The NHTD Waiver in New York: Who Qualifies and What It Covers
A short, plain-English guide to the Nursing Home Transition and Diversion waiver — what it funds, who it is for, and how to start.
NHTD stands for Nursing Home Transition and Diversion. It is a New York Medicaid Home and Community Based Services waiver for people who need a nursing home level of care but can live safely at home with the right support. It has two jobs, both in the name: transition people out of nursing facilities, and divert people from having to enter one. Applications go through your Regional Resource Development Center (RRDC).
What the NHTD Waiver Covers
NHTD funds supports that ordinary Medicaid does not. The exact package is set in your approved Service Plan, and commonly includes:
A coordinator builds the Service Plan, arranges providers and keeps everything current. The most important choice you make.
Hands-on help with bathing, dressing, grooming, meals and supervision at home.
One-time help setting up a home when moving out of a nursing facility — deposits, essential furnishings, moving costs.
Nursing oversight, medication management and health monitoring at home.
Ramps, grab bars, bathroom modifications and assistive technology to make a home workable.
Rental assistance for eligible participants, shared with the TBI waiver, where community housing is otherwise unaffordable.
Who Qualifies
- Medicaid eligible in New York State.
- Assessed as needing a nursing home level of care — but able to live safely in the community with waiver services in place.
- Living in, or moving to, an approved community setting.
- Able to participate in developing a Service Plan, directly or through a representative.
Age and disability criteria apply and have changed over the years, so confirm the current requirements with your RRDC rather than relying on anything you read online, including this page.
NHTD or TBI? They are sibling programs that share the housing subsidy and much of the service menu. The TBI waiver serves people with traumatic and related acquired brain injuries. The NHTD waiver serves seniors and people with physical disabilities who need nursing home level care. Your RRDC handles both and will tell you which fits. See our guide to NHTD and TBI support services.
How to Apply
- Already in a nursing facility? Ask the discharge planner for a referral to the RRDC or to Open Doors.
- Living in the community? Contact the RRDC for your region directly — a hospital social worker or home care agency can point you to yours.
- Sort Medicaid first. It is the biggest accelerator. See how to qualify for Medicaid home care, and pooled income trusts if income is over the limit.
- Choose a Service Coordinator from the approved list, then build the Service Plan together.
- Approval and start. The RRDC and Department of Health review the plan, then services begin.
Expect months rather than weeks, and expect paperwork. Families who move fastest get Medicaid in place early and ask their coordinator for a written checklist on day one.
What You Can Do While You Wait
Waiver approval is slow; need is not. Most families bridge with private-pay hours or, if Medicaid is already in place, with authorised personal care aide hours — waiver services sit alongside regular Medicaid, not instead of it. See also home care for adults with disabilities.
Quick Answers
What does NHTD stand for?
Nursing Home Transition and Diversion — a New York Medicaid waiver that helps people live in the community instead of a nursing facility.
Is the NHTD waiver the same as regular Medicaid home care?
No. Waiver services are additional to regular Medicaid coverage. A participant can receive both personal care hours and waiver services.
Does NHTD help with rent?
Eligible participants can access the housing subsidy shared with the TBI waiver, which covers rent above roughly one third of the participant’s monthly income, up to fair market rent limits.
Where do I apply?
Through the Regional Resource Development Center for your area. If you are in a nursing facility, the discharge planner can make the referral.
How long does it take?
Typically months, driven mostly by Medicaid status and documentation. Start Medicaid first if it is not already in place.
Can a home care agency help with the process?
Yes. We work alongside service coordinators and RRDCs across the five boroughs and can staff the hands-on care while the waiver application runs.
Trying to Get Someone Home?
Whether it is a nursing home discharge or keeping someone out of one, tell us the situation and we will tell you what is possible and how fast.
Call 718-375-2707 See Our NHTD & TBI Services