Assisted Living in Ohio

Agency: Ohio Department of Health
Phone: (614) 466-7713
Website: www.odh.ohio.gov

Residential care facilities provide accommodations for 17 or more unrelated individuals; supervision and personal care services for three or more of those individuals who are dependent on the services of others by reason of age or physical or mental impairment; or accommodations for three or more individuals and skilled nursing care services for at least one individual.

Facility Scope of Care:
Facilities may provide supervision and personal care services, administer or assist with self-administration of medication, supervise special diets, perform dressing changes, and accept individuals requiring part-time intermittent enteral feedings. Facilities may also provide up to 120 days of skilled nursing

Move-In/Move-Out Requirements:
Facilities may admit or retain individuals who require skilled nursing care beyond the supervision of special diets, application of dressings, or administration of medication only if the care is on a part-time/intermittent basis for not more than a total of 120 days in any 12-month period, except for hospice residents.

Resident Assessment:
A resident assessment must be completed on or before admission, annually, and upon significant change. There are specific components, but not a mandated form.

Medication Management:
Residents must either be capable of self-administering medications or the facility must provide for medication administration by a home health agency, hospice, or qualified staff person (e.g., a registered nurse (RN), licensed practical nurse, or physician). Trained, unlicensed staff may assist with self-administration only if the resident is mentally alert, able to participate in the medication process, and requests such assistance. Assistance includes reminders, observing, handing medications to the resident, and verifying the resident's name on the label, etc. Ohio also is conducting a pilot program for certified medication aides in residential care facilities and nursing homes that will expand who may administer medications

Physical Plant Requirements:
Private resident units must be a minimum of 100 square feet and multiple-occupancy resident units must provide a minimum of 80 square feet per resident.

Residents Allowed Per Room:
A maximum of four residents is allowed per resident unit.

Life Safety:
Sprinklers and smoke detectors have been required since 1974. The current Life Safety Code does not apply to residential care facilities but they must comply with the Ohio Fire Code and Ohio Building Code, which have been brought up to National Fire Protection Association and International Fire Code standards. Each residential care facility must develop and maintain a written disaster preparedness plan to be followed in case of emergency or disaster. Twelve fire drills are required annually, to be done for each shift and at least every three months. Buildings must be equipped with both an automatic fire extinguishing system and fire alarm system. Each residential care facility must conduct fire safety inspections at least monthly.

Alzheimer's Unit Requirements:
Facilities that have special units must disclose information about unit placement, transfer and discharge policies, special assessments, unit services and resident activities, unit staffing and staff qualifications, special physical design features, family involvement, and costs for services on unit. The attending physician must also document the need for such placement.

Staff Training for Alzheimer's Care:
Licensure rules had required staff training to address the needs of residents with dementias and behaviors. The new amendments to staff training requirements outline specific training on hire and annually related to specialized populations. Activity staff must also receive specialized training related to those with cognitive impairments, behaviors, and/or seriously mentally ill individuals as appropriate.

Staffing Requirements:
A facility must have an administrator who is responsible for its daily operation and provides at least 20 hours of service in the facility during each calendar week between 8 a.m., and 6 p.m. At least one staff member must be on duty at all times and sufficient additional staff members must be present to meet the residents' total care needs. For facilities that provide personal care services, at least one staff member trained and capable of providing such services, including having successfully completed first aid training, must be on duty at all times. Sufficient nursing staff are required to provide needed skilled nursing care. New language requires enough onsite RN time to manage the provision of skilled nursing care if that care is provided by the facility, excluding medication administration, supervision of special diets, or application of dressings. At night, a staff member may be on call if the facility meets certain call signal requirements, but another person must also be on call in such cases. A dietitian working as consultant or employee is necessary for facilities that provide and supervise complex therapeutic diets

Staff Education Training:
Staff members providing personal care services must be at least 16 years of age, have first aid training, and complete a specified training program. All staff must be able to understand and communicate job-related information in English and be appropriately trained to implement residents' rights.

Medicaid Policy and Reimbursements:
An assisted living Medicaid waiver program was implemented in 2006 and can accommodate 1,800 individuals.