I. Paying for Memory Care in Ohio

The Cost of Memory Care in Ohio

Because of the specialized staff training and resources required to provide high-quality memory care, memory care typically costs more than other types of residential care. On average, memory care will cost 20-30% more than assisted living.

In Ohio, the average cost of assisted living is $4,339 per month, which is almost $300 higher than the national average of $4,051 per month. As memory care costs an average of 25% more than assisted living, seniors can expect to pay around $5,424 for memory care in one of Ohio’s residential care facilities.

Across the state, memory care costs vary from city to city. In the capital city of Columbus, assisted living services cost an average of $3,945 per month. Some cities are quite affordable, such as the Cleveland area which costs an average of $3,575 per month, while others are above the state median, such as Cincinnati at $4,245 per month and Dayton at $4,455 per month. Costs can climb as high as $5,036 in Toledo. It’s also important to note that these amounts are for standard assisted living services, and memory care may be anywhere from $860 to $1,300 more expensive per month, depending on the location of the facility and services offered.

   

Ohio Medicaid Programs for Memory Care

MyCare Ohio Plan (MCOP)

Also known as the Integrated Care Delivery System (ICDS) Medicaid Waiver, the MyCare Ohio Plan (MCOP) is a program for Ohio seniors enrolled in both Medicare and Medicaid, which allows participants to have a single point of contact to access care services. Some of the services provided include doctor visits, medical transportation, meal delivery services, assistance with home modifications and a full range of personal care services.

  • Who is Eligible: The program is available across 29 counties, and residents must reside in one of these counties to apply. Seniors must be aged 65 or older and be eligible for both Medicare and Medicaid. Single applicants must have a monthly income no greater than $771 and no more than $2,000 in financial assets, while married applicants cannot surpass a monthly income of $1,157 or have assets exceeding $3,000.
  • How to Apply: To enroll, seniors can either apply online or contact the Ohio Medicaid Consumer Hotline at 800-324-8680.

PASSPORT Waiver

PASSPORT stands for Pre-Admission Screening System Providing Options and Resources Today. Part of the state’s Medicaid waiver program, PASSPORT provides seniors access to a variety of resources and support services to assist with activities of daily living and home maintenance. Some of the services offered include minor repairs, housekeeping, accessibility modifications and personal care.

  • Who is Eligible: The PASSPORT Program is available to residents of Ohio aged 60 or older who have a physical disability and financial need. Seniors must show that they require significant assistance with activities of daily living, with special procedures in place to assess the needs of seniors with Alzheimer’s or dementia. Financially, an individual senior’s gross monthly income must be less than three times the Federal Benefit Rate (FBR), which was $2,313 as of 2019. Even if a senior is married, both partners’ incomes are considered separately. With the exception of real estate, assets cannot exceed a total of $2,000 for single applicants or $3,000 for a married couple.
  • How to Apply: To apply for PASSPORT, seniors should contact their local agency on aging or contact the Department of Aging at 866-243-5678.

Assisted Living Waiver

The Assisted Living Waiver Program is part of Ohio’s Medicaid program. While it does not cover the complete cost of assisted living, it helps reduce the cost of services offered in residential care settings so seniors can enjoy the flexibility and recreational activities of group living. Some of the services it covers include health assessments and monitoring, personal care, medication assistance, housekeeping and nonmedical transportation.

  • Who is Eligible: This program was designed for Ohio residents aged 21 and older, and applicants are evaluated to determine their level of impairment and financial need. Seniors over the age of 65 do not need to have a disability, however, they must require a nursing home level of care and daily assistance. As of 2019, applicants’ monthly income must not exceed $2,313, which is three times the Federal Benefit Rate.
  • How to Apply: Seniors can begin the application process for this program by contacting their local Ohio Area Agency on Aging or calling 866-243-5678.

Non-Medicaid Financial Assistance Programs for Memory Care in Ohio

Residential State Supplementation (RSS)

Ohio’s Residential State Supplement program is a state-funded cash assistance program designed to help Medicaid-eligible seniors pay for the cost of care in RCFs and other adult care facilities. The program is intended to supplement the funding a senior already receives from Social Security, Supplemental Security Income (SSI) or Disability benefits to help pay for accommodations, supervision and personal care services. The RSS is administered by the Ohio Department of Mental Health (OhioMHAS) and Addiction Services, in partnership with the County Department of Job and Family Services.

  • Who is Eligible: The program is designed for Ohio residents aged 60 and older who have demonstrated that they can no longer receive the level of care they require in their own home. Seniors must be participating in regular Medicaid and should have a monthly income of no more than $1,300, and no more than $2,000 in countable assets.
  • How to Apply: Seniors have the option of applying online by filling out an application on the OhioMHAS website or by submitting the necessary paperwork by fax or email. Seniors can get more information by calling OhioMHAS Community Transitions at 614-752-9316.

Ohio Elderly Services Program (ESP)

The Ohio Elderly Services Program (ESP) provides in-home services for seniors who do not qualify for Medicaid based on disability and income levels, but still require assistance. It offers help with housekeeping and chores, minor home repairs, pest control, home-delivered meals and adult day care.

  • Who is Eligible: The program is open to Ohio seniors aged 60 or older who reside in Butler, Clinton, Hamilton or Warren Counties. Any senior can apply, regardless of their financial situation, however, a cost of care may be assessed on a sliding scale depending on the applicant’s income.
  • How to Apply: Seniors can contact the Council On Aging at 800-252-0155 or 513-721-1025. An initial screening will be conducted over the phone, followed by an in-home assessment for qualified applicants.

More Ways to Pay for Memory Care

  • Long-Term Care Insurance: Depending on the policy details, long-term care insurance may be used to pay for memory care services. It’s best to sign up for a policy early, as coverage will likely be denied if one already has long-term care needs. More information about the intricacies of long-term care insurance can be found at longtermcare.acl.gov.
  • Reverse Mortgages: Reverse mortgages allow some homeowners to take out a loan as an advance from the eventual sale of their primary residence. This can be a good way to fund memory care in the short-term, but the loans will need to be paid back after the sale of the home. The most commonly used type of reverse mortgages for seniors is the Home Equity Conversion Mortgage, which is the only reverse mortgage insured by the federal government.
  • Veterans Benefits: The Department of Veterans Affairs offers several programs that veterans and their spouses may use to cover health care needs such as memory care. More information about these programs can be found on the VA website.
  • Life Insurance: Some life insurance policies allow policyholders to cash out their policy before a qualifying death. There may be some downsides to accessing a life insurance benefit early, so be sure to read more about the process.

II. Memory Care Laws and Regulations in Ohio

Memory Care Regulation

In Ohio, facilities that provide memory care services in an assisted living environment are known as residential care facilities (RCFs). Across the state, the terms assisted living and residential care can be used interchangeably. The Ohio Department of Health (ODH) is responsible for the licensing, inspection and certification of all RCFs throughout the state.

According to the state, to be classified as an RCF, a facility must offer accommodations for 17 or more unrelated individuals, with supervision and personal care services for at least three residents who experience limitations due to their age, physical or mental impairments. Smaller communities that provide some skilled nursing care services can also be licensed as RCFs.

These RCFs may have specialized units or an entire facility designed specifically for residents who have Alzheimer’s or another type of dementia. The ODH has specific requirements for these special care units, which must be outlined when a facility applies for their residential care license.

Facility Scope of Care

RCFs may provide residents with a variety of services, including supervision, daily personal care, medication administration, diet supervision, dressing and assistance with part-time intermittent enteral feedings. Skilled nursing services may also be provided on a part-time basis for no more than 120 days, with the exception of hospice residents and those whose physicians have recommended skilled nursing care as part of their routine.

Admissions Requirements

RCFs offer care services for a variety of residents, though they do have some restrictions on who they can admit. The table below outlines who may or may not be admitted to an RCF.

Residents Who May Be AdmittedOlder adults and people with:

  • Dementia
  • Mental Health Conditions
  • Developmental Disabilities
  • Physical Disabilities
  • AIDS
  • Traumatic Brain Injuries
  • A need for skilled nursing care for fewer than 120 days
Residents Who May NOT Be AdmittedThose who:

  • Are bedridden with limited potential for improvement
  • Have Stage III or IV pressure ulcers
  • Have a medically complex condition
  • Require skilled nursing beyond the Ohio Revised Code or what the facility can provide
  • Require care for more than eight hours per day or 40 hours per week
  • Require chemical or physical restraints
  • Have a complex medical condition that requires constant monitoring
  • Are listed on the Ohio sex offender registry

Care Plan Requirements

Facilities are required to complete a residential assessment within 48 hours of a senior moving in, and after that, on a yearly basis or following any significant health changes. A licensed health professional must also determine if a senior is able to self-administer medication or requires medication administration assistance. Additional assessments may be conducted for residents with medical, psychological, developmental or intellectual impairments.

Residents are also allowed to contract with third-party providers, such as a licensed hospice agency, certified home health agency or mental health agency, if they feel they could benefit from additional services.

Medication Management Requirements

Any medications administered to residents must be done so by authorized personnel, such as physicians, registered nurses (RNs), licensed practical nurses (LPNs) or certified medication aides who have undergone special training.

Residents who are mentally alert and capable of self-administering their own medications may do so with the help of trained nonlicensed staff as required. Assistance includes reminders, observation, handing medications to the resident and verifying labels, and in the case of physically impaired residents, removing medications from containers, placing a container to the resident’s mouth and applying medication upon request.

Facility Requirements

As licensing rules do not dictate a requirement for apartment-style rooms, RCFs can have both private and shared rooms. Private units must be a minimum of 100 square feet in size and multiple-occupancy units are required to provide a minimum of 80 square feet for each resident, not including bathrooms or closet space. The maximum occupancy for an individual unit is four individuals. For every eight residents, there must be one toilet, sink and tub or shower provided. If more than four seniors of one gender are residing on a single floor, a bathroom for each gender must be provided on that floor.

The facility is required to have safety items such as sprinklers, smoke detectors and carbon monoxide alarms installed, as well as a disaster preparedness plan.

Staffing Requirements

RCFs are required to have direct care staff to provide personal care services, at least one of whom is trained in first-aid, and an administrator who oversees daily operations and is accessible at all times. If a facility offers skilled nursing services, it must have a registered nurse either on staff or under contract, and if it offers medication administration services, an RN, physician, LPN or authorized staff member must be on duty. RCFs must also have a psychologist or physician on staff if they provide memory care services.

While the state does not enforce a minimum staff ratio, sufficient numbers must be available to properly care for residents’ needs. All staff members are required to go through orientation and training to learn their responsibilities, facility procedures, emergency assistance and resident rights. Training must be conducted by a licensed nursing professional. Any staff who provide direct care to residents must complete first-aid training within 60 days of their hiring.

Staff must participate in eight hours of continuing education on an annual basis to keep up to date on personal care techniques, refine their observational skills and develop their communication skills.

Medicaid Policy

Ohio has two Medicaid waiver programs to cover the cost of services in residential care facilities: the Assisted Living Program and the Managed Care Demonstration Waiver, known as MyCare. Additionally, seniors who are eligible for Medicaid can receive monthly assistance from the state-funded Residential State Supplement (RSS) to help cover the cost of accommodations, supervision and personal care services in an RCF.

Reporting Abuse

To register a complaint about an RCF, seniors can call the Ohio Department of Health complaint department toll-free at 800-342-0553 or fill out a form online. Complainants can choose to remain anonymous. Concerns or complaints dealing with the care or treatment of residents in an RCF can also be directed to the area’s regional long-term care ombudsman program or by calling 800-282-1206.

III. Free Memory Care Resources in Ohio

ResourceContactDescription
Ohio Council of the Alzheimer’s Association

 

800-272-3900The Ohio Council of the Alzheimer’s Association is comprised of seven regional chapters that advocate for the interests of Ohioans with Alzheimer’s and other memory-related diseases. Each chapter offers educational resources and support services for seniors and their families, and hosts a variety of fundraising and awareness efforts.
The Golden Buckeye Program

 

800-422-1976The Golden Buckeye program is a service offered by the Ohio Department on Aging to help older adults make community connections. Participants receive a card that entitles them to receive special discounts and support from local businesses and services, including dining, entertainment, dental offices, optometrists, home maintenance and salons.
Caregiver Support

 

To find Caregiver support in your area, contact your local Area Agency on Aging.Through the National Family Caregiver Support Program, caregivers to seniors with Alzheimer’s and dementia can access local support services including training, resources, support groups, respite care, housekeeping and home maintenance services.
Opening Minds through Art (OMA)

 

513-529-2914Opening Minds through Art (OMA) is an award-winning, intergenerational art program for seniors with Alzheimer’s disease and other forms of dementia that offers opportunities for creative self-expression and social engagement.
Music and Memory

 

800-266-4346The program seeks to help seniors who experience cognitive and physical challenges to find meaning and connection in their lives through the healing power of music. The state-wide intuitive is a partnership between the Ohio Department of Aging (ODA) and Office of the State Long-term Care Ombudsman and offered in 250 facilities across Ohio.