REFERRAL PARTNERS

If you’re coordinating a patient’s transition home from a hospital or skilled nursing facility, home care is often the piece that determines whether that transition actually works. This guide is a plain-English reference for how Touch of Love Homecare Agency fits into a discharge plan, what we need from you to move fast, and how the programs we accept actually work.

The three ways a patient’s home care gets paid for

• NHTD (Nursing Home Transition and Diversion) Waiver — a New York Medicaid 1915(c) Home and Community Based Services program for adults who meet a nursing-facility level of care but want to remain in, or return to, the community. Referrals can start with us directly or through the patient’s Regional Resource Development Center.
• TBI (Traumatic Brain Injury) Waiver — the parallel Medicaid 1915(c) waiver for individuals with a qualifying traumatic brain injury who need nursing-facility-level supports to remain at home. We work alongside the TBI service coordinator rather than in place of them.
• EISEP (Expanded In-Home Services for the Elderly Program) — a New York State (not Medicaid) program for adults 60+, income-eligible, who need help with daily activities. EISEP is non-medical — no physician’s order required — which typically means a faster start. It’s administered through the local Office for the Aging.
• Private pay — for patients who don’t qualify for or don’t want to pursue a waiver program, we also arrange care privately, starting at $32/hour with a 4-hour minimum. Often the fastest path when coverage needs to start within a day or two of discharge.

We don’t administer any of these programs — the state, the local Area Agency on Aging, or the relevant waiver office does. Our role is providing HHA and PCA staffing once a patient is approved, or bridging the gap with private-pay care while a waiver application is in process.

What we need from you to move fast

• The patient’s name, discharge date (or target date), and location
• Which program applies — NHTD, TBI, EISEP, or private pay — if known
• Any specific care needs or hours requested
• Your direct contact information, so we can follow up with you (not just the family) as staffing is confirmed

We serve Brooklyn, Queens, Manhattan, the Bronx, Staten Island, Nassau, Suffolk, and Westchester Counties, with our main office in Bay Ridge, Brooklyn and a satellite office in Melville, Suffolk County. If a referral falls in our service area, we’ll confirm staffing availability and get back to you — we know discharge timelines don’t leave room for a referral to sit unanswered.

Why discharge planners work with us

• We’re licensed and Medicaid/waiver-experienced. NHTD, TBI, and EISEP referrals are a regular part of how we operate, not an exception.
• We keep referral partners in the loop. You’ll hear back from us as a case is staffed, not just from the family after the fact.
• We can bridge the gap. When a waiver application is still processing, private-pay care can start the coverage clock immediately.
• One office, one number. You’re not navigating a call center — you’re reaching our office directly.

Call 646-760-5363 to start a conversation about a patient’s care needs. We’re happy to talk through a case before it’s finalized, including whether it’s likely to be a fit for a waiver program or better suited to private pay.

Related reading

• NHTD Waiver Home Care: A Provider Guide for Case Managers

CAREERS

If you’re compassionate, reliable, and looking for steady, meaningful work, home care might be the career you didn’t know you were looking for. New York State needs more Home Health Aides (HHAs) and Personal Care Aides (PCAs) every year, and the path to getting certified is more accessible than a lot of people expect. Here’s what the process actually looks like.

HHA or PCA — what’s the difference?

• Personal Care Aide (PCA): 40 hours of state-approved training, combining classroom instruction with hands-on practice. PCAs help with activities of daily living — bathing, dressing, meal prep, light housekeeping, mobility, and companionship — along with infection control basics and emergency procedures.
• Home Health Aide (HHA): 75 hours of state-approved training — 59 hours of classroom instruction plus 16 hours of supervised practical training, at least half in an actual patient care setting. HHA training covers everything in the PCA curriculum plus additional health-related tasks.

Many caregivers start as a PCA and go on to complete HHA training later — it’s a natural next step once you know the work suits you.

What training actually covers

New York State requires approved training programs to complete the full curriculum within 60 days of a candidate starting. Once training is complete and a candidate passes their competency evaluation, they’re added to the New York State Home Care Registry — the official record agencies use to verify a caregiver’s certification before hiring.

If you already have relevant experience — for example, you worked as a nursing assistant in a hospital within the last five years, trained as an aide in another state, or served as a military medic or medical technician — you may be able to qualify through a competency evaluation instead of completing the full training program. It’s worth checking with a training program directly, since eligibility depends on your specific background and documentation.

Once certified, HHAs need 12 hours of in-service training per year to stay current — most agencies, including ours, build this into your regular schedule so it’s never a scramble.

Why caregivers choose to work with Touch of Love Homecare

Certification gets you in the door. What keeps caregivers in this field — and with a particular agency — is usually about the day-to-day experience: Do you get consistent hours? Does the office actually pick up the phone when you call? Do you feel supported, not just scheduled?

At Touch of Love Homecare, we work with HHAs and PCAs across Brooklyn, Queens, Manhattan, the Bronx, Staten Island, Nassau, Suffolk, and Westchester, matching caregivers with clients and families who need consistent, dependable care. We aim to offer flexible scheduling, responsive office support, and the kind of steady client relationships that make this work sustainable — not just a job, but a career you can build.

• See open positions on our Careers page

FAMILY RESOURCES

Bringing in help for an aging parent or family member is a decision most people only make once or twice in their lives — and it usually happens on a compressed timeline, right after a hospital stay, a fall, or a diagnosis that changes what “getting by” looks like. It’s hard to know what to ask when you’ve never done this before. Here’s a practical checklist for evaluating any home care agency in New York.

A five-step checklist

1. 1Confirm the agency is actually licensed. In New York, home care agencies serving private-pay clients must hold a Licensed Home Care Services Agency (LHCSA) license from the State Department of Health. You can check any agency’s license status yourself, for free, at profiles.health.ny.gov, or by calling the state’s Home Health Hotline at 800-628-5972.
2. 2Ask how caregivers are trained and supervised. A Home Health Aide (HHA) completes 75 hours of state-approved training (59 classroom hours plus 16 supervised practical hours); a Personal Care Aide (PCA) completes 40 hours. Every active HHA and PCA also completes 12 hours of in-service training a year. Ask who on staff holds which certification and how the agency verifies it before a placement.
3. 3Understand what happens if your regular caregiver can’t make it. This is one of the most common gaps with informal or independently-hired caregivers — no backup plan. A licensed agency should have a bench of staff and a process for filling a shift on short notice.
4. 4Get the billing structure in writing before care starts. Ask about the hourly rate and any per-visit minimum, whether rates differ for nights, weekends, or holidays, overtime terms, and what’s required to start service (such as a deposit).
5. 5Ask about Medicaid waiver options too. If your family member has, or may qualify for, Medicaid, ask whether the agency accepts NHTD, TBI, or EISEP waiver referrals — so a family that starts on private pay while an application is pending doesn’t have to switch agencies once it’s approved.

What Touch of Love offers

• NYS DOH-licensed — verifiable directly through the state, not just a claim on our website.
• Both private pay and Medicaid waiver programs (NHTD, TBI, EISEP) — one agency, whichever path fits your situation.
• A team that answers the phone. When you call, you’re reaching our office directly, not a call center.

Related reading

• Signs It Might Be Time for Home Care
• How Much Does Home Care Cost in New York?

FAMILY RESOURCES

Most older adults have a clear preference about how they want to spend their later years: at home. According to AARP’s 2024 Home and Community Preferences Survey, 75% of adults 50 and older want to remain in their current home as they age, and 73% want to stay in their current community — which tells you this isn’t a passing trend, it’s what most families are already trying to plan around.

Why aging in place is the default preference

The reasons families give for wanting to stay home are rarely complicated: familiarity, independence, staying near friends and a community, and — very often — cost. Moving into a facility is a major financial and emotional decision, and for a lot of families it’s simply not the first choice if there’s a reasonable way to avoid it.

AARP’s survey also found that a large share of older adults expect they’ll need some kind of support to make staying home work long-term — things like home modifications, personal safety systems, and in-home help with the tasks that get harder to manage alone (cooking, bathing, dressing, getting around the house, running errands). The wish to stay home is nearly universal; making it work usually requires a plan, not just a hope.

Where to start: New York’s public resources

Before looking at private options, New York has a genuinely useful starting point: NY Connects, the state’s official “no wrong door” resource for long-term services and supports. It’s free, and it can point families toward benefits counseling, local Offices for the Aging, transportation, meal programs, and home care options based on where they live.

• NY Connects — the statewide, no-cost starting point for long-term care questions.
• NYC Aging (Aging Connect) — 212-244-6469 or 311, plus a network of over 300 older adult centers offering free programs, meals, and caregiving support.

These public resources are a good first call for any family that’s just starting to figure out what “support at home” could look like for their situation — whether that ends up meaning a home care agency, a caregiver support group, transportation assistance, or some combination.

Where home care fits in

For a lot of families, the piece that actually makes staying home workable is a dependable person coming into the house on a regular schedule — someone to help with daily routines, keep an eye on things, and simply be there. That’s the role a Home Health Aide (HHA) or Personal Care Aide (PCA) plays, and in New York it’s available through a few different paths:

• Medicaid waiver programs for those who qualify, including NHTD (Nursing Home Transition and Diversion), TBI (Traumatic Brain Injury), and EISEP (Expanded In-Home Services for the Elderly Program, non-medical, no MD order required).
• Private pay, for families who want to arrange care directly without going through a waiver program, on their own schedule.

Both paths lead to the same basic goal: consistent, trustworthy help at home so that moving isn’t the only option on the table.

How Touch of Love Homecare fits into the picture

Touch of Love Homecare Agency is a NYS DOH-licensed home care agency based in Brooklyn, serving families across Brooklyn, Queens, Manhattan, the Bronx, Staten Island, Nassau, Suffolk, and Westchester. We work with NHTD, TBI, and EISEP waiver clients, and we also serve private-pay families directly at $32/hour with a 4-hour minimum.

If your family is somewhere in the process of figuring out whether aging in place is realistic — whether you’re just starting to research, already working with NY Connects or a local Office for the Aging, or ready to talk about a caregiver — we’re glad to have a straightforward conversation about what that could look like.

Related reading

• Signs It Might Be Time for Home Care
• How Much Does Home Care Cost in New York?
• Home Care vs. Assisted Living: How to Decide

FAMILY RESOURCES

If you’re researching home care for yourself or a family member, the price is usually the first question — and one of the hardest to get a straight answer to. Rates vary by agency, region, and hours needed, and a lot of what’s published online is a national average that doesn’t reflect New York specifically. Here’s a clear breakdown.

The going rate for home care in New York

The CareScout (formerly Genworth) Cost of Care Survey, a widely cited industry benchmark, put the national median rate for non-medical home care at $35 per hour in 2025. New York-specific estimates based on the 2024 edition put the New York state median closer to $34 per hour.

Touch of Love Homecare’s private-pay rate is $32 per hour, with a 4-hour minimum per visit — below both benchmarks above. We also offer live-in and overnight arrangements for families who need more continuous coverage.

What actually drives the cost of home care

• Hours per week. A few hours a few days a week costs far less than daily coverage, which costs less than live-in or 24/7 care.
• Type of care. Non-medical personal care is typically billed differently than skilled nursing care, which isn’t what most HHA/PCA-based agencies (including TOL) provide.
• Minimum visit length. Most agencies, including TOL, set a minimum per visit (ours is 4 hours) rather than billing in smaller increments.
• Region. Costs in New York City and surrounding counties tend to run higher than upstate.

A rough monthly picture

Here’s what a few common schedules look like at TOL’s $32/hour rate (4-hour minimum applies per visit):

• 4 hours/day, 5 days/week: roughly $2,560/month
• 4 hours/day, 7 days/week: roughly $3,584/month
• 8 hours/day, 7 days/week: roughly $7,168/month

These are simple hours-times-rate estimates, not quotes — actual cost depends on your family’s specific schedule.

You may not have to pay privately at all

If your loved one is enrolled in — or may be eligible for — one of New York’s Medicaid home and community-based waiver programs, home care may be covered at no direct cost to the family:

• NHTD (Nursing Home Transition and Diversion) — for adults with physical disabilities who qualify for a nursing-home level of care but want to remain at home.
• TBI (Traumatic Brain Injury) — for individuals with a qualifying brain injury on a similar path.
• EISEP (Expanded In-Home Services for the Elderly Program) — a non-medical program (no MD order required).

Eligibility for NHTD and TBI generally requires New York Medicaid enrollment, income and asset limits, and a nursing-home level-of-care determination — it’s not automatic, and there can be a waiting list. Touch of Love works directly with NHTD, TBI, and EISEP referrals and can help you figure out where you stand.

Questions worth asking any agency about cost

1. 1What’s your hourly rate, and is there a minimum number of hours per visit?
2. 2Are there different rates for daytime, overnight, weekend, or holiday coverage?
3. 3Is there a deposit or minimum commitment required upfront?
4. 4Do you accept Medicaid waiver programs (NHTD, TBI, EISEP), and can you help determine if I qualify?
5. 5Is the quoted rate the same rate the caregiver is paid, or is there a large spread?

Touch of Love Homecare’s rates, in one place

• Private pay: $32/hour, 4-hour minimum per visit
• Medicaid waiver programs accepted: NHTD, TBI, EISEP — typically no direct cost once approved
• Service area: Brooklyn, Queens, Manhattan, the Bronx, Staten Island, Nassau, Suffolk, and Westchester

Related reading

• How to Choose a Home Care Agency in New York
• Signs It Might Be Time for Home Care
• Home Care vs. Assisted Living: How to Decide

REFERRAL PARTNERS

Case managers and discharge planners who work with NHTD often know the waiver in outline but not in the week-to-week detail — how long each stage actually takes, who is responsible for what, and when a home care provider like Touch of Love Homecare enters the picture. This guide walks through the real process, stage by stage, so you can set accurate expectations with patients and families and know exactly when to loop us in.

What NHTD Is, in Plain Terms

The Nursing Home Transition and Diversion (NHTD) Medicaid waiver is a New York State home and community-based services program for people who meet a nursing-facility level of care but can live safely in the community with the right supports. It serves two groups: people transitioning out of a nursing home, and people at risk of nursing home placement who want to avoid it. To qualify, a person generally must:

• Be enrolled in community-based Medicaid
• Be assessed at a nursing-facility level of care
• Be age 18–64 with a documented physical disability, or age 65 and older
• Be able to live safely in the community with waiver and other services in place
• Not be concurrently enrolled in certain other care-management programs (Health Homes, MLTC, PACE, or HARP)

NHTD covers service coordination, home and community support services (HCSS), respite, meals, environmental modifications, and more. Touch of Love provides the hands-on HCSS staffing (HHA and PCA support) once a participant’s plan authorizes it — we don’t determine eligibility or manage the case, and we want referral partners to know exactly where that line sits.

The Referral and Enrollment Process, Step by Step

1. 1Referral to the Regional Resource Development Center (RRDC). The process starts when the person (or a discharge planner or case manager acting on their behalf) contacts the RRDC covering their region — that date is the official “referral date.” The RRDC has 5 business days to confirm basic eligibility.
2. 2Intake meeting, scheduled within 30 calendar days of referral — the applicant learns how the waiver works and completes the Application for Participation and Freedom of Choice forms.
3. 3Choosing a Service Coordination agency. The applicant has 30 days to interview and select a Service Coordinator — a separate role from a home care provider. Once selected, that agency has 5 business days to respond to the RRDC.
4. 4Application packet development — an Initial Service Plan, a UAS-NY level-of-care evaluation, a Plan of Protective Oversight, and Medicaid/disability verification.
5. 5RRDC eligibility determination. Once the packet is complete, the RRDC has 14 days to issue a formal Notice of Decision.
6. 6Services begin. The Service Coordinator distributes the approved service plan to the selected HCSS/home care provider, and staffing begins — this is the stage where Touch of Love typically enters.

Taken together, referral sources should generally expect two to four months from first contact to services starting, assuming the applicant already has stable housing and no major documentation gaps.

Where a Bridge Matters

Because NHTD enrollment isn’t fast, a common problem is a patient ready to leave a hospital or nursing facility well before their waiver services are authorized. In those cases, private-pay home care ($32/hour, 4-hour minimum) can start immediately and hand off to waiver-funded HCSS once the Notice of Decision comes through — so discharge doesn’t have to wait on the waiver timeline.

What to Send Us When You Have an NHTD Case

• Where the patient is in the process (referred, intake complete, application submitted, or approved)
• The name of the Service Coordination agency involved, if one has been selected
• The patient’s location within our service area (Brooklyn, Queens, Manhattan, the Bronx, Staten Island, Nassau, Suffolk, or Westchester)
• Any known care needs or anticipated hours
• Your direct contact information, so we can coordinate with you as well as the Service Coordinator

See also

• A Quick Reference Guide for Discharge Planners & Case Managers

FAMILY RESOURCES

For a lot of families, this comparison comes up at a specific moment: a parent or spouse is managing less easily on their own, and the question becomes whether to bring help into the home or move to a community that provides care on-site. Both are legitimate, common paths — which one fits depends less on which is “better” and more on a handful of practical questions about care needs, cost, and what the person themselves wants.

What each option actually is

Home care means a Home Health Aide (HHA) or Personal Care Aide (PCA) comes to the person’s own home — from a few hours a few days a week up to live-in or around-the-clock coverage — to help with bathing, dressing, meal prep, light housekeeping, medication reminders, mobility, and transportation. The person stays home; the support comes to them.

Assisted living is a residential setting — in New York, typically a licensed Assisted Living Residence (ALR), certified as Basic, Enhanced, or Special Needs. Residents get their own room, meals, housekeeping, personal care, medication management, and staff on-site around the clock. The person moves; the support is built into where they live.

Both are meant for people who need help with daily activities but not hospital-level or skilled nursing care. Neither is a substitute for a nursing home.

The core differences

• Setting. Home care keeps someone in their own house, surrounded by familiar belongings. Assisted living means relocating to a community residence.
• Coverage. Home care is scheduled around however many hours a family arranges. Assisted living includes staff on-site at all times as part of the base arrangement.
• Social environment. Assisted living builds in group meals and activities. Home care keeps someone in their existing social world but doesn’t automatically add new social contact.
• Independence and control. Home care tends to preserve more day-to-day independence. Assisted living trades some autonomy for built-in supervision.
• Who arranges and pays. Home care is contracted directly with an agency for the hours needed. Assisted living is a single monthly fee bundling housing, meals, and care.

Comparing the cost

Cost comparisons are genuinely situational, but industry benchmarks give a starting point. The CareScout (formerly Genworth) 2025 Cost of Care Survey put the national median cost of assisted living at $6,200 per month, and the national median rate for non-medical home care at $35 per hour — Touch of Love’s private-pay rate is $32/hour with a 4-hour minimum per visit.

Translating hours into a monthly figure at TOL’s rate: roughly $2,560/month for 4 hours a day, 5 days a week, or roughly $3,584/month for 4 hours a day, 7 days a week. At that level of need, home care runs well below the national assisted living median. As care needs grow toward 8+ hours a day or live-in coverage, the hourly math can meet or exceed assisted living’s flat monthly fee. There’s no single crossover point — it depends on the actual schedule of care needed.

One wrinkle: some Assisted Living Residences in New York participate in the state’s Assisted Living Program (ALP), a Medicaid-funded program with limited slots, separate from the home care waivers below. Worth asking any ALR directly whether they have ALP slots.

Medicaid waiver programs: a home care–specific advantage

If a family is Medicaid-eligible, home care–specific waiver programs can cover home care at no direct cost — something without a direct equivalent in most private-pay assisted living:

• NHTD (Nursing Home Transition and Diversion) — for adults with physical disabilities who qualify for a nursing-home level of care but want to remain at home.
• TBI (Traumatic Brain Injury) — for individuals with a qualifying brain injury on a similar path.
• EISEP (Expanded In-Home Services for the Elderly Program) — a non-medical program (no MD order required) that can help eligible seniors with personal care and housekeeping.

Questions that help families decide

• How many hours of help are actually needed right now — a few hours a few days a week, daily, or near-constant supervision?
• How does the person feel about staying home versus moving?
• Is the home itself manageable, or would it need modification to stay workable long-term?
• Is there family nearby who can help coordinate care?
• Is the person enrolled in, or likely eligible for, a Medicaid waiver program?
• Is social isolation a concern that weighs against staying in a familiar home?

Where Touch of Love Homecare fits in

Touch of Love Homecare Agency is a NYS DOH-licensed home care agency — not an assisted living facility — serving families across Brooklyn, Queens, Manhattan, the Bronx, Staten Island, Nassau, Suffolk, and Westchester, through NHTD, TBI, and EISEP waiver programs or private pay at $32/hour with a 4-hour minimum.

Related reading

• Signs It Might Be Time for Home Care
• Aging in Place in New York: What Families Need to Know
• How Much Does Home Care Cost in New York?

FAMILY RESOURCES

Most families don’t wake up one day and decide it’s time for home care. It’s usually a slower realization — a handful of small things that, taken together, add up to “we should probably look into this.” If you’re trying to figure out whether you’re at that point, here are the everyday signs families most often notice first, and what reasonable next steps look like.

This isn’t a medical checklist, and it isn’t a substitute for one. If you’re worried about a specific health change — a fall, new confusion, a medication problem — that’s a conversation for a doctor, not a blog post. What follows is the practical, day-to-day side of the question: is daily life at home getting harder to manage safely and comfortably?

Signs around the house

• The house looks different than it used to. Stacks of unopened mail, spoiled food in the fridge, or laundry piling up are often the first visible signs that daily tasks have become harder to keep up with.
• Difficulty with everyday tasks like cooking regular meals, managing medications, getting dressed, bathing, or keeping track of bills.
• New safety concerns — unexplained bruises, a stove left on, tripping hazards, or a recent fall, even a minor one.
• Changes in appearance or hygiene, like wearing the same clothes repeatedly or a general decline in grooming.

Signs around daily life and routines

• Missed appointments or medications — forgetting doctor’s visits or taking medication incorrectly.
• Withdrawal from usual activities, sometimes because getting there is harder, sometimes out of embarrassment about needing help.
• Driving becoming a struggle — new dents on the car, getting lost on familiar routes, or avoiding driving altogether.
• Isolation. Living alone with little regular contact can make small problems harder to catch early — home care can double as a reliable check-in, not just hands-on help.

Signs the family caregiver is stretched thin

Sometimes the clearest sign isn’t about the person who needs care — it’s about the family member who’s been providing it.

• Feeling consistently exhausted, overwhelmed, or behind on your own work, family, or health.
• Resentment, guilt, or tension building up around caregiving duties.
• Realizing you’re the only one covering nights, weekends, and emergencies, with no backup plan.

Bringing in a home care aide isn’t an admission that a family failed — it’s often what allows a family caregiver to keep showing up as a spouse, child, or sibling instead of running on empty as an unpaid, round-the-clock aide.

What to do if some of this sounds familiar

1. 1Start with a conversation, not a decision. Talk to your loved one about what you’re noticing, specifically and gently, rather than arriving with a plan already made.
2. 2Loop in their doctor if anything here looks like a health change. Home care can run alongside a medical evaluation, but it isn’t a replacement for one.
3. 3Figure out what kind of help actually fits — a few hours a day, daily personal care, or live-in coverage. A good agency will ask questions before recommending anything.
4. 4Ask about cost and coverage early. Medicaid waiver programs like NHTD, TBI, and EISEP can cover home care for those who qualify, alongside private-pay options. See our How Much Does Home Care Cost in New York? guide for a full breakdown.

How Touch of Love Homecare can help

Touch of Love Homecare Agency is a NYS DOH-licensed home care agency based in Brooklyn, serving families across Brooklyn, Queens, Manhattan, the Bronx, Staten Island, Nassau, Suffolk, and Westchester. We provide HHAs and PCAs for everything from a few hours a week to full-time and live-in care, through NHTD, TBI, and EISEP waiver programs or private pay at $32/hour (4-hour minimum).

If you’re noticing some of the signs above and aren’t sure what to do next, you don’t have to figure it out alone.

Related reading

• Home Care vs. Assisted Living: How to Decide
• Aging in Place in New York: What Families Need to Know
• How to Choose a Home Care Agency in New York