Ohio Assisted Living
Ohio is quickly becoming a great retirement location with its low cost of living, scenic beauty, friendly Midwestern lifestyle, abundant outdoor recreational activities, and robust culture. The state is also home to some of the best universities in the country, and residents have easy access to world-class health care.
Social Security benefits are exempt from state income taxes, and while certain retirement income is taxable, available credits make Ohio a tax-friendly state for older adults. The following information can help you understand what assisted living options are available, how much they cost, and how Ohio regulates long-term care communities in the state.
The Ohio Department of Health licenses residential care facilities (RCFs). This term is used for residential care and assisted living facilities (ALFs). The Department on Aging regulates and licenses adult foster care facilities (AFCs). AFCs provide personal care services for up to two adults unrelated to the residence owner.
There are two definitions of residential care facilities available in Ohio. The first provides accommodations for 17 or more unrelated residents, supervision, and personal care services for three or more residents who need assistance. The second provides accommodation for three or more unrelated residents, personal care services for three or more unrelated residents dependent on the services or others, and skilled nursing care to at least one resident.
Every resident must receive a written agreement from the facility. The resident agreement defines the facility's monthly charges, fees, and payment policies. The agreement lists the services offered, the type of skilled nursing care allowed and provided, care for persons with cognitive impairment, accommodations for residents with disabilities, advanced directives, and discharge criteria.
An advice directive is a document that provides instructions about health care wishes in case the resident cannot speak for themself due to a medical condition.
Facilities that serve resident populations with dementia must disclose a statement that includes the following:
The services offered by RCFs include supervision and personal care, activities, assistance with self-administration of medication, medication administration if necessary, and part-time or intermittent skilled nursing services.
On or prior to admission, each resident must have a health assessment. The assessment will be performed annually and when there is a significant change in their health situation. The assessment includes the resident’s overall medical diagnosis, psychological history, health and physical history, cognitive status, any medications required, ability to function independently, and need for skilled nursing services. A licensed health professional must determine residents’ ability to self-administer medications, either with or without assistance or their need for medication administration.
There may be situations where the facility and the resident or the person responsible for the individual could enter into a risk agreement. This risk agreement is a process where the facility and the resident share the responsibility for making and implementing decisions that would affect the scope and quality of services provided by the facility. The facility is also responsible for identifying the risks inherent in a decision about the resident not receiving services provided by the facility. Residents can contract with a licensed hospice agency, a certified home health agency, or a mental health agency to provide these services.
Facilities may choose to provide between one and three meals per day or choose not to provide meals. Facilities that choose not to provide meals must ensure that each resident unit is safely equipped with food storage and preparation appliances. The facility must maintain these appliances.
Meals provided by the facility must meet recommended daily allowances for nutrition and must be based on a standard dietitian-approved meal plan. Any facility that provides meals for a special diet must monitor the staff that prepares and serves these meals. A consulting or employee dietitian is required for facilities that provide and supervise complex therapeutic diets.
Every facility must employ an administrator responsible for the daily operations of the facility. The administrator must work a minimum of 20 hours per week between the hours of 8 a.m. and 6 p.m. When the administrator is not present at the facility, they must be accessible.
A registered nurse (RN) must be on staff or under contract if the facility provides skilled nursing services. The facility must have direct care staff that provides personal care services. For facilities that provide personal care services, at least one staff member must be trained in first aid.
A facility that administers resident medications must have one of the following on duty: an RN, a physician, or an LPN who has completed a state-approved course in medication administration and administers medication at the direction of an RN or physician.
A facility must employ or contract a psychologist or a physician if it has residents with late-stage cognitive impairment with significant ongoing assistance needs, cognitive impairments with increased emotional needs, behaviors that cause problems for the resident or other residents, or a serious mental illness.
There are no minimum staffing requirements for RCFs. There must be sufficient staffing present to meet the residents' care needs. All facilities providing skilled nursing care must have sufficient nursing staff and a licensed nurse on call when one is not on-site.
Every staff member must receive an orientation and training program related to their job responsibilities, facility procedures, emergency assistance policies, and residents’ rights. Every year, staff must receive eight hours of continuing education in personal care techniques, observation, and communication skills. A licensed nurse must offer this training. All direct care staff must receive first aid training within 60 days of hire.
Every year, administrators must receive nine hours of continuing education in gerontology, health care, business administration, and RCF operations. If an RCF admits or retains residents with cognitive or mental impairments. it must also provide two hours of training in the care of such residents within 14 days of employment and four hours of continuing education annually.
RCFs are not required to provide apartment-style units. The maximum occupancy of each unit is four residents. Every eight residents must have one toilet, sink, and tub or shower. If there are more than four residents of the same gender on a floor, a bathroom must be provided for each gender on that floor.
For residents who receive assistance from the Medicaid waiver program, the program requires apartment-style units with shared units only permitted by residents' choice.
There are several requirements that each assisted living community must provide for its residents. The facility must offer both general observations and health supervision to assist in identifying each resident's health condition and ability to function. The facility must assist residents with all ADLs and medication services and assess the need for medication attention or nursing services.
If a resident requires their medications to be administered for them, the medications can only be administered by a physician, a registered nurse, a licensed practical nurse, or a certified medication aide who has completed an appropriate training program and is supervised by an RN.
Trained, non-licensed staff are permitted to assist residents to self-administer medication when the resident is mentally alert and can participate in the medication process. This assistance includes reminders to take medication, observing the self-administration of medications, handing medications to the resident, verifying the name on the medication label, removing oral or topical medications from their containers, applying medication upon request, and placing the medication container in the resident's mouth. The assistance can also include helping the resident to organize medications in a pill planner if the resident can differentiate between pills and actively participate in the organization of the medications.
In Ohio, RCFs must provide care and services in the resident’s care plan. This can include coordinating medical care and appointments. Communities may also deliver health services, with some communities providing skilled nursing. Many have health care specialists and on-site services, with 63% of communities offering dental care.
Mental health issues are a growing consideration for communities, and services to address these concerns are becoming more common. In Ohio, 87% of communities conduct depression screenings and 62% offer mental health counseling. Social work programs are also found in 59% of ALFs. Social workers can provide counseling, conduct assessments, and help ensure residents can access all necessary resources.
Some assisted living residents live with various medical conditions. In Ohio, 41% have Alzheimer's disease or another form of dementia. In addition, 56% have high blood pressure, 35% have heart disease, 23% have depression, and 19% have diabetes.
A primary service of assisted living that benefits residents is receiving help with activities of daily living (ADLs). These are fundamental tasks that a person must do regularly to sustain life and general health, including toileting, bathing or showering, dressing, transferring (getting in and out of bed or a chair), ambulating (walking), and eating. Signs that a person may benefit from living in assisted living include increased isolation, loss of mobility, noticeable weight loss or gain, and/or neglect of household chores.
Residents in Ohio’s assisted living facilities often receive help with their ADLs. In Ohio, 20% of residents need help eating. Other commonly used services include bed transfer (36%), toileting (41%), and walking (49%). Caregivers in ALFs help 49% of residents dress, and 63% need help bathing.
The average cost of assisted living care in Ohio is $4,635. This is $135 higher than the monthly national average of $4,500. The cost of living in Ohio is less than the national average by 8.7%, with health care costs less than the national average by 2.8% and housing costs less than the national average by 23.5%.
The level of care a person requires impacts the cost of care, as does where you live. The cost of assisted living ranges from a low of $3,660 in the Springfield area to a high of $4,993 per month in the Akron area of Ohio.
If you or your loved one lives near one of the state borders or have relatives living nearby, you might be considering an assisted living community in one of those states. The median monthly cost of care in Michigan is $3,500. In Indiana, it’s $4,025; in Kentucky, $3,445; in West Virginia, $3,750; and in Pennsylvania, $3,450.
How to Pay for Assisted Living
The Ohio Department of Health maintains oversight of the state’s residential care facilities. The Ohio Department of Aging offers resources to help older Ohioans get the necessary care. If an assisted living resident has a problem or dispute, the Ohio Long-Term Care Ombudsman is available to help.
Ohio Department of Health
Ohio Department of Aging
Ohio Long-Term Care Ombudsman
Pro Seniors is a statewide non-profit organization that provides advocacy and support services for older adults. People aged 60 years over have access to a legal helpline to speak with an attorney at no cost. In addition to long-term care ombudsman services, there is the Senior Medicare Patrol, which helps beneficiaries identify and report fraudulent activities and billing errors. The Ohio Legal Helpline assists with issues related to health care, government benefits, consumer rights, and estate planning.
Social Security benefits are exempt from state income taxes, and while certain retirement income is taxable, available credits make Ohio a tax-friendly state for older adults. The following information can help you understand what assisted living options are available, how much they cost, and how Ohio regulates long-term care communities in the state.
Assisted Living Facility (ALF) Definitions
The Ohio Department of Health licenses residential care facilities (RCFs). This term is used for residential care and assisted living facilities (ALFs). The Department on Aging regulates and licenses adult foster care facilities (AFCs). AFCs provide personal care services for up to two adults unrelated to the residence owner.
There are two definitions of residential care facilities available in Ohio. The first provides accommodations for 17 or more unrelated residents, supervision, and personal care services for three or more residents who need assistance. The second provides accommodation for three or more unrelated residents, personal care services for three or more unrelated residents dependent on the services or others, and skilled nursing care to at least one resident.
Resident Agreements and Disclosures
Every resident must receive a written agreement from the facility. The resident agreement defines the facility's monthly charges, fees, and payment policies. The agreement lists the services offered, the type of skilled nursing care allowed and provided, care for persons with cognitive impairment, accommodations for residents with disabilities, advanced directives, and discharge criteria.
An advice directive is a document that provides instructions about health care wishes in case the resident cannot speak for themself due to a medical condition.
Facilities that serve resident populations with dementia must disclose a statement that includes the following:
- Admission and discharge criteria.
- Staffing plan.
- The service mission or philosophy of the facility, reflecting the population's needs.
- Specialized staff training and continuing education practices.
- Assessment and service planning process.
- Behavioral health services.
- Physical environment and design features to support the residents.
- Services and policies for resident families.
- Description of activities offered, including the frequency and type of activity and how the activities are used to meet the needs of the residents.
Assisted Living Admission and Retention
The services offered by RCFs include supervision and personal care, activities, assistance with self-administration of medication, medication administration if necessary, and part-time or intermittent skilled nursing services.
On or prior to admission, each resident must have a health assessment. The assessment will be performed annually and when there is a significant change in their health situation. The assessment includes the resident’s overall medical diagnosis, psychological history, health and physical history, cognitive status, any medications required, ability to function independently, and need for skilled nursing services. A licensed health professional must determine residents’ ability to self-administer medications, either with or without assistance or their need for medication administration.
There may be situations where the facility and the resident or the person responsible for the individual could enter into a risk agreement. This risk agreement is a process where the facility and the resident share the responsibility for making and implementing decisions that would affect the scope and quality of services provided by the facility. The facility is also responsible for identifying the risks inherent in a decision about the resident not receiving services provided by the facility. Residents can contract with a licensed hospice agency, a certified home health agency, or a mental health agency to provide these services.
Assisted Living Food and Dietary Provisions
Facilities may choose to provide between one and three meals per day or choose not to provide meals. Facilities that choose not to provide meals must ensure that each resident unit is safely equipped with food storage and preparation appliances. The facility must maintain these appliances.
Meals provided by the facility must meet recommended daily allowances for nutrition and must be based on a standard dietitian-approved meal plan. Any facility that provides meals for a special diet must monitor the staff that prepares and serves these meals. A consulting or employee dietitian is required for facilities that provide and supervise complex therapeutic diets.
Assisted Living Staffing Requirements
Every facility must employ an administrator responsible for the daily operations of the facility. The administrator must work a minimum of 20 hours per week between the hours of 8 a.m. and 6 p.m. When the administrator is not present at the facility, they must be accessible.
A registered nurse (RN) must be on staff or under contract if the facility provides skilled nursing services. The facility must have direct care staff that provides personal care services. For facilities that provide personal care services, at least one staff member must be trained in first aid.
A facility that administers resident medications must have one of the following on duty: an RN, a physician, or an LPN who has completed a state-approved course in medication administration and administers medication at the direction of an RN or physician.
A facility must employ or contract a psychologist or a physician if it has residents with late-stage cognitive impairment with significant ongoing assistance needs, cognitive impairments with increased emotional needs, behaviors that cause problems for the resident or other residents, or a serious mental illness.
There are no minimum staffing requirements for RCFs. There must be sufficient staffing present to meet the residents' care needs. All facilities providing skilled nursing care must have sufficient nursing staff and a licensed nurse on call when one is not on-site.
Assisted Living Staff Training Requirements
Every staff member must receive an orientation and training program related to their job responsibilities, facility procedures, emergency assistance policies, and residents’ rights. Every year, staff must receive eight hours of continuing education in personal care techniques, observation, and communication skills. A licensed nurse must offer this training. All direct care staff must receive first aid training within 60 days of hire.
Every year, administrators must receive nine hours of continuing education in gerontology, health care, business administration, and RCF operations. If an RCF admits or retains residents with cognitive or mental impairments. it must also provide two hours of training in the care of such residents within 14 days of employment and four hours of continuing education annually.
Assisted Living Housing Requirements
RCFs are not required to provide apartment-style units. The maximum occupancy of each unit is four residents. Every eight residents must have one toilet, sink, and tub or shower. If there are more than four residents of the same gender on a floor, a bathroom must be provided for each gender on that floor.
For residents who receive assistance from the Medicaid waiver program, the program requires apartment-style units with shared units only permitted by residents' choice.
What Is Included With Assisted Living Care In Ohio?
There are several requirements that each assisted living community must provide for its residents. The facility must offer both general observations and health supervision to assist in identifying each resident's health condition and ability to function. The facility must assist residents with all ADLs and medication services and assess the need for medication attention or nursing services.
Assisted Living Medication Provisions
If a resident requires their medications to be administered for them, the medications can only be administered by a physician, a registered nurse, a licensed practical nurse, or a certified medication aide who has completed an appropriate training program and is supervised by an RN.
Trained, non-licensed staff are permitted to assist residents to self-administer medication when the resident is mentally alert and can participate in the medication process. This assistance includes reminders to take medication, observing the self-administration of medications, handing medications to the resident, verifying the name on the medication label, removing oral or topical medications from their containers, applying medication upon request, and placing the medication container in the resident's mouth. The assistance can also include helping the resident to organize medications in a pill planner if the resident can differentiate between pills and actively participate in the organization of the medications.
Health Care Services
In Ohio, RCFs must provide care and services in the resident’s care plan. This can include coordinating medical care and appointments. Communities may also deliver health services, with some communities providing skilled nursing. Many have health care specialists and on-site services, with 63% of communities offering dental care.
Mental health issues are a growing consideration for communities, and services to address these concerns are becoming more common. In Ohio, 87% of communities conduct depression screenings and 62% offer mental health counseling. Social work programs are also found in 59% of ALFs. Social workers can provide counseling, conduct assessments, and help ensure residents can access all necessary resources.
Some assisted living residents live with various medical conditions. In Ohio, 41% have Alzheimer's disease or another form of dementia. In addition, 56% have high blood pressure, 35% have heart disease, 23% have depression, and 19% have diabetes.
Activities of Daily Living (ADLs) Assistance Services
A primary service of assisted living that benefits residents is receiving help with activities of daily living (ADLs). These are fundamental tasks that a person must do regularly to sustain life and general health, including toileting, bathing or showering, dressing, transferring (getting in and out of bed or a chair), ambulating (walking), and eating. Signs that a person may benefit from living in assisted living include increased isolation, loss of mobility, noticeable weight loss or gain, and/or neglect of household chores.
Residents in Ohio’s assisted living facilities often receive help with their ADLs. In Ohio, 20% of residents need help eating. Other commonly used services include bed transfer (36%), toileting (41%), and walking (49%). Caregivers in ALFs help 49% of residents dress, and 63% need help bathing.
Cost Of Assisted Living Care In Ohio
The average cost of assisted living care in Ohio is $4,635. This is $135 higher than the monthly national average of $4,500. The cost of living in Ohio is less than the national average by 8.7%, with health care costs less than the national average by 2.8% and housing costs less than the national average by 23.5%.
The level of care a person requires impacts the cost of care, as does where you live. The cost of assisted living ranges from a low of $3,660 in the Springfield area to a high of $4,993 per month in the Akron area of Ohio.
How Costs Compare In Nearby States
If you or your loved one lives near one of the state borders or have relatives living nearby, you might be considering an assisted living community in one of those states. The median monthly cost of care in Michigan is $3,500. In Indiana, it’s $4,025; in Kentucky, $3,445; in West Virginia, $3,750; and in Pennsylvania, $3,450.
How to Pay for Assisted Living
Ohio Assisted Living Oversight
The Ohio Department of Health maintains oversight of the state’s residential care facilities. The Ohio Department of Aging offers resources to help older Ohioans get the necessary care. If an assisted living resident has a problem or dispute, the Ohio Long-Term Care Ombudsman is available to help.
Ohio Department of Health
Ohio Department of Aging
Ohio Long-Term Care Ombudsman
Legal Resources
Pro Seniors is a statewide non-profit organization that provides advocacy and support services for older adults. People aged 60 years over have access to a legal helpline to speak with an attorney at no cost. In addition to long-term care ombudsman services, there is the Senior Medicare Patrol, which helps beneficiaries identify and report fraudulent activities and billing errors. The Ohio Legal Helpline assists with issues related to health care, government benefits, consumer rights, and estate planning.
