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New York's In-Home Medicaid Waiver (NHTD), Explained

The Nursing Home Transition and Diversion (NHTD) Medicaid Waiver is New York's primary in-home HCBS waiver for seniors needing nursing-home-level care.

HomeState RulesNew York's In-Home Medicaid Waiver (NHTD), Explained
Short answer

New York's primary in-home Medicaid waiver for seniors needing nursing-home-level care is the Nursing Home Transition and Diversion (NHTD) Medicaid Waiver, a federal 1915(c) HCBS waiver administered by NYSDOH through Regional Resource Development Centers.

What NHTD covers, and what it does not

NHTD funds home and community-based services intended to transition a Medicaid-eligible senior or person with a physical disability out of a nursing facility, or to divert them from institutional placement altogether. It pays for services, not room and board or rent.

In practice, most Nassau and Suffolk seniors needing ongoing community-based long-term care are more commonly directed toward Managed Long Term Care (MLTC) enrollment, which has been mandatory in both counties since 2013 for Medicaid recipients who need more than 120 days of community-based long-term care and can remain safely at home at enrollment.

Who administers it locally

Start with the Nassau County Office for the Aging (516-227-8900) or the Suffolk County Office for the Aging (631-853-8200), both of which serve as local NY Connects access points and can screen for NHTD and MLTC eligibility.

Source: NYSDOH NHTD Waiver program page

Questions families ask

How much does assisted living cost in New York State?

According to CareScout's 2025 Cost of Care Survey, the median cost of an assisted living community (private one-bedroom) in New York State is $225 per day, or about $7,110 per month and $85,320 per year. This is a statewide median - CareScout's published state-level data tables do not break out a separate Long Island or metro New York figure.

What does a nursing home cost per day in New York?

CareScout's 2025 Cost of Care Survey puts the New York State median at $511 per day ($15,528/month, $186,333/year) for a semi-private room and $550 per day ($16,729/month, $200,750/year) for a private room, both based on 365 days of care. These are statewide figures; CareScout does not publish a separate Long Island-specific nursing home rate.

How much does hourly in-home caregiving cost in New York?

CareScout's 2025 Cost of Care Survey reports a New York State median of $35 per hour for what it now calls non-medical caregiver services, a category that merged the formerly separate homemaker services and home health aide categories in 2025 due to price convergence. Based on a 44-hour week, that works out to roughly $6,673 per month or $80,080 per year. Private duty nursing, a higher-acuity service, runs a New York State median of $120 per hour.

What does adult day care cost in New York, and could it help delay a move to assisted living?

CareScout's 2025 Cost of Care Survey puts New York State's Adult Day Health Care median at $144 per day, or about $3,120 per month based on five days a week, $37,440 per year. That's up from $113 per day in the 2024 survey, an increase of roughly 27 percent year over year, the largest percentage jump among CareScout's surveyed New York categories.

Is there a separate published cost for memory care in New York?

No. CareScout's Cost of Care Survey, the primary published cost benchmark used on this site, does not survey or publish a distinct memory care cost category in either its 2024 or 2025 New York State data tables. CareScout only publishes figures for Assisted Living Community, Nursing Home (semi-private and private), Adult Day Health Care, and in-home care categories.

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