private or semi-private room, private or shared bath, all meals and snacks, housekeeping and laundry services, and 24-hour supervision. Supportive services provided are targeted to those residents who need personal care assistance with activities of daily living, such as bathing, dressing, grooming, eating, and assistance with the self-administration of medications, but who do not need continual nursing or medical care. Other supportive services include case management, scheduling doctors’ appointments, helping people obtain their financial entitlements, and offering meaningful on-site and community activities.




Assisted living residences combine housing with personal services and healthcare assistance.  They promote independence while providing care and support on a 24-hour basis.  Assisted living facilities are for people needing assistance with Activities of Daily Living (ADLs) but wishing to live as independently as possible for as long as possible.  Assisted living exists to bridge the gap between independent living and nursing homes.  Residents in assisted living centers are not able to live by themselves but do not require constant care either. Assisted living facilities offer help with ADLs such as eating, bathing, dressing, laundry, housekeeping, and assistance with medications.  Many facilities also have centers for medical care.  Most assisted living facilities create a service plan for each individual resident upon admission.  The service plan details the personalized services required by the resident and guaranteed by the facility.  The plan is updated regularly to assure that the resident receives the appropriate care as his or her condition changes.

New York has three models of assisted living: adult homes, enriched housing programs and assisted living programs.

An Adult Home is a New York State-licensed adult care facility that provides long-term residential care including room, all meals and snacks, housekeeping, laundry, 24-hour supervision, assistance with medication, personal care assistance, case management services and structured activity programs to people 18 years or older.

An Enriched Housing Program is a New York State-licensed adult care facility that provides long-term residential care to adults, primarily persons 65 years of age or older including an individual apartment, some meals, housekeeping, laundry, supervision, assistance with medication, personal care assistance, case management services and structured activity programs.

The Assisted Living Program (ALP) is an Adult Home or Enriched Housing Program that is certified by New York State Department of Health to provide Medicaid-funded home care services. The ALP is an alternative to nursing home care that enables nursing home eligible people to receive home health care services in the Adult Home or Enriched Housing Program, delaying or preventing the need for admission to a nursing home.  Care services are provided by an on-site licensed home care agency operated by the Adult Home or Enriched Housing Program and a community certified home health agency (CHHA) under contract.

The residential portion of services is reimbursed either through Supplemental Security Income (SSI) Level II or privately by the ALP client.  The home care services portion of ALP is reimbursed through Medicaid or private payment.



Family Type Homes are certified by the New York State Office of Children and Family Services to provide long term residential care and/or supervision to four or fewer adults who are not related to the operator.  New York State law requires certification by a state agency of these homes. 

The basic responsibilities of the caregiver are the provision of a room (which may be shared), board, laundry, housekeeping, personal care, and medical supervision.  The residents who are eligible for this type of care are people who have lost their local support systems, such as family, neighbors, or relatives.

Family Type Homes are operated by one or more persons in their own home, and the residents share the life of the family, eating or watching television together, and sharing common rooms.  Many proprietors have pets, take residents on family outings, and some provide such special extras as beauty care or special diets.  A few provide short-term respite care by the day or week.

Contact the Dutchess County Department of Community & Family Services, Adult Services Unit at (845) 486-3300 for additional information & referral.



Foster Care matches elderly and physically disabled adults with families willing and able to share their homes and provide needed supervision and personal care.  The purpose of the program is to maintain people in a home setting for as long as is safely possible, thereby delaying nursing home placement and providing a community care alternative at reduced cost.

Foster Family Care can sometimes be an option for respite care, convalescence or rehabilitation. The Foster Family Care program is monitored by the Dutchess County Department of Community & Family Services.  Medicaid payment for the personal care services component is authorized by NY Connects.


NURSING HOMES (Residential Health Care Facilities)

Nursing homes are facilities for those individuals who are in need of skilled nursing care or supervision on a 24-hour basis, 7 days per week.  Nursing home costs vary.  Payment sources include insurance, private- pay and/or Medicaid.

In New York State, admissions are based on the needs of residents as determined by a PRI (Patient Review Instrument) evaluation and whether a particular nursing home can meet these needs. 

Dutchess County nursing homes are licensed and monitored by the New York State Department of Health. All nursing homes must meet the local and state Life Safety codes.  Concerns and complaints can be referred to The Long Term Care Ombudsman Program or the New York State Department of Health.


NURSING HOME PLACEMENT EVALUATION (Patient Review Instrument/Screen & Home Assessment)

As part of the nursing home application process, a formal evaluation needs to be done by a professional who has received training approved by New York State.  This is a Patient Review Instrument, sometimes called a PRI evaluation.  It may be done in the hospital or in the community and a fee may be charged.

The purpose of the evaluation is to determine the level of care a client needs, as well as the most appropriate placement setting.  In addition, the need for active treatment for persons with a psychiatric diagnosis or those developmentally delayed is assessed, as these persons may not be appropriate for nursing home placement.

The PRI is normally valid for 90 days, but if done in a hospital setting must be redone when the client returns to the community.  Clients who are receiving Certified Home Health Agency (CHHA) or Long Term Home Health Care Program services should request the PRI be done by the trained person in that agency. 

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Todd N. Tancredi,Director Todd N. Tancredi
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