For individuals that require specialized care in New Jersey, home care is a popular option that allows an individual minimal life disruption. Learn about your home care options in New Jersey, relevant state regulations, and the funding resources available for long-term care.
Home care in New Jersey
The state of New Jersey, known for higher than average costs for assisted living, ranks average in-home care costs. Home care costs range from a minimum of $11 per hour, up to $26 per hour in New Jersey.
For individuals that will require more intensive care, home health care is an option outside of the typically certified home health aides that most agencies offer. The cost of home health care will differ slightly than live-in care aides.
In New Jersey, there are hundreds of home care options, varying from personal aides to extensive home health nurses and care providers. These options can be found by reaching out to the NJ Board of Nursing, who offers a comprehensive guide to health aides. You can also reach out to NJ EASE, which helps individuals find resources they require and can further locate a home care agency that is best for family members.
New Jersey has regulations and safety standards beyond the federal standards that insist on high-quality care. The NJ Department of Health with the Office of Health Care Quality Assessment collects data on the quality of these health services to help consumers such as yourself make informed decisions about your family members care.
Services and safety
NJ home care is similar to that in surrounding states, offering different non-medical home care for your loved one including:
- Meal and cooking assistance
- Daily living
- Personal care in-home assistance such as toileting and bathing
- Transportation and managing of healthcare and arranging appointments
- Laundry and cleaning assistance in the home
- Medication assistance and organizing
- Assistance with recreational activities and socialization
In-home care services such as these will differ from agency to agency. Medical home health care is also available by a trained and registered nurse. These health services may include medication in-home assistance, physical therapy, speech therapy, pain management and more. It is important to discuss with a potential in-home senior care agency the types of care they provide before deciding.
Quality and safety
New Jersey has high standards for all healthcare. Following Medicare’s quality standards, star ratings are used to measure the quality of home health care agencies which are reported on Home Health Compare through Medicare. Regardless of a patients age, these measures can be used to find a quality healthcare provider for your loved one.
According to Medicare, “The quality of patient care star ratings are calculated using each home health agency’s scores on 9 individual quality measures, which are based on home health agency patient assessments and Medicare claims.” These star ratings are updated quarterly to keep you up to date on quality for your home health agency.
The quality measures are as follows:
How often the agency
- Initiated patient care in a timely manner
- Provided patient/caregiver drug education on all medications
- Ensured patients received the flu vaccine for the current season
How often the patient
- Got better at walking or moving around
- Got better at getting in and out of bed
- Got better at bathing themselves
- Was able to engage in activity with less pain
- Experienced less shortness of breath
- Required acute care hospitalization
With these care measures, you can be assured that your loved one is receiving the highest quality of care possible in the state. Alongside quality control are strict safety standards, laid out by OSHA, the Occupational Safety and Health Administration.
There are safety concerns with home health that include:
- Little control over the work environment
- Patient lifting and moving concerns
- Hostile animals and pets
- Unhygienic situations and pathogens
OSHA is here to provide services to ensure the safety of the home health provider as well as the patient receiving home health care. OSHA provides many different resources for patient safety to ensure that your loved one is perfectly safe and receives high-quality care each day. With these regulations set forth by OSHA, home health has become a safe alternative to facility-provided care.
Home care costs in New Jersey
According to a survey compiled by Genworth in 2015, there is a stark difference between homemaker services and certified home health aides. The costs between these two will differ, due to the type of care provided.
Homemaker services in New Jersey are an average of $20 an hour, with the lowest being $11 and the maximum being $26 an hour. This creates an annual rate of $46,332 for the state of New Jersey as a whole. These numbers vary by city and are lower in locations such as Ocean City and Trenton.
Home health aid costs for New Jersey were at a $21 an hour average with the lowest being $11 an hour and the maximum coming in at $26 an hour. This creates an annual rate of $48,506 as an average for the state. These numbers are lower in locations such as Ocean City and Vineland-Bridgeton.
Both types of care have a projected five-year annual growth of 1%, creating a positive outlook for 2018 and beyond. Costs will, of course, vary throughout the state, depending on location, services provided and the insurance coverages of the individual.
New Jersey offers many resources for home health seekers and their families. Some of these community resources include:
- Congregate Housing Services Program – Provides supportive services for elder care and the disabled of all ages residing in housing facilities.
- JACC or Jersey Assistance for Community Caregiving – Much like the MLTSS that we will discuss, this caregivers program aids individuals with slightly higher incomes.
- MLTSS or Managed Long-Term Services and Supports - MLTSS uses a managed care approach for the delivery of public-funded Medicaid long-term in-home care services.
There are more resources available for residents of New Jersey depending on the care required. You can find more information about these resources here.
Home care and home health eligibility requirements and costs in New Jersey depend on the individual’s insurance coverage, as well as state requirements. Let’s break down the eligibility requirements for Medicare, New Jersey’s state Medicaid, as well as private insurance coverage.
Medicare does cover home health services including:
- Intermittent skilled nursing care
- Physical therapy
- Speech therapy
- Continued occupational services and more
Under Medicare, the home health agency will coordinate services that the individual’s provider orders for the patient. In turn, Medicare does not cover:
- 24-hour-a-day care
- Meals delivered to the home
- Meal preparation
- Homemaker services
- Personal care
To receive these levels of care with Medicare, the individual must be covered by both Medicare Part A and Part B with the following conditions met:
- The individual must be under the care of a doctor or physician and must be receiving services under an established plan of care
- The physician must certify that the individual needs either intermittent nursing care or PT, OT or speech-language pathology
- The home health agency you choose must be approved by Medicare
- A doctor certifies the individual is homebound
Individuals who require more than part-time or more than intermittent nursing care will not be eligible for the Medicare home health benefit. The cost for Medicare home health that meets all the requirements is $0 with 20% of the Medicare-approved amount for durable medical equipment if applicable.
If Medicare is the only insurance coverage the individual has, home health that is not covered under this benefit will need to be paid out of pocket. It is critical to understand what the individual’s doctor is ordering and requiring to best understand the costs and benefits.
New Jersey Medicaid
New Jersey Medicaid offers the MLTSS or Medicaid Managed Long-Term Services and Supports for individuals covered under Medicaid. This is extremely beneficial to individuals who have Medicare primary and Medicaid secondary who need more assistance with long-term senior home care.
According to New Jersey’s Division of Medical Assistance and Health Services, “MLTSS uses NJ Family Care managed care organizations (also known as HMOs or health plans) to coordinate ALL services. MLTSS provides comprehensive services and supports, whether at home, in an assisted living facility, in community residential services, or in a nursing home.”
With MLTSS, New Jersey Medicaid covers services such as:
- Personal in-home senior care
- Respite care
- Care management services
- Home and vehicle modifications
- Home delivered meals
- Meal preparation
- Mental health services
- Nursing home care
Other services are also covered depending on the individual’s needs. To qualify for MLTSS, individuals must meet three established-Medicaid requirements including:
- Financial requirements. These requirements include monthly income as well as total liquid assets. The financial requirements will vary, and you can read more about these requirements here.
- Qualifications for a nursing home level of care, able to provide assistance with activities of daily living.
- Be at least 65 years old or officially disabled/blind according to the Social Security Administration of New Jersey.
If the individual is elderly yet does not meet the requirements of income, there is the New Jersey PACE program for those individuals with a higher income level.
New Jersey Medicaid, combined with Medicare can be the best benefit level for elder care. Those who are younger, without a diagnosis of disability, can be eligible for home health through private insurance coverage if applicable.
Private insurance coverage depends on the type of care required. Most insurance companies will cover home health, although the coverage depends on the plan. These companies rarely cover home health that is not considered medically necessary. So many non-medical care services are likely not covered. And, skilled care may not be covered at 100% such as with Medicare-covered services. With private insurance, it is best to consult your insurance provider for a home health quote for your loved one, prior to accepting services.
Top providers in New Jersey
There are many different options for home health care in New Jersey. It can be overwhelming trying to find the best option for your loved one. Through using the Quality of Patient Care Ratings, you can pinpoint the best options in your area.
Some of the best and highest rated providers, having between 4 and 5-star ratings in New Jersey include:
- VNA of Englewood – Englewood, New Jersey
- Holy Name Home Care – Teaneck, New Jersey
- Seabrook Home Health Agency – Tinton Falls, New Jersey
- Community Nursing Service – Vineland, New Jersey
- Meridian Home Care – Neptune, New Jersey
- VNA of Somerset Hills – Basking Ridge, New Jersey
There are many other high-rated options available throughout New Jersey. To find a provider in your area, you can use the Home Care and Hospice Association of New Jersey’s online directory of agencies per county here.
For more assistance with home health care decisions in New Jersey, there are other resources available:
- New Jersey Area Agency on Aging – "This office helps coordinate senior care services for adults over the age of 60 including information assistance, outreach, transportation, case management and more."
- Statewide Respite Care Program – "Health care services including companions, homemakers, medical or social adult day in-home care services and more on an as-needed basis."
- Aging and Disability Resource Connection (ADRC) – "A location in every county, to help with senior care services and other individuals and their caregivers find out about important state, federal, and local long-term services and supports."
Many other resources can be found through the Department of Human Services through the Division of Aging Services through the State of New Jersey.
Home health care may be the most important decision you make for your loved one. With proper planning, you can rest assured that your loved one will receive the best senior home care possible in New Jersey.