There are four different levels of senior care. Let’s begin by looking at the differences between each one.

Personal Care Homes (PCH)

Personal Care Homes (PCH) are residences that provide shelter, meals, supervision, and assistance to people who need support with daily activities or medication management. A fee, based on the size of the space and level of care required, is paid monthly. 

PCHs are inspected and licensed through Pennsylvania’s Department of Human Services. They are typically privately owned and can be licensed for a few or many residents. 

In York County, there are many personal care homes for people with means, but fewer for those with lower incomes. Supplemental Security Income (SSI) and some veteran programs can help low-income adults cover PCH costs.

There is a public-private partnership with a cross-section of housing, health, and human services stakeholders called ALPHA (Alliance for Low Income Personal Care Home Advancement) working to address this shortage. ALPHA advocates at the state level for an increase in the daily SSI allowance, which will help the business model of ALPHA homes. ALPHA also gives  PCHs resources to help operators offer the best quality of care possible. Most importantly, ALPHA works to increase the shortage of PCH beds for low-income older adults. 

Assisted Living Residency 

An assisted living residency is similar to a personal care home in that it serves people who need daily living assistance or medication management. However, in addition to paying a monthly fee,  a community fee may be collected up front. A community fee is a non-refundable, one-time fee paid to senior living communities at move-in. It is always best to talk with a professional who can help explain the details of these fees.

You can view a detailed listing of Assisted Living and Personal Care Homes in York County here.

Memory Care

Memory Care is like assisted living, but with a focus on supporting people living with Alzheimer’s or dementia. In memory care, the staff makes sure residents get meals, participate in activities and move through their day (unlike assisted living or personal care, where these things are optional). 

Skilled Care

Skilled Care, formerly known as a nursing home, is for residents requiring 24-hour care. This level of care is either paid for privately, by insurance, or by Medicare(for a short period), and Medicaid.

You can view a detailed listing of Skilled Care (Nursing Homes) in York County here.


Embrace your reason: What is your purpose and hope for the future? How does each type of senior care living help support that purpose and cultivate a life that gives you meaning?


Paying for Care

When it comes to paying for care, it’s important to understand your options. Medicare, medical assistance, and long-term care insurance all have advantages and disadvantages. Here’s what you should know about each:

  • Medicare A&B covers much of a hospital stay cost.
  • Medicare may cover short term rehabilitation services in a nursing facility following a qualified hospital stay.
  • Medicare covers approved in-home and community-based rehabilitation services.
  • Medicare does not pay for long-term nursing home stay.
  • Medicare does not contribute to the cost of an assisted living or personal care home.
  • Medical assistance may support some long-term care services following an assessment.
  • Long-term care insurance can be a valuable resource:
    • Policies vary in cost and service provision
    • Policies over both in home and residential care
    • Policies are purchased as an insurance option

Additional Resources

These three resources also provide information about local providers offering the levels of care discussed in this article.  Or, connect with a TroveStreet navigator for help in narrowing the best options for you.

  1. PA 211
  2. Seniors Bluebook of South Central PA
  3. beyond50 Resource Directory

TroveStreet is Here to Help

Take advantage of our free TroveStreet Planning Tool, which you can access directly in your dashboard or download as a PDF. Want someone to walk you through it? Sign up for our Aging Navigation & Plan Creation package and a TroveStreet navigator will be by your side through the process.

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