Choosing the right Licensed Home Care Services Agency, or LHCSA, can make a major difference in how well a loved one receives care at home through New York’s Nursing Home Transition and Diversion waiver.
The NHTD waiver supports eligible individuals who want to live safely in the community instead of a nursing home. But not every home care agency is approved to provide NHTD waiver services. Families, caregivers, and waiver participants need to know what to ask before selecting an agency.
In this guide, you’ll learn five practical things to keep in mind, including how to confirm approval, review services, ask about staffing, check reputation, and evaluate communication.
- Confirm the LHCSA Is Approved for NHTD Waiver Services
The first step is simple but important: confirm that the agency is approved to provide services through the NHTD waiver.
Not all Medicaid providers are automatically approved as NHTD waiver providers. Agencies must meet New York State requirements and work through the Regional Resource Development Center (RRDC) application process to become an approved waiver service provider.
What to Ask
Before moving forward, ask:
- Are you approved to provide services under the NHTD waiver?
- Which region or counties are you approved to serve?
- Which waiver services are you approved to deliver?
- Can my service coordinator or RRDC confirm your approval?
This helps prevent delays and ensures the agency can provide services under the participant’s approved service plan.
- Understand Which Services the Agency Can Provide
An LHCSA may be approved to provide certain hands-on services, but that does not mean it provides every NHTD waiver service. The services available depend on the agency’s approval, licensing, staffing, and the participant’s service plan.
For example, New York State requires a copy of an LHCSA license when a provider is seeking approval to provide Home and Community Support Services, also called HCSS, or Respite.
Services to Discuss
Ask whether the agency is approved for services such as:
- Home and Community Support Services
- Respite services
- Personal care support connected to approved waiver needs
- Safety monitoring, cueing, or supervision when appropriate
- Support with daily activities based on the care plan
A strong agency should explain clearly what it can and cannot provide.
- Ask About Staffing, Training, and Backup Coverage
Care quality often depends on the people coming into the home. A reliable LHCSA should have clear hiring, training, supervision, and backup procedures.
Key Questions for the Agency
Ask:
- How do you screen aides and staff?
- Do you complete background and reference checks?
- What training do staff receive before working with participants?
- Do staff receive ongoing training?
- How do you match aides with participants?
- Who supervises staff in the field?
- What happens if an aide calls out or cannot make a shift?
Backup coverage matters. If a participant depends on help with daily needs or safety supervision, missed shifts can create stress and risk. Ask how the agency handles urgent staffing changes.
- Check Reviews, References, and Local Reputation
Reviews can give you a useful first impression, but they should not be your only deciding factor. Look for patterns in what families say about reliability, kindness, scheduling, and communication.
What to Look For
When reviewing an agency, pay attention to comments about:
- Aides arriving on time
- Respectful and compassionate care
- Clear scheduling updates
- Responsiveness to concerns
- Consistency of caregivers
- Professional office staff
You can also ask the agency if it can share references while respecting privacy rules. If you work with a service coordinator, ask whether they have experience with the agency.
- Evaluate Communication From the Start
Good communication is essential in home care. The agency should be easy to reach, patient with your questions, and clear about next steps.
Signs of Strong Communication
Look for an agency that:
- Responds quickly to calls or emails
- Explains services in plain language
- Provides a clear point of contact
- Communicates schedule changes early
- Listens to participant preferences
- Takes concerns seriously
- Works respectfully with families and service coordinators
Here’s the part many families miss: the first few conversations often show how the agency will communicate later. If the agency is hard to reach before services begin, that may continue after care starts.
Contact HouseCalls Home Care
HouseCalls Home Care helps families and waiver participants understand home care options and find support that fits their needs. If you have questions about care at home or want to learn more about available services, our team is here to help.
Call 718-922-9200, email info@HouseCallshc.org, or register through our online form, and we will get back to you.
Key Takeaways
Choosing an LHCSA for the Nursing Home Transition and Diversion waiver should be done carefully. Confirm the agency is approved for NHTD services, ask which services it can provide, and make sure those services match the participant’s approved plan.
Also ask about staffing, training, backup coverage, reviews, references, and communication. The right agency should be qualified, responsive, and committed to helping the participant live safely and with dignity at home.
