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Rule 5160-44-01 | Nursing facility-based level of care home and community-based services programs: home and community-based settings

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

What this rule requires your agency to do

  • 1The individual must have freedom to furnish and decorate their unit, control their own schedule and activities, have access to food at any time, and have visitors of their choosing at any time, in a physically accessible setting.(Rule 5160-44-01 | Nursing facility-based level of care home and community-based services programs: home and community-based settings)
  • 2In a provider-owned or controlled residential setting, the individual's unit must be occupied under a legally enforceable agreement providing eviction protections comparable to R.C. Chapters 5321 and 1923.(Rule 5160-44-01 | Nursing facility-based level of care home and community-based services programs: home and community-based settings)
  • 3Any modification of the provider-owned/controlled setting conditions must be supported by a specific assessed need and justified in the person-centered services plan under rule 5160-44-02.(Rule 5160-44-01 | Nursing facility-based level of care home and community-based services programs: home and community-based settings)
  • 4The individual must have privacy in their sleeping/living unit, including entrance doors lockable by the individual with only appropriate staff having keys, and choice of roommates when sharing a unit.(Rule 5160-44-01 | Nursing facility-based level of care home and community-based services programs: home and community-based settings)
  • 5Individuals receiving HCBS must reside in and/or receive services in a private residence or another setting that meets the home and community-based setting requirements of this rule, and settings may not be a nursing facility, IMD, ICF/IID, hospital, or PRTF.(Rule 5160-44-01 | Nursing facility-based level of care home and community-based services programs: home and community-based settings)
  • 6HCBS settings shall be integrated in and support full community access, be selected by the individual from among options documented in the person-centered services plan, ensure privacy/dignity/respect and freedom from coercion and restraint, optimize individual autonomy, and facilitate choice of services and providers.(Rule 5160-44-01 | Nursing facility-based level of care home and community-based services programs: home and community-based settings)

Applies to: personal care

Defines the federal home and community-based settings requirements (CMS settings rule) that a residence or setting must meet for individuals to receive HCBS under Ohio's NF-based level of care waiver programs, including provider-owned/controlled residential setting conditions.

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