Ohio Residential Alzheimer’s Care (Memory Care): Rules, Costs & Financial Help

Legal Definition of Assisted Living/Memory Care in Ohio

In Ohio, the term residential care facilities is used interchangeably with assisted living and memory care, and these facilities are licensed by the Ohio Department of Health, Office of Health Assurance and Licensing. A residential care facility in Ohio is defined as either (1) a place that provides accommodations for 17 or more unrelated individuals, and provides supervision and personal care services for three or more of those individuals who are dependent on that care due to age, or physical or mental impairment; or (2) provides accommodations for three or more unrelated individuals, and supervision and personal care services for three or more of those individuals who are dependent on that care due to age, or physical or mental impairment, and provides at least one of the individuals with skilled nursing care as authorized in section 3721.011 of Ohio’s Revised Code.

There are also special requirements for residential care facilities in Ohio that provide care to residents with Alzheimer’s disease and other dementias, which are discussed below. Ohio has approximately 770 residential care facilities, and about 370 of them offer memory care for residents with dementia.

Ohio Assisted Living Laws & Regulations

Admissions Process and Requirements

As of 2025 in Ohio, a residential assessment by a healthcare professional working for the residence must be completed within 48 hours of moving in. The assessment will cover medical and personal needs, and is used to create a service plan that guides staff in providing personalized care to your loved one. Residents must be reassessed annually, and after any significant health change.

Residents with medical, psychological or developmental or intellectual impairments, which could include dementia, are required to have additional assessments. However, a dementia diagnosis is not required to move into a memory care facility. Applicants or their representatives should ask the facility what their policy is for admissions, including the assessments. The cost of assessment might be included in the base rate or there may be a community fee that covers up-front move-in costs like the first assessment and deep cleaning of a new resident’s room. Community fees usually run between $1,500 and $2,500.

Residential care facilities in Ohio are not allowed to admit anyone on the Ohio sex offender registry. And they also can not admit any individual who:

• requires skilled nursing care for at least eight hours a day or 40 hours per week
• requires chemical or physical restraints
• is bedridden with limited movement ability
• has stage III or IV pressure ulcers
• has a medical condition that changes so constantly that it requires monitoring and frequent adjustments to the person’s treatment regimen

While it is possible to move into memory care on short notice in Ohio, it is not a good idea. Dementia patients and their families should take as much time as possible to investigate options before making a decision. Ideally, one would begin looking at memory care homes before a move is necessary so the individual with dementia can have as much input in the decision as possible.

Upon moving in to a residential care facility in Ohio, the facility must provide new residents or their representatives with a copy of the written residential agreement, which must include the following information:

• an explanation of all charges, fines, and penalties
• a list and explanation of services provided
• a promise to discharge or transfer any resident who becomes dependent on skilled nursing care beyond what the residence can provide
• residents’ rights policies and procedures (including a definition of skilled nursing care)

Scope of Care

Residential care facilities in Ohio are allowed to provide supervision, personal care services, medication management, dressing changes, and intermittent enternal feedings. If an an applicant needs care beyond that, they will not be admitted. Applicants who need skilled nursing care for more than 120 days in a 12-month period will not be admitted either, unless skilled nursing care is determined to be routine for them by a physician.

When it comes to medication management, the facility may administer medication to residents who have a prescriber’s orders. The administration must be done by a qualified staff person, such as a registered nurse, a licensed practical nurse who has completed a medication management course, or another individual who legally authorized to administer medication. Unlicensed staff members may help residents who are self-administering their medication.

Staff and Training

There are no staffing ratio requirements for residential care facilities in Ohio, but there must be at least one staff member on duty at all times plus enough staff to meet all of the residents’ care needs. This includes having staff on hand who are trained to handle any specialized needs, such as dementia.

All staff members who work at facilities that admit and retain residents with dementia must receive four hours of training during the first two weeks of their employment, plus eight hours of annual training on caring for people with dementia, and they must be trained on how to facilitate activities that improve cognitive ability. And managers at facilities that care for residents with dementia must be trained to administer activities that strengthen cognitive abilities, and they must be able to provide assistance with the Activities of Daily Living (mobility, bathing, grooming, eating, toileting).

In addition to those requirements, managers at all Ohio residential care facilities must:

• be at least 21 years old
• be licensed as a nursing home administrator
• have 3,000 hours of work with direct operational responsibility,
• have 100 credit hours of post-high school education in a relevant field, be a licensed health-care professional or hold a baccalaureate degree
• train nine hours in a relevant field every year
• be trained on residents’ rights
• complete eight hours of annual continuing education in a field relevant to caring for residents

And staff members at all residential care facilities in Ohio must:

• be at least 16 and anyone under 18 must be supervised
• be trained in first aid
• be trained on residents’ rights
• complete eight hours of annual continuing education in a field relevant to caring for residents

Evictions & Discharges

Unlike most other states, there are not clear rules in Ohio about how residential care facilities must handle evictions. Generally, a resident cannot continue living in a home that isn’t equipped to handle their medical condition. For example, if staff isn’t trained to help someone who is non-ambulatory, any resident who loses the ability to walk could not stay there and would need to be evicted.

The process of eviction might vary depending on the residence. Very often, 30 days notice and assistance finding a new place to live is required, but this is not specified in Ohio regulations. So, before agreeing to a move-in contract, dementia patients and their families should ask questions about evictions at the facility, such as: What are a home’s specific rules for evictions? Can a resident be evicted for non-payment or late payment of bills? Getting the answers in writing could be critical if there is an unfair eviction, which is a common problem in assisted living residences across the country. To read more about assisted living evictions and what dementia patients can about them, click here.

How Much Does Memory Care Cost in Ohio?

There can be significant differences in the cost of assisted living and memory care depending on what part of Ohio you are in. The table below lists the median monthly cost of both assisted living and memory care facilities in different regions of the state as of 2025, and it includes the statewide median cost, as well as the median cost for non-metropolitan areas. Individuals who are in the early to mid stages of dementia may be best suited for assisted living facilities, which are less expensive than memory care, while those with more severe symptoms or who are in the late stages of dementia will likely need memory care.

Financial Assistance and Care Support for Dementia Patients in Ohio

There are several sources of financial assistance and care support for qualified Ohio seniors with Alzheimer’s disease and other dementias who live in residential care facilities. They include Ohio Medicaid’s Assisted Living Waiver and MyCare Ohio Plan, the Program of All-Inclusive Care for the Elderly (PACE), Veterans Affairs (VA) pensions and Supplemental Security Income (SSI), as well as elder loans, tax credits and reverse mortgages.

Medicaid Long-Term Care

Ohio Medicaid will not cover room and board costs at residential care facilities, but it will pay for some long-term care services and supports in those facilities for qualified individuals via the Assisted Living Waiver, MyCare Ohio Plan, Aged, Blind and Disabled (ABD) Medicaid, and PACE.

Assisted Living Waiver
Ohio Medicaid’s Assisted Living Waiver provides long-term care benefits to Ohio residents who require a Nursing Facility Level of Care (NFLOC) but instead live in a residential care facility. It’s important to note that a dementia diagnosis does not automatically equate to a NFLOC designation. The state of Ohio uses the Adult Comprehensive Assessment Tool to determine if a NFLOC is required. While the Assisted Living Waiver will pay for services and supports in residential care facilities or assisted living residences, it will not pay for room and board in these settings.

Assisted Living Waiver benefits will be made available depending on each individual’s needs and circumstances. These benefits can include nursing care, homemaker services, social activities, medication management, non-medical transportation and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). The Assisted Living Waiver will not pay for room and board at residential care facilities, just like all Medicaid programs.

The Assisted Living Waiver is not an entitlement, which means eligible applicants are not guaranteed by law to receive the program’s benefits. Instead, there are a limited number of enrollment spots (roughly 6,000 as of 2025), and once those spots are full, additional eligible applicants will be placed on a waitlist. To qualify for the Assisted Living Waiver, applicants must also meet an asset limit ($2,000 for an individual in 2026) and an income limit ($2,982/month in 2026) as well as the medical requirement of needing a NFLOC.

MyCare Ohio Plan
The MyCare Ohio Plan is a managed care program for Ohio residents who are eligible for both Medicaid and Medicare, otherwise known as dual eligible, and require a NFLOC. It is also known as the Integrated Care Delivery System Medicaid Waiver, or the ICDS Demonstration. Program participants can live in a residential care facility, at home or in the home of a loved one.

This program provides medical care as well as personal care services and supports and delivers all of that through a single Medicaid plan provided by a managed care organization. MyCare Ohio is available in 29 counties across the state, and each county has several plans individuals can choose from. Those counties are Butler, Clark, Clermont, Clinton, Columbiana, Cuyahoga, Delaware, Franklin, Fulton, Geauga, Greene, Hamilton, Lake, Lorain, Lucas, Madison, Mahoning, Medina, Montgomery, Ottawa, Pickaway, Portage, Stark, Summit, Trumbull, Union, Warren, Wayne and Wood. For dual eligible Ohio residents (people eligible for both Medicaid and Medicare) who live in one of the counties listed above, enrollment in MyCare Ohio is mandatory.

MyCare Ohio Plan benefits include medical care, such as doctor’s visits, lab work and hospitalization, as well as long-term care benefits such as housekeeping, respite care, non-emergency transportation, personal emergency response systems and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting).

There are no enrollment caps on the MyCare Ohio Plan. To qualify, applicants must require a NFLOC, and meet two financial requirements – an asset limit ($2,000 for an individual in 2026) and an income limit ($2,982/month for an individual in 2026).

Aged, Blind and Disabled (ABD) Medicaid
Ohio’s Aged, Blind, and Disabled (ABD) Medicaid provides healthcare coverage and long-term care services and supports to financially needy Ohio residents who are aged (65 and over), blind or disabled and live in residential care facilities or elsewhere in the community. ABD Medicaid can sometimes be referred to as state Medicaid or regular Medicaid for seniors, but it should not be confused with the regular Medicaid that is available for financially needy people of all ages.

Eligible Ohio seniors with dementia who show a medical need for long-term care services and live in a residential care home can receive those services through ABD Medicaid. These benefits can include personal care, meal delivery, home modifications and Personal Emergency Response Systems (PERS). To qualify for these benefits, dementia patients in Ohio must show a need for them and meet two financial requirements – an asset limit ($2,000 for an individual in 2026) and an income limit ($994/month in 2026).

Program of All-Inclusive Care for the Elderly
Ohio residents age 55 and over who require a NFLOC can have all of their healthcare coverage, including Medicaid and Medicare, streamlined into one plan with the Program of All-Inclusive Care for the Elderly (PACE). PACE also offers vision, dental and hearing care, and PACE day centers provide day-time supervision, meals, social activities and regular health checkups for program participants. Being enrolled in Medicaid and/or Medicare is not a requirement for PACE, but it is free for Ohio Medicaid beneficiaries.

Ohio’s PACE program is is called McGregor PACE and is located in Cleveland Heights. To learn more about PACE, click here.

Veterans Affairs (VA)

Qualified Ohio veterans (or their surviving spouses) with dementia can also receive financial assistance through a Veterans Affairs (VA) Pension that they could use to pay for a residential care facility.

There are three levels of VA Pensions – Basic, Aid & Attendance (A&A) and Housebound. To qualify for any of them, veterans or their surviving spouses need to meet a net worth limit of $163,699 (effective Dec. 1, 2025 – Nov. 30, 2026), which is calculated by adding the total of their assets to their annual income. Some assets are exempt, like a primary home, primary vehicle and household furniture and appliances. VA Pension applicants also have to meet an income limit to be eligible – their income must be less than the VA Pension they are applying for in order for them to qualify. And veterans must meet a military service requirement, which includes not having received a dishonorable discharge.

To qualify for A&A, veterans or their surviving spouses must also meet a medical requirement, which is one of the following must be true:

• They need help to perform the Activities of Daily Living (mobility, bathing, dressing/grooming, eating, toileting) OR
• They have to stay in bed for at least a large portion of the day due to illness OR
• They are in a nursing home due to loss of mental or physical abilities OR
• Their eyesight is extremely limited (5/200 or less in both eyes even with glasses or contacts; or concentric contraction of the visual field to 5 degrees or fewer)

To qualify for Housebound, veterans must spend most of their time in their home due to a permanent disability.

There is no medical requirement for VA Basic Pensions.

Qualified veterans or their surviving spouses are entitled to their Maximum Annual Pension Rate (MAPR) minus their annual income. The following MAPRs are effective from Dec. 1, 2025 to Nov. 30, 2026:

VA Basic Pension MAPRs

• Veterans without spouses or children: $17,441
• Veterans with dependent spouses or children: $22,839
• Surviving spouses without dependent children: $11,699
• Surviving spouses with dependent children: $15,311
• Two veterans married to each other: $22,839

VA Aid & Attendance MAPRs

• Veterans without spouses or children: $29,093
• Veterans with dependent spouses or children: $34,488
• Surviving spouses without dependent children a maximum of $18,697
• Surviving spouses with dependent children: $22,304
• Two veterans married to each other and one qualifies for A&A: $33,548
• Two veterans married to each other and one qualifies for A&A and one for Housebound: $38,350
• Two veterans married to each other and both qualify for A&A: $46,143

VA Housebound MAPRs

• Veterans without spouses or children: $21,313
• Veterans with dependent spouses or children: $26,710
• Surviving spouses without dependent children: $14,298
• Surviving spouses with dependent children: $17,902
• Two veterans married to each other and one qualifies for Housebound: $26,710
• Two veterans married to each other and both qualify for Housebound: $30,580
• Two veterans married to each other and one qualifies Housebound and the other for A&A: $38,350

Veterans’ Homes
There are two state-run Veterans’ Homes in Ohio that are operated by the Ohio Department of Veterans Services. They are located in Sandusky and Georgetown, and both of them offer memory care services for eligible veterans with dementia, as well as skilled nursing care.

Since the Veterans Homes are managed by the state, there is no uniform nationwide cost. Many factors affect the price one has to pay after qualifying to be admitted. There is the cost of the VA home, a person’s service-connected disability rating, their assets, and monthly income. There are limits set as to how much a VA facility can charge (again these vary state by state) and they cost approximately 50 to 70% of a typical privately owned assisted living facility or nursing home.

To learn more about the VA Homes in Ohio, click here.

Supplemental Security Income

Dementia patients age 65 and over with limited income and assets may qualify for Supplemental Security Income (SSI). These funds can be used to pay for the cost of assisted living or memory care. As of 2026, the maximum SSI benefit for an individual is $994/month and for a married couple it’s $1,491/month.

To qualify for SSI, applicants must be age 65 and over or have a significant disability, and they must meet an income limit and an asset limit. As of 2026, individuals may meet the SSI income limit if they earn less than $2,073/month OR they get less than $1,014/month from non-work sources, like Social Security benefits or pension payments. They may meet the SSI asset limit if they have $2,000 or less in countable assets. For couples, the income limit is $3,067/month in work income or $1,511/month in non-work income, and the asset limit is $3,000.

Other Options

1) Elder care loans exist for families to cover the costs of moving into memory care while waiting for other financial resources to become available. For example, if one is waiting for Medicaid approval or waiting to sell a home. More on bridge loans for memory care.

2) Some tax credits and deductions can provide financial relief for seniors with dementia and their families. Seniors with limited financial resources can claim the Credit for the Elderly and/or the Disabled, as long as no one can claim them as a dependent. If someone (like an adult child) can claim the senior as a dependent, they can utilize the Child and Dependent Care Credit, and they can deduct any medical or dental expenses they paid for the senior.

3) A reverse mortgage loan can be a viable option for some senior homeowners who are in need of extra income to help pay dementia care. However, reverse mortgages are not recommended for every senior homeowner who needs extra income, so it’s important to consult with a professional before taking out one of these loans.