Senior care in Central New York: home care, rehab and assisted living

This guide is for families in Central New York working out care for an aging parent or spouse, and for older adults who want to plan before a hospital stay forces the decision. It explains the main levels of care in plain terms, from a few hours of help at home to a nursing home bed, and what Medicare does and does not pay for.

It also lists the county offices that help families sort through options for free, the state and federal tools for checking an agency or facility’s record, and a few long-running providers. Facts were checked as of October 2, 2026.

Start with the county aging office or NY Connects

Each county has an office for the aging that plans, funds and delivers services for people 60 and older, and most of them also run NY Connects, the state program that gives information on long-term services and supports to people of any age. The statewide NY Connects line is 1-800-342-9871. A call to either one can tell you what help exists near you and whether you qualify for programs that cost less than paying privately.

The eight county offices are:

• Onondaga: the Onondaga County Office for Aging, a division of Adult and Long Term Care Services, on the 10th floor of the Civic Center at 421 Montgomery St. in Syracuse; (315) 435-2362.
• Oneida: the Office for Aging and Continuing Care; (315) 798-5456.
• Oswego: the Oswego County Office for the Aging, which also runs the county’s NY Connects program.
• Otsego: the Office for the Aging and NY Connects, at The Meadows Office Complex.
• Cortland: the Cortland County Office for Aging.
• Madison: the Madison County Office for the Aging.
• Herkimer: the Herkimer County Office for the Aging and NY Connects.
• Chenango: the Chenango County Area Agency on Aging, listed in the state’s directory of local offices.

Some help is free or subsidized based on income. Oneida County, for example, says people 60 and older without Medicaid can ask the county for an assessment, and care may be fully subsidized for those at or below 150 percent of the federal poverty level, with a cost share above that.

The levels of care, from least help to most

Home care: CHHA or LHCSA

New York licenses two main kinds of home care agencies. The state Health Department says certified home health agencies, or CHHAs, provide part-time, intermittent health care and support services to people who need intermediate and skilled care, such as nursing and therapy. Licensed home care services agencies, or LHCSAs, provide home care to people who pay out of pocket or have private insurance. State law requires any organization that provides or arranges home care to be licensed or certified by the Health Department.

Medicare covers home health care only when you need part-time or intermittent skilled services and are homebound. Medicare does not pay for 24-hour care at home, meal delivery, homemaker services such as shopping and cleaning, or personal care like bathing and dressing when that is the only care you need. People on Medicaid who need personal care at home are assessed through the New York Independent Assessor Program, the state’s contracted assessor.

Adult day programs

Adult day programs give a family caregiver time to work or rest while the older adult spends the day in a supervised setting. Some are medical programs. In New Hartford, Sitrin Health Care Center runs an Adult Day Health Care Program, which the center calls a medical adult day program, and posts a state health equity impact assessment about expanding the program from 40 to 60 slots. Others are social programs, which Oneida County lists among the services families can arrange through NY Connects.

Adult homes and assisted living

The Health Department licenses adult homes, enriched housing programs and residences for adults, together called adult care facilities. The state’s definitions are worth knowing before you tour:

• An adult home provides room, board, housekeeping, personal care and supervision to five or more adults.
• Enriched housing provides similar care in apartment-style settings, mostly for people 65 and older.
• An assisted living residence adds 24-hour on-site monitoring, case management and an individual service plan for each resident, and must operate within a licensed adult home or enriched housing program.
• A residence with the state’s EALR certification can keep residents who need another person’s help to walk or climb stairs, depend on medical equipment, or have chronic incontinence, so they can age in place.
• A special needs assisted living residence serves people with dementia or other cognitive impairment.

Adult care facilities can also take residents for respite stays of up to 120 days in a 12-month period while a caregiver is away.

The Assisted Living Program (ALP)

The Assisted Living Program is a separate license. The state says an ALP serves people who are medically eligible for nursing home placement in a less medically intensive, lower-cost setting, and provides personal care, nursing, home health aides, therapy, medical supplies and nurse case management on top of room and board. Ask any assisted living residence whether the residence holds an ALP license and how many ALP beds are available.

Nursing homes and short-term rehab

Nursing homes provide both long-term care and short-term rehab after a hospital stay. Medicare covers a skilled nursing facility stay only after a qualifying inpatient hospital stay of at least three days in a row, not counting the day you leave. Time spent under observation or in the emergency room before admission does not count, even overnight, so ask the hospital whether you have been admitted as an inpatient. Medicare does not pay for long-term custodial care.

PACE: nursing home level care at home

PACE, the Program of All-Inclusive Care for the Elderly, keeps people at home who would otherwise qualify for a nursing home. In Onondaga County the program is PACE CNY, which is open to people 55 and older who live in Onondaga County, are certified by the state as needing nursing home level care, and can live safely in the community when they enroll. PACE CNY covers doctor visits, prescriptions, home care, hospital stays and nursing home care when needed, and runs day centers with on-site clinics in North Syracuse, at 100 Malta Lane, and in East Syracuse, at 115 Creek Circle. Transportation to the centers and appointments is free. For people with Medicaid, or with both Medicare and Medicaid, fees are fully covered, though some Medicaid recipients may have a spend-down; others pay a monthly fee. Call (315) 452-5800.

How to check an agency or facility

Two free public tools show inspection results and quality data. The state’s NYS Health Profiles site covers nursing homes, home care agencies, hospices and adult care facilities, and lets you search by county and compare certified home care agencies on measures such as patient satisfaction and preventing unplanned hospital care. The federal Care Compare site rates nursing homes and home health agencies that take Medicare.

Complaints about an adult home, assisted living residence or ALP go to the state’s Centralized Complaint Intake Program at 1-866-893-6772, staffed 8:30 a.m. to 4:45 p.m. weekdays. Complaints about a nursing home go to the Health Department in writing, and the department has an online complaint form.

Long-running providers

These organizations have served the region for decades and cover several levels of care. Inclusion here is not a rating; check each one on the tools above.

• In Syracuse, Loretto was founded in 1926 by the Roman Catholic Diocese of Syracuse and was reorganized as a private nonprofit in 1976. Loretto says the organization has 19 programs and more than 2,500 employees, with several locations on East Brighton Avenue, and that The Heritage is the only dedicated memory care community in the area that accepts Medicaid. The main number is (315) 469-5570.
• With a Jamesville mailing address, The Nottingham at 1301 Nottingham Road opened in 1988 as a Loretto campus where residents can move from independent living to assisted living, memory care and skilled nursing without leaving; (315) 445-9242.
• In New Hartford, Sitrin, a nonprofit, began in 1951 as a six-bed home and now runs a 188-bed center at 2050 Tilden Ave. with a 46-bed inpatient rehab unit, a 32-bed unit for people with Huntington’s disease and ALS, and 110 skilled nursing beds, along with assisted living and enriched housing; (315) 797-3114.
• In Utica, Masonic Care Community opened in May 1893 as the Masonic Home and is now open to everyone. More than 500 older adults live on the 400-acre campus at 2150 Bleecker St., which has skilled nursing, rehab, adult residential care and home care; (315) 798-4800.

Good to know

These dates and rules were current as of October 2, 2026:

• Medicare’s open enrollment period runs October 15 to December 7, 2026. Changes made by December 7 take effect January 1.
• The three-day inpatient rule for Medicare rehab coverage can be waived for some Medicare Advantage members and for patients of certain accountable care organizations. Ask the hospital or your plan before discharge.
• PACE CNY covers Onondaga County only. Residents of other counties should ask their county aging office about home care and Medicaid options.

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