By SLC Senior Advisor Care Team · September 16, 2026
A person who has lived in a licensed Utah assisted living facility for 365 days or more, needs nursing facility level of care and meets Medicaid financial rules can apply for the New Choices Waiver. The waiver pays for services, not room and board. Families should confirm at move-in that the facility accepts waiver residents and what room-and-board rate it charges them.
Why the 365-day path matters
Utah Medicaid does not pay assisted living rent. What it can pay for, through the New Choices Waiver (NCW), is the care a resident receives there. Utah DHHS lists four ways into the waiver; for families paying privately for assisted living, the relevant one is having lived in a licensed assisted living facility, or a small health care Type N facility, on an extended stay of 365 days or more.
That means a parent who moves into a Salt Lake facility on private funds and stays for a year has a possible bridge to Medicaid help when savings run low, provided the family planned for it.
The month-by-month timeline
| When | What to do |
|---|---|
| Before move-in | Ask in writing whether the facility accepts NCW residents, how many, and the room-and-board rate it charges them |
| Month 1 | Keep the admission agreement and proof of the move-in date; start a folder of monthly statements |
| Months 3-6 | Estimate how long savings will last at the current rate plus likely care-level increases |
| Months 6-9 | Talk to an elder law attorney about Medicaid's resource limit and spousal protections |
| Month 12 | If resources are near the $2,000 limit, contact the NCW program office and DWS |
| After approval | A case management agency sets up services; the resident's income pays room and board |
None of these steps commits the family to Medicaid. They keep the option open.
Who qualifies besides the 365 days
The time in a facility is only one part. Utah DHHS lists the core criteria: the applicant must be at least 18, meet Utah Medicaid financial eligibility, need a nursing facility level of care, not have mental illness as the primary condition, not need an intensive skilled level of care, and not be eligible for an intermediate care facility for people with intellectual disabilities.
Financial eligibility is decided by the Department of Workforce Services. Utah's resource limit for aged, blind and disabled Medicaid is $2,000 for one person and $3,000 for a two-person household under R414-305-3, with exclusions such as a home and one vehicle. Married couples should get advice on spousal protections before spending down.
The room-and-board gap
Because the waiver is a medical program, the resident's own income, usually Social Security and any pension, must cover the facility's room-and-board charge. If a facility charges waiver residents a room-and-board rate higher than the resident's income, the waiver will not close that gap.
That is why the question at move-in matters. Some Salt Lake facilities accept waiver residents and set a room-and-board rate designed for them; some limit the number of waiver residents; some do not participate. A facility's answer today may change, so ask again around month nine.
Applying from a nursing facility instead
The other common path is a Medicaid-paid nursing facility stay of 90 days or more. Utah DHHS says most waiver slots are reserved for people in nursing facilities, hospitals and other medical institutions, and that people in those settings, and those already living in licensed assisted living or Type N facilities, may apply at any time until the participant cap is met. DHHS also states it does not anticipate exceeding the cap.
For someone living at home, the Aging Waiver is usually the route instead, and it has a waiting list.
Common mistakes that delay New Choices
The first is waiting until the money is gone to ask the facility about the waiver. If the building does not accept waiver residents, the family then faces a move at the worst possible time. The second is giving money to children or others in the years before applying; Medicaid looks back at transfers, and gifts can delay eligibility. The third is losing track of the move-in date and stay history, which matter for the 365-day path.
A short meeting with an elder law attorney around the six-month mark usually costs far less than fixing any of these later.
Who to call
The New Choices Waiver program office is at 801-538-6155 (option 6) or 1-800-662-9651 (option 6), and newchoiceswaiver@utah.gov. Salt Lake County Aging & Adult Services (385-468-3200) can explain local programs, and our New Choices Waiver guide lists the services the waiver covers.
Frequently asked questions
Does the New Choices Waiver pay assisted living rent?
No. It pays for assessed care services. The resident's own income pays the facility's room-and-board charge.
Does the 365 days have to be in the same facility?
The fact sheet describes an extended stay of 365 days or more in a licensed assisted living or Type N facility. Ask the program office how your parent's specific history counts before relying on it.
Is there a waiting list for New Choices?
Utah DHHS says people in facilities may apply year-round until the participant cap is met and that it does not anticipate exceeding the cap. The Aging Waiver, for people at home, has a waiting list.
Can a memory care resident use the waiver?
Yes, if eligible. A secure unit is part of a licensed assisted living facility, and the waiver can pay for services there.
Who manages services after a resident joins New Choices?
A case management agency coordinates the waiver services. DHHS lists approved agencies, and Salt Lake County Aging and Adult Services is among them.
