Medicaid Home Modification Assistance in New York
New York covers home modifications through the Nursing Home Transition and Diversion (NHTD) Medicaid Waiver, administered by the New York State Department of Health. It's available to Medicaid-eligible seniors (65+) and physically disabled adults (18-64), and covers environmental and home modifications alongside other community-based services.
New York’s approach to Medicaid-funded home modifications centers on a single, clearly named waiver focused specifically on keeping people out of institutional care.
The Nursing Home Transition and Diversion (NHTD) Waiver
NHTD (opens in a new tab) is a Home and Community-Based Services (HCBS) 1915(c) Medicaid waiver administered by the New York State Department of Health. It serves two related purposes reflected in its name: helping Medicaid-eligible nursing home residents transition back into the community, and helping people at risk of needing nursing home care remain at home instead (“diversion”). It’s available to eligible individuals 65 and older, and physically disabled individuals ages 18-64.
The program has, at times, reached its approved enrollment cap and paused new referrals — check the program page above for current enrollment status before assuming a spot is available, and ask about waitlist timing if it’s closed when you apply.
What’s covered
Along with services like in-home personal care assistance, home-delivered meals, and assistive technology, NHTD specifically funds home modifications for safety and accessibility as part of an individualized service plan. Covered modifications are determined based on the person’s specific needs and living situation, not a fixed list.
How to apply
If you’re currently in a nursing facility and interested in transitioning home, start with the facility’s discharge planner, who typically works with a regional Open Doors Transition Specialist to coordinate housing, services, and modification needs. If you’re applying to avoid nursing home placement (diversion) rather than transitioning out of one, contact the New York State Department of Health’s NHTD program directly, or your local Department of Social Services, to begin an application and needs assessment.
Other assistance to check
Veterans in New York should check the VA HISA grant (opens in a new tab) as a separate, federal benefit that can be used alongside NHTD. For modifications needed before a Medicaid waiver determination is complete, New York has an extensive network of Rebuilding Together and other local nonprofit affiliates — see our nonprofit and local grants guide (opens in a new tab).
Frequently Asked Questions
What does 'transition and diversion' mean in this program's name?
'Transition' refers to helping someone move from a nursing home back into the community; 'diversion' refers to helping someone at risk of needing nursing home care avoid that outcome in the first place by supporting them at home instead. The NHTD waiver serves both situations under one program.
Who helps coordinate an NHTD waiver application if I'm currently in a nursing facility?
If you're a nursing home resident interested in transitioning to the community, the facility's discharge planner typically works alongside a regional Open Doors Transition Specialist to explore housing options, needed services, and home modifications as part of the transition plan.