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Provider Information
Assisted Living
Statute - Ohioans on Medicaid now
have one more option for long-term care. Track the
development of this new Waiver program and learn how
to become a provider.
Interested in becoming an Assisted Living
provider?
The
initial enrollment process is somewhat lengthy and
will take several months to complete. All potential
providers must meet the Conditions of Participation
and Service Specifications for the Assisted Living
Service.
Ohio Administrative Code Rules
Conditions of
Participation
Assisted Living
Service Specifications
Community
Transition Services
ASSISTED LIVING ENROLLMENT PACKET
The
Quality Assurance Department is available 8:00
a.m. through 4:30 p.m., Monday through Friday.
If you need technical assistance, feel free
to call us at 1-800-582-7277.
Interested providers must complete all enrollment
forms and include all required attachments. Forms
must be submitted with attachments and include
original signatures. Faxed or photocopied signatures
will not be accepted and will be returned as
incomplete.
Mail Completed Forms to:
Area Agency on Aging, District 7,
Inc.
Quality Assurance Department
F32-URG, P.O. Box 500
Rio Grande, Ohio 45674-0500
ATTENTION:
In accordance with Conditions of Participation, you
must be “a formally organized business or service
agency registered with the Ohio secretary of state
that has been operating, providing, and being paid
for the same services for which certification is
being applied, for at least two adults in the
community for a minimum of three months at the point
of application.”
Download
the free .pdf viewer by clicking here.
(Must complete ALL links
for complete packet)
Frequently Asked Questions
AL Application for Organizations
Homeland
Security
Ohio Health Plans Instructions
Ohio Health
Plans ODA 1105
Residential Care
Facility Entry
IRS W-9
ADDITIONAL LINKS (for your convenience only,
not part of packet)
Bureau of
Criminal Investigation & Identification
State of Ohio
Registration
Online Defensive Driving
HIPAA Compliance Information
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