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Rule 5160-44-26 | Nursing facility-based level of care home and community-based services programs: community transition services

OhioregulationOhio Department of Medicaid (ODM)· effective 2024-01-01

What this rule requires your agency to do

  • 1For each service provided, the provider shall maintain a record including the individual's name, date of service, a detailed description of each expense, a receipt for each expense, verification the individual was involved in item selection, and the individual's signature verifying receipt.(Rule 5160-44-26 | Nursing facility-based level of care home and community-based services programs: community transition services)
  • 2The provider shall involve the individual and/or caregiver(s) in the selection of items purchased on the individual's behalf.(Rule 5160-44-26 | Nursing facility-based level of care home and community-based services programs: community transition services)
  • 3The service is authorized only if no other person (including a landlord) has a legal or contractual responsibility to fund the expense and family, neighbors, friends, or community resources are unavailable.(Rule 5160-44-26 | Nursing facility-based level of care home and community-based services programs: community transition services)
  • 4Providers shall be an ODM-approved/ODA-certified waiver agency or non-agency provider, an ODM-contracted transition coordination service provider, or an ODA-certified assisted living provider, and shall comply with rule 5160-44-31 (or Chapter 173-39 for PASSPORT/assisted living).(Rule 5160-44-26 | Nursing facility-based level of care home and community-based services programs: community transition services)
  • 5Community transition may be used only one time per individual per waiver enrollment and shall not exceed two thousand dollars per individual per waiver program enrollment.(Rule 5160-44-26 | Nursing facility-based level of care home and community-based services programs: community transition services)
  • 6Community transition is payable only when determined reasonable and necessary through the person-centered planning process and clearly identified in and authorized in the individual's person-centered services plan by ODM, ODA, or their designee.(Rule 5160-44-26 | Nursing facility-based level of care home and community-based services programs: community transition services)

Applies to: personal care

Defines the community transition service that pays non-recurring start-up living expenses for individuals moving from an institution to an HCBS setting, its limitations, provider requirements, and the per-service documentation the provider must keep.

Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.