Providers

Becoming an Assisted Living Provider

The Medicaid Assisted Living Waiver program is seeking providers that meet the required guidelines. Applicant organizations must already be licensed by the Ohio Department of Health as a Residential Care Facility prior to the time of application. A prospective provider must also meet the Conditions of Participation and Service Specifications established by the Ohio Department of Aging in order to apply for certification. The documents necessary to assist a provider through the application process are listed and available for download below. Be sure to review ALL documents carefully. Additional assistance or questions may be directed to the Contracting and Evaluation Manager at 330-746-2938.

Applications to become a provider in the Assisted Living Program are accepted at any time.

Prospective providers must review the rules and regulations to first verify their compliance or modify their processes to come into compliance before applying to be a provider.

Once a prospective provider is in compliance, they may submit an application to the Area Agency on Aging for review. The application is forwarded to the Ohio Department of Health, which will schedule a site visit to verify compliance. A site visit will also be conducted by Area Agency on Aging staff.

Upon completion of the site visits, the application is forwarded to the Ohio Departments of Aging and Job and Family Services for acceptance or denial.

Provider Reimbursement

Approved Residential Care Facilities must accept the approved Room and Board rate, established by the state, from the individual seeking placement.

Assisted living services are reimbursed to the provider in three tiers, depending on the need of the enrolled individual, and the ability of the provider to meet the unscheduled needs.

Assisted Living Provider Application Materials

1. Ohio Department of Aging Application for Certification as a Long Term Care Agency, Non-Agency and Assisted Living Service Provider
2. Ohio Health Plans Provider Enrollment Application- JFS Form Number 06750 -this form is available in paper format by calling the Area Agency on Aging 11 at 330-746-2938 or by visiting the Ohio Department of Job and Family Services web site to download the .pdf file
3. Ohio Health Plans Provider Enrollment Application Instructions
4. Form W-9
5. Declaration Regarding Material Assistance/ Non-Assistance to a Terrorist Organization NOTE: This form is REQUIRED for any organization receiving state funding

Conditions of Participation and Service Specifications:

1. Conditions of participation
2. Provider Certification
3. Sanctions for Non-compliance
4. Assisted Living Services
5. Community Transition Services

Additional Resources

1. Frequently Asked Questions
2. Ohio Long Term Care Consumer Guide

Additional questions should be directed to the Contracting and Evaluation Manager at 330-746-2938.