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What Medicare Does and Does Not Pay For

Medicare covers short skilled nursing stays, home health and hospice. It does not pay for assisted living or custodial care, in any state.

HomeCosts & PayingWhat Medicare Does and Does Not Pay For
Short answer

Medicare does not pay for assisted living, memory care, or long-term custodial care anywhere in the country. It covers limited skilled nursing facility stays after a qualifying hospital admission, intermittent skilled home health, and hospice.

What Medicare covers

  • Skilled nursing facility care after a qualifying inpatient hospital stay, for a limited period, when skilled care is needed daily. This is rehabilitation, not long-term placement.
  • Home health that is intermittent and skilled — nursing visits, physical, occupational or speech therapy. Not a caregiver who stays with your parent.
  • Hospice — the hospice team, medications related to the terminal diagnosis, and equipment. Not room and board in a facility.
The observation status trap. A Medicare skilled nursing benefit requires a qualifying inpatient hospital admission. Time spent under “observation status” does not count, even if your parent slept two nights in a hospital bed. Ask the hospital directly whether your parent is admitted as an inpatient or under observation, and ask in writing.
What senior care costs. The 2025 CareScout Survey puts New York's assisted living median at $7,110/month and a private nursing home room at $16,729/month -- state figures, not Staten Island-specific. Read the full explanation →

Questions families ask

How much does adult day health care cost in New York?

The 2025 CareScout survey's New York State median for adult day health care is $144/day, or roughly $3,120/month at a five-day-a-week schedule -- a state figure, not a Staten Island-specific one.

Why doesn't CareScout publish a Staten Island or New York City-specific cost figure?

CareScout's Cost of Care Survey is designed and published at the state level only, across every state it covers -- there is no metro-specific breakout for New York City, Staten Island, or any other individual region within the state, from CareScout or from any other primary source we could locate.

What does the Long-Term Care Ombudsman actually do for a Staten Island family?

The ombudsman advocates for a resident of a long-term care facility, independent of the state regulator, and can attend care conferences with a family. It does not license, inspect or fine a facility -- that is NYSDOH's role. Staten Island's ombudsman coverage runs through CIDNY's NYC-region program at 1-888-855-9807.

How do I reach the Long-Term Care Ombudsman that covers Staten Island specifically?

Staten Island falls under the New York City region (Region 3) of the Long-Term Care Ombudsman Program, sponsored by the Center for Independence of the Disabled, New York (CIDNY), reachable at 1-888-855-9807 or ltcop@cidny.org. The statewide LTCOP hotline is 1-855-582-6769.

Does the ombudsman need my parent's consent before getting involved?

Yes. The ombudsman acts only with the consent of the resident, or their legal representative if the resident lacks capacity to consent. This surprises many adult children, particularly when a parent with intact decision-making capacity does not want a complaint pursued that the family feels strongly about.

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