These are alternative housing options for seniors, in which multiple levels of care, including independent living, assisted living and long term nursing home care are contained within one community. The number of these communities is growing rapidly in New York State.

An initial entrance fee is required. These entrance fees can range from $100,000 to $1MM, depending on the health of the resident, the type of housing, and the type of service contract. In addition to the down payment, the resident must pay a monthly maintenance fee, which can range from $3,000 to $5,000 a month. Additional fees may be incurred for housekeeping, social activities and transportation. The resident must maintain a Medicare and a Medigap insurance policy.

The advantage of these communities is having multiple levels of care prearranged in a single place, without a need for multiple moves. Since home care and nursing home care is arranged, Medicaid planning will not be necessary. There will be no need to transfer assets and the individual can retain control of all of his assets. Furthermore, depending on the contract, the down payment may be protected from an unexpected death. If a resident enters the community and dies 3 months later, the contract may provide for a refund to the family of a percentage of a down payment