Medicaid Assisted Living Facilities In Nj

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Assisted Living In New Jersey Defined

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Assisted living in New Jersey is a combination of housing, health care and personalized support for those who require assistance with activities of daily living. Assisted living is for those who need some support, but do not require the 24/7 nursing care found in a nursing home. Typically, assisted housing programs will provide:

  • Three meals a day
  • Physical and mental wellness programs
  • Social and recreational activities

An Overview Of New Jerseys Assisted Living Regulations

An Overview of New Jerseys Assisted Living Regulations

New Jersey, like all states, has its own set of assisted living rules and regulations. Additionally, how New Jersey defines assisted living can be different from most other states.

This is where the assisted living industry can be confusing to families researching care. Often times, families are researching for a loved-one across state lines, and what may fall within the boundaries of law in one state may not in another.

This is where knowing about specific State regulations for assisted living and long-term care is essential for making informed decisions based on accurate information from trusted publications and agencies.

First, for New Jersey, its helpful to know who is responsible for the oversight and regulation of assisted living throughout the state.

This title goes to the New Jersey Department of Health, and their Division of Health Facilities Evaluation and Regulation.

Their site looks like this:

The Department of Health regulates a wide range of health care settings for quality of care, such as hospitals, nursing homes, assisted living residences, ambulatory care centers, home health care, medical day care and others. The full list includes:

  • Adult Day Care Services

The full list includes a short definition of the service, which is unique to New Jersey.

Learn more about filing a complaint and hotlines for New Jersey here:

How to see New Jerseys Assisted Living Regulations:

How To Apply For Long

Conveniently, one can begin the application process while seeking information at the same time. You can call our office to set up a consultation, and we can advise you on whether Medicaid planning is the right choice for you. Alternatively, an individual looking to start the process can call their local countys Area Agency on Aging and ask to speak to the Aging and Disability Resource Connection . Someone at the ADRC can provide you with information and answer any questions you have. If you are interested in applying to Medicaid or another related program, the ADRC will perform a screening questionnaire.

The questionnaire covers specific questions about the applicants daily routine, the tasks they need assistance with, and other medical and personal needs. Once the screening has been completed, the information will be submitted to NJ FamilyCare, who will contact you in order to continue the screening process.

As part of the process, applicants need to not only provide medical documentation but also statements regarding income and certain assets. NJ FamilyCare provides a convenient checklist detailing the income and resources documentation they require.

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What Services And Benefits Are Offered As Part Of Medicaid Long

Medicaid long-term care in New Jersey is referred to as Managed Long Term Services and Supports . The program is provided through New Jersey Medicaids NJ FamilyCare managed care program, and it can support individuals who require long-term care, according to their individual needs. That support may be care at home, residency at a nursing home or assisted living facility, or access to community residential services.

The New Jersey Division of Medical Assistance and Health Services states that the purpose of Medicaid long-term care is to expand home and community-based services, promote community inclusion and ensure quality and efficiency.

Some of the specific offerings include:

  • Access to all NJ FamilyCare Plan A Benefits
  • Care Management
  • Community Residential Services
  • Nursing Home Care

Eligible individuals can receive care at a qualifying facility, through in-home support, or via services like transport to medical appointments.

Other Financial Assistance Programs For Assisted Living

Assisted Living Facilities in Paterson, New Jersey (NJ)  Senior Care

Optional State Supplement

New Jersey seniors aged 65 and older who receive Supplemental Security Income benefits may be eligible for additional benefits for use toward the room and board portion of assisted living costs through the Optional State Supplement program.

To help control the costs of assisted living for low-income seniors, the state limits what assisted living facilities can charge for room and board. In New Jersey, this limit equals the combined maximum amount available through SSI and OSS to ensure SSI-eligible seniors can cover the cost of assisted living.

The maximum total monthly combined SSI/OSS payment in New Jersey for a single senior in assisted living is $981.05 and $1,895 for a couple.

For more information on the New Jersey Optional State Supplement, contact the Glassboro Social Security office at 772-1213.

Veterans Aid and Attendance Benefit

Honorably discharged veterans and their survivors who are currently eligible to receive a VA pension and require daily assistance due to a disability or incapacity may be eligible for a pension top-up through the Aid and Attendance benefit.

Veterans who are currently excluded from receiving a VA pension due to excess income may also be eligible for a pension under the increased rates provided through this benefit.

To qualify, applicants must meet at least one of the following criteria:

Veterans Housebound Allowance

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Spring Oak Toms River

Spring Oak at Toms River is newly renovated to provide modern facilities while maintaining a charming, homey, environment. Amenities include a computer room, a TV room, a fitness room and bistro, and a patio area for taking in fresh air. A skilled nursing team oversees medication management and health care needs, and residents can opt for visits from third-party medical specialists. Family and friends are invited to join residents for dinner or even overnight visits.

Cost begins at $7,000 per month.

Reformed Church Home Old Bridge

Reformed Church Home is known for their compassionate team who treats residents like family. Certified nursing assistants are available 24/7, a registered nurse is there daily to oversee medical care, and a geriatric physician visits residents at least once a week. A full time activities director creates a fun schedule of social activities, and a dietician ensures that all meals are meeting residents nutritional needs. For seniors who wish to partake in religious services, an ordained Reformed Church minister coordinates programs for varied denominations.

Cost begins around $4,000 per month.

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Adult Day Health Care Programs

These programs provide daily nursing and nutritional services and medical monitoring in a comfortable non-residential environment. Adult day health care services allow the elderly to maintain residency at home as long as medically possible while providing supervised daily care. These programs offer relief to family caregivers that allows them to continue with daily routines and/or employment, knowing their loved one is safe and comfortable during the day. Most programs offer a full range of social activities and provide transportation services. Adult day health care programs are licensed by the New Jersey Department of Health and have specific standards of licensure they must meet.

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The Southern New Jersey Area

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Southern New Jersey is a multitude of counties located on the southern region of New Jersey. Southern New Jersey is made up of 5 counties: Burlington County, Camden County, Cumberland County, Gloucester County and Salem County. Cities within Southern New Jersey include Browns Mills, Camden, Maple Shade, Vineland and Washington Township. Southern New Jersey hosts sites such as Battleship New Jersey, Camden aquarium and Campbells Field. Southern New Jersey will certainly fulfill many of you and your loved ones needs.

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Paying For Senior Care With Ssi

Social Security Supplemental Income payments are provided on a monthly basis and can be used for a variety of expenses. Some seniors may choose to use their payments to cover the cost of their food, entertainment, shelter, clothing or even medical care. An income threshold must be met in order to qualify for SSI. Most seniors who are able to receive SSI also qualify for Medicare. The government benefit eligibility screening tool is a great way to see if you or your loved one qualifies for SSI, SSDI, Medicare, veterans benefits or any other federal senior assistance programs.

Most assisted living communities will have several different payment options for seniors, including those who would like to use SSI, SSD, or OSS benefits. In some facilities, seniors may use their full SSI benefits to cover their full expenses. Not every assisted living community will provide subsidies for their monthly fees for those on SSI, so it is important to check the locationâs rules prior to enrollment. Seniors who require skilled nursing care can use a combination of Medicaid and SSI for their care. Other senior care payment options are PACE, Long term care insurance, veterans aid, and life settlements. Every senior will face a different set of circumstances, and it is important to keep current and future health complications in mind when choosing a payment option.

Medicaid’s Income Limit For Long

New Jerseyans who are 65 or older can qualify for Medicaid if they meet certain income and asset limits. If you receive SSI, you already qualify to receive Medicaid in New Jersey. But if you are elderly, blind, or disabled and not receiving SSI, then your monthly income in 2019 must be less than $1,041 per month .

There is a higher income limit for seniors who need assisted living or home health services. If you are 65 or older, blind, or disabled, you can qualify for Medicaid long-term care services as long as your monthly income is no more than $2,313 per month for 2019. The limit for a couple is $4,626 per month.

If your income is above the limit, you still might be able to qualify for Medicaid if you have a lot of medical expenses. With New Jersey’s Medically Needy Program, you can use medical bills that you incur each month to “spend down” your income and qualify for Medicaid. The Medically Needy spend-down income limit is $367 per month for an individual in 2019. If you have a household of two people, the income limit is $434 per month. You must show that you have incurred medical expenses each month that would leave you with no more than those amounts. You do not actually have to pay the bills, just receive them. Because nursing homes are so expensive, it can be easy for nursing home residents to qualify for the Medically Needy Program — their nursing home bills help them spend down their income.

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Assisted Living Options For People With Disabilities

Seniors and people with disabilities often need supportive living options. When the time comes to start considering your options for assisted living, its easy to become overwhelmed by the sheer number of housing options. Not only are there different categories of assisted living to choose from, there are also a plethora of homes from which to choose. The right choice depends on a number of factors, including support needs, expense, and personal preference.

Once a home is chosen, theres still a significant barrier to overcome: figuring out how to pay for it. There are a number of different options, but its important to choose the option that will allow for comfortable living now, while also ensuring your resources arent used up too quickly.

This guide helps those searching for assisted living homes overcome the two main barriers: choosing a home and figuring out how to pay for it. In this guide, you will learn about the different types of assisted living homes, how to choose the right home for you, how to pay for that home, and state-specific resources to assist you in your search.

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Who May Receive Nursing Facility Services

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NF services for are required to be provided by state Medicaid programs for individuals age 21 or older who need them. States may not limit access to the service, or make it subject to waiting lists, as they may for home and community based services. Therefore, in some cases NF services may be more immediately available than other long-term care options. NF residents and their families should investigate other long-term care options in order to transition back to the community as quickly as possible.

Need for nursing facility services is defined by states, all of whom have established NF level of care criteria. State level of care requirements must provide access to individuals who meet the coverage criteria defined in federal law and regulation. Individuals with serious mental illness or intellectual disability must also be evaluated by the stateâs Preadmission Screening and Resident Review program to determine if NF admission is needed and appropriate.

Nursing facility services for individuals under age 21 is a separate Medicaid service, optional for states to provide. However, all states provide the service, and in practice there is no distinction between the services.

In some states individuals applying for NF residence may be eligible for Medicaid under higher eligibility limits used for residents of an institution. See your state Medicaid agency for more information.

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Does Medicaid Cover Assisted Living In Nj

Iâm not going to hold you in suspense the answer is yes. New Jersey Medicaid does cover assisted living. New Jersey Medicaid also covers in-home care through the same program as well as a couple of others . Medicaid in NJ has undergone some really big changes in the last few years, and they are part of the reason that the programs seem so confusing. The state recently transitioned its care from a state-managed system to one through so-called Managed Care Organizations, which is another way of describing those big health insurance companies that we all know about . The State has also moved back to an income cap structure, which it hadnât used since the 1990s. You may hear this referred to as global options or the comprehensive waiver program, but the question is the same: What does this all mean?

What Are Medicaids Benefits For Assisted Living Residents

Medicaid provides health insurance for low-income individuals and families. It is a joint federal and state program, which means that each state has different Medicaid eligibility requirements. In general, Medicaid will cover the cost of assisted living for seniors who meet the following criteria:

  • Seniors must be 65 years of age or older.
  • Seniors must be US citizens or legal permanent residents.
  • Seniors must have a Medicaid card.
  • Seniors must meet the states Medicaid income requirements.

Medicaid will cover the cost of care at an assisted living facility, as well as other services such as transportation and meals. Medicaid also covers the cost of medications for seniors who reside in assisted living facilities.

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Facility Scope Of Care

ALR and CPCH facilities in New Jersey should operate according to assisted living values that encourage and promote independence, dignity and privacy for residents in a homelike environment. These facilities provide housing along with a coordinated range of 24-hour supportive services to meet the needs of residents. The personal and health-related services offered may be provided by the facilitys staff or arranged through outside providers and may include:

  • Assistance with personal care
  • Nutritious daily meals plus snacks
  • Necessary nursing care
  • Supervision and assistance with self-administration of medication
  • Administration of medication by trained staff
  • Healthcare services
  • Transportation

Assisted Living Medicaid Policy

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Medicaid will pay for assisted living in New Jersey for those that demonstrate financial or personal care needs. Some facilities are contracted through the DOHS to provide care for residents and offer two programs:

  • The Managed Long-Term Services and Supports program covers personal care, nursing, mental health, and other services for those aged 65 and older.
  • The Program of All-Inclusive Care for the Elderly covers all the same services for adults aged 55 and older but is limited to specific counties of New Jersey.

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Medicaid In New Jersey

Medicaid is a joint federal-state program that provides limited health insurance for people who have low income and minimal assets. Each state operates its own Medicaid program.

In New Jersey, Medicaid is called the NJ FamilyCare program and administered by the New Jersey Department of Human Services, Division of Medical Assistance and Health Services, which uses a number of Managed Care Organizations to manage health care for Medicaid clients. New Jersey residents aged 65 and older who meet specific financial and functional criteria may qualify for NJ FamilyCare coverage.

To qualify, single seniors may earn no more than $2,313 per month and have countable assets valued at $2,000 or less. Couples applying together can earn no more than $4,426 per month and own no more than $3,000 in countable assets.

In New Jersey, Medicaid applicants are exempt from counting personal belongings, furniture, one vehicle, a burial trust and a home valued up to $878,000 as long as the applicant and/or their spouse lives in the home. Note that there is a 5-year look-back period to assess any assets that were gifted or sold prior to the submission of a Medicaid application.

Under the new MLTSS system assisted living enrollment caps have been eliminated for seniors, allowing for faster access to an assisted living placement.

Does My Parent Need Assisted Living

Still not sure if your parent needs assisted living? Lets go over a few example scenarios to help clear things up:

SCENARIO #1

Is Mary a good fit?

Yes. Most important, in an assisted living community, Mary could receive help with medication management. Meals would also be provided, and the housekeeping would be taken care of for her.

SCENARIO #2

Richard

Richard suffered a fall and hospitalization about three months ago. He has since recovered, but his children are worried. Hes a bit unsteady on his feet, and although he insists hes fine, theyve noticed that he has issues getting around the house and dressing himself. He used to love being out and about, but now hes always at home.

Is Richard a good fit?

Yes. When mobility becomes a concern, assisted living can be a good fit. The suites are designed with senior needs in mind, and theres a trained, professional staff available around the clock in the event of a fall, or if Richard needs help getting dressed in the mornings. Additionally, there will be plenty of activities and programs to get him back to his social self.

SCENARIO #3

Dottie

Dotties daughter has noticed recently that Dottie isnt cooking anymore. She usually goes out to eat or heats up frozen meals. Also, the house is getting messy. When her daughter asks her if everythings okay, Dottie is dismissive and says she just doesnt bother with it anymore.

Is Dottie a good fit?

Researching assisted living? We have resources that can help.

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