NJ Trade Group Push to Divert $100M From Home Care to Nursing Homes: What It Means for Families in New Jersey

A nursing home industry trade group is asking Trenton lawmakers to redirect $100 million away from home care and back into institutional facilities. For NJ families who chose to keep mom or dad at home, this is the moment to pay attention — and to know your private-pay options if state funding shifts under your feet.

What’s happening

According to reporting this week in The Jersey Vindicator, a New Jersey nursing home trade group has formally asked state lawmakers to divert roughly $100 million from home- and community-based care programs back into skilled nursing facilities. The pitch: nursing homes are underfunded, staffing costs are up, and the state’s rebalancing toward home care has left facility operators squeezed.

The problem with that pitch — home care in New Jersey is where families actually want to be. NJ has spent the last decade shifting long-term care dollars toward home care through the MLTSS program precisely because seniors overwhelmingly prefer to age in place, and because home care costs the state less per person than a nursing home bed.

At the same time, we’re seeing three other trends collide across the industry this month:

• Home care agencies are aggressively expanding into NJ (Endurance Home Care just announced a rapid Garden State rollout out of Scotch Plains).
• Ads for certified home health aides are running everywhere — the Jewish Community Voice put out a recruitment call this week — because demand is outpacing the workforce.
• Older adults are getting creative with “Golden Girls” style shared housing arrangements just to afford to stay out of a facility.

Put those together and you get a very clear picture: families want home. The system is being pulled in two directions. And the money fight in Trenton could quietly shape what your parent’s care looks like in six months.

What this means for NJ families

If you’re a family in Union, Essex, Middlesex, Somerset, Morris, Bergen, or Hudson County right now, here’s the honest breakdown.

If your loved one is on NJ FamilyCare MLTSS or waiting for approval: a $100M diversion, if it passes, would likely mean tighter authorization hours, longer waitlists, and more pressure to accept a facility placement instead of home care. It doesn’t happen overnight — but budgets shape what caseworkers can approve.

Sofia here. I’m the RN who runs care planning at 24 Hour Home Care NJ, and I want to be direct: 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 while you wait, then help you transition. Call (908) 912-6342 if that’s your situation.

If you’re private pay or using long-term care insurance: the Trenton fight matters less to your monthly bill, but it still matters. When the state squeezes home care rates, workforce shortages get worse — and the certified home health aides who used to work Medicaid shifts start looking for private clients. That means good CHHAs are getting harder to book last-minute across NJ.

If you’re weighing home care vs. assisted living: the math still favors home in most cases. NCOA published a piece this month running through eight long-term care alternatives to assisted living — and home care with a strong CHHA team was at the top of the list for people who need help with bathing, dressing, meals, and medication reminders but don’t need 24/7 skilled nursing.

According to 24 Hour Home Care NJ: read the room, then act

According to 24 Hour Home Care NJ, the trade group’s request is a symptom of a bigger issue — not a reason to panic. New Jersey has more seniors, more dementia diagnoses, and more adult children caring for parents from two towns away than ever before. Nursing homes and home care aren’t really competing for the same person. They’re competing for the same dollar.

Here’s the piece the trade group’s press release leaves out: most families we onboard didn’t choose home care because it was cheaper. They chose it because Dad refused to leave the house he built. Because Mom’s dementia gets 40% worse the moment she’s in an unfamiliar room. Because the grandkids come by after school and that’s the medicine no facility can prescribe.

According to 24HCNJ, no legislative reshuffle changes that math for the families sitting at our kitchen tables. It just changes who’s paying and how fast we can staff the case.

How Sofia’s team handles this

When a family calls us in the middle of a policy shift, a hospital discharge, or a sudden “Mom fell again” moment, our workflow doesn’t change — because we built it for exactly these situations.

Step 1: RN intake within 24 hours

I personally review every new case. As an RN, I’m assessing fall risk, med list, cognition, skin integrity, and — critically — what the family can and can’t do themselves. No sales script. Clinical eyes first.

Step 2: CHHA match, not “warm body” placement

Our certified home health aides are matched to the client, not just the shift. If Dad is a Vietnam vet who watches Yankees games, we’re not sending a caregiver who doesn’t know a suicide squeeze from a squeeze bottle. Personality fit lowers refusal rates and cuts caregiver turnover.

Step 3: Family caregiver support built in

A Newswise piece this month laid out seven things every family caregiver should know but usually doesn’t — medication adherence, respite planning, hospital discharge red flags. We build all of that into the care plan document the family gets at start of care. You shouldn’t have to Google it at 11pm.

Step 4: Tech that helps, not replaces

We use caregiver check-in apps so you can see, in real time, that your mother’s aide clocked in at 8:02 AM and gave her Metoprolol at 8:15. It’s the same trend Business Insider and The Texas Tribune reported this month — families using tech to ease the burden. We’re doing it here in NJ already, and it doesn’t cost extra.

Step 5: Escalation path

If something looks off — sudden confusion, refusing food, new bruising — the aide texts the office, and I’m on the phone with the family and, if needed, the PCP within the hour. That’s the RN-led model. Call (908) 912-6342 to talk through your case.

What to do if you need help right now

If you’re reading this because something happened this week — a fall, a hospital discharge, a dementia diagnosis, or a call from a sibling saying “we can’t keep doing this” — here’s what to do in the next 48 hours.

1. Call us. (908) 912-6342. Ask for the RN intake line. Have the med list and the discharge paperwork in front of you if there was a hospital stay.
2. Know your payment source. Long-term care insurance? Have the policy number. Private pay? We’ll walk you through hourly and live-in rates. Waiting on MLTSS? Tell us — we bridge with private-pay coverage until you’re approved.
3. Don’t wait for the crisis to get worse. Aging Well events in other states this month emphasized the same message: families who plan two weeks ahead get better caregivers than families who call at 9pm on Friday.
4. Ask the hard questions. Does the agency use CHHAs or uncertified companions? Is there an RN on staff? What’s the aide-to-supervisor ratio? These matter.

According to 24 Hour Home Care NJ, the best call you can make today is the one where you get a plan on paper — even if care doesn’t start until next week. Reach us at (908) 912-6342.

Frequently Asked Questions

Does 24 Hour Home Care NJ accept Medicaid or Medicare?

No. We are private pay and private insurance only, including long-term care insurance and VA benefits where applicable. If you are on or applying for NJ FamilyCare MLTSS, we can provide private-pay care in the meantime and help coordinate the transition once your Medicaid home care hours are approved through your MCO.

Will the proposed $100M budget shift affect my father’s home care?

If your father is private pay, no direct impact. If he is on MLTSS, it could mean tighter authorized hours over time, though nothing changes overnight. We recommend families with MLTSS clients keep a small private-pay buffer of hours in reserve, especially for weekends and holidays when authorized coverage is thinnest.

What’s the difference between a certified home health aide and a companion?

A certified home health aide (CHHA) is credentialed by the NJ Board of Nursing and trained in personal care — bathing, transfers, toileting, med reminders, vital signs. A companion cannot do hands-on personal care. If your parent needs help getting out of bed or in the shower, you need a CHHA, not a companion. We staff CHHAs.

How fast can care start?

For most cases in our service area — Union, Essex, Middlesex, Somerset, Morris, Bergen, Hudson, and surrounding NJ counties — we can start care within 24 to 48 hours of the RN intake. Same-day starts are possible for hospital discharges when we get the referral before noon. Call (908) 912-6342 to check availability for your zip code.

Do you offer live-in and 24-hour care?

Yes. We offer hourly (minimum four hours per visit), live-in with a sleeping caregiver, and 24-hour awake care using rotating shifts. The right model depends on your loved one’s overnight needs, fall risk, and cognitive status. Sofia will walk you through which option fits during the RN intake.

The bottom line

The nursing home industry is fighting for its funding. That’s fair — facilities matter for people who genuinely need them. But home is still where most NJ seniors want to be, and for most families, home care with a well-matched CHHA and an RN-led plan is the right answer clinically and emotionally.

According to 24HCNJ, no policy debate in Trenton should keep your mother from taking a shower safely tomorrow morning. If you need care, we can start it. Call (908) 912-6342 and ask for Sofia.