Fain's Private Duty
Fain's Private Duty Home Care is a nationwide private duty operator built on 17 years of New Jersey home care operating experience. New Jersey is our first launch market.
PRIVATE PAY PLANNING

Private pay home care planning

Private pay home care in New Jersey is a real cost that a family plans for the way she plans for a college tuition or a mortgage: with published rates, honest arithmetic, and the courage to think in years rather than months. FAINS publishes rates so families can plan. This page walks through rate estimation across tiers, quarterly budget planning, the Medicaid five-year lookback that shapes many families' asset decisions, and when the family should bring an elder-law attorney into the picture. The perspective draws from seventeen years of Irina Fain planning private pay cases with New Jersey families since 2009.

The arithmetic of private pay home care in New Jersey

Every family planning private pay home care benefits from starting with the actual numbers. The FAINS pricing page publishes the tier rates. This section walks the arithmetic families can do on the back of an envelope to arrive at monthly and annual estimates.

Companion tier at $40 per hour. - Four hours a day, five weekdays a week: 20 hours per week times $40 equals $800 per week times 52 weeks equals approximately $41,600 per year, or about $3,500 per month. - Eight hours a day, five weekdays a week: 40 hours per week times $40 equals $1,600 per week or approximately $6,900 per month. - Full-time daytime seven days a week (eight hours a day): 56 hours per week times $40 equals $2,240 per week or approximately $9,700 per month.

CHHA tier at $46 per hour. - Four hours a day, five weekdays: 20 hours per week times $46 equals $920 per week or approximately $4,000 per month. - Eight hours a day, five weekdays: 40 hours per week times $46 equals $1,840 per week or approximately $8,000 per month. - Twelve hours a day, seven days a week: 84 hours per week times $46 equals $3,864 per week or approximately $16,700 per month.

Live-in CHHA at $420 per day. - Seven days a week: seven times $420 equals $2,940 per week or approximately $12,700 per month.

24-hour hourly at CHHA tier. - Three eight-hour shifts, seven days a week: 168 hours per week times $46 equals $7,728 per week or approximately $33,500 per month.

LPN tier at $78 per hour (for skilled nursing tasks in the plan of care). - Four hours a day of skilled nursing, five days a week: 20 hours per week times $78 equals $1,560 per week or approximately $6,800 per month.

RN tier at $95 per hour (for RN-scope tasks or family engagement of the RN Supervisor beyond bundled case supervision). - Available on the same hourly structure; case supervision is included in the base hourly rate for the caregivers on the case, so RN direct-hourly is unusual for standard cases.

These numbers are estimates. The actual invoice each week is the actual hours worked times the actual tier rates, matched to the shift log. Mileage of one dollar per mile beyond 15 miles from Mount Olive appears when applicable. ACH is free; card is available with a three percent surcharge. Nothing else appears on the invoice.

Quarterly budget planning for a private pay case

Families planning a case that will run for months or years benefit from thinking in quarters rather than months. Home care needs shift with the client's condition, and a rigid month-to-month budget often misses the arc.

Quarter one budget typically includes: the initial hours scoped at intake, a one-week deposit collected before the first shift and applied to the final invoice, and any specific equipment or setup costs the plan of care may recommend (grab bars, a shower bench, a bed rail, transfer belts; FAINS does not sell these but coordinates with the family on what the plan of care requires).

Quarter two through four budget typically settles into a steadier monthly rhythm as the case picture becomes familiar. Some cases escalate in this window (a client whose dementia progresses, a client whose overnight needs grow); others taper (a post-hospital recovery client who stabilizes). The RN Supervisor's 60-day visit is the natural checkpoint for reviewing whether the current structure is still the fit and whether the monthly figure should change.

Year two and beyond for cases that run long benefit from annual budget planning. The FAINS rates on the pricing page are the rates in force today; when rates change, the change is announced 60 days in advance in writing to every active client, and the rate on the day the case started is honored on the invoice until the effective date of the announced change. That predictability lets a family model the multi-year cost with confidence.

Cash reserves for care cases are best held in easily accessible accounts rather than tied up in illiquid assets. Families often set aside a specific care-purpose account funded quarterly from the client's income (Social Security, pension, RMDs from retirement accounts) and topped up from other sources when the case's needs exceed the income flow. Financial planners help with this arithmetic when the family's picture is complex.

Medicaid five-year lookback and its planning implications

New Jersey Medicaid's long-term care coverage rules include a 60-month lookback on asset transfers when a person applies for Medicaid long-term care benefits. The essential mechanic is this: transfers of assets for less than fair market value made during the 60 months before the Medicaid application can trigger a penalty period during which the applicant is ineligible for Medicaid long-term care coverage. The penalty is calculated based on the transferred amount and the state's average monthly cost of nursing home care.

The lookback matters even for families who expect to pay privately throughout the case, because circumstances change. A case that begins on private pay may run longer than the family's assets can sustain, and if Medicaid becomes the eventual payer, transfers made during the prior 60 months become relevant. Families whose long-term outlook may include Medicaid benefit meaningfully from thinking about the lookback before care starts, not after.

The relevant asset-planning strategies belong to the elder-law attorney's practice. Common structures include:

Establishing an irrevocable Medicaid asset protection trust well outside the five-year window. Assets in such a trust are typically excluded from the Medicaid asset calculation, provided the trust is properly structured and the five-year clock has run.

Purchasing a Medicaid-compliant annuity that converts a countable asset into an income stream compliant with Medicaid rules.

Structuring transfers to children with careful attention to the lookback penalty math (sometimes strategic transfers are better than the alternative even with the penalty).

Coordinating spousal impoverishment protections when the applicant has a community spouse.

Establishing a Miller trust or qualified income trust in states where income limits apply and the applicant's income exceeds them.

None of these strategies is one-size-fits-all. Each has tax implications, control implications, and family-specific considerations. FAINS strongly recommends families whose picture includes any of these questions consult an accredited NJ elder-law attorney before proceeding.

Spousal impoverishment protection

For married couples where one spouse needs long-term care and the other does not, spousal impoverishment protection is federal and state Medicaid policy that lets the community spouse retain a portion of the couple's income and assets while the institutionalized (or waiver-eligible) spouse qualifies for Medicaid long-term care coverage. The protection prevents the community spouse from being financially devastated by the applying spouse's need for care.

The specific NJ figures adjust annually. The community spouse resource allowance (the amount of countable assets the community spouse can retain) has a floor and a ceiling set by federal law with NJ following the federal rules. The monthly minimum needs allowance (the income the community spouse can retain from the couple's combined income) also has federal and NJ standards. Elder-law attorneys and Medicaid planners are the right advisors on the current figures and how they apply to a specific couple's picture.

The protection is significant because it means Medicaid long-term care planning for a couple does not require the community spouse to lose everything. The community spouse retains a home, retains a car, retains a portion of countable assets, and retains an income floor. The specifics require professional advice because the calculations are technical and the stakes are substantial.

When to consult an elder-law attorney

Before care starts if asset preservation matters. The five-year Medicaid lookback rewards early planning. Waiting until care has been in place for months or years narrows the attorney's planning options significantly.

At the point a case looks likely to run longer than the family's initial cost estimate. If a case scoped as a six-month recovery arc has extended into month twelve and looks likely to continue, an elder-law consultation reviews options for the family's picture.

At any material change in the family's financial situation. Death of a spouse, sale of a business, inheritance received, sale of a family home, or a shift in retirement income are all points at which the family's planning picture warrants a review.

Before making significant asset transfers to children or other family members. The lookback math is technical and the penalty can be substantial. An elder-law attorney reviews whether the transfer makes sense, how it interacts with the family's broader planning, and how it fits the family's tax picture.

Before establishing a trust. Trust structures have tax implications, control implications, and estate implications that require professional structuring.

FAINS maintains a referral list of accredited NJ elder-law attorneys with private duty home care experience. FAINS is not paid by these attorneys and does not receive referral fees; the list exists because families ask and Irina has worked alongside these offices for years.

Applies to every FAINS private pay case

Every FAINS private pay case is governed by the seven pillars of The Fain Standard. Every case has a Registered Nurse Supervisor of record who scopes the plan of care, license-verified caregivers checked monthly against the state registry, the four-hour minimum shift applied consistently, weekly transparent invoicing on the Monday through Sunday cycle at published rates, chemistry-matched caregivers introduced before the first shift with swap without penalty, the 24-hour cancellation window applied both ways, and private pay and private insurance only as the operating scope.

The seventh pillar is what makes private pay planning transparent: FAINS is a private duty agency, the rates are the rates, and the family knows what she is buying and what it costs. Families who need Medicaid or Medicare coverage are served better by a fit-for-purpose provider in that reimbursement world, and FAINS maintains a referral list for exactly that reason.

Families ready to start planning a private pay case can call FAINS at the number in the header. The intake conversation includes scoping the plan of care, walking through the arithmetic on the pricing page, and thinking together about how the case's expected arc fits the family's planning picture.

Common questions

What does private pay home care actually cost per month in NJ?
The arithmetic is straightforward once the hours are named. A CHHA at the FAINS published rate of $46 per hour, working four hours a day five weekdays, costs approximately $4,000 per month. The same CHHA at eight hours a day five weekdays costs approximately $8,000 per month. A live-in CHHA at $420 per day for seven days a week costs approximately $12,600 per month. 24-hour hourly staffing at three eight-hour shifts costs approximately $33,000 per month at the CHHA tier. The wide range reflects the wide range of actual case shapes; the pricing page and the RN Supervisor's assessment together produce the estimate for a specific case.
How long does a typical private pay case last?
The range is wide and depends heavily on the case type. Post-hospital recovery cases often run six to twelve weeks and end when the client returns to independent function. Dementia and Alzheimer's cases often run one to five years as the arc progresses. End-of-life cases often run three months to two years depending on the disease trajectory. Live-in and 24-hour arrangements for stable long-term cases can run for years. Budget planning should reflect the expected duration of the specific case type, and the RN Supervisor's initial assessment includes an honest read on the likely arc.
What is the Medicaid five-year lookback?
New Jersey Medicaid (like federal Medicaid generally) reviews asset transfers made during the 60 months prior to a Medicaid application when the applicant is applying for long-term care coverage. Transfers of assets for less than fair market value during the lookback period can trigger a penalty period during which the applicant is ineligible for Medicaid long-term care coverage even if she otherwise qualifies. The lookback significantly shapes how families whose long-term outlook may include Medicaid should structure asset decisions today. Elder-law attorneys are the right advisors on lookback strategy; FAINS is not qualified to give legal or Medicaid planning advice.
What is spousal impoverishment protection?
When a married person applies for Medicaid long-term care coverage, spousal impoverishment protection allows the non-applying spouse (the community spouse) to retain a portion of the couple's income and assets while the applying spouse (the institutionalized or waiver spouse) qualifies for Medicaid. The specific amounts adjust annually and are set by federal and NJ rules. The protection is significant because it means Medicaid long-term care planning does not require the community spouse to lose everything before the applying spouse can qualify. Elder-law attorneys and Medicaid planners are the right advisors on how the protection applies to a specific couple's picture.
Should we set up a trust to protect assets from care costs?
Trust planning for asset protection is a specialty area where an elder-law attorney is essential. Common structures include irrevocable Medicaid asset protection trusts (which must be established before the five-year lookback window to work as intended), qualified income trusts (Miller trusts), and various family-specific arrangements. Trust planning has tax implications, control implications, and estate implications that go well beyond the care question. FAINS strongly recommends families with meaningful assets and a long care horizon consult an accredited NJ elder-law attorney before making trust decisions. FAINS is not qualified to give trust advice and does not.
When should a family consult an elder-law attorney?
Before care starts if asset preservation matters. Waiting until care has been in place for months or years narrows the elder-law attorney's planning options significantly. The five-year Medicaid lookback rewards early planning. Even families who expect to pay privately throughout the case benefit from a one-time consultation to understand the options if the case runs longer than budget expected. The consultation typically takes two hours and costs $500 to $1,500 in NJ; the value of getting the strategy right often runs into six figures.
Can FAINS help plan the budget for a case?
The RN Supervisor's initial assessment includes an honest scope of the hours the case will require and the expected arc. Multiplied by the published rates on the pricing page, the assessment produces an initial monthly budget estimate. The estimate is revisited at each 60-day review as the case picture evolves. FAINS is transparent about what will change the monthly figure (adding overnight coverage, escalating to 24-hour, transitioning to live-in) and gives the family enough advance visibility to plan. FAINS is not a financial planner and does not give investment advice; the budget conversation is scoped to what a specific plan of care will cost.