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My spouse needs more care than I can give

Options that keep a couple together, and the spousal protections Medicaid provides.

Quick answer

Options that keep a couple together, and the spousal protections Medicaid provides.

HomeBy SituationMy spouse needs more care than I can give

Caring for a spouse is different from caring for a parent, financially and otherwise. Ohio's spousal impoverishment protections shield a set amount of the couple's income and assets for the spouse who stays home when the other needs Medicaid-covered care.

Short answer

Options that keep a couple together, and the spousal protections Medicaid provides.

What to do, in order

  1. Understand the spousal protections. Ohio's Community Spouse Resource Allowance and Minimum Monthly Maintenance Needs Allowance figures change annually -- confirm current amounts with the Council on Aging or an elder law attorney before making decisions.
  2. Look at communities that keep couples together. Several campuses offer more than one level of care on one site.
  3. Be honest about your own health. Spousal caregivers routinely under-report their own decline.
  4. Get an objective assessment. The Area Agency on Aging serving your county can assess both of you at no cost.

Questions families ask

Does Ohio require a separate certification for memory care?

Only in one specific context: Residential Care Facilities serving residents under Ohio's Assisted Living Waiver must be certified for memory care under OAC 173-39-02.16. Private-pay memory care units outside that waiver are not certified the same way.

How does Ohio license nursing homes differently from assisted living?

Nursing homes are licensed under a separate administrative rule chapter, OAC 3701-17, distinct from OAC 3701-16 for Residential Care Facilities. Nursing homes are also federally certified and CMS star-rated, which assisted living in Ohio is not.

How many days can an assisted living community in Ohio provide skilled nursing before a resident must transfer?

Ohio caps the skilled nursing an RCF may provide at 120 days in any 12-month period per resident, under ORC 3721.011, with exceptions for physical/occupational/speech therapy and hospice residents.

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