What Is a "Tri-Party Agreement" in an Ohio Assisted Living Community?

As we explain in how Ohio licenses assisted living, a residential care facility isn't purely non-medical — Ohio allows a licensed RCF to provide time-limited skilled nursing care, generally capped at 120 days in a year, as a specific carve-out from what would otherwise require a nursing home license. The question families run into is what happens when a resident's short-term skilled need — post-hospital wound care, for example — looks like it might run past that 120-day mark. Ohio's answer is a tri-party agreement: a written arrangement signed by the resident, the resident's physician, and the facility, confirming that continuing skilled nursing care in the assisted living setting, rather than transferring to a nursing home, remains clinically appropriate. If your family is navigating a temporary skilled-nursing need inside a Columbus-area community, it's worth asking directly whether the situation falls within the standard 120-day carve-out or would require this kind of agreement, and how the community has handled it for other residents.