With 11.7 million residents, including 2 million seniors, Ohio is the nation’s seventh most populous state, and the number of seniors is projected to increase by more than 30% in the coming years.

While Ohio lags behind other contenders in our 2022 Senior Living Report, it ranks in the top 20 for senior housing, transportation, affordability and community involvement. The cost of living is 17% lower than the national average, which is ideal for retirees who want to stretch their savings. Ohio is also home to several nationally recognized medical centers, including the Cleveland Clinic. Residents in need of assisted living can choose from 774 licensed facilities. The median cost of care in these facilities is $4,635 per month, which is $135 above the national average.

This guide explores the cost of assisted living and long-term care in Ohio and the state’s major cities, and it takes an in-depth look at financial assistance programs. You’ll also find information about assisted living regulations and state agencies that can help you access and pay for the care you need.

The Cost of Assisted Living in Ohio

According to the Genworth 2021 Cost of Care Survey, assisted living prices in Ohio are just 3% higher than average at $4,635 compared to $4,500 nationwide. Prices are also higher than other states in the Ohio Valley region. Seniors in Kentucky enjoy below-average rates of $3,448, which provides a monthly savings of $1,187. Pennsylvania and West Virginia have similar prices of $4,100 and $4,160, respectively, and assisted living facilities in Michigan and Indiana charge $4,250 and $4,283 per month, respectively.

$4635

Ohio

$4500

The United States

$4100

Pennsylvania

$4283

Indiana

$4250

Michigan

$3448

Kentucky

$4160

West Virginia

The cost of assisted living is fairly stable across Ohio’s largest cities, but you can enjoy some savings if you’re willing to relocate. Columbus, the state’s capital and most populous city, has some of the lowest assisted living prices at $4,085 per month. Facilities in Dayton and Toledo average around $4,250 and $4,219 per month, respectively. Assisted living fees in Cincinnati are very close to the state median at $4,666, and seniors in Youngstown pay about $100 more than average at $4,738. In northeast Ohio, prices in Cleveland and Akron average $4,940 and $4,993, respectively, which is about 7% higher than the state median.

$4085

Columbus

$4940

Cleveland

$4666

Cincinnati

$4219

Toledo

$4993

Akron

$4250

Dayton

$4738

Youngstown

If you need help around the house and are looking for more social interaction, assisted living can be a great choice. These communities cost about $420 less than full-time in-home care, which averages $5,053 per month for both home care from a homemaker and home health care services. Plus, assisted living rates include room, board, personal care and many extras.

If you live at home and are comfortable traveling to a community center with assistance, you can sign up for an adult day health care program for $1,733 per month. This can provide substantial savings since assisted living prices are about 2.5 times higher. Seniors with more significant medical needs pay $7,300 per month for a semiprivate room in a nursing home or $8,213 per month for private accommodations.

$4635

Assisted Living

$5053

Home Care

$5053

Home Health Care

$1733

Adult Day Health Care

$7300

Nursing Home Care (semiprivate)

$8213

Nursing Home Care (private)

Does Medicaid Cover Assisted Living in Ohio?

Ohio Medicaid covers assisted living indirectly through a specialized home- and community-based services waiver. Individuals must meet financial requirements to qualify for Medicaid. They must also have significant medical needs that require personal assistance. Other benefits may be available to low-income residents who receive Social Security, including Supplemental Security Income or Social Security Disability Insurance. The Residential State Supplement doesn’t cover personal care, but it helps with the cost of room and board.

What Assisted Living Services Are Covered by Medicaid in Ohio?

Ohio’s Assisted Living Waiver Program covers the cost of personal care services provided in residential facilities. It also provides transitional support for seniors who want to move out of a nursing home and into assisted living. Here are some of the services that the waiver covers:

  • Personal care
  • Nursing
  • Three daily meals
  • Housekeeping
  • Laundry
  • Maintenance
  • Transportation
  • Recreational activities

Assisted Living Waiver Programs in Ohio

Assisted Living Waiver Program 

The Assisted Living Waiver Program is available to adults aged 21 or older who need one-on-one assistance with activities of daily living, such as grooming, bathing, dressing or eating. Transitional services can help with assisted living admissions, furnishings and move-in expenses.

Applicants must be financially eligible for Medicaid long-term care, and they must be able to pay a pre-negotiated rate for room and board. Required payments are based on the federal SSI benefit rate minus a $50 personal needs allowance. The residential care facility must participate in this state-sponsored program, and a waiting list may apply.

To see if you qualify, contact your local Area Agency on Aging or PASSPORT Administrative Agency. Staff members will screen you for Medicaid eligibility and arrange a personal needs assessment to determine which services you need. Call the Department of Aging at (800) 266-4346 or the AAA hotline at (866) 243-5678. The state’s long-term care ombudsman can help you locate a facility that participates in the program.

Ohio Residential State Supplement 

Ohio’s Residential State Supplement provides a monthly income supplement to adults who need help paying for room and board at assisted living facilities, including adult care homes and class II residential facilities. The state sets a monthly allowable fee, which is the maximum amount that facilities can charge. Participants should have at least $200 left as a personal needs allowance once assisted living fees are paid using government benefits and the Residential State Supplement. To qualify for this program, applicants must: 

  • Be aged 18 or older
  • Live in a nursing home or require institutional care
  • Be eligible for regular Medicaid
  • Receive Social Security, SSI or SSDI
  • Have an approximate monthly income of up to $1,300

This program is managed by the Ohio Mental Health & Addiction Services in partnership with the County Department of Job & Family Services offices. Application forms are available online. Once you complete your application, you can email it to RSS@mha.ohio.gov or fax it to (614) 485-9747. Case managers, guardians and hospital or nursing home discharge planners can complete an application on your behalf. For questions, call OhioMHAS at (614) 752-9316.

How To Know If You’re Eligible for Medicaid in Ohio

Medicaid eligibility requirements depend on your age, health and disability status. If you require a nursing home level of care or want to apply for home- and community-based services, such as the Assisted Living Waiver Program, you must meet the financial requirements described below.

The majority of your income must go toward the cost of long-term care, excluding a $50 personal needs allowance and possible spousal maintenance needs allowance. While assets are usually capped at $2,000-$3,000, there are exemptions for a home, vehicle and personal belongings.

2022 Medicaid Income Limits for Seniors in Ohio

Income Limits*

Asset Limits

Single Applicant

$30,276

$2,000

Two-Person Household
(One Spouse Applying)

$30,276 for applicant

$2,000 for applicant
$137,400 for non-applicant

Two-Person Household
(Both Spouses Applying)

$60,552

$3,000

*Per year 

Eligibility requirements vary depending on the program you’re applying for. To qualify for long-term care, you must be: 

  • Aged 65 or older
  • Blind or disabled
  • A U.S. citizen or legal alien
  • An Ohio resident
  • Classified as low-income

How To Apply for Medicaid in Ohio

You can apply for Medicaid online at Benefits.Ohio.gov or Healthcare.gov. If you want to apply in person, you can complete a paper application or contact your County Department of Job and Family Services. A complete directory of locations in all 88 counties is available online.

Alternatively, you may call your Area Agency on Aging or the office of Long-Term Services and Supports at (844) 644-6582 to begin the application process. Agents at the statewide Medicaid consumer hotline are also available to help. Call (800) 324-8680 to get started.

Information You Will Need 

Medicaid applications ask a variety of questions about your household. Make sure you have the following information available:

  • Social Security numbers
  • Proof of citizenship
  • A photo ID
  • Employment information
  • Tax return information
  • Proof of income
  • Proof of assets
  • Details about any deductions
  • Health insurance policies
  • Monthly expenses
  • Proof of age and disability

How To Get Help Applying for Medicaid

If you need help applying for Medicaid or aren’t sure where to start, the following agencies can provide assistance. They can also answer questions about notices, renewals and appeals.

Resource

Contact

Description

(866) 244-0071

If you want to apply for Medicaid long-term care or other financial benefits, contact your County Department of Job and Family Services. These local offices help with a variety of government benefits, and they offer adult protective services in cases of suspected abuse or neglect.

(800) 324-8680

Choice Counselors with the Department of Medicaid are available Monday through Saturday to answer questions, check your application status or help you change plans. They can also provide information about medical transportation, notices and ways to appeal decisions through a state hearing.

(800) 686-1578

The Department of Insurance manages the Senior Health Insurance Information Program. This free service provides one-on-one counseling to more than 435,000 seniors annually. It educates residents about Medicare, long-term care insurance and financial assistance programs, such as Medicaid.

Does Medicare Cover Assisted Living in Ohio?

The short answer is that no, Medicare does not cover the cost of assisted living in Ohio. Assisted living facilities are considered to be a “residential setting” and not a “clinical setting,” (think nursing homes). While Medicare doesn’t cover the cost of care received in an assisted living community, it does still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.

For more information about when Medicare can be used to pay for senior living in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in Ohio.

Other Financial Assistance Options for Assisted Living in Ohio

Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Assisted Living affordable.

How to Apply

How It Works

Aid and Attendance

Learn more and apply online at va.gov.

Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Assisted Living.

Reverse Mortgages

Learn more about your options and how to apply at ftc.gov

If you own a home, you may be able to use a reverse mortgage to help pay for Assisted Living. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.

Long-Term Care (LTC) Insurance

Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.

Seniors who already have long-term care insurance may be able to use it to pay for Assisted Living. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Assisted Living will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in Ohio

The following agencies provide free assistance to seniors who require long-term care. They offer information, help with financial benefits and referrals to other community-based partners.

Resource

Contact

Description

(800) 266-4346

The Department of Aging works with the state's Area Agencies on Aging and other partners to administer services funded by Medicaid and the Older Americans Act. It provides information about long-term care waivers, healthy aging, fall prevention and community-based supports. Seniors aged 60 and older qualify for the Golden Buckeye Card, which offers discounts at a variety of businesses.

(866) 243-5678

Seniors aged 60 and older, disabled adults and unpaid family caregivers are served by 12 Area Agencies on Aging that cover all 88 counties. They provide information about long-term care and available benefits and arrange personal needs assessments that are required to participate in the state's Assisted Living Waiver Program.

(800) 772-1213

The Social Security Administration operates more than 50 offices in midsize cities and major metropolitan areas throughout the state. Staff members can help with Social Security retirement or disability benefits and SSI payments, which can be used for room and board in assisted living. The SSA also handles Medicare enrollment and Extra Help benefits that can lower your out-of-pocket expenses.

(800) 698-2411

The U.S. Department of Veterans Affairs operates an extensive network of health care facilities, outpatient clinics and benefits offices, including five VA hospitals. Veterans and their spouses can also contact their local Veterans Service Organization or county veterans affairs office for help with benefits, including Aid & Attendance payments, which can be used for personal care and assisted living.

(800) 282-1206

Regional staff and volunteer ombudsmen are available to assist residents who live in nursing homes or assisted living facilities or need help accessing long-term care. They advocate for residents, investigate complaints and provide informational assistance to help with facility selection and government benefits.

(800) 488-6070

Pro Seniors is a statewide nonprofit offering a variety of advocacy services for older adults. Its Legal Helpline assists residents aged 60 and older on issues related to health care, estate planning, government benefits and consumer rights. It offers ombudsman services for long-term care residents, and Senior Medicare Patrol helps beneficiaries detect and report fraud and billing errors.

COVID-19 Rules for Assisted Living in Ohio

The following information is based on research done on several government websites, including The Ohio Department of Health and CDC. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 3/8/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visitation Policies

RULES FOR OHIO COMMUNITIES

Can I visit my relative in person if he/she wants emotional support from me?

Yes (Conditions Apply)

Can I visit my relative in person for end-of-life compassion care?

Yes

Will my loved one be required to self-quarantine after I visit him or her?

No

Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?

Yes

Are Hairdressers and other non-medical contractors still allowed in senior living facilities?

Yes

Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?

Yes

Are visitors being screened for elevated temperatures?

Yes

Are visitors being asked questions about health, travel, and potential virus contact?

Yes

Outings & Social Activities

RULES FOR OHIO COMMUNITIES

Are residents allowed to leave the facility for non-medical reasons?

Yes

Are residents of senior living facilities who leave and return required to self-quarantine?

No (Conditions Apply)

Are senior living facilities required to cancel all group outings?

No

Are residents still eating together in the dining hall?

Yes (Conditions Apply)

Are facilities still allowed to host group activities within the community?

Yes (Conditions Apply)

COVID-19 Safety Measures for Staff and Residents

RULES FOR OHIO COMMUNITIES

Are staff members and contractors being screened for elevated temperatures?

Yes

Are staff members and contractors being tested for Coronavirus?

Yes (Conditions Apply)

Are staff members and contractors being asked questions about health, travel, and potential virus contact?

Yes

Are staff members required to regularly screen residents for coronavirus symptoms?

Yes

Are residents relied on to screen themselves and self-report potential coronavirus symptoms?

No

Are staff members required to take residents’ temperatures?

Yes

Are residents being tested for coronavirus?

Yes (Conditions Apply)

Assisted Living Laws and Regulations in Ohio

Assisted living communities, also called residential care facilities, are licensed by the Bureau of Regulatory Operations, which is part of the Ohio Department of Health. You can learn more about some of these regulations below.

OHIO LAWS AND REGULATIONS

Assisted Living Service Plan Requirements

Qualified health care providers must complete a written health assessment within 48 hours of admission. Provisions for skilled care must be made within 14 days of admission. Additionally, individual service plans must be reviewed within one year and 30 days of the previous assessment or following a significant change in health. Physician authorization may be required to determine whether certain services are necessary.

Assisted Living Admission Requirements

Residential care facilities may not admit individuals who require more than 120 days of intermittent skilled nursing annually. Facilities are prohibited from admitting individuals who are permanently bedridden, have advanced pressure ulcers or have complex medical conditions unless they're receiving hospice care.

Assisted Living Scope of Care

Assisted living facilities may provide personal care and limited skilled nursing consistent with applicable care standards. Residents may or may not receive meals, depending on their needs. Facilities must encourage residents to participate in social, recreational and leisure activities and provide opportunities that are consistent with residents' interests.

Assisted Living Medicaid Policy

Ohio's Medicaid program includes an Assisted Living Waiver that pays for the cost of personal care, meals, housekeeping and related services. This program is available to low-income seniors who have qualifying medical or personal needs. Individuals who receive Supplemental Security Income or Social Security Disability may receive a Residential State Supplement to help with the cost of room and board.

Assisted Living Facility Requirements

Single-occupancy apartments must provide at least 120 square feet of living space, excluding closets, and companion suites must have at least 80 square feet of living space per person. Apartments cannot be shared by more than four residents. There must be at least one bathroom for every eight residents. Bathrooms must be equipped with safety features, and apartments must have emergency call systems. Different rules may apply for facilities licensed before 1964.

Medication Management Regulations

Assisted living residents must be able to take their own medications as determined by a health care professional to qualify for admission. Alternatively, medication assistance may be provided by a licensed health care professional, specially trained medication aide, hospice provider or home health care agency.

Staffing Requirements

Ohio does not have minimum staffing ratios for assisted living facilities. However, they must employ sufficient staff, including on-site or on-call nurses, to meet residents' needs. Medication management services must be overseen by an on-duty nurse or physician. Facility administrators must be on-site at least 20 hours per week and available at all other times if needed.

Staff Training Requirements

Direct-care staff members must receive in-service orientation related to their job responsibilities and the facility's procedures. Staff must be certified in first aid and complete eight hours of continuing education annually. Certified nursing assistants must complete 75 hours of training consistent with federal requirements. Additional training is required for individuals who work in special care settings. Although Ohio does not license RCF administrators, they must complete at least nine hours of continuing education annually.

Background Checks for Assisted Living

Direct-care workers must pass a comprehensive background check using data from the Ohio Bureau of Criminal Identification and Investigation. Federal databases are used to review criminal records for individuals who have lived in the state for less than five years. Offenses related to abuse, fraud, theft or drugs prohibit workers from employment.

Requirements for Reporting Abuse

The complaint unit at the Bureau of Regulatory Operations investigates reports of abuse or neglect occurring in the state's assisted living facilities. Residents may call (800) 342-0553 for assistance. Complaints can also be submitted online or by mail.

Assisted Living Facilities in Ohio (156)