Book Appointment Now
NHTD Waiver Services in New York
The Nursing Home Transition and Diversion (NHTD) waiver helps Medicaid-eligible seniors and adults with physical disabilities stay in their own homes and communities, with the right support in place. Care you can trust, right at home.
What Is the NHTD Waiver?
The Nursing Home Transition and Diversion (NHTD) waiver is a Medicaid program run by New York State. It is designed for seniors and adults with physical disabilities who qualify for nursing home-level care but want to keep living at home or in their community instead.
Instead of moving into a nursing home, NHTD connects you with a team of support services built around your needs, from help with daily living skills to emotional support during major life changes. The goal is to help you stay independent, safe, and connected to the people and places you care about.
What's Included
Service Coordination (SC)
Your service coordinator builds a personalized plan, connects you with the right providers, and helps you access the services you need to remain in the community instead of an institution.
Independent Living Skills Training (ILST)
One-on-one support to rebuild daily living skills, like cooking, budgeting, or managing medication, that may have been affected by a disability or health change.
Community Integration Counseling (CIC)
One-on-one counseling for people adjusting to life changes, including a transition out of a nursing home. Counselors help you cope emotionally and coordinate with your other providers.
Home and Community Support Services (HCSS)
Available under the NHTD waiver: support with daily activities and supervision at home, coordinated as part of your service plan.
Respite Services
Available under the NHTD waiver: short-term relief for family members and unpaid caregivers, coordinated as part of your service plan.
Assistive Technology & Environmental Modifications
Available under the NHTD waiver: equipment and home modifications, like grab bars or mobility aids, coordinated as part of your service plan.
Ready to Talk Through Your Options?
How the NHTD Waiver Process Works
Getting started with NHTD services involves a few clear steps. Here is what the process generally looks like:
1. Reach Out for a Free Consultation
We will talk through your situation and help you understand if NHTD may be a fit.
2. Confirm Medicaid & Waiver Eligibility
Eligibility is based on your Medicaid status and your level of care needs.
3. Get Matched With a Service Coordinator
Your coordinator gets to know your needs and builds an Individualized Service Plan (ISP) with you.
4. Services Are Authorized & Begin
Once your plan is approved, services start, and your team checks in regularly to make sure your plan still fits your life.
NHTD vs. TBI Waiver vs. PCA vs. MLTC — Which Program Fits?
These four names get used almost interchangeably by families researching home-based care options in New York — but they’re separate programs with different requirements. Here’s a plain-language side-by-side to help you get oriented before you reach out.
| Program | Generally Serves | Typical Focus |
|---|---|---|
| NHTD Waiver (Nursing Home Transition and Diversion) | Adults with disabilities and seniors who meet a nursing-home level of care but want to live in the community instead of a facility | Community-based services and supports built around an individualized service plan |
| TBI Waiver | Individuals with a traumatic brain injury who need specialized, coordinated support to live in the community | Rehabilitative and community-support services tailored to brain-injury recovery and daily functioning |
| PCA / Personal Care Assistance | People who need hands-on help with everyday activities — bathing, dressing, meal prep, mobility — but not full nursing-home-level care | Direct, hands-on personal care in the home |
| MLTC (Managed Long Term Care) | A separate NY Medicaid managed-care pathway for people needing long-term services | Enrollment and care management run through a managed care plan rather than the NHTD/TBI waiver process |
PCHS provides services under NHTD, the TBI Waiver, and PCA. We don’t administer MLTC plans directly, but if you’re not sure which pathway applies to your situation, our team can help you figure out where to start.
Wondering If an NHTD Conversation Makes Sense? A Few Things Families Notice
There’s no single sign that means someone will qualify for NHTD support, and many of the changes below can have other explanations entirely. This is meant purely as a starting point for conversation, not a checklist for self-diagnosis. Want a more structured way to think it through? Try our free NHTD/TBI eligibility checklist.
You might consider starting a conversation about NHTD if you’re noticing:
- Increasing difficulty managing daily routines safely — meals, medication reminders, mobility around the home
- Memory or thinking changes that are starting to affect everyday safety, like leaving appliances on or getting confused on a familiar route
- A recent hospital stay, fall, or health scare that raised new questions about living alone
- An existing disability or health condition alongside a strong preference to stay in the community rather than move into a nursing facility
- Family caregivers feeling stretched thin trying to cover the level of support that’s needed
This list is for informational purposes only and is not medical advice, and it is not a medical diagnosis or an official eligibility determination. If any of this sounds familiar, the next step is a conversation — with a physician, a Medicaid service coordinator, or our team — to find out what’s actually available and whether NHTD is the right fit.
Getting Ready to Apply: What Families Typically Have on Hand
Every NHTD application moves through New York State’s process, and your care team will confirm exactly what’s needed for your specific situation. As a general starting point, it helps to have the following ready before you begin:
- Proof of current NY Medicaid enrollment (or documentation that an application is underway)
- Basic identification — photo ID and proof of date of birth
- Recent medical records or a physician’s summary describing the relevant health condition or disability
- Contact information for your current doctor(s) and any case manager or hospital discharge planner
- A general sense of daily support needs — what kind of help, how often, and from whom
- Prior nursing home, hospital, or rehab discharge paperwork, if applicable
Not sure what applies to your specific situation? Our team is happy to walk through it with you before anything gets submitted.
Not Sure Which Program Fits? Start Here
NHTD, the TBI Waiver, and Personal Care Assistance (PCA) all support people who want to stay in their own home or community — but they’re built for different situations. As a quick starting point:
- If your main need is everyday hands-on help — bathing, dressing, meal prep, mobility — without nursing-home-level needs, Personal Care Assistance (PCA) may be the more direct starting point.
- If you or a loved one has a traumatic brain injury and needs specialized rehabilitative and coordinated support to live in the community, our TBI Waiver page has more detail on that pathway.
- If you’re an adult or senior who meets a nursing-home level of care but want to remain living at home or in the community instead, NHTD is generally the better starting point.
This is just a starting point, not an official determination of which program you qualify for — the fastest way to know for sure is to talk with our team.
Frequently Asked Questions
What is the NHTD waiver?
The NHTD (Nursing Home Transition and Diversion) waiver is a New York State Medicaid program that helps seniors and adults with physical disabilities receive care and support at home instead of in a nursing home.
Who is eligible for NHTD services?
Eligibility is generally based on Medicaid enrollment and needing a nursing home level of care. If you are not sure whether you or a loved one qualifies, we can help you understand your options.
How do I start NHTD services with Priority Cares HS?
Call us at (718) 400-6166 or fill out our online contact form. We will walk you through the next steps, from checking eligibility to building your service plan.