Most people want to age at home, but that is not always possible, physically or financially.
Rather than move to a large assisted living community or a skilled nursing facility, another alternative exists, perhaps in an area near home. Depending on where you live, the concept may be called adult family homes, board and care homes, residential assisted living or residential care homes.
States, which license the homes, have more than 30 terms to refer to these types of living arrangements. Think of it as assisted living but in a house.
In Wisconsin, about half of the assisted living providers are adult family homes, but they offer only about 1 in 7 of all assisted living beds. In many states, these small homes are an option that often slips under the radar.
Residential care homes can provide the same basic services as large assisted living centers. Staffers help with personal needs such as bathing, dressing, eating, medication management and toileting and can respond to emergencies. Some states allow for various levels of care in the homes, from independent living to high levels of assisted living, so make sure you know what’s included.
Most offer transportation to medical appointments or will contract with a third party. What you won’t find is the same level of care as in a nursing home.
Group homes are licensed by states under the same requirements as any other assisted living community. They typically house five to 10 people (but there may be as many as 20, depending on state regulations). Staff who directly care for residents have mandated annual training.
Residents must have care plans. Employees are required to keep records on them, too.
Some homes allow pets or have staff that can speak multiple languages. Some focus on memory care, specific disease management or general care. Someone is on site 24/7.
Group homes are usually owned by private individuals, although some are owned by companies that may operate several facilities. Staff may live in the house, sometimes along with their families.
Residential care homes often cheaper
The cost for services at board and care homes across the country hasn’t been precisely calculated. A 2021 cost-of-care survey from Genworth, a Richmond, Virginia-based company that sells long-term care insurance, puts the national median charge for assisted living at $54,000 a year and the median annual charge for skilled nursing at $95,000 to $108,000, depending on whether a resident is living in a double or single room.
The report does not include the costs at group homes, but the fees are typically less than traditional assisted living or skilled nursing.
For example, in California — one of the most expensive states to live in, according to the Council for Community and Economic Research’s annual Cost-of-Living Index — Genworth estimates median annual costs of $63,000 for assisted living and $117,530 to $146,000 for a nursing home.