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Long-Term Care Services

Long-Term Care: Nursing Home and Institutional Care

  • Sometimes, the best solution for a person with a severe disability or medically unstable condition is care in a Nursing facility.  These types of facilities provide care for people who are unable to care for themselves in their home and who need help with activities of daily living.
  • The Ohio Long-Term Care Consumer Guide is available to help families find an appropriate care settings based upon their specific needs.
  • There are also alternatives to institutional care. Medicaid has several programs for people who have extensive care needs and would prefer to receive services in their home and community. Visit the Ohio Department of Medicaid website for more information.

Basic Eligibility Requirements

  • There are specific regulations regarding the amounts of income & resources you may have to qualify for Medicaid.
  • Depending on your circumstances, the amounts will vary.(i.e. married, single, living in your home or facility)

Long Term Care Medicaid applicants

  • Complete & submit an application. Click here for ways to apply.
  • An appointment letter with be mailed along with a checklist of necessary verifications
  • An interview will be conducted with a Eligibility Specialist who specializes in Long Term Care Medicaid
  • The eligibility specialist will guide you on Medicaid rules and remove potential misconceptions about the process.

Resource Assessments

SCJFS offers free Resource Assessments for all applicants.

 

Long-Term Care:  Home-Based Waiver Services

What is a Medicaid Home and Community-Based Services Waiver?

Medicaid home and community-based services waivers allow people with disabilities and chronic conditions to receive care in their homes and communities instead of in long-term care facilities, hospitals or intermediate care facilities. These programs are called waiver programs because, under current law, eligible people with disabilities and chronic conditions are entitled to facility-based care, but home- and community-based care is considered optional. Therefore, states must apply for "waivers" from the federal government in order for Medicaid to provide home and community-based services. Waivers allow individuals with disabilities and chronic conditions to have more control of their lives and remain active participants in their community.

Medicaid provides funding for and is ultimately responsible for all of Ohio's nine waivers. In state fiscal year 2012, waivers provided alternative access to long-term care to almost 80,000 Ohioans.

Click here for information on the types of waiver available.

Basic Eligibility Requirements

  • There are specific regulations regarding the amounts of income & resources you may have to qualify for Medicaid.
  • Depending on your circumstances, the amounts will vary. (i.e. married, single, living in your home or facility)

Long Term Care Medicaid applicants

  • Complete & submit an application. Click here for ways to apply.
  • An appointment letter with be mailed along with a checklist of necessary verifications
  • An interview will be conducted with a Eligibility Specialist who specializes in Long Term Care Medicaid
  • The eligibility specialist will guide you on Medicaid rules and remove potential misconceptions about the process.

Resource Assessments

SCJFS offers free Resource Assessments for all applicants.

 

What is "Level of Care"?

A level of care is one component of Medicaid eligibility in order to approve enrollment on a Medicaid waiver or authorize Medicaid payment to a nursing facility.

A person who wants to be enrolled on a Medicaid waiver must meet the specific level of care that is required for that waiver. All individuals must meet and exceed the requirements of a Protective level of care, which includes a need for assistance with instrumental activities of daily living (IADLs) and/or supervision of one activity of daily living (ADL) or medication administration.

There are currently two levels of care associated with Medicaid waivers:

  1. Intermediate Care Facility for persons with Mental Retardation (ICF-MR) level of care. This level of care includes a presence of a substantial developmental delay or a severe, chronic disability. A Medicaid waiver that requires an ICF-MR level of care provides services as an alternative to instituitional care.
  2. Nursing Facility-Based (NF-Based) level of care. A Medicaid waiver that requires a NF-Based level of care provides services as an alternative to nursing facilities, hospitals, or rehabilitation facilities.  This level of care includes the Intermediate and Skilled levels of care:
    • Intermediate level of care includes a need for assistance with ADLs, medication administration and/or a need for at least one skilled nursing or skilled rehabilitation service.
    • Skilled level of care indicates a higher level of need than the Intermediate and ICF-MR levels of care and include presence of an unstable medical condition and a need for a specific amount of skilled nursing or skilled rehabilitation services.
Waiver rules in the Ohio Administrative Code can be found online at http://codes.ohio.gov/oac/5101:3-1-06
 


Stark County Commissioners Executive Director
Stark County Job & Family Services
221 3rd St SE
Canton, OH, US 44702
Nic
888-698-6893
330-452-4661
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