Level of care is a classification system in the Ohio Administrative Code (rules) which is used to determine the appropriate types of long-term care Medicaid will provide for consumers, either in an institutional setting or in the home and community through a waiver program. Different home and community-based services (HCBS) waiver programs, which serve as an alternative to institutional care, have different level-of-care requirements for enrollment. Each person applying for services is assigned only one level of care, but that level can change as the person's condition and functional abilities change. People who want to enroll on a home and community-based services Medicaid waiver must meet the specific level-of-care requirements for that waiver. Before qualifying for one of the institutional levels of care listed below, they must qualify for Protective Level of Care as a baseline.

• ICF-MR Level of Care is required for persons to be enrolled in the Transitions Waiver, administered by ODJFS, or in one of the waivers administered by the Ohio Department of Mental Retardation and Developmental Disabilities. These include the Individual Options Waiver, the Residential Facilities Waiver, and the Level I Waiver. All these waivers serve as an alternative to care in an ICF-MR, or intermediate care facility for people with mental retardation or developmental disabilities.
  
  
• Intermediate Level of Care or Skilled Level of Care is required for persons to be enrolled in the Ohio Home Care Waiver. This waiver serves as an alternative to care in a nursing home, hospital, or rehabilitation facility.