OUT-OF-HOME RESPITE SERVICES PROVIDER IN OHIO

Fatumata Kaba
Sep 17
4 min read

PROVIDING TEMPORARY, QUALITY CARE IN SAFE SETTINGS WHILE SUPPORTING FAMILY CAREGIVERS

Out-of-Home Respite Services in Ohio offer temporary care for individuals with disabilities, chronic conditions, or age-related needs outside of their primary residence. These services are designed to give family caregivers a break while ensuring that their loved one receives high-quality support in a licensed, structured environment. Out-of-Home Respite Services are authorized under Ohio’s Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: Ohio Department of Medicaid (ODM)

Role: Administers Medicaid waiver funding for Out-of-Home Respite Services and oversees provider enrollment, service authorization, and billing.

Agency: Ohio Department of Developmental Disabilities (DODD)

Role: Oversees services for individuals with developmental disabilities, including out-of-home care in certified settings.

Agency: Ohio Department of Aging (ODA)

Role: Oversees waiver programs for older adults and caregivers, including those accessing respite services.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight to ensure that Medicaid-funded respite services comply with HCBS quality and person-centered care standards.

2. OUT-OF-HOME RESPITE SERVICES OVERVIEW

Out-of-Home Respite Services temporarily support individuals in licensed facilities such as group homes, respite centers, or certified provider homes.

Approved providers may deliver:

24-Hour Supervision: Safe and structured care for individuals during the caregiver’s absence.
Personal Care Services: Assistance with bathing, dressing, hygiene, and eating.
Recreational Activities: Engaging participants in social and leisure activities.
Health Monitoring: Administering medications and observing for medical concerns.
Transportation Support: Coordinating rides to and from the respite setting.
Behavioral Support (if applicable): Providing care for individuals with behavioral health needs.
Meal Services: Providing nutritious meals and snacks throughout the stay.
Emergency Preparedness: Immediate care in case of unexpected caregiver crises.
Family Communication: Updates and coordination with caregivers during respite stays.
Documentation: Logging all care activities, services rendered, and participant observations.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register the business entity with the Ohio Secretary of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver provider through the Medicaid Provider Network (MPN) or Ohio's Provider Enrollment System.
Obtain necessary certifications through DODD or ODA, depending on the population served.
Maintain general liability and professional liability insurance.
Ensure facility meets building, fire safety, and accessibility codes.
Develop policies for supervision, safety, medication administration, and emergency response.
Ensure staff meet background checks, CPR/First Aid certification, and respite care training requirements.

4. OHIO PROVIDER ENROLLMENT PROCESS

Initial Application:

Apply through the Ohio Medicaid Provider Network or Ohio Benefits system for enrollment as an Out-of-Home Respite Services provider.

Certification (if serving individuals with DD):

Apply through DODD for agency or independent provider certification and meet compliance requirements.

Submission of Documentation:

Submit incorporation documents, insurance proof, site inspection reports (if applicable), policy manuals, and staff training certifications.

Readiness Review:

ODM or DODD reviews facilities, staff qualifications, and operational policies to determine eligibility.

Final Approval:

Upon approval, the provider is issued a Medicaid billing number and authorized to deliver and bill for services.

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business Registration (Ohio Secretary of State)
IRS EIN confirmation
NPI confirmation
Proof of liability insurance
DODD or ODA certification (if required)
Respite Services Policy & Procedure Manual including:
- Supervision, safety, and emergency protocols
- Medication management and health monitoring procedures
- Staff training, background checks, and CPR/First Aid documentation
- Documentation standards for participant care and Medicaid billing
- Facility safety, sanitation, and accommodation plans
- HIPAA compliance and participant rights protections
- Grievance procedures and quality assurance monitoring