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Medicaid Waivers and Assisted Living

Ohio runs PASSPORT (in-home only) and the Assisted Living Waiver (care services inside a licensed community) -- here is what each actually pays for.

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Short answer

Ohio runs several separate Medicaid HCBS programs rather than one combined waiver. PASSPORT and Ohio's Assisted Living Waiver are the two most relevant to a family comparing home care against a move to a licensed community.

PASSPORT: in-home services only

PASSPORT pays for personal care, homemaker services, adult day care, respite, home modifications and similar in-home supports for seniors who need a nursing-facility level of care but want to remain at home. It does not pay for assisted living room and board.

Ohio's Assisted Living Waiver: care services inside a licensed RCF

This is the waiver that actually pays for care services delivered inside a Residential Care Facility. It still does not cover room and board -- only the care component -- and not every RCF holds a provider agreement, so ask directly rather than assuming.

Applying

Both programs are administered locally, for our coverage area, through the Council on Aging of Southwestern Ohio, which can also tell you current waitlist status.

How families pay for care. Ohio runs PASSPORT (in-home only) and the Assisted Living Waiver (care services inside a licensed RCF, not room and board). Read the full explanation →

Questions families ask

Should we choose in-home care or assisted living for my parent?

It depends heavily on weekly hours needed. Home care tends to be more cost-effective under roughly 30-40 hours a week; beyond that, and especially at near-continuous supervision levels, a licensed community's flat monthly rate usually becomes the better value using Ohio's published cost medians.

What is the difference between a CCRC and a standalone assisted living community?

A Continuing Care Retirement Community (CCRC or Life Plan Community) combines independent living, assisted living, memory care and skilled nursing on one campus, usually for an entry fee plus monthly rent. A standalone community offers one level of care, typically without a large entry fee.

What is the difference between hospice and palliative care?

Palliative care focuses on symptom relief and quality of life and can run alongside curative treatment at any stage of an illness. Hospice is for a life-limiting illness, generally when a physician expects six months or less, and typically follows a decision to stop curative treatment.

Nursing home vs. assisted living: which does my parent actually need?

The determining factor is medical need, not preference. If a resident needs 24-hour licensed nursing care, or exceeds Ohio's 120-day skilled-nursing cap for assisted living communities, a nursing home is the appropriate licensed setting rather than assisted living.

What license does Ohio require for assisted living, and what law covers it?

Ohio licenses assisted living as a Residential Care Facility (RCF) under Ohio Revised Code Chapter 3721, with day-to-day operating rules in Ohio Administrative Code Chapter 3701-16. The Ohio Department of Health issues and inspects the license.

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