In Ohio, assisted living homes that provide full-time care and supervision are legally called “residential care facilities,” though the term is interchangeable with “assisted living.” Special units of residential care (or an entire residence) may be specifically for people with Alzheimer’s or a related dementia, and these are often called memory care or Alzheimer’s care. Residential care facilities in Ohio are regulated by the Department of Health’s Division of Quality Assurance.
Residential care communities can supervise and assist residents, help with self-administration of medication, monitor special diets, and help with dressings. Someone in need of full-time nursing care should reside in a nursing home rather than residential care or assisted living, but residential care can provide a resident with part-time, skilled nursing care for up to 120 days.
The average cost of memory care per month in Ohio is $5,704, which breaks down to about $187 per day and $68,448 annually. Costs are required to be entirely disclosed in residential agreements in Ohio, including all charges and any possible fines or penalties, so there should be no surprises. Assisted living, without the additional services required for memory care, costs Ohio residents about and $4,359 per month and $52,308 per year.
Ohio is one of the country’s most populated states, so of course the pricing varies depending where you live. The most expensive place for memory care is Akron, running $6,063 per month and $72,756 annually. The least expensive is Cleveland and Youngstown, for $4,706 per month and $56,472 annually. Other notable cities include Cincinnati, where memory care costs $5,584 per month and $67,008 annually; and Columbus, Ohio’s most populated city, where memory care costs $5,185 per month and $62,220 annually.
Residential care homes should not admit someone who needs skilled nursing care for more than 120 days out of the year. Someone also should not be admitted who needs services beyond the scope of care at a particular residence.
Residences in Ohio must search for new residents in the Ohio sex offender registry before admission.
No one should be admitted 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 regime
Future residents must receive the following in writing:
– 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)
A residential assessment must be completed within 48 hours of moving in. Residents must be reassessed annually, and after any significant health change.
Bedrooms must be at least 100 square feet. For multiple occupants, there must be at least 80 square feet per person. (These figures do not include closets or bathrooms.) Four residents maximum are allowed per bedroom. There must be one toilet, sink, and tub or shower for every eight residents. Every residence must have an updated disaster preparedness plan, and conduct at least 12 fire drills annually. There must be fire alarms and an automatic fire extinguishing system.
Staff who work with residents who have dementia must have two hours of training specific to dementia care within 14 days of beginning the job. There is no staffing ratio requirement in Ohio, but regulations say at least one employee must be on duty at all times and staffing must always be sufficient to meet the needs of all residents. Homes whose residents require special diets must have a dietician or consultant as a member of the staff.
Administrators must be at least 21 and must 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. Administrators must train nine hours in a relevant field every year. Staff members must be at least 16 and be trained in first aid. Anyone under 18 must be supervised. All staff must be trained on residents’ rights. For specifically memory-care staffers, their training must be adequate to assist with activities of daily living (ADL) and activities that strengthen thinking ability.
Eight hours of continuing education in a field relevant to caring for residents is required of all staff members annually.
The Assisted Living Waiver Program is an Ohio Medicaid program to help supplement the costs of assisted living for eligible Ohioans. The program will not cover the price of room and board, but can help with these services:
– Health assessments and monitoring
– Personal care
– Medication reminders and assistance
– Skilled nursing as needed
– Housekeeping and laundry
– Recreational activities
– Non-medical transportation
– On-site response around the clock
– Transitioning from a nursing home into assisted living
Applicants who meet the eligibility guidelines, including monthly income below $2,313 in 2019, should begin the process as soon as possible because there can be long waiting lists to get Ohio’s Assisted Living Waiver. One can take a Medicaid-eligibility test here.
The Residential State Supplement (RSS) Program provides financial assistance to Medicaid-qualified Ohio residents to help pay for the cost of rent in assisted living, adult foster care, or adult family care homes in residences approved by the Ohio Department of Health. Acceptance into the RSS program also entitles the individual to Ohio Medicaid’s medical and prescription drug coverage benefits. The RSS program supplements the assistance already received by people from Social Security, Supplemental Security Income (SSI), or Disability Benefits. Although the RSS benefit is provided as cash, it can only be used toward the cost of residential care. RSS recipients must be eligible for Ohio Medicaid. Click here for a Medicaid eligibility test or here to apply.
Veterans are statistically more likely to develop dementia. Relevant in all states including Ohio is the VA’s Aid & Attendance pension program for veterans and surviving spouses, which is an amount of money added to veterans’ and survivors’ basic pension. Applicants must be at least 65 years old (or disabled) and require assistance with activities of daily living (ADLs) like eating, bathing, and mobility. The cash assistance from these pensions can be used as the recipient wishes, meaning it can go toward the cost of memory care. In addition, the cost of residential care can be deducted from one’s income, effectively reducing the amount of calculable income used to determine the benefit amount. The latest (2020) maximum amount a veteran can receive through A&A is $27,194 per year, and surviving spouses can receive as much as $14,761. Learn more here.
There are also Veterans homes in Ohio, which are residential care facilities that provide long-term care for veterans. In addition to nursing home care, assisted living and memory care may be provided. Payment is made directly from the VA to the facility. State veterans homes are typically reserved for veterans whose need for care stems at least 70 percent from their military service. Because there is often a waiting list, contact a home before visiting to see if your loved one is eligible to live there.
Other ways to help pay for assisted living with memory care include tax credits and deductions like the Credit for the Elderly and the Disabled, or the Child and Dependent Care Credit (if you can claim your elderly loved one as a dependent). Remember also that medical and dental expenses can be deducted, and that may include some assisted living costs.
A reverse mortgage may be a good option for a married person moving into memory care, if their spouse continues to live in the home. Should their spouse move out of their home, the reverse mortgage would become due.
Elder care loans are for families to cover initial costs of moving into memory care, if you need a little help at first but can afford costs after the initial payments. For example, if one is waiting for a VA pension to be approved or waiting to sell a home.