What are Care Homes and How Much Should they Cost?

Last Updated Jan. 10th, 2017

A Comprehensive Guide to Residential Care Homes

This guide was created by the staff at Assisted Living Today to provide comprehensive information on care homes.

Across the country they are called by a variety of different names, including care homes, residential care homes and personal care homes. But they all provide a very basic and needed service: care for seniors in a home-like setting.

In some areas, in some states, residential care homes are the last resort for finding placement for residents who don’t quite meet the criteria for nursing home placement, but may not have the funds for assisted living. These also tend to be the choice for residents who have mental health disorders that hinder their 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 to care for three or four residents, where others can care for 20-30. Some are larger, hotel-like buildings which provide accommodations for dozens of residents.

In some states, there is no distinct regulatory difference between personal care homes and assisted living facilities. However, in some facilities the level 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.

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Cost: As with assisted living facilities, the cost of personal care homes (aka “care homes”) varies from location to location. On average the cost ranges between $1500 and $3000 per month for room and board. This often includes three meals a day, but each facility designates its own costs. The biggest difference is that some personal care homes accept Medicaid to help cover the costs of residency. in addition to private funds other programs such as the veteran’s Aid and Attendance benefits may be available 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 residential care homes are privately owned, there are regulatory boards that oversee the well-being of the residents. In many states, inspections are performed by various departments to ensure the facilities are compliant with codes, policies and procedures and to ensure residents are receiving proper care. If the facility accepts Medicaid as a form of payment, the state’s Department of Public Welfare will also be involved in the inspection process. All inspection findings are public record and can be made available upon request.

Activities: Many residential care homes offer group activities to keep their residents occupied. From group programs, movie and game night to classic bingo games, socialization and companionship is a key component of 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 in health or behavior that may warrant a visit to the physician. Often, the staff can also arrange for transportation.

Freedom: Most care homes allow residents to come and go as they please. They also may allow for smoking on premise, which is often restricted in other senior living settings. Of utmost importance, the residential care home must provide the resident with respect and dignity and unless they are incapable of making their own decisions because 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 even unannounced, 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 to prevent 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 this a 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 see the latest state inspection survey. This will list any infractions that the facility received and their plan of correction. Take notice of any trends or 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?

Other Residents:

  • 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 transition often comes after living independently and can often take some time to adjust to a new way of living. Other residents find themselves in a care home after an illness or injury and they or their families feel returning to their private home is not in their best interest. Again, the transition may be quite difficult. This guide is intended to make that transition a little easier.

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