Rochester Senior AdvisorWhat is the difference between an ALR bed and an ALP bed?
An ALR bed is private assisted living with a market monthly rate, while an Assisted Living Program bed serves a person medically eligible for nursing home care, with Medicaid paying for the care and room and board set at the SSI Congregate Care Level 3 amount.
In the 2026 Q2 capacity report, 7 Rochester-area residences hold Assisted Living Program beds, 307 in all: Cobbs Hill Manor (93), Cirrus Manor Residential Center (57), Horizons (47), Woodcrest Commons (42), The Terrace at Newark (32), Heathwood Assisted Living at Penfield (25), Fairport Baptist Homes Adult Care Facility (11).
Who qualifies for each?
Anyone whose needs fit the residence's license can pay privately for an ALR bed, but an ALP bed requires both nursing-home-level medical eligibility and Medicaid eligibility, or private payment for the ALP services.
That makes ALP a program for people with significant needs and limited money, not a discount on ordinary assisted living.
How much does each cost the resident?
A private ALR resident pays the residence's quoted rate, which New York's 2025 median puts at $7,110 a month, while an ALP resident on SSI pays from a $1,688 monthly SSI amount in 2026 and keeps a $262 personal needs allowance.
ALP residents with income above the SSI level contribute more, under Medicaid's budgeting rules.
Why are ALP beds hard to find?
Each residence is approved for a fixed number of ALP beds, the room-and-board payment is set at the SSI level, and demand from hospitals and families is steady, so ALP beds tend to have waiting lists.
Ask any ALP residence how many beds it holds, how many are open and how long its list is. A residence that holds both ALR and ALP beds may move a private resident into an ALP bed if one opens after their savings are spent.
Which is right for a parent leaving the hospital?
If a parent cannot go home, qualifies for a nursing home medically, and has limited savings, an ALP bed may be a better fit than a nursing home; if they can pay privately and need less care, an ALR is simpler to arrange.
The hospital discharge planner can refer to ALP providers directly. Ask for that referral before agreeing to a nursing home placement if your parent would prefer a residence.
At a glance
| ALR (private) | ALP (Medicaid) | |
|---|---|---|
| Who | Anyone whose needs fit the license | Nursing-home-eligible, Medicaid-eligible |
| Room and board | Market rate | SSI Congregate Care Level 3, $1,688 in 2026 |
| Care paid by | The resident | Medicaid |
| Availability | Varies | Fixed bed counts, often waiting lists |
Sources include the N.Y. Social Services Law and Public Health Law, 18 NYCRR Parts 487-494, 10 NYCRR Parts 415 and 1001, Department of Health GIS messages, CMS, the VA and CareScout, as cited above; see our editorial standards.
