If you or a loved one wants to avoid nursing home placement and receive care at home instead, New York’s Nursing Home Transition and Diversion, or NHTD, waiver may be an option. This Medicaid program helps eligible adults receive nursing home-level care and community-based support while living in the community.
Understanding the eligibility requirements can help families prepare for the application process and make informed decisions.
What Is the NHTD Waiver?
The NHTD waiver is a New York State Medicaid program for adults who need nursing home-level care but want to remain in the community. It is designed to support independence while providing access to services that promote safety and daily functioning.
The program generally serves:
- Adults ages 18 to 64 with a verified physical disability
- Adults aged 65 or older
Applicants must also be able to live safely in the community with available services and support.
Who May Be Eligible?
To qualify for the NHTD waiver, a person must generally:
- Be eligible for community-based Medicaid
- Need a nursing home level of care. Be aged 18 to 64 with a verified physical disability, or age 65 or older
- Be able to live safely in the community with support
Some individuals may not qualify even if they meet the basic criteria. For example, a person living in, or planning to live in, an Assisted Living Program or another licensed congregate care setting is not eligible. In addition, Medicaid does not allow duplication of certain long-term care services. People enrolled in programs such as MLTC, PACE, HARP, or Health Homes may need to disenroll before joining the NHTD waiver.
How Is Eligibility Reviewed?
Eligibility is based on more than age and Medicaid status. The applicant must also show a need for nursing home-level care.
In many cases, this is determined through the UAS-NY community health assessment. For people transitioning from a nursing home or hospital, the HC-PRI and SCREEN may be used at first.
Applicants may also need to provide:
- Proof of Medicaid eligibility
- Proof of age
- Proof of physical disability for applicants under 65
- A signed Freedom of Choice form
- An Initial Service Plan
- A Plan of Protective Oversight
These documents help show that the applicant can live safely in the community with the right services.
What Are the Steps in the Application Process?
The process usually begins with a referral to the Regional Resource Development Center, or RRDC. After that, the applicant attends an intake meeting, chooses a Service Coordination provider, and works with a Service Coordinator to complete the application.
The application packet typically includes the service plan, safety planning documents, and level of care assessment. The RRDC then reviews the file and issues a Notice of Decision.
If approved, services may begin once eligibility is authorized. If denied, the applicant receives information about the reason for the denial and appeal rights.
What Services May Be Available?
Approved participants may receive a range of support based on individual needs. These can include:
- Assistive Technology
- Community Integration Counseling
- Environmental Modifications
- Home and Community Support Services
- Independent Living Skills Training
- Respite Services
- Service Coordination
- Social Transportation
- Wellness Counseling
Not every participant receives the same services. Support depends on the person’s condition, goals, living situation, and approved service plan.
Why the NHTD Waiver Matters
The NHTD waiver can help older adults and people with physical disabilities stay in the community while receiving needed care. For many families, it provides a practical alternative to institutional care and supports greater independence at home.
If you need help understanding home care options, HouseCalls Home Care is here to help. Call 718-922-9200 or email info@HouseCallshc.org to learn more.
Key Takeaways
The NHTD waiver helps eligible New Yorkers receive nursing home-level care and supportive services while living at home or in the community. To qualify, applicants generally need community-based Medicaid, nursing home level of care, qualifying age or disability status, and a safe community living plan. The application process involves the RRDC, assessments, documentation, and service planning.
