Everything You Need to Know About Residential Care Homes

Merritt Whitley
By Merritt WhitleyJune 8, 2020
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Residential care homes are often tucked into neighborhoods and provide increased supervision, as well as assistance with activities of daily living (ADLs), for elderly adults.

Just like every house on the block is different, no two residential care facilities are styled or managed the same way. Learn more about what’s included in residential care homes, including the services, staffing, costs, and more.

What else are residential care homes called?

There are many other terms used to talk about residential care homes. Depending on where you live, they might be called:

  • Elder care home
  • Purpose built home
  • Adult family home
  • Foster care home
  • Private care home
  • Personal care home
  • Private assisted living
  • Board and care home
  • Home for the aged

What services are included in board and care homes?

Residential homes are intended for those who may require increased care but don’t have intensive medical needs, such as requiring daily injections or a feeding tube.

“Adult family homes are a higher level of care than assisted living,” says Cindy Nelson, a Senior Living Advisor at A Place for Mom. “It’s usually the next step when someone requires more supervision and attention.”

General residential home care services include:

  • A private or shared room
  • Home-cooked meals
  • Assistance with toileting, bathing, and dressing
  • Custodial care including laundry and housekeeping
  • Transportation
  • Administering medicine
  • Planning activities

How much do care homes cost?

The price tag for living in a residential care community is often half the cost of a nursing home. In some states, it’s even more affordable than an assisted living community. Although prices vary considerably, residential home cares usually cost around $3,500 to $4,500 per month. Care homes that specialize in dementia care typically range from $5,000 to $6,000 per month.

How can I pay for residential care homes for the elderly?

Personal care homes are typically private pay. However, some long-term care insurance policies pay for residential care home costs. Veterans may also receive some financial assistance through the U.S. Department of Veterans Affairs Community Residential Care (CRC) program.

Maria Macariola, an adult care home owner and trauma nurse in Washington, says that many of her residents with long-term care policies are fully reimbursed for their care home services. People often forget they have this coverage, she says. 

Medicaid health insurance, administrated by states, is the largest public payer of long-term health care services. It can help pay for medical and long-term care for low-income people who qualify. However, some residencies don’t accept Medicaid. Medicare doesn’t typically pay for custodial care or care home fees.

What’s the atmosphere like in residential care homes?

Residential care homes are usually quieter than assisted living facilities and offer a smaller, homelike family setting for seniors, says Nelson.

Care home residencies typically are located in traditional neighborhood homes and are equipped to care for a small number of residents, usually between two and 10. Limited part-time medical care is offered, but it’s not a primary focus in this type of senior living.

How much staffing is available?

A care home’s family-like atmosphere is fostered by a high staff-to-patient ratio, which is typically higher than nursing homes or assisted living communities. The staff-to-resident ratio varies, ranging from 1-to-3 to 1-to-6.

Staffing requirements

There are basic educational requirements for caregivers, according to Macariola. They must be a certified nursing assistant and health care aid. The Nursing Aid Registries provides a state-based directory of nurse aid registries.

You can check within your state to ensure that the caregivers’ certifications are complete and valid. Each state is different, so some may require more training to become certified.

Is this type of care best for my senior loved one?

Finding the right care involves matching your loved one’s unique needs and preferences with an atmosphere and staff equipped to assist them.

1. Consider their activity levels

For a senior citizen who is very active, a residential care home may not offer enough stimulation depending on their hobbies and interests.

“We have arts, crafts, and music in our adult home. On the weekends we have a salon that comes in, and families can visit on the weekends, too,” says Macariola.

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It’s usually best to ask the care home what kinds of activities are available, as each home is different. Often, larger assisted living communities offer a wider range of social activities, including games, events, field trips, and more.

2. Consider the care needed

“Individuals in residential care homes usually have high care needs,” says Nelson. “We usually refer families to them when someone has a high risk of falling, or if they’re getting closer to their final years of life.”

Residential care homes vary greatly, so it’s essential to assess the needs of the future resident. If they require around-the-clock staff care, for example, it’s important to visit several homes to find the best combination of staffing and resources for your aging family member.

Many residential care homes also cater to people with dementia, says Nelson.

3. Consider licensing and safety

Researching adult family homes can be complicated because there are no federal standards for these communities. Some states have regulations and licensing rules, while others don’t require it.

For example, Missouri’s licensing for residential care facilities is provided by the Department of Health and Human Services. They have applications and a directory of licensed facilities online.

In states that license residential care homes, surveys on each elder care home are available at local licensing offices. Care homes are required to provide their most recent survey if it’s requested.

“You can ask the homeowner for their recent survey results to find out if there are any citations,” Nelson says. “A social worker from the state completes these annually.”

To learn more about care home and assisted living licensing in your state, check out our comprehensive guide to assisted living regulations.

Explore senior living options near you

There are many different types of senior communities and care available. Contact our Senior Living Advisors to schedule tours, ask questions, and find more senior living resources.

Merritt Whitley
Merritt Whitley

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