What are Care Homes and How Much Should they Cost?
Across the country they are called adult family homes, personal care home, adult foster homes, and group homes or perhaps, board and care home, but they all provide a very basic and needed service: care for seniors in a home-like setting.
This guide is intended to provide information on care homes. For the sake of this guide, we will use Personal Care Home (PCH) to refer to these seniorliving establishments.
In some areas, in some states, PCHs are the last resort for finding placement for residents who don't quite meet the criteria for nursing homeplacement, but may not have the funds for assisted living. These also tend to be the choice for residents who have mental health disorders that hindertheir abilities to live independently or be accepted into assisted living facilities because of their perceived needs.
Most care homes are located in once single-family homes that have been converted into multi-unit dwellings. These homes may only have the ability tocare for three or four residents, where others can care for 20-30. Some are larger, hotel-like buildings which provide accommodations for dozens ofresidents.
In some states, there is no distinct regulatory difference between personal care homes and assisted living facilities. However, in some facilities thelevel of care can vary significantly. Some are simply for those who may need companionship while others help with select activities of daily living,such as dressing and bathing. In some settings, if appropriately staffed, medication administration and limited medical care may be provided.
Cost: As with assisted living facilities, the cost of PCHs varies from location to location. On average the cost ranges between $1500 and $3000 per month forroom and board. This often includes three meals a day, but each facility designates its own costs. The biggest difference is that some PCHs acceptMedicaid to help cover the costs of residency. in addition to private funds other programs such as the veteran's Aid and Attendance benefits may beavailable to help pay for room and board.
When considering facilities, some questions to ask regarding cost include:
- What is the monthly rate and what is included in this rate?
- Are there other services available and at what cost?
- What are the payment policies?
- What happens if someone leaves the facility for medical care during? Will their room be held or will they rent be refunded?
- What happens when private funds are depleted? Are there other forms of financial assistance?
- Can Medicaid assist in covering room and board?
Regulations: Although most PCHs are privately owned, there are regulatory boards that oversee the well-being of the residents. In many states, inspections areperformed by various departments to ensure the facilities are compliant with codes, policies and procedures and to ensure residents are receivingproper care. If the facility accepts Medicaid as a form of payment, the state's Department of Public Welfare will also be involved in the inspectionprocess. All inspection findings are public record and can be made available upon request.
Activities: Many PCHs offer group activities to keep their residents occupied. From group programs, movie and game night to classic bingo games, socialization andcompanionship is a key component of personal care homes.
Personal Assistance: Some facilities are able to provide assistance in scheduling and keeping doctor's appointments. The staff may also notice when there is a change inhealth or behavior that may warrant a visit to the physician. Often, the staff can also arrange for transportation.
Freedom: Most PCHs allow residents to come and go as they please. They also may allow for smoking on premise, which is often restricted in other senior livingsettings. Of utmost importance, the PCH must provide the resident with respect and dignity and unless they are incapable of making their own decisionsbecause of mental incapacities, they should have the rights guaranteed to all.
As with any senior-living setting, it is important to tour each facility. It is recommended to tour the facility at varying times, and evenunannounced, to ensure you are seeing the facility at all different times of the day. While touring here is a list of key factors to take notice of:
- Cleanliness: Does the facility appear clean? Does it have a noticeable odor? Do the residents appear bathed and groomed?
- Staff Interaction: Is the staff treating the residents with respect and courtesy? Do they appear to enjoy their jobs?
- Room Accommodations: Are the rooms private, semi-private or bunk rooms? Will your loved one be comfortable sharing his/her bedroom with others?
- Bathrooms: Are there ample restrooms for the number of residents in the home? Are there private showers?
- Resident Interaction: Does it appear as if the residents get along and enjoy one another's company?
- Smoking: Does the facility allow smoking in common areas? Are there designated smoking/smoke-free areas?
- Safety: Are hallways and stairwells free of obstacles and fall hazards? Are exits well lit and easily accessible? Are there security systems in place toprevent unwanted visitors?
- Surroundings: Does the home offer good lighting, clean furnishings, and well-kept grounds? Are there outdoor areas that can be used? By appearance alone, is thisa place you would be comfortable living in?
In addition to touring it is highly encouraged to spend some time asking questions of the administrator or intake coordinator. Make sure you ask to seethe latest state inspection survey. This will list any infractions that the facility received and their plan of correction. Take notice of any trendsor sever infractions that could pose harm to your loved one.
Some additional questions to consider:
- What qualifications does the staff have? Are they specially trained or licensed?
- How long has the facility been under the direction of the current administrator?
- What is staff turn-around like? What is the average length of employment?
- Is the facility staffed 24/7?
- Are staff continually re-educated on new policies, trends and techniques in elder care?
- Do the residents eat together or do they eat on their own?
- Are meals prepared? Are dietary preferences taken into consideration?
- Can the residents cook independently?
- Can they cook in their room via microwave or hot plate?
- Are there accommodations for special diets, i.e. diabetic, heart healthy or gluten-free?
Services and Activities:
- What type of personal care assistance, such as bathing, grooming, dressing, is available?
- Is there medical care available?
- What happens when my loved one no longer meets the criteria for self-care at the facility?
- Are there any transportation services available?
- Are there regularly planned activities?
- Are there religious events?
- What are visiting hours?
- Are pets allowed? Does the home have a “house” pet?
- Do residents speak highly of the facility and staff?
- How are room changes and roommate concerns handled?
- Is there a resident's council that allows residents to freely voice their concerns?
- Do any of the residents have a history of violent or aggressive behaviors? How are these situations handled by staff?
Making the move to a personal care home can be scary for many older adults or for adults with mental health issues or disabilities. This transitionoften comes after living independently and can often take some time to adjust to a new way of living. Other residents find themselves in a PCH after anillness or injury and they or their families feel returning to their private home is not in their best interest. Again, the transition may be quitedifficult. This guide is intended to make that transition a little easier.