Long-Term Care Facilities
Long-term care facilities are part of a comprehensive support system designed to assist individuals who, beyond simple medical treatment, have difficulty performing Activities of Daily Living (ADLs: bathing, dressing, eating, etc.) independently due to physical or cognitive limitations. *Important to know: long-term care is not a single program. It is a category covering many services and several ways of paying for them. Depending on who pays, there are three main paths: - Medicare: Covers short-term, medically necessary skilled nursing or home health care only, on a limited basis. It does not cover general long-term custodial care.
- Medicaid (in New Jersey: NJ FamilyCare MLTSS): Covers long-term care for those who meet income, asset, and clinical criteria. In New Jersey it is delivered through MLTSS (Managed Long Term Services and Supports).
- Long-term care insurance / private pay: Paid through a private long-term care insurance policy or out of pocket.
This guide focuses on the Medicaid MLTSS path, the route most commonly used by New Jersey seniors and their families. Types of Long-Term Care Services
Residential Care
- Assisted Living
A residence for those who can live independently but need help with meals, medication, and personal hygiene. Around-the-clock medical nursing is often not provided. Costs are primarily paid out-of-pocket, though Medicaid benefits may apply in limited cases.
Rehabilitation and Skilled Nursing Care
- Services provided directly by professional medical staff when medically complex treatments (wound care, IV therapy) or intensive rehabilitation (physical/occupational therapy) are required. Used for short-term intensive rehabilitation after surgery or illness.
Home and Community-Based Services (HCBS)
Medical services provided by professionals such as nurses, home health aides, and physical/occupational therapists who visit the home per doctor’s prescription.
Provides social activities and health monitoring in a safe facility during the day, offering respite to family caregivers.
Hospice Care
A special form of care provided to patients with terminal illnesses or a life expectancy of six months or less. It focuses on pain management and emotional support rather than curative treatment.
Official NJ MLTSS covered benefits
New Jersey MLTSS coordinates and provides: NJ FamilyCare Plan A benefits, care management, home and vehicle modifications, home-delivered meals, respite care, personal emergency response systems, mental health and addiction services, assisted living, community residential services, and nursing home care.
Eligibility: Who Can Use These Services?
Who is served?
- Older adults (age 65+) who need help with daily living
- People with chronic conditions and those recovering from surgery or illness
- People with disabilities (including blindness)
- People with cognitive impairment (such as dementia) who need supervision
New Jersey MLTSS Eligibility (age 21+)
Both clinical and financial criteria must be met.
- Clinical criteria
The person must be assessed as needing a Nursing Facility level of care. Specifically: hands-on help with 3 or more ADLs — such as bathing, dressing, toileting, walking, transferring, eating, or moving in bed — or, due to cognitive impairment, supervision or direction with 3 or more ADLs. Assessments may be conducted through an MCO (managed care organization) or the Division of Aging Services / Office of Community Options.
- Age / disability criteria
Age 65 or older, or under 65 with a blindness or disability determination from the Social Security Administration (SSA) or the State of New Jersey.
- Financial criteria
Monthly income and countable-asset limits apply, and they change from year to year. Limits also vary with household size, spousal status, and use of a Qualified Income Trust (QIT), so always confirm with an official agency.
For reference: in 2026, the institutional Medicaid monthly income limit is $2,982/month and the individual asset limit is $2,000.
How to Apply: Steps and What to Prepare
Application steps
- Assess your needs: Identify which ADLs require help. A letter from your doctor helps.
- Get counseling: Contact AWCA for free counseling (201-862-1665), or reach out to the ADRC (Aging and Disability Resource Connection) / Area Agency on Aging, or your County Board of Social Services.
- Apply for NJ FamilyCare (Medicaid): Medicaid eligibility is based on income and assets. MLTSS is delivered through Medicaid managed care. (https://www.njfamilycare.org/)
- Clinical assessment: An MCO or the relevant state office evaluates whether a nursing-facility level of care is needed.
- Approval and care planning: Once approved, you are assigned to an MCO and work with a care manager to build a personal service plan.
- Begin services: Receive services at home, in assisted living, or in a nursing home, as planned. Eligibility is re-evaluated periodically.
Document checklist
- Photo ID
- Citizenship / immigration status documents
- Proof of income (Social Security, pension, pay stubs, etc.)
- Proof of assets (bank statements, insurance policies, property documents)
- Medical records, current medication list, doctor’s letter
- Current health insurance information (e.g., Medicare card)
- Proof of address (utility bill, lease, etc.
Choosing a Long-Term Care Facility
Considerations for Selection
- Check the 5-Star Ratings of the facility at Medicare.gov/care-compare (Includes health inspections, staffing, and quality of life measures.) Health inspections reflect state survey results, staffing reflects nursing staff levels and hours, and quality measures reflect statistics on residents’ health and quality of life. It is best to review all three domains together rather than relying on a single score.
- Review Inspection Reports:Request and read the most recent state government Survey Report available at the facility. Survey reports let you see past violations and corrective actions.
- Consult the Long-Term Care Ombudsman: The Long-Term Care Ombudsman is a government-designated advocate who protects the rights of long-term care facility residents. Residents, family members, or concerned parties can contact the Ombudsman directly and confidentially, free of charge. Before choosing a facility, it is also a good idea to ask whether any complaints have been filed about it. .
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