The Assisted Living Waiver: Medicaid help in an Ohio RCF

What is Ohio's Assisted Living Waiver?

It is an Ohio Medicaid home and community-based services waiver, run by the Ohio Department of Aging, that pays for personal care and supportive services delivered by a licensed residential care facility to Medicaid-eligible adults who need a nursing home level of care.

The waiver does not pay room and board. The resident pays that part to the facility from their own income, at a rate the waiver caps. Only RCFs that hold a waiver provider agreement can take waiver residents, so the first question for any Dayton building is whether it participates and how many waiver residents it serves.

How much does a waiver resident pay for room and board?

The resident pays room and board directly to the RCF at a rate capped at the SSI federal benefit rate minus a $50 personal needs allowance, which works out to $944 a month in 2026, keeping $50 for personal spending.

That cap is what makes the waiver valuable: a resident with modest Social Security can live in a participating RCF while Medicaid pays for the care. The personal needs allowance on the Assisted Living Waiver stayed at $50 a month after Ohio raised the nursing home allowance to $75 in October 2025. Family members may pay for extras, but the facility cannot charge more than the cap for the room and board itself.

Who qualifies for the Assisted Living Waiver?

Adults 21 and older who meet Ohio's nursing facility level of care, have a hands-on need for help with activities of daily living, and qualify for Medicaid under the aged, blind and disabled rules: income up to $2,982 a month in 2026 (more with a Qualified Income Trust) and countable assets of $2,000 or less.

Sources: Ohio Medicaid MEPL No. 191 (January 1, 2026 figures), MEPL No. 195, OAC 5160:1-6-04, 5160:1-6-06 and 5160:1-6-07.

The level-of-care assessment is done by the Area Agency on Aging's staff. The financial application goes through the county Job and Family Services office or benefits.ohio.gov. A married applicant's spouse keeps protected assets and income under Ohio's spousal rules.

How do Dayton families apply for the waiver?

Call the Area Agency on Aging, PSA 2 at 1-800-258-7277; it assesses applicants in all six counties we cover, explains enrollment and any waiting period, and helps match the resident with a participating RCF.

Start before savings run out. A resident who enters an RCF as private pay and later qualifies can switch to the waiver only if the building participates, so ask at move-in whether it will accept a current resident who converts. Waiver capacity and which local RCFs hold provider agreements change over time and are not published in one place; the Area Agency on Aging has the current picture.

Does the waiver cover memory care?

Yes, in RCFs certified for memory care under the waiver's standards (OAC 173-39-02.16), which carry their own staffing, training and building requirements and a higher service rate; an uncertified unit cannot bill the waiver's memory care rate.

Ask any memory care unit you consider whether it holds that certification. For a family paying privately now but likely to need Medicaid within a few years, a certified unit avoids a second move later. Across the six counties, 12 of the 73 licensed RCFs list Alzheimer's disease among their ODH-registered services (roster retrieved November 6, 2026); others run secured units without registering the service.