Ohio's Push for Cameras in Assisted Living: A Step Toward Transparency, But Is It Enough?

In a state where elder abuse affects 1 in 10 adults over 60, and only 1 in 5 cases is reported, according to the Ohio Department of Aging, any tool that empowers families to monitor care is a welcome development. Ohio is now considering legislation to extend "granny cam" rights to assisted living communities, allowing residents and their loved ones to install cameras in private rooms to deter or document abuse. S.B. No. 154, introduced by Sen. Catherine D. Ingram, would build on Ohio's existing "Esther's Law," adopted in 2022 for nursing homes,  mandating that assisted living facilities accommodate such devices without compromising patient privacy. As reported by McKnight's Senior Living, the measure aims to close a gap affecting 60% of Ohio's senior living market, where assisted living residents lack similar protections. For readers of the Aging-in-Place- Planning and Elderlaw Blog, this initiative is a timely step. Yet it raises questions: Does it go far enough to prevent the "invisible crimes" lurking in understaffed facilities, or is it a band-aid on a system that needs an overhaul? 
As we've delved into in our article on "Esther's Law: Ohio's Granny Cam for Nursing Homes" and "The Limits of Nursing Home Cameras: Addressing Unseen Risks in Institutional Care," cameras are a tool, not a panacea, essential for transparency but insufficient without complementary reforms. This piece dives into the bill's details, its potential impact, and why it underscores the case for home-based alternatives.The Bill: A Bid to Extend 'Granny Cam' Rights to Assisted LivingThe proposed legislation would amend Ohio Revised Code § 3721 to require assisted living facilities (also called Residential Care Facilities or RCFs) to permit electronic monitoring devices in resident rooms, provided:

• The resident or their representative pays for installation, maintenance, and removal.
• Cameras are positioned to avoid capturing common areas or other residents without consent.

Facilities can't retaliate against residents (e.g., by issuing eviction threats) and must provide reasonable accommodations to residents.

The proposed extension would cap installation and maintenance costs to ensure affordability. Communities could charge up to $50 for device installation and a $2 monthly fee for internet access. The bill also would provide greater flexibility in camera options and who can access footage.

This push mirrors a national trend: 16 states (e.g., Connecticut, Minnesota, Texas) already mandate assisted living camera accommodations, with Rhode Island's law taking effect January 2026.
If the law is not approved and submitted to the governor by December 2026, it will need to be reintroduced in the following session. 
A Critical Look: Progress or Partial Fix?
On the surface, the bill is a victory for transparency.  Families could install cameras to monitor interactions, potentially deterring overt abuse. It addresses a key flaw in assisted living's lighter regulation compared to nursing homes, a gap that Esther's Law has helped address. Yet, a deeper dive reveals hurdles and limitations:

• Privacy and Practical Hurdles: Organizations like LeadingAge Ohio argue cameras invade privacy or create liability (e.g., capturing other residents), potentially leading to lawsuits or refusals. The bill requires consent but doesn't mandate facility cameras or dignity training.
• Not a Cure-All: As we noted in "The Limits of Nursing Home Cameras: Addressing Unseen Risks in Institutional Care," cameras catch overt abuse but miss subtler neglect, like understaffing or emotional isolation. With understaffing being ubiquitous, cameras alone won't fix systemic rot.
• Enforcement Gaps: No penalties for non-compliance beyond civil suits, and assisted living's voluntary reporting (vs. mandatory for nursing homes) means violations could slip through.

Overall, it's progress.  Extending Esther's Law could boost reporting 10-15% (similar to other states), but without broader reforms like mandatory staffing cameras, which empower but don't prevent the abuse of substandard care, seems like a pyrrhic victory for residents and their families; true reform demands a cultural shift toward quality care outcomes and autonomy.
What It Means for Seniors and Families: A Window to Watch, or a Door to Home?
For Ohio seniors, the bill means potential oversight of care, potentially reducing overt abuse. Families gain leverage in captured cases; cameras could document neglect, aiding lawsuits or APS reports. Yet, it reinforces institutional reliance, where cameras band-aid a system in crisis. The real takeaway? Use this as a prompt to prioritize home: With 80% of seniors preferring aging in place, cameras highlight why.  Home preserves privacy and control, without the "acuity mismatch" and risks of assisted living.  Better a door to your home than a window to a more dangerous and less safe alternativeStrategies: From Watching to Walking Away

• Advocate for Passage: Contact Rep. Brent (614-466-4891) or Sen. Craig (614-466-5087) to push for more vigorous enforcement.

• If Enacted, Use Wisely: Install cameras with consent; review footage routinely with family.

• Legal Shields: Add to advance directives which prioritize home care: "Utilize cameras in facilities, and avoid institutions where they are not permitted or are discouraged. 

• Home as Haven: Stay at home using family caregivers and in-home aides funded by HCBS waivers, Medicare supplemental insurance, or Medicare Advantage Plans. 

• Evaluate and Compare Facilities: See our article "Choosing a Nursing Home or Skilled Nursing Facility: Navigating the Long-Term Care Crisis," for tips, tricks, tools, and strategies.

Conclusion: Cameras as a Step, Home as the Goal

Ohio's bill is a flicker of progress, but cameras alone can't fix a flawed system. While this article has provided a thorough analysis of the initiative and its implications, it is by no means comprehensive. The landscape evolves rapidly. Readers must remain vigilant. By combining awareness with proactive planning, families can safeguard independence and thrive as they age in place. For support, consult a professional. Your security depends on proactive engagement.

 

Ohio's 'What's Done in the Dark' Initiative: A Spotlight on Elder Abuse and Exploitation

In a state where 1 in 10 adults over 60 faces abuse or exploitation, yet only 1 in 5 cases is reported, Ohio Attorney General Dave Yost has launched a statewide campaign to raise awareness and encourage reporting. Announced on October 27, 2025, the initiative features a compelling video titled “What’s Done in the Dark,” aimed at destigmatizing victimization and educating families on signs of financial scams, neglect, and emotional abuse. Unveiled at the Attorney General's Elder Abuse Commission meeting, the video and accompanying resources on Yost's Elder Justice Unit webpages are designed to spark conversations and empower Ohioans to spot and stop the "invisible crime" affecting over 100 daily referrals to Adult Protective Services (APS). 

For readers of the Aging-in-Place Planning and Elderlaw Blog, this effort is timely amid a 27% rise in elder abuse reports since 2020, but it raises a key question: Does it represent genuine reform, or is it more window dressing for a system in need of structural overhaul? As we've explored in "Rethinking Elder Abuse Strategies: How Prophylactic Planning Can Safeguard Autonomy and Aging in Place," tangible protection lies in proactive tools such as advance directives, supported decision-making (SDM) agreements, powers of attorney, and trusts.  While awareness videos can increase reporting after the fact, proper planning and proactive measures can help avoid problems altogether. This article reviews the initiative, analyzes its potential impact, and whether it addresses root causes.

The Initiative: A Video and Resources to Shine Light on the 'Dark'
At its core, Yost's campaign is a public education push, partnering with the Ohio Pharmacists Association to train professionals in spotting abuse. The video  features survivors sharing stories of financial scams and isolation, emphasizing "the shame belongs only to those who harm." Key elements include:

• Warning Signs: Unexplained financial changes, unpaid bills, or sudden account alterations.
• Reporting Tools: Hotline (855-OHIO-APS) and online portals for APS referrals, and filing an Elder Justice Unit Complaint; Elder Justice Unit at 800-282-0515 for legal aid.
• Pharmacist Training: Pharmacies serve as frontline sentinels to flag suspicious prescriptions or behavior.
• Website Resources: ag.state.oh.us/elderjustice for guides, videos, and protections like the Ohio Consumer Sales Practices Act.

Yost stated: "There is an epidemic of underreporting...Our elders need to know there is no shame in being victimized." The campaign launches amid a 38,000-case surge in 2024, targeting Ohio's 2.5 million seniors amid a "graying" population projected to hit 36% of the total population in key counties by 2040.Critical Analysis: Awareness or Actual Reform?It's unquestionably a positive step; videos humanize victims, and pharmacist training could catch more cases of financial exploitation or abuse. Ohio's legal protections, though, already rank high (4th nationally, according to WalletHub 2025), with mandatory APS reporting and Elder Justice Unit prosecutions averaging 200 cases annually. In other words, at least compared to other states, there's not much more the state can offer to meaningfully reduce the risk of abuse.  Increasing reporting is an undeniably laudable goal.  
The video is compelling, recounting raw stories of scams and isolation.  It is not "required viewing," for example, in guardianship training or courts, or even for pharmacists. It's promotional, not mandatory. Ohio's Supreme Court offers elder abuse resources for attorneys; however, there is no statewide mandate that ties this video to probate or guardianship education, or any other event beyond pharmacists, pharmacies, and the public education associated with the campaign.  The video is also likely to miss the most vulnerable, seniors who are homebound or must rely on third parties to run errands. Regardless, however, laudable these efforts are, they focus on reporting abuse after the fact, rather than preventing abuse.   The Funnel of Failure: From Report to Resolution
Even if reporting dramatically increases, the extent of elder abuse and exploitation is unlikely to drop in a meaningful way. Enforcement is even less likely than reporting (possibly explaining some of the underreporting- why report a crime when you know that no one is going to be able to do anything about it?).  The journey from “I was scammed” to “Justice served” is a gauntlet most never finish. Below are the cold, hard numbers that show why the system feels broken, and what families can do tonight to slam the door on predators. 

Step	% That Make It Through	Real-World Meaning
Reported	1 in 5 (20%)	80% of victims never tell anyone—shame, fear, or dementia                    silence them.
Investigated	1 in 25 (4%)	Local Adult Protective Services (APS) is swamped: 1 worker per 1,000 cases in many states.
Prosecuted	1 in 100 (1%)	Only financial crimes over $100k usually cross a DA’s desk.
Convicted	1 in 250 (<0.4%)	Plea deals or jury sympathy for “family” abusers drop most charges.

Sources:

• National Adult Maltreatment Reporting System (NAMRS) 2024: 1.2 million reports translate to 48,000 investigations leading to 12,000 prosecutions.
• U.S. Senate Special Committee on Aging, 2025: “Of 38,000 financial-exploitation reports, 98% closed without arrest.”
• DOJ Elder Justice Initiative, 2025: “Telephone/internet scams comprise 72% of reports, with a 0.3% conviction rate.”

This means that only 1 in 1,250 actual elder-abuse victims (1 out of every 1,250 seniors who are abused) ever sees the abuser convicted. That’s 0.08% of the true total.  Enforcement is made nearly impossible by the nature of modern crime.  Most scams are borderless, cashless, and anonymous.  A Romanian call-center spoofing U.S. numbers can’t be extradited for a $2,000 wire fraud.  Crypto “pig-butchering” scams (DOJ seized $15 billion from just one Cambodian scammer in 2025) vanish into untraceable wallets. Grandparent scams evolve weekly, with AI voice clones now mimicking your “grandson in jail.”  The tragic reality is that even a dramatic increase in reporting is unlikely to result in a meaningful decrease in either identification of or enforcement actions against abuse and exploitation.   

Protecting Yourself or a Loved One

While the odds of catching an abuser are slim, you can drastically increase your odds of safety by taking prophylactic measures tonight.  Prevention is undeniably the best tool.  After reading our article, Rethinking Elder Abuse Strategies, read and implement the strategies outlined in Safeguarding Seniors: Comprehensive Strategies to Prevent Elder Fraud and Financial Abuses; it is full of tips, tricks, tools, and information.  

 

How You Can Help Drive Real Change

If you want to help: 

• Share the Video: Post on social media to destigmatize reporting.
• Advocate Locally: Contact your local Adult Protective Services, senior center, probate judge, church, or charitable organization to volunteer or help spread the word. 

 Your voice amplifies the campaign.
Conclusion: From Awareness to Action

Prevention beats reaction every time.  Build the fence at the top of the cliff, rather than relying on the ambulance at the bottom. While this article has provided a thorough analysis of the campaign and reform gaps, it is by no means comprehensive. The landscape evolves rapidly. Readers must remain vigilant.