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Adult Day Care vs. In-Home Care

Adult day care runs on a schedule and gives a caregiver their day back. In-home care comes to the house on whatever schedule you set.

HomeComparisonsAdult Day Care vs. In-Home Care
Short answer

New York's 2025 CareScout median for adult day health care is $144/day, or about $3,120/month. In-home care runs about $35/hour. Whether Managed Long Term Care (MLTC) or the NHTD waiver helps cover either depends on the specific plan and assessed level of need.

What each actually is

Adult day health care runs on a facility's schedule -- typically weekday daytime hours -- and gives a family caregiver their day back while providing supervision, meals, and often therapy or medical monitoring on site. In-home care comes to the house on whatever schedule the family sets, from a few hours a week to around-the-clock.

Why families often combine both

A caregiver working full time might use adult day health care on weekdays and in-home care evenings or weekends -- neither option alone always covers the gap, and combining them is common rather than unusual.

Source: CareScout Cost of Care Survey

Questions families ask

What's the difference between an Adult Home and an Enriched Housing Program in New York?

Both are base-level Adult Care Facility license types under NYSDOH, but Enriched Housing Programs are generally structured around apartment-style independent units with supportive services, while Adult Homes are typically more institutional in layout. Either can add ALR certification on top to become licensed for assisted-living-level care.

Does New York rate assisted living communities the way it rates nursing homes?

No. Federal CMS star ratings apply only to Medicare/Medicaid-certified nursing homes, published at profiles.health.ny.gov/nursing_home and on CMS Care Compare. Assisted living and memory care communities in New York do not carry CMS star ratings -- the only public quality record for them is the NYS Health Profiles inspection history.

What is Managed Long Term Care (MLTC), and is it mandatory on Staten Island?

MLTC is New York's Medicaid managed-care delivery system for long-term care -- either PACE (age 55+) or MLTC Partial Capitation/Medicaid Advantage Plus. Enrollment has been mandatory in New York City, including Richmond County/Staten Island, since 2012 under Medicaid Redesign Team Initiative #90, approved August 31, 2012.

What is the NHTD waiver, and how is it different from MLTC?

The Nursing Home Transition and Diversion (NHTD) waiver is a Medicaid 1915(c) home- and community-based services waiver, administered through NYSDOH Regional Resource Development Centers, for Medicaid-eligible people 65+ (or younger with a disability) assessed as needing nursing-home-level care who want to receive services in the community instead. MLTC is a managed-care delivery system; NHTD is a specific waiver program.

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