Assisted Living in New Jersey

New Jersey is known for its rich topographical and cultural diversity, with popular locations such as Atlantic City and the Jersey Shore. It also has access to some of the world’s best medical facilities, museums, and theaters across the bridge in New York City, which makes it an ideal state for many seniors to retire in.

Paying For Assisted Living in New Jersey

The Cost of Assisted Living in New Jersey

The median cost of assisted living in New Jersey is $6,065, much higher than the national average of $4,000. New Jersey is easily the most expensive among its neighbors, being almost twice as expensive as Pennsylvania whose median is $3,750.

The average monthly cost of assisted living in New Jersey varies dramatically from city to city – the state capital of Trenton is $7,280 a month, while Ocean City’s monthly average is about $2,500 cheaper at $4,800.

Median costs for assisted living in New Jersey are lower than those associated with other types of care except for independent living, which doesn’t provide the same level of care. While comparatively expensive in the state, assisted living is still considerably more affordable than a semi-private room in a nursing care facility.

Financial Assistance for Assisted Living in New Jersey

New Jersey Family Care, the state’s Medicaid program, is available to pay for assisted living in New Jersey. There are currently two programs that eligible seniors are able to use in covering some costs of assisted living.

Managed Long-Term Services and Supports

Applicants may apply and qualify for the Managed Long-Term Services and Support (MLTSS) program, and although this program will not pay for rent and meals, it will cover the cost of assistance with personal care tasks such as bathing, eating and getting dressed in assisted living facilities. MLTSS services may be used at all assisted living facilities that hold a valid license to operate from the New Jersey Department of Human Services.

Who Is Eligible?

MLTSS is open to adults aged 65 and older or can be classified as blind or disabled if under 65. In order to qualify, a financial eligibility and personal care need assessment will be conducted. The financial assessment has a five-year look-back and will take into account all assets, including liquid assets (cash, bank accounts, CDs, stocks), and property ownership. There is an income cap of $2,250 for single adults seniors and $3,375 for couples.

If unable to qualify due to being over the income limit, applicants may still qualify under the Medically Needy Program if they can prove they have high medical bills and the excess income is used to satisfy those bills. The income limit for the medically needy program is $367 per month for a single person and $434 for couples.

How to Apply

Once a determination of need has been assessed after applying for MLTSS or PACE, applicants will then need to contact their county Area Agency on Aging office for information and assistance with applying. If not already covered under NJ Family Care, applicants should contact their county welfare agency or board of social services to enroll.

PACE

The Program of All-Inclusive Health for the Elderly (PACE), is a program that offers all the same benefits as MLTSS, but applicants will need to live in one of the 7 counties where the program is available. PACE has the added benefit of a small dedicated team of interdisciplinary professionals that provides comprehensive medical and social services. Like the MLTSS program, PACE will also not cover the cost of meals or rent for an assisted living facility.

PACE is available in the following counties:

• Burlington
• Camden
• Cumberland
• Gloucester
• Hudson
• Mercer
• Salem

Who Is Eligible?

PACE is open to adults 55 years and older that live in one of its 7 county service areas. Financial eligibility requirements are the same as those of the MLTSS program, and those over the monthly financial threshold may also qualify through the Medically Needy Program.

How to Apply

For more information on PACE and to get help with applying, you can visit the website or call (800) 792-8820.

More Ways to Finance Assisted Living

Some additional ways to finance assisted living costs include:

• Veterans Benefits: Veterans can take advantage of several different pension programs to help cover the cost of assisted living. For more information, see the article on benefits.va.gov.

• Life Insurance Policies: Even if a spouse or loved one hasn’t died, certain types of life insurance policies can be used to pay for assisted living. More information is available at longtermcare.acl.gov.

• Long-Term Care Insurance: Long-term care insurance is a type of insurance policy that pays for long-term care when it becomes necessary, including the cost of assisted living. For more information on the benefits and drawbacks of this financing method, visit longtermcare.acl.gov.

• Reverse Mortgages: Reverse mortgages allow seniors to access the equity from a home that they own, and these funds can be used to pay for assisted living. The U.S. Department of Housing and Urban Development offers a federally insured reverse mortgage program.

Free Assisted Living Resources in New Jersey

Long-Term Care Ombudsman Program

New Jersey’s Long-Term Care Ombudsman is a resident-focused advocacy agency, authorized by the federal Older Americans Act. The agency works with local residents and facilities to introduce policy initiatives at both the state and federal level. The stated mission of the New Jersey Ombudsman is to advance the rights, dignity, and self-determination of the elderly in long-term care.

Complaints of elder abuse in all forms may also be filed with the ombudsman office anonymously.

Area Agency on Aging

Area Agency on Aging (AAA) is a network of hundreds of nonprofit organizations across America that provide federally funded services to adults over 60 in their local areas. In New Jersey, these agencies may also be known as the Aging and Disability Resource Connection. A range of services and resources that are aimed at making the lives of seniors easier are provided by these agencies.

Among the services that agencies may provide are, escorted transportation when necessary, meal delivery, adult day care services, legal advice and other services that may be state specific. To find a local area agency office and for more information on all the services they provide consult the list below.  

Veterans Affairs

As part of their benefits package, U.S. Armed Services Veterans may receive a pension which they can use to pay for assisted living. In addition to the monthly pension amount they receive, some veterans may also be eligible for an increased rate based on need through one of two additional pension benefits:

• Aid & Attendance is targeted at veterans who are bedridden, reside in a nursing home, or those that need help with daily tasks such as bathing, dressing, and eating.
• Housebound is an additional benefit paid to veterans confined to the home due to a permanent disability.

For help understanding your benefit options and assistance with applications, contact your nearest VA office from the list below.

Social Security Offices

Another avenue of financing assisted living is through social security benefits. For more information and to gain better insight into what options are available to you or a loved one with social security, you may call or visit one of the local social security offices on the list below.

Assisted Living Laws and Regulations in New Jersey

The New Jersey Department of Human Services (DOHS) is the agency that oversees the laws and regulations that govern assisted living. However, the Division of Aging Services (DoAS) is the administrative agency that provides oversight for all programs and services on aging. DoAS is the home of the state’s adult protective services and also conducts all Medicaid clinical eligibility and quality assurance.

Assisted Living Admission Requirements

New Jersey assisted living facilities have no restrictions or requirements that limit admission. However, if a resident does require long-term, specialized care, such as needing continued access to respirators or needing intensive behavioral management, mandatory discharge is required. Additional discharge requirements are left up to the discretion of the facility. These may include prolonged illnesses that require 24-hour nursing, or a resident becoming a danger to themselves or others.

An initial assessment must be conducted for all residents upon admission to determine the needs of the resident. A healthcare assessment should be completed within 14 days of admission if the initial assessment shows that the resident has specific health needs, and may only be conducted by a registered nurse or medical professional employed by either the facility or the DOH. Residents must also have continued reassessments in a time frame that is consistent with their health service plan.

Assisted Living Scope of Care

All facilities must provide health services and supportive personal care services, including:

• Limited nursing care
• Dining
• Pharmacy
• Assistance with personal care such as bathing
• Planned recreational activities
• Social work services tailored to the individual needs of residents

Assisted Living Medicaid Policy

Medicaid will pay for assisted living in New Jersey for those that demonstrate financial or personal care needs. Some facilities are contracted through the DOHS to provide care for residents and offer two programs:

• The Managed Long-Term Services and Supports (MLTSS) program covers personal care, nursing, mental health, and other services for those aged 65 and older.
• The Program of All-Inclusive Care for the Elderly (PACE) covers all the same services for adults aged 55 and older but is limited to specific counties of New Jersey.

Assisted Living Facility Requirements

In order to receive a license from the Department of Human Services, assisted living facilities must adhere to specific guidelines on room size and facility safety set forth by the DOHS:

• Private units in a facility should have no less than 150 sq ft of space, while semi-private units must have an additional 80 sq ft of space per resident.
• The square footage requirement should be clear usable space and as such excludes bathrooms, kitchenettes, closets, hallways, corridors, foyers, and vestibules.
• At maximum, a unit may contain two residents.
• Each unit must contain a bathroom, shower or bathtub, and a sink.
• The facility should have sufficient public toilet areas to meet the need of residents, staff, and visitors to the facility.
• Unless an exemption has been granted by the DOHS, all facilities must have an automatic fire suppression system in place throughout the facility.
• Smoke detectors are required in all resident bedrooms, living rooms, studio units, and apartments, as well as common areas.

Medication Management Regulations

Only under the delegation of a registered nurse are some employees of the assisted living facility allowed to dispense or administer medication and injectables to residents. These employees include certified nurses aides, certified home health aides, and facility employees that have completed and passed the DOHS medication aide certification. Epinephrine, prefilled insulin, and disposable insulin pens are the only injectables that may be administered by someone other than a registered nurse.

Staffing Requirements

A facility administrator must be at least 21 years old and hold a high school diploma or General Equivalency Diploma (GED). They must also have an up to date New Jersey nursing home administrator license or be already certified as a New Jersey assisted living administrator. A minimum of 30 hours of continuing education on topics pertaining to assisted living is required once every three years.

In a facility with more than 60 beds, a designated alternate is to be available at all times, in the event that the administrator is not. Both the administrator and the alternate are responsible for the running of the facility 24-hours a day. In facilities with less than 60 beds, an administrator is to be available at least half the time.

Staff Training Requirements

All orientation should take place at the time of employment, with annual re-education on all topics. The facility is responsible for putting together its own training and orientation program complete with materials it deems most relevant to the care of residents which may include such topics as:

• The care of residents with physical ailments
• Emergency procedures and plans
• Infection prevention and control
• Residents rights
• Abuse and neglect
• Pain management
• The care of residents with dementia
• Cognitive and physical impairment

Every two years medication aides must complete an additional 10 hours of continuing education related to elder drug use and medication administration. Personal care assistants must complete 20 additional hours of continuing education, and have successfully completed a DOHS approved nurse aide, home health aide, or equivalent training program.

Background Checks for Assisted Living

All facility employees must submit to both a state and federal fingerprint-based background check.  

Requirements for Reporting Abuse

All staff at an assisted living facility are designated as mandatory reporters even if they do not have direct and consistent contact with residents. If abuse of any sort is suspected the reporter should call adult protective services office for their county. If they believe that the resident is in imminent danger they should call 911. Failure to report abuse can result in a fine of up to $5,000.

Residents that wish to report abuse of their own or another resident, should call 911 if they believe themselves or the abused party to be in danger. They may also call the local office of adult protective services, the number to which should be prominently displayed in a conspicuous area as required by the DOHS.

Facilities that engage in unlawful or exploitative practices may also be reported by staff members, residents or their families. Behaviors that may be considered unlawful or exploitative may be:

• Unexplained billings
• Conditions within a facility or its grounds that are dangerous or unsanitary
• Unreported falls and injuries
• Refusal to comply with medical orders
• Medication errors and mistakes,
• Ignoring to a resident’s complaints
• Staff members that are unable to provide adequate care to residents due to inadequate training

Residents, their families, or staff that wish to file a complaint against a facility that is engaging in unlawful behaviors, may do so by calling the New Jersey DOHS at (800) 792-9770. They may also contact the Long-Term Care Ombudsman intake line at (877) 582-6995 or via email at [email protected].