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

Last Updated: February 24, 2021

 

In Ohio regulations, assisted living homes that provide full-time care and supervision are called “residential care facilities,” though the term is interchangeable with “assisted living.” Special units of residential care, or even an entire residence, may be specifically for people with Alzheimer’s or a related dementia. These are often called “memory care” or “Alzheimer’s care.”

Residential care communities generally can supervise and assist residents, help with self-administration of medication, monitor special diets, and help with dressings. Memory care homes go steps further by providing dementia-friendly programs and environments with extra training for staff. (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.)

Residential care facilities in Ohio are regulated by the Department of Health’s Division of Quality Assurance. There are 370 memory care homes in Ohio. There are also 30 board and care homes, which offer the same services as assisted living (sometimes including memory care) for 12 or fewer residents in a more house-like environment. For free help finding memory care of any size to fit your family’s needs and budget, click here.

 COVID-19 Vaccination in Ohio Memory Care
Staff and residents in assisted living were among the first group (Phase 1A) to receive immunizations against the coronavirus, starting in December 2020. If you have a loved one in memory care, they should have received a vaccination by now. For more, click here.

 

How Much Does Memory Care Cost in Ohio?

The average cost of memory care per month in Ohio is $5,130, which breaks down to about $61,560 annually. This is about equal to the national average. Assisted living, without the additional services required for memory care, costs Ohio residents about $1,200 less per month.

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 Dayton, running $6,170 per month and $74,040 annually. The least expensive is Cleveland, for $4,663 per month and $55,956 annually. In Columbus, Ohio’s most populated city, memory care costs $5,309 per month and $64,680 annually. Other notable Ohio cities and memory care costs:

Ohio Memory Care / Assisted Living Costs (updated Feb. 2021)
Region / City Monthly Cost Annual Cost
Statewide $5,130 $61,560
Columbus $5,309 $64,680
Cleveland $4,663 $55,956
Cincinnati $5,596 $67,152
Akron $5,740 $68,880
Canton $5,453 $65,436
Youngstown $4,771 $57,252

Western Ohio residents might be able to find more affordable memory care in Pennsylvania, where the monthly average for memory care costs is about $4,663. More specifically, Pittsburgh (only about an hour from Youngstown) costs much less than most Ohio cities, at about $4,197 monthly and $50,364 per year. Indiana averages higher memory care costs than Ohio, about $5,166 per month, but people who live in west central and northwest Ohio might find more affordable memory care in Fort Wayne, within 30 minutes of the state border, for $4,125 monthly. These are just a few examples to show that Ohioans might save money on memory care by searching for homes outside the state.

 Did You Know? The number of people in Ohio with Alzheimer’s disease is expected to grow from 220,000 in 2020 to more than 250,000 in 2025, an increase of 13.6%.

 

Ohio Assisted Living Laws & Regulations

Admissions Process & Requirements

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. Because dementias are progressive diseases, meaning symptoms get worse over time, you want to be certain a home can handle your loved one’s condition as it advances from early into the middle and later stages. Otherwise, an eviction might become necessary (see below).

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 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. 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 a new resident’s room. Community fees usually run between $1,500 and $2,500.

Prior to moving in, the new resident must get an up-to-date medical history from their own doctor, updated within a week of admission. For this reason, be sure to keep your loved one’s personal physician up-to-date on the process of finding memory care. There are no standard forms for the history or any of these assessments.

A doctor’s diagnosis of Alzheimer’s, or related disease including vascular, frontotemporal, or Lewy body dementia, is not required to move into memory care in Ohio. Diagnosing dementia is difficult as symptoms change and vary, requiring expensive tests including PET brain scans. The residence will be able to tell if someone is a good fit or not based on its own assessment.

And while it is possible to move into memory care on short notice in Ohio, this is not a good idea. You should take as much time as possible to investigate options before making a decision. Ideally, you would begin looking at memory care homes before a move is necessary. The sooner you begin searching, the more input the person with dementia can provide.

 COVID-19 Rules for Admissions in Ohio Memory Care
The Department of Health has said that every assisted living home in Ohio must develop a plan for admissions during the coronavirus pandemic. This may mean quarantining new residents for 14 days before they can join the general population. Check with specific homes for guidelines.

 

Facility / Residence

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.

“Special design features” for memory care residences are required by Ohio regulations, though what exactly this means is somewhat vague. Examples that have been shown to benefit people with dementia include clear sightlines and easily navigated layouts, circular hallways so strolling residents won’t encounter a dead end, and soft paint colors. When considering a memory care community, be sure to inspect the spaces with an eye on whether your loved one will be comfortable there.

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.

 COVID-19 Visitation Rules in Ohio Memory Care
During the pandemic, an assisted living home may allow visitors depending on the county infection rate and whether the home had a recent positive test for the coronavirus. It is possible that only outdoor visits are allowed. Check with a specific home for guidelines, or visit this regularly updated link.

 

Staff & Training

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 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 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.

 

Evictions & Discharges

Unlike most other states, there are not clear rules in Ohio regulations about how assisted living homes must handle evictions. Very generally, a resident cannot continue living in a home that isn’t equipped to handle their medical condition. If staff isn’t trained to help someone who is nonambulatory, for instance, then a resident who loses the ability to walk could not stay there and would need to be evicted.

Anyone who develops these issues cannot live in assisted living in Ohio:
– Needs skilled nursing care for eight or more hours daily or 40 hours per week
– Needs chemical or physical restraints
– Becomes bedridden
– Develops stage III or IV pressure ulcers
– Has a constantly changing medical condition that requires monitoring and adjustments

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. This is not specified in Ohio regulations, however, so you’ll want to be clear on how evictions work at the home before agreeing to a move-in contract. What are a home’s specific rules for evictions? Can a resident be evicted for nonpayment or late payment of bills? Get the answers in writing, because unfair evictions are a big problem in assisted living nationwide. If you receive an eviction notice and need to know what to do next, click here.

 

Financial Assistance for Residential Alzheimer’s Memory Care

Ohio’s Medicaid Assisted Living Waiver

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 should begin the process as soon as possible because there can be long waiting lists to get Ohio’s Assisted Living Waiver. More information is available at this link.  One can take a Medicaid-eligibility test here.

 

Residential State Supplement Program

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 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 Affairs (VA)

Because medical issues including traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) are more common in those who served in combat, 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 income improvement pensions can be used as the recipient wishes, meaning it can pay for 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 (2021) maximum amount a veteran can receive through A&A is $27,540 per year, and surviving spouses can receive as much as $14,928. Learn more here.

There are also two veterans’ homes in Ohio, which are residential care facilities that provide long-term care for veterans. They are located in Georgetown (outside Cincinnati) and Sandusky (northern Ohio on the shore of Lake Erie). In addition to nursing home care and assisted living, memory care is 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 the homes before visiting to see if your loved one is eligible to live there. For contacts and more information, click here.

 

Other Options

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.