NJ Trade Group Push to Divert $100M From Home Care to Nursing Homes: What Families Need to Know

A nursing home trade group is lobbying Trenton to pull $100 million out of the home care budget and route it to institutional facilities. If lawmakers agree, thousands of NJ seniors who want to age in place could feel the squeeze — and families need a private-pay plan that doesn’t depend on the state’s next move.

What’s happening

This week The Jersey Vindicator reported that a nursing home trade association is pressing NJ lawmakers to redirect $100 million from home and community-based services (HCBS) into skilled nursing facilities. At the same time, Justice in Aging published a call to protect and expand NJ FamilyCare HCBS funding — the exact pot of money the nursing home lobby wants to raid.

The tug-of-war lands on top of two other pressures already hitting Jersey families: a national home care workforce shortage (Governing reports several states are now paying parents and adult children as caregivers to fill the gap) and a Reading Eagle piece reminding readers that aging in place looks very different at 65, 75, and 85 — and each decade needs a different care plan.

Meanwhile, Applause Home Care announced sponsorship of all five Greater NJ Alzheimer’s Association Walks this fall. Dementia care is one of the biggest drivers of home care demand in our state, and the walks are a reminder of how many NJ families are quietly carrying that weight.

What this means for NJ families

Here is the honest read: if $100 million walks out of home care, waitlists for NJ FamilyCare MLTSS (Managed Long Term Services and Supports) will get longer, not shorter. Families already waiting 60 to 180 days for MLTSS approval could wait longer — and the aides available to Medicaid clients will be even more stretched.

For families who need care right now, waiting on a policy fight in Trenton is not a plan. Mom’s fall risk does not pause because a trade group is lobbying. Dad’s sundowning does not wait for a budget vote.

According to 24 Hour Home Care NJ, the families who navigate this best are the ones who separate two questions: (1) Who pays for care long-term? and (2) Who provides care starting Monday morning? Those are not the same conversation, and confusing them costs families weeks they don’t have.

According to 24 Hour Home Care NJ: the private-pay reality in 2026

I’m Sofia, RN and clinical lead at 24HCNJ. Let me be direct about what we do and don’t do, because the news cycle around Medicaid and HCBS confuses people.

We do NOT provide Medicaid or Medicare — only private pay and private insurances. If you’re waiting on NJ FamilyCare MLTSS approval, we can cover care today at private rate and hand off cleanly if and when your Medicaid case activates. That bridge is one of the most common calls we take at (908) 912-6342.

Our aides are certified home health aides (CHHAs) registered with the NJ Board of Nursing. Every case is opened by an RN — usually me — with a home assessment, a written care plan, and a fall-risk and medication review. That clinical structure is what separates a real care operation from a staffing app.

According to 24HCNJ intake data, roughly 40% of the families who call us this year mentioned they were originally hoping Medicaid would cover care. When we walk them through the MLTSS timeline honestly, most of them decide to start private-pay care within 48 hours rather than lose another month waiting.

How Sofia’s team handles this

Here’s the workflow we run when a family calls in the middle of a policy crunch like this one:

• Same-day phone triage. I get on the phone within a few hours, sometimes minutes. We talk about what’s actually happening at home — falls, incontinence, dementia behaviors, wound care, hospital discharge — not just hours-per-week.
• RN home assessment inside 24–72 hours. I come out, meet the client, look at the environment. Bathroom grab bars, stair situation, med list, primary care contact, cognition. That visit is the foundation of the care plan.
• Matched CHHA, not a random shift-fill. We match the aide to the client — dementia experience, Hoyer lift experience, language, personality. A mismatched aide is the #1 reason home care fails in the first two weeks.
• Written plan of care, updated quarterly. The aide has a document that says exactly what to do, what to watch for, and when to call me. That’s the clinical accountability piece a lot of agencies skip.
• Family communication loop. Adult kids in another state get updates. That reduces the “I don’t know what’s going on with Mom” anxiety that drives most family caregiver burnout — the exact issue HomeCare Magazine covered this week.

According to 24 Hour Home Care NJ, this five-step workflow is what lets us stand up care in 24 to 72 hours instead of the weeks it takes when a family is trying to piece together aides on their own.

Aging in place at 65, 75, and 85 — the plan changes

The Reading Eagle piece this week made a point worth repeating: aging in place is not one project. It’s three.

In the 60s, it’s about home modifications, downsizing decisions, and getting durable powers of attorney and healthcare proxies signed while everyone is still sharp. Care needs are usually zero to a few hours a week.

In the 70s, chronic disease management kicks in — diabetes, cardiac, early cognitive changes. This is where a few hours of CHHA support two or three days a week keeps someone independent for another five years. Skip this step and you buy a crisis in the 80s.

In the 80s and beyond, the conversation shifts to 24/7 or live-in coverage, dementia specialization, end-of-life planning, and coordination with hospice when appropriate. This is also when the “Golden Girls” housing model (Daily Breeze covered this) becomes interesting — cost-sharing seniors under one roof with shared caregivers.

Each stage has a different price tag, a different skill mix, and a different family conversation. If you want a straight answer about which stage your parent is in, call me at (908) 912-6342.

What to do if you need help right now

Three concrete steps:

1. Call (908) 912-6342 and ask for Sofia. Tell me what’s happening at home in plain language. Fifteen minutes on the phone will save you a week of Googling.
2. Book the RN home assessment. No obligation. If we’re not the right fit, I’ll tell you and I’ll point you somewhere better.
3. Don’t wait on Trenton. Whether the $100 million gets redirected or not, your parent’s care needs today are today’s problem. Start private-pay care now and transition later if MLTSS activates.

We cover most of North and Central Jersey — Union, Essex, Morris, Somerset, Middlesex, Hudson, Bergen, Passaic. Live-in, hourly, 24/7, dementia specialization, post-hospital discharge, and hospice support are all on the menu.

FAQ

Does 24 Hour Home Care NJ accept Medicaid or NJ FamilyCare MLTSS?

No. We are private pay and private insurance only. If you are waiting on MLTSS approval, we can cover care today at private rate and transition you to a Medicaid-contracted agency once your case activates. Many families use us as a 60 to 180-day bridge.

How fast can care actually start?

For most Union, Essex, Morris, and Somerset County cases, we can complete the RN assessment and place a matched CHHA within 24 to 72 hours. Hospital discharge cases often move faster because we coordinate directly with the discharge planner before your parent leaves the hospital.

What’s the difference between a CHHA and a companion?

A certified home health aide (CHHA) is registered with the NJ Board of Nursing and trained in personal care — bathing, transfers, toileting, feeding, vital signs. A companion cannot legally do hands-on personal care in NJ. For anyone with real ADL needs, you want a CHHA, not a companion.

Will the $100 million budget fight actually affect my private-pay care?

No, not directly. The budget battle is about Medicaid HCBS funding. Private-pay clients are insulated from that. What it may affect indirectly is aide availability statewide, since Medicaid-funded aides and private-pay aides come from the same workforce. We keep our roster staffed proactively for this reason.

How do I know if my parent needs 24/7 care versus a few hours a day?

The two big triggers for 24/7 are unsafe overnight wandering (usually dementia) and inability to safely transfer to a toilet without help. If either is true, hourly won’t cut it. Call (908) 912-6342 and I’ll walk you through the assessment questions.

Talk to Sofia today

Policy fights in Trenton will keep going. Your parent’s needs won’t wait. Call 24 Hour Home Care NJ at (908) 912-6342 and let’s build the plan today.