PASSPORT vs. Nursing Home in Ohio: What It Actually Costs a Family in 2026

Genworth's 2024 Cost of Care Survey put Ohio's median semi-private nursing facility rate near $7,500-$7,800 per month. Most facilities raise rates 4-6% per year, so 2026 numbers in Lucas County are landing slightly above that range.

Medicaid (long-term care) covers nursing-home costs after the resident has spent down assets to Ohio's limits. Most of the resident's Social Security and pension income then goes to the facility as patient liability, with a small personal-needs allowance retained.

Private pay before Medicaid eligibility is where most families burn through retirement savings. The average 'spend-down' to qualify in Ohio takes 18-30 months at private rates.

A common Lucas County PASSPORT care plan is 4-6 hours of personal care per weekday plus a weekly homemaker visit and 8-16 hours of respite per month. That's roughly 25 hours per week of professional support delivered in the home.

If the family is fully Medicaid eligible, the out-of-pocket cost for that plan is $0 to a small monthly patient liability based on income. The same hours billed at private rates would run roughly $1,600-$2,000 per week.

PASSPORT does not pay for room and board. That stays the family's responsibility (mortgage, utilities, food).

Nursing-home Medicaid takes nearly all the resident's monthly income. PASSPORT leaves the income with the resident. That alone is often the deciding factor for spouses still living at home.

PASSPORT does not cover overnight care. Families either trade off nights themselves, add private-pay hours, or apply for the DODD waiver if the under-60 medical criteria fit a younger spouse.

Home modifications (grab bars, a ramp, a stair lift evaluation) are PASSPORT-covered. Most families do not realize this until month four.

If the person needs hands-on care more than 14 hours a day and there is no family present at home, a nursing facility is usually the safer option. Below that threshold, PASSPORT plus a few private-pay hours is almost always cheaper and almost always preferred by the family.

Run both numbers on paper, with the patient-liability calculation included. Most Area Office on Aging case managers will help. A Reliance coordinator will too.

CMS allows states to spend Medicaid dollars on home-based services through 1915(c) waivers specifically because it is cheaper than institutional care. Ohio's PASSPORT waiver was one of the first in the country and remains a national model.

What this means for your family: the state agency wants you to qualify for the waiver. Case managers are measured in part on whether they can keep people at home. Lean into that.