Leaving a Nursing Home to Live at Home in NYC: How the Move Back Works

Can You Leave a Nursing Home and Go Home in NYC?

Yes. Living in a nursing home is not a one-way door. People leave every week: after short-term rehab, after a health crisis stabilizes, or after months or years when it becomes clear that the right support at home would let them live more freely. Federal rules give residents the right to ask about returning to the community, and New York has programs built specifically to help people make that move.

Families often type something like “leave nursing home go home NYC” into a search bar late at night, unsure where to even begin. The questions are practical ones. Where will the person live? Who will help them with bathing, dressing, toileting and moving around? How will it be paid for? And what needs to be set up before the van pulls up to the building?

If you are still weighing the two options, our guide to nursing home vs home care in NYC lays out the trade-offs.

Short-Term Rehab vs Long-Term Stay

The path depends on what kind of stay it is.

• Short-term rehab: after a hospital stay, Medicare may cover a skilled nursing stay for rehab for a limited period if conditions are met. Discharge home is the expected outcome, and the facility plans for it. See coming home from rehab for a setup checklist.
• Long-term stay: someone who has lived in the facility for months, usually with Medicaid paying. Going home is very possible, but it takes more planning: Medicaid budgeting changes, the person may no longer have an apartment, and the care plan has to be built from scratch.

Step by Step: How the Move Back Works

1. Say it out loud. Tell the social worker, the care team and the doctor that the resident wants to go home. Ask that it be written into the care plan. Residents are periodically asked whether they want to talk about returning to the community; the answer “yes” should trigger a referral.
2. Ask about Open Doors. Open Doors is New York’s nursing home transition program, connected to the federal Money Follows the Person initiative. Transition specialists and peers can help with housing searches, benefits and planning. The social worker can make a referral.
3. Look at the right Medicaid program. Many people return home with Medicaid home care through a managed long-term care plan. Others, especially people with physical disabilities or brain injury who want more services, may fit a waiver. Read the NHTD waiver in New York and NHTD vs MLTC to compare.
4. Get the assessment and plan of care in place. Home care hours are set by the assessment process and plan of care, based on how much help the person needs with bathing, dressing, toileting, transferring and eating. This can take several weeks, so start early. Once a plan is chosen, see how to choose an MLTC plan.
5. Secure housing. If the apartment was kept, check that it is still accessible. If it was given up, housing is often the hardest piece. Transition programs and some waivers can help with housing search or subsidies; ask what applies.
6. Arrange equipment and the home. Hospital bed, wheelchair, commode, shower chair, grab bars. See what Medicaid covers for equipment and modifications and the home safety checklist.
7. Confirm the aide schedule before discharge. Do not accept a discharge date until the home care agency confirms who is coming, when, and for how many hours on day one.

How Medicaid Changes When You Move Home

Medicaid works differently in a nursing home than in the community. In a facility, most of a resident’s income typically goes toward the cost of care, with a small personal needs allowance kept. At home, community Medicaid rules apply, with their own income and resource limits, and the person needs income to pay rent, food and utilities.

For someone whose income is above the community limit, tools like a pooled income trust can help them qualify while keeping money for living expenses. See excess income and pooled income trusts. Rules and limits change, so confirm the current figures with HRA or a Medicaid professional before discharge.

Plan enrollment can also shift when someone has been a long-term nursing home resident. Ask the social worker or the transition program which plan or program the resident will be enrolled in after discharge, and make sure there is no gap in coverage.

Is Home Safe Enough? Questions to Ask Honestly

Going home is a goal worth fighting for, and it should also be safe. Before discharge, ask:

• How many hours of help does the person truly need, and at what times of day and night?
• Can they get to the bathroom at night alone, or will they need someone present? If so, look at overnight and live-in care.
• Does the building have an elevator, or are there stairs? Is there a step into the shower?
• Who handles medications, and who coordinates doctor visits?
• What is the backup plan if an aide cannot come?

Many people do well at home with a combination of aide hours, family involvement, visiting nurse services when needed, and a good primary care doctor. The first few weeks are the adjustment period; expect some changes to the schedule as everyone learns what works.

Related Guides

Nursing home vs home care · The NHTD waiver · NHTD vs MLTC · Coming home from rehab