The Garden State has much to offer older adults, including low crime rates, excellent medical facilities, and no tax on retirement benefits from Social Security or the Railroad Retirement Board. New Jersey has high living costs, however, along with some of the highest property taxes in the nation. This guide introduces the senior care options available to New Jersey residents. It provides an overview of the resources available to help older adults pay for needed services, preserve their health, and handle their legal affairs.

Assisted Living Facility (ALF) Definitions

In New Jersey, assisted living consists of three types of services: assisted living residences (ALRs), comprehensive personal care homes (CPCHs), and assisted living programs (ALPs). The New Jersey Department of Health and Senior Services is the licensing agency that grants licenses for operation. Assisted living refers to an array of 24-hour-per-day personal and health services provided in a home-like environment for residents.

An ALR is a licensed facility to provide apartment-like housing, including group dining and services as needed to four or more adults. The apartments, at a minimum, provide a furnished room, a bathroom, a kitchenette, and a lockable door.

A CPCH is a facility that provides room and board to four or more adults and provides services to its residents as needed. Housing units cannot house more than two residents and must have a lockable door.

An ALP provides meals and services as needed to tenants of subsidized housing that cannot be licensed as an ALR.

Adult foster care is a 24-hour living arrangement for up to three persons who need help with activities of daily living (ADLs) and have services provided by licensed caregivers in adult family care homes. These programs match residents with caregivers, train caregivers, and develop a care plan for all residents.

Resident Agreements and Disclosures

Before being admitted into a facility, each resident and their representative must be interviewed by the facility administrator. In this interview, the administrator must disclose the program’s policies, business hours, fees, the services provided, and admission and discharge criteria. The agreement must state the facility’s services for the resident, the public programs or benefits it accepts, and the policies that could impact the residents’ ability to remain in residence.

Assisted Living Services and Service Planning

ALRs and CPCHs must provide or arrange to assist with personal care, health care, nursing, pharmacy, activities, recreation, and transportation to meet the needs of its residents. There are several medication services they must also provide. These facilities must provide supervisory services and assistance with the self-administration of medications and the administration of medications. Administration of medications must be performed by trained and supervised personnel.

ALPs must have contracts with service providers. Through these contracts, the provider must arrange for assistance with personal care, nursing, pharmacy, dietary, recreational activities, and transportation.

Within 30 days before being admitted, the potential resident must provide an assessment from a health care practitioner that indicates that the level of care provided by the facility is appropriate for the level of care the individual requires. When a resident is admitted, an RN will conduct an assessment. Within 14 days, the RN will develop a general service plan for the resident. If health care services are required, a further health care assessment must be completed within 14 days, with a further service plan developed for these needs.

Assisted Living Food and Dietary Provisions

ALRs and CPCHs must provide three meals daily, snacks, and beverages between meals.  All food provided by the facilities must be prepared according to the dietary allowances of the Food and Nutrition Board.  The food must meet nutritional and dietary needs and adhere to food habits and personal preferences.  A dietician must be available to reassess nutritional needs, provide dietary services and revise any dietary requirements in the residents’ service plans.

ALPs must provide dining services or meal preparation services to meet the nutritional needs of the residents.

Assisted Living Staffing Requirements

All three types of facility must employ and administrator. The administrator must be full-time. They or their designee must always be on-site in facilities with 60 or more beds. The administrator must be employed half-time with fewer than 60 beds. Each facility must have a registered nurse available on staff or on-call 24 hours a day. Each ALP must have a staff member on site 24 hours per day.

Facilities must have a designated food service coordinator that is either a trained dietitian or has consulted with a dietitian. A pharmacist must be designated to direct all pharmaceutical services and consult between the facility, residents, and physicians as needed. Personal care assistants must be certified nurse aids, certified homemaker-home health aides, or must have passed a personal care assistant training course.

There are no designated staff ratios or minimums assigned. One personal care assistant must be awake and available 24 hours per day. Both licensed and unlicensed staff must be available to provide for the care and needs of the residents.

Assisted Living Staff Training Requirements

Administrators must complete at least 30 hours of continuing education every three years. 

All personal care aides (PCAs) must receive an orientation on assisted living concepts, emergency plans and procedures, infection control, and preventive care for residents with impairments, residents’ rights, abuse and neglect, pain management, and the care of residents with Alzheimer’s or other forms of dementia. PCAs must complete 20 hours of continuing education every two years. Medication aides must complete 10 hours of continuing education every two years.

Assisted Living Housing Requirements

ALRs must provide apartment-style units with a private bathroom, kitchenette, and a lockable entrance. No more than two residents can occupy a unit. Additional toilet facilities must be provided throughout the facility to meet the needs of residents, staff, and visitors.

CPCHs must provide single or double-occupancy units with a lockable entrance. Private bathrooms and kitchenettes are not required.

ALPs are licensed as a service, not as a residential solution.

What Is Included With Assisted Living Care In New Jersey?

There are several requirements that each assisted living community must provide for its residents. The facility must offer both general observations and health supervision to assist in identifying each resident’s health condition and ability to function. The facility must assist residents with all ADLs and medication services and assess the need for medication attention or nursing services.

Medication Provisions

Facilities can supervise and assist residents with the self-administration of medications.  Facilities are also allowed to administer medications as long as the employees administering the medications are trained and supervised. Staff permitted to administer medications include certified nurse aides, certified home health aides, and trained staff.

Health Care Services

In New Jersey, facilities must provide care and services in the resident’s care plan. This can include coordinating medical care and appointments. Communities may also deliver health services, with 80% of communities providing skilled nursing. Many have health care specialists and on-site services, with 81% of communities offering dental care. In addition, 87% of ALFs have hospice services. 

Mental health issues are a growing consideration for communities, and services to address these concerns are becoming more common. In New Jersey, 89% of communities conduct depression screenings, and 76% offer mental health counseling. Social work programs are also found in 70% of ALFs. Social workers can provide counseling, conduct assessments, and help ensure residents can access all necessary resources.

State Mental Health Resources

New Jersey’s Division of Aging Services connects people with services that can help them address mental health issues and improve their emotional well-being. The Department of Human Services can help older adults access Medicaid and other benefits that can be used to pay for mental health services. New Jerseyans can also call 211 for referrals to nonprofits and government agencies that can help with various mental health concerns.

Activities of Daily Living (ADLs) Assistance Services

A primary service of assisted living that benefits residents is receiving help with activities of daily living (ADLs). These are fundamental tasks that a person must do regularly to sustain life and general health, including toileting, bathing or showering, dressing, transferring (getting in and out of bed or a chair), ambulating (walking), and eating. Signs that a person may benefit from living in assisted living include increased isolation, loss of mobility, noticeable weight loss or gain, and/or neglecting household chores. 

Residents in New Jersey’s assisted living facilities often receive help with their ADLs. In New Jersey, 16% of residents need help with eating. Other commonly used services include bed transfer (31%), toileting (41%), and walking (62%). Caregivers in ALFs help 51% of residents dress and 60% of residents bathe.

Cost Of Assisted Living Care In New Jersey

The average cost of assisted living care in New Jersey is $6,495. This is $1,995 higher than the monthly national average of $4,500. The cost of living in New Jersey is more than the national average by 15.2%, with health care costs less than the national average by 2.8% and housing costs more than the national average by 36.6%.

The level of care a person requires impacts the cost of care, as does where you live. The cost of assisted living ranges from a low of $5,807 in the Atlantic City area to a high of $8,145 per month in the Trenton area of New Jersey.

How Costs Compare In Nearby States

If you live close to one of New Jersey’s borders, you may find assisted living in a neighboring state is an affordable option. All three bordering states have a lower average monthly cost of assisted living. Pennsylvania assisted living residents pay an average of $4,957 per month, New Yorkers pay $5,529 on average, and those in Delaware pay $5,995 on average.

How to Pay for Assisted Living

New Jersey Assisted Living Oversight

The Department of Health is responsible for ensuring that New Jersey assisted living facilities follow all regulations governing their operation. New Jersey’s licensing regulations require each ALF to hire a skilled administrator, meet certain training requirements for staff members, and adhere to other requirements designed to keep residents safe and ensure they receive high-quality care. 

In New Jersey, assisted living communities must also follow extensive rules regarding resident transportation, community policies and procedures, records retention, and the involuntary discharge of residents.

Quality and Safety of Assisted Living Facilities in New Jersey

The New Jersey Department of Health monitors assisted living communities in New Jersey. They ensure that residents can access clean, safe living environments. This agency also collects data related to the ALFs operating within the state, giving the public access to information on available services, administrator qualifications, and staffing levels. Residents who are concerned about the quality of the care they receive can file reports with the New Jersey Long-Term Care Ombudsman.

All assisted living communities in New Jersey must obtain an operating license and keep that license in good standing. If an inspection reveals that an ALF is in violation of state regulations, the New Jersey Department of Health may suspend or even revoke its license. At a minimum, licensed assisted living communities must provide assistance with personal care, medication administration, social work services, and a full range of social and recreational activities.

Legal Resources

When many people think of elder law, they think of attorneys who prepare estate documents or help older adults having difficulty accessing public benefits. Unfortunately, the elder law field is growing rapidly, due in part to rising rates of elder abuse and neglect. New Jersey has several resources to help residents deal with these issues and a wide range of civil matters.

LSNJLaw offers educational information for older adults who want to learn about government aid, long-term care, and other relevant topics. The site also offers a list of non-legal resources to help people who need emergency assistance. Legal Services of New Jersey operates a hotline for New Jersey residents who have limited financial resources and need help with evictions and other civil issues. The Department of Human Services also maintains a directory of legal aid offices throughout the state, along with comprehensive information about common legal documents that are relevant to people living in New Jersey.

You might find these resources helpful as you make a decision regarding assisted living care for your loved one:

New Jersey Department of Health

New Jersey Division of Aging Services