Assisted Living Service Plan Requirements

A health assessment is required for all new residents before or immediately after the move-in date. These are used to create a plan for services provided by the community. Health assessments should also be performed annually and upon any resident who has recently experienced a significant change in condition. Each assessment should include a medical history, physical and mental functionality tests and lists of all medications and diagnoses. A licensed staff member checks the resident for the ability to self-administer medication and makes the determination if reminders are sufficient or if full medication setup is required.

The resident or their responsible party may become part of a risk assessment agreement with the assisted living community. A resident has the right to decline a recommended service as long as they fully understand the health risks involved and agree to shoulder the responsibility of these risks.

Assisted Living Admission Requirements

Lengthy periods of skilled nursing care may cause a person to become ineligible to live at an assisted living residence. The maximum allowable amount of skilled care is 120 days in a 12-month period. Individuals who are bedridden, have very complex medical conditions or have severe skin ulcers may not be admitted to an assisted living residence. Exceptions are sometimes made for hospice care.

Assisted Living Scope of Care

Assisted living communities in Ohio provide personal assistance, accommodations, and supervision to seniors and disabled individuals. Most communities provide one to three meals a day, however, it is not a requirement. If meals are not provided, each room must have the necessary conveniences to prepare meals. Limited part-time nursing skills are available to residents and occasional short-term periods of skilled nursing care.

Assisted Living Medicaid Policy

Assisted Living Waivers and the Ohio's Residential State Supplemental program may help supplement the costs associated with assisted living services. Applicants must demonstrate need for care and proof of low income.

Assisted Living Facility Requirements

Medicaid waivers require the use of apartment-style units and residents have a choice of whether to share their room. State licensing rules do not insist upon apartment-style for all other residents but do require a maximum of four persons to be allowed in one unit. Occupants may share a bathroom but there must be one toilet, tub/shower or sink for every 8 people.

Meals are considered optional by the licensing board and each community may vary between providing no-meal service to three meals a day.

Medication Management Regulations

If the patient has been approved during their health assessment to self-administer their own medication, trained non-licensed staff may assist with this procedure. This could include reminders, opening containers, helping the resident organize their pills, verifying and reading labels and handing the medication to the resident.

All other residents will receive their medication from licensed personnel such as an RN, LPN, physician or certified medication aide. Licensed home health and hospice agencies may also administer medications.

Staffing Requirements

The staff at an Ohio assisted living community is comprised of an administrator and assorted direct care staff. The administrator runs the day-to-day operations and should be available at all times when not on-site. This person must work a minimum of 20 hours per week during the times of 8:00 a.m. and 6:00 p.m.

Direct care staff assist residents in their daily living activities. Communities will vary in the type of licensed staff they employ depending on the services offered. If medication administration is provided, a physician, RN or LPN under the direction of an RN must be in-house at all times.

In addition, communities may contract with a physician, psychologist and/or nurse if they have residents that need advanced care.

There are no minimum staff ratios, but the law states that each location must have sufficient direct care staff to meet each resident’s needs.

Staff Training Requirements

Ohio ensures that the residents in assisted living communities receive the best possible care by establishing a variety of training stipulations for all staff.

• Orientation - occurs immediately upon hire and includes job responsibilities, resident’s rights, emergency preparedness and building procedures
• Continuing education - must be completed annually and is comprised of 8 hours of training in personal care, communication and observation
• First aid - must be completed within 60 days of hire

Additionally the administrator must complete 9 hours annually of classes on aspects of senior care and health administration

Any assisted living residence that includes memory impaired individuals requires their staff to complete 2 hours of specialty training in dealing with cognitive issues along with a 4-hour annual continuing education class.

Background Check for all ALR Staff in Ohio

All staff who have any direct contact with residents are required to apply for a background check and provide fingerprints to the Bureau of Criminal Identification and Investigation. Any staff member that has resided in the state of Ohio for less than 5 years must also apply for a background check with the Federal Bureau of Investigation.

Requirements for Reporting Abuse

In Ohio, the Adult Protective Services care about elder abuse. If at any time, you suspect abuse or neglect call 1-855-OHIO-APS (1-855-644-6277) toll-free 24/7. It is best to provide as much information as possible including name, address, age and suspected abuse.

In addition, you may file a complaint against a health-care community with the Ohio Department of Health at 1-800-342-0553.