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Nursing Homes in New Jersey

An estimated 9.3 million people live in New Jersey, with seniors comprising 16.9% of the local population. Aging adults in the Garden State can benefit from several tax-friendly policies, such as having no income tax for Social Security benefits and partial income tax for pensions and retirement savings. Across New Jersey, nursing homes and hospitals have more physicians per capita than the national norm and the cost of health care is 5% lower than the U.S. average. Morristown Medical Center, Hackensack University Medical Center and The Valley Hospital are among the state’s top-class health care facilities.

Nursing homes can help seniors who have significant clinical or therapeutic care needs but who don’t require hospital admission. These facilities provide help through services such as skilled nursing, rehabilitation therapies and assistance with personal care. Per KFF’s figures, New Jersey has around 350 certified nursing homes, each with an average of 146.7 beds. As of July 2022, approximately 37,350 individuals reside in the state’s nursing homes. 

This guide covers ways to pay for nursing home care in New Jersey and lists useful resources. It also details rules and regulations that facilities must adhere to.

Popular Cities in New Jersey

Newark

Cost of New Jersey Nursing Homes

The average cost of nursing homes in New Jersey is $320 per day. This is higher than the national average which is $228 per day.

 

Can You Use Medicaid to Pay for Nursing Home Care in New Jersey?

In New Jersey, the state Medicaid program is called NJ FamilyCare. Almost 2.2 million people are enrolled in NJ FamilyCare, with the program paying for approximately 57% of all nursing home residents. NJ FamilyCare covers nursing home fees through Managed Long Term Services and Supports (MLTSS), with services provided by managed care organizations. The state no longer operates home- and community-based waiver programs; instead, MLTSS covers care at home or in the community for eligible individuals, and there are no enrollment caps. The joint Medicaid-Medicare Program of All-inclusive Care for the Elderly (PACE) operates in select zip code areas.

Eligibility for Medicaid in New Jersey

To qualify for Medicaid in New Jersey, seniors must meet income and asset limits. Annual income limits are $32,904 for a single applicant. This figure is doubled for a couple where both spouses apply for financial assistance. Medicaid beneficiaries can keep a monthly personal allowance of $50 and sums needed to pay Medicare or other health insurance premiums. Otherwise, they must use all of their income to pay toward their care. Countable asset caps for single applicants and joint applicant couples are $2,000 and $3,000, respectively.

Income Limits*Asset Limits
Single Person$32,904$2,000
Two-Person Household$65,808$3,000

*Per year

Seniors must also satisfy criteria related to citizenship and residency and have a functional need for nursing home care. Additional eligibility requirements include:

  • Residency in New Jersey on a permanent, full-time basis
  • U.S. citizenship, nationality or legal residency
  • Need assistance with at least three activities of daily living

Applying for Medicaid in New Jersey

Seniors can apply for Medicaid in person at their local county welfare agency office or over the phone at (800) 701-0710. New Jersey Department of Human Services, Division of Medical Assistance and Health Services operates an online portal through which seniors can easily apply for Medicaid. Alternatively, individuals can download and print a paper application form. Completed forms should be returned by mail or in person to an individual’s local county welfare agency.

What Information You Will Need

Seniors will likely need to provide various supporting documents with their Medicaid application. Failure to supply necessary information can result in claims being delayed or canceled. Information may include:

  • Proof of identity, including date of birth
  • Social Security number
  • Proof of citizenship
  • Proof of residency in New Jersey
  • Proof of all income, including pensions and benefits
  • Details of all assets, including bank statements, property deeds, car registration documents, stocks, bonds, shares and burial contracts
  • Information about any assets transferred during the lookback period of 5 years
  • Details about all insurance policies
  • Veteran discharge papers (if applicable)
  • Monthly housing and medical costs

Additional Medicaid Support & Resources in New Jersey

Although applying for financial assistance can feel overwhelming, seniors have several sources of support at their disposal. Nonprofit organizations and government agencies provide information, assess eligibility and help seniors to complete claims and appeals.

ContactService
NJ Family Care(866) 472-5338Trained advisors help individuals understand their choices regarding managed care organizations (MCOs). These advisors inform seniors of which MCOs can cover their particular medical needs and help seniors enroll with a provider.
Area Agencies on Aging(877) 222-3737New Jersey’s network of 21 Area Agencies on Aging provides a wide array of aging-related advice and information to help seniors maintain a good quality of life. Regarding Medicaid, advisors can assess eligibility and help individuals submit claims, understand coverage and appeal rejected claims.
Benefits.gov(800) 356-1561The website provides an overview of New Jersey’s Medicaid program and has a tool for checking basic entitlement. Individuals can also fill in the Benefits Finder questionnaire to make sure they are receiving all public assistance they qualify for.

Can You Use Medicare to Pay for Nursing Home Care in New Jersey?

Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it's most valuable for those who are recovering from an injury, illness, or surgery.

Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.

What Does Medicare Cover?

Medicare covers a number of specific services, including:

  • Meals
  • A semiprivate room
  • Medications
  • Skilled nursing
  • Physical therapy
  • Occupational therapy
  • Speech therapy
  • Audiologist care
  • Medical supplies
  • Medical social services
  • Nutritional counseling
  • Ambulance transportation

What Isn't Covered by Medicare?

Medicare does not cover long-term custodial care that addresses seniors' day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.

For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.

Medicare Support & Resources in New Jersey

Older adults and their families can take advantage of several supportive resources, geared toward empowering Medicare beneficiaries and helping people understand their health insurance options. Programs also include those that raise awareness about Medicare fraud and billing errors.

ContactService
State Health Insurance Assistance Program(800) 792-8820Using a statewide network of trained volunteers, the State Health Insurance Assistance Program educates seniors on Medicare-related issues. Counselors help seniors find the best coverage for their needs. Services are free, impartial and confidential.
GetCoveredNJUse the online search tool to identify local assistance or call (833) 677-1010GetCoveredNJ is New Jersey’s health insurance marketplace through which individuals can enroll for coverage. The website contains in-depth information and enables seniors to connect with navigators who offer free enrollment help and advice, both in person and over the phone.
Senior Medicare Patrol(800) 927-4357Connect with an SMP advisor at (877) 767-4359 or via the online contact form.

Other Financial Assistance Options for Nursing Home Care in New Jersey

While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.

How to ApplyHow It Works
Aid and AttendanceLearn more and apply online at va.gov.Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for skilled nursing care.
Reverse MortgagesLearn more about your options and how to apply at ftc.gov.If you own a home, you may be able to use a reverse mortgage to help pay for nursing care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. This type of funding can be especially useful for married couples when only one partner needs nursing care, as the other residents of the home may continue living there. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.
Long-Term Care (LTC) InsuranceLearn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.Seniors who already have long-term care insurance may be covered for skilled nursing care. Most policies cover at least a portion of the cost of nursing home care, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not be eligible to sign up for a LTC insurance policy.

Nursing Home Laws and Regulations in New Jersey

Licensing RequirementsAll nursing facilities in New Jersey must be licensed by the New Jersey Department of Health. The department ensures facilities comply with regulations and laws. It is also responsible for licensing care staff members such as nursing home administrators, personal care assistants and nursing aides.
Staffing RequirementsDuring the daytime on weekdays, there should be at least one certified nursing assistant (CNA) for every eight residents. On weekend days this drops to one CNA per 10 residents. At night, there must be one CNA for every 14 residents.
Staff Training RequirementsNursing home administrators must be suitably qualified for the role and complete an additional 100 hours of job-related training. Nurses must be appropriately registered or licensed. CNAs must complete 90 hours of training that includes diverse work-related topics.
Admission RestrictionsNew Jersey's nursing homes can't admit any individual that they can't provide suitable care for. In the case of admission being refused, the facility must inform applicants of this decision in writing.
Care Planning RequirementsWithin 2 weeks of admission, staff must fully assess new residents. This initial evaluation should include an assessment by a qualified medical professional, such as a doctor. Care plans should take into account this assessment, and needs must be reviewed following a change in circumstances.
Dietary and Nutritional Services RequirementsNursing facilities must hire a full-time food service director. This staff member should either be a qualified dietitian or consult with one regarding residents' meals and nutritional needs. Facilities must follow state rules regarding meal times, staff assistance and nutritional advice for residents.
Specialized Rehabilitative ServicesSuitably licensed staff members may administer occupational, physical and speech therapy to residents, as recommended by a medical professional.
Medication and Pharmaceutical ServicesFacilities must provide pharmaceutical services 24/7. They must also employ an in-house pharmacist or contract with a consulting pharmacist to ensure regulatory compliance regarding drug storage, labeling and dispensing. Only qualified caregivers may administer medications.
Activities RequirementsNursing homes must provide social and enrichment programming each day, including on at least two evenings. Staff must post a weekly activity schedule, which should allow for optional religious worship. Nursing homes should also have communal spaces available where residents can enjoy leisure and recreation.
Infection Control RequirementsNursing homes must follow all state and federal regulations related to disease prevention and infection control. Staff members may not work if there's any risk they could pass an infectious disease to residents.
Medicaid CoverageSeniors with limited income and assets and who need ongoing help with at least three activities of daily living may qualify for NJ FamilyCare to cover all fees associated with nursing home care. Funding covers the costs of medical, therapeutic and personal care.

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