Overview Ohio certifies providers for adult day service (ADS) under

OHIO

Overview

Ohio certifies providers for adult day service (ADS) under Medicaid through the Pre-Admission

Screening System Providing Options and Resources Today (PASSPORT) Waiver, administered by the

Department of Aging. The certification requirements for PASSPORT are described in this profile. Ohio

also provides and regulates providers for Center-based Day Health (CBDH) services under the Ohio

Home Care Waiver under the Department of Job and Family Services. Regulations related to the Ohio

Home Care Waiver are listed as Relevant Medicaid Contracting Requirements later in this profile. Ohio

does not otherwise regulate ADS providers.

Licensure and Certification Requirements

Licensure

Only

Certification

Only

Both

Required

Other

Definitions

Adult day service is a nonresidential community-based service designed to meet the needs of

functionally and/or cognitively impaired adults through an individualized care plan that encourages

optimal capacity for self-care and/or maximizes functional abilities. It consists of structured,

comprehensive, and continually supervised components that are provided in a protective setting.

Enrollees who receive ADS attend on a planned basis during specified hours. There are two levels of

ADS: enhanced and intensive.

Enhanced adult day service includes supervision of all activities of daily living (ADL) and supervision

of medication administration and/or hands-on assistance with one ADL (except bathing) and medication

administration, comprehensive therapeutic activities, and health assessment and intermittent monitoring

of health status.

Intensive adult day service includes all services mentioned in enhanced services above plus

assistance with two or more ADLs; assistance with bathing; health assessment and regular monitoring

of, or intervention with, health status; skilled nursing services (e.g., dressing changes and other

treatments) and rehabilitative nursing procedures; rehabilitative and restorative services, including

physical therapy, speech therapy, and occupational therapy; and social work services.

ADS programs shall be certified by the Ohio Department of Aging as enhanced or intensive providers.

Parameters for Who Can Be Served

The definitions of enhanced and intensive adult day services listed above indicate the parameters for

who can be served in ADS programs. Participants must meet the state’s waiver criteria. No specific

criteria for discharge were identified.

Inspection and Monitoring

Yes No

The PASSPORT Administrative Agency conducts an on-site visit within 45 calendar days after the

receipt of a complete certification application to measure compliance with the PASSPORT conditions of

participation.

An on-site provider structural compliance review shall occur at least annually.

Providers are required to allow representatives of the Centers for Medicaid & Medicare Services (CMS),

the Ohio Department of Human Services, the Ohio Department of Aging, and the PASSPORT

Administrative Agency general access to the provider facility.

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Required and Optional Services

Adult Day Service

Enhanced

Adult Day Service

Intensive

Required Optional Required Optional

ADL Assistance

X X

Health Education and Counseling

Health Monitoring/Health-Related

Services

X X

Medication Administration

X X

Nursing Services

X X

Physical Therapy, Occupational Therapy,

or Speech Therapy

Skilled Nursing Services

Social Services

Transportation

X X

*Note that enhanced services include intermittent monitoring of health status, whereas intensive

services include regular monitoring of, or intervention with, health status and skilled nursing services

and rehabilitative nursing procedures. Both medication administration and supervision of medication

administration are specified services.

Provisions Regarding Medications

No provisions were identified.

Provisions for Groups with Special Needs

Dementia Mental Retardation/

Developmental Disabilities

Other

Staffing Requirements

Type of staff. A registered nurse (RN) or licensed practical nurse (LPN) under the supervision of an RN

shall be on site at the ADS center for those nursing services which require the skills of an RN or an LPN

under the supervision of an RN.

An activity director shall supervise enrollee activities.

Staffing ratios. At least two staff shall be present in the ADS center when more than one enrollee is in

attendance. At least one of the two staff must be a paid direct service staff. The staff-to-enrollee ratio

shall be at least one staff to six enrollees.

Training Requirements

ADS staff must participate in at least 8 hours of in-service or continuing education each calendar year.

Task-based instruction must be provided for center personal care assistant staff that deliver personal

care services to enrollees prior to providing personal care service to enrollee(s).

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Relevant Medicaid Contracting Requirements for Adult Day Services Providers

Ohio provides ADS under Medicaid through the PASSPORT Waiver under the regulations outlined in

this profile, administered by the Ohio Department of Aging.

Ohio also provides CBDH services under the Ohio Home Care Waiver administered by the Ohio

Department of Job and Family Services (formerly the Ohio Department of Human Services), which also

certifies providers under regulations identified as follows:

Definition. Adult day care provides comprehensive services in a congregate ambulatory care setting to

persons who are nonresidents and who are not capable of living independently due to functional

impairments. An organized and continually supervised program of therapeutic, rehabilitative, and

supportive activities and health and social services is provided.

Inspection and monitoring. The Department shall operate an oversight program of providers of the

Ohio home care program. The review process may include on-site visits to the provider’s location. The

Department reserves the right to conduct unannounced structural reviews at any time, and providers

will cooperate by making available appropriate meeting space.

Relevant CBDH services include but are not limited to ADL assistance; therapeutic, recreational, and

educational activities; social work counseling; and transportation.

Type of staff. A licensed social worker or licensed independent social worker. Service staff members

include nurses, physical therapists, licensed physical therapy assistants, speech therapists,

occupational therapists, certified occupational therapy assistants, social service providers, client activity

providers, and personal care providers.

Location of Licensing, Certification or Other Requirements

1. http://goldenbuckeye.com/pp_oac/5101-3-31-08.pdf

2. http://goldenbuckeye.com/pp_oac/5101-3-31-09.pdf

3. http://goldenbuckeye.com/pp_oac/5101-3-31-10.pdf

4. http://goldenbuckeye.com/pp_oac/5101-3-31-13.pdf

5. http://onlinedocs.andersonpublishing.com/oh/lpExt.dll?f=templates&fn=main-h.htm&cp=OAC

(These sections of the code cannot be accessed directly but are available through this online

search engine.)

6. On file at RTI, provided by Sarah Adult Day Services, Inc., Canton, Ohio. Not available online.

Citations

1. Provider conditions of participation for the passport HCBS waiver program. Ohio Administrative

Code 5101:3-31-08. [Review Date 9/1/03]

2. Passport HCBS waiver program services specifications. Ohio Administrative Code 5101: 3-31-09.

[Review date [undated]

3. Passport HCBS waiver provider initial and ongoing certification. Ohio Administrative Code 5101:3-

31-10. [Review date 9/1/03]

4. Passport HCBS waiver provider structural compliance review. Ohio Administrative Code 5101:3-31-

13. [Review date 9/1/03]

5. Ohio Home Care Program. Ohio Administrative Code 5101:3-12-07. [Review date 7/1/03]

6. Ohio Home Care Program. Ohio Administrative Code 5101:3-12-08. [Review date 7/1/03]

7. Ohio Home and Community-Based Waiver IV. Ohio Department of Human Services, Bureau of

Community Services. [Submitted 2/28/90]

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REGULATORY REVIEW OF ADULT DAY SERVICES:

Final Report

PDF Files Available for This Report

Cover, Table of Contents, Acknowledgments and Introduction

http://aspe.hhs.gov/daltcp/reports/adultday.pdf

SECTION 1. Overview of Adult Day Services Regulations

http://aspe.hhs.gov/daltcp/reports/adultday1.pdf

SECTION 2. State Regulatory Profiles

http://aspe.hhs.gov/daltcp/reports/adultday2.pdf

Each state can also be viewed separately at:

Alabama

http://aspe.hhs.gov/daltcp/reports/adultdayAL.pdf

Alaska

http://aspe.hhs.gov/daltcp/reports/adultdayAKpdf

Arizona

http://aspe.hhs.gov/daltcp/reports/adultdayAZpdf

Arkansas

http://aspe.hhs.gov/daltcp/reports/adultdayAR.pdf

California

http://aspe.hhs.gov/daltcp/reports/adultdayCA.pdf

Colorado

http://aspe.hhs.gov/daltcp/reports/adultdayCO.pdf

Connecticut

http://aspe.hhs.gov/daltcp/reports/adultdayCT.pdf

Delaware

http://aspe.hhs.gov/daltcp/reports/adultdayDE.pdf

District of Columbia

http://aspe.hhs.gov/daltcp/reports/adultdayDC.pdf

Florida

http://aspe.hhs.gov/daltcp/reports/adultdayFL.pdf

Georgia

http://aspe.hhs.gov/daltcp/reports/adultdayGA.pdf

Hawaii

http://aspe.hhs.gov/daltcp/reports/adultdayHI.pdf

Idaho

http://aspe.hhs.gov/daltcp/reports/adultdayID.pdf

Illinois

http://aspe.hhs.gov/daltcp/reports/adultdayIL.pdf

Indiana

http://aspe.hhs.gov/daltcp/reports/adultdayIN.pdf

Iowa

http://aspe.hhs.gov/daltcp/reports/adultdayIA.pdf

Kansas

http://aspe.hhs.gov/daltcp/reports/adultdayKS.pdf

Kentucky

http://aspe.hhs.gov/daltcp/reports/adultdayKY.pdf

Louisiana

http://aspe.hhs.gov/daltcp/reports/adultdayLA.pdf

Maine

http://aspe.hhs.gov/daltcp/reports/adultdayME.pdf

Maryland

http://aspe.hhs.gov/daltcp/reports/adultdayMD.pdf

Massachusetts http://aspe.hhs.gov/daltcp/reports/adultdayMA.pdf

Michigan

http://aspe.hhs.gov/daltcp/reports/adultdayMI.pdf

Minnesota

http://aspe.hhs.gov/daltcp/reports/adultdayMN.pdf

Mississippi

http://aspe.hhs.gov/daltcp/reports/adultdayMS.pdf

Missouri

http://aspe.hhs.gov/daltcp/reports/adultdayMO.pdf

Montana

http://aspe.hhs.gov/daltcp/reports/adultdayMT.pdf

Nebraska

http://aspe.hhs.gov/daltcp/reports/adultdayNE.pdf

New Hampshire

http://aspe.hhs.gov/daltcp/reports/adultdayNH.pdf

New Jersey

http://aspe.hhs.gov/daltcp/reports/adultdayNJ.pdf

New Mexico

http://aspe.hhs.gov/daltcp/reports/adultdayNM.pdf

New York

http://aspe.hhs.gov/daltcp/reports/adultdayNY.pdf

Nevada

http://aspe.hhs.gov/daltcp/reports/adultdayNV.pdf

North Carolina

http://aspe.hhs.gov/daltcp/reports/adultdayNC.pdf

North Dakota

http://aspe.hhs.gov/daltcp/reports/adultdayND.pdf

Ohio

http://aspe.hhs.gov/daltcp/reports/adultdayOH.pdf

Oklahoma

http://aspe.hhs.gov/daltcp/reports/adultdayOK.pdf

Oregon

http://aspe.hhs.gov/daltcp/reports/adultdayOR.pdf

Pennsylvania

http://aspe.hhs.gov/daltcp/reports/adultdayPA.pdf

Rhode Island

http://aspe.hhs.gov/daltcp/reports/adultdayRI.pdf

South Carolina

http://aspe.hhs.gov/daltcp/reports/adultdaySC.pdf

South Dakota

http://aspe.hhs.gov/daltcp/reports/adultdaySD.pdf

Tennessee

http://aspe.hhs.gov/daltcp/reports/adultdayTN.pdf

Texas

http://aspe.hhs.gov/daltcp/reports/adultdayTX.pdf

Utah

http://aspe.hhs.gov/daltcp/reports/adultdayUT.pdf

Vermont

http://aspe.hhs.gov/daltcp/reports/adultdayVT.pdf

Virginia

http://aspe.hhs.gov/daltcp/reports/adultdayVA.pdf

Washington

http://aspe.hhs.gov/daltcp/reports/adultdayWA.pdf

West Virginia

http://aspe.hhs.gov/daltcp/reports/adultdayWV.pdf

Wisconsin

http://aspe.hhs.gov/daltcp/reports/adultdayWI.pdf

Wyoming

http://aspe.hhs.gov/daltcp/reports/adultdayWY.pdf