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What In-Home Care Costs

New York's 2025 CareScout non-medical caregiver median is $35/hour -- the math on when a licensed community becomes the cheaper option.

HomeCosts & PayingWhat In-Home Care Costs
Short answer

New York State's 2025 CareScout median for a non-medical caregiver/home health aide is $35/hour, or roughly $6,673/month at a full-time equivalent. There is no Staten Island-specific figure published anywhere.

The hours-per-week math

Hours/weekApprox. monthly cost at $35/hr
10 hrs/week~$1,517
20 hrs/week~$3,033
40 hrs/week~$6,067
60 hrs/week~$9,100
168 hrs/week (round-the-clock)~$25,480

The crossover point

New York's 2025 CareScout assisted living median is $7,110/month. At $35/hour, that is roughly 41 hours a week of in-home care -- once a parent needs meaningfully more supervision than that, a licensed community is often the less expensive option on paper, even before counting the value of round-the-clock staffing a single hired caregiver cannot provide alone.

Home health is different math entirely. Medicare-covered home health -- skilled, intermittent nursing or therapy visits ordered by a physician -- is billed per visit, not hourly, and is not a substitute for the custodial caregiver hours in the table above.

Source: CareScout Cost of Care Survey

Questions families ask

Does New York rate assisted living communities the way it rates nursing homes?

No. Federal CMS star ratings apply only to Medicare/Medicaid-certified nursing homes, published at profiles.health.ny.gov/nursing_home and on CMS Care Compare. Assisted living and memory care communities in New York do not carry CMS star ratings -- the only public quality record for them is the NYS Health Profiles inspection history.

What is Managed Long Term Care (MLTC), and is it mandatory on Staten Island?

MLTC is New York's Medicaid managed-care delivery system for long-term care -- either PACE (age 55+) or MLTC Partial Capitation/Medicaid Advantage Plus. Enrollment has been mandatory in New York City, including Richmond County/Staten Island, since 2012 under Medicaid Redesign Team Initiative #90, approved August 31, 2012.

What is the NHTD waiver, and how is it different from MLTC?

The Nursing Home Transition and Diversion (NHTD) waiver is a Medicaid 1915(c) home- and community-based services waiver, administered through NYSDOH Regional Resource Development Centers, for Medicaid-eligible people 65+ (or younger with a disability) assessed as needing nursing-home-level care who want to receive services in the community instead. MLTC is a managed-care delivery system; NHTD is a specific waiver program.

What is New York's Assisted Living Program (ALP), and does it pay room and board?

The Assisted Living Program (ALP), under 18 NYCRR Part 494, is Medicaid-funded care delivered inside a qualifying Adult Home or Enriched Housing Program setting -- covering personal care, home health aides, nursing, therapy, medical supplies, adult day health care and RN case management. It folds room and board into its rate structure differently than a pure HCBS waiver, so the exact private-pay portion varies by community.

Is ACA Medicaid expansion the same thing as long-term care Medicaid for seniors?

No. New York fully expanded Medicaid under the ACA effective January 1, 2014, covering adults 19-64 up to 138% of the federal poverty level with no asset test. Long-term care Medicaid for seniors uses a completely separate pathway -- the non-MAGI aged/blind/disabled test -- which is asset-tested and has its own spousal protection rules.

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