Board and Care Homes are a specific type of housing and support option for older adults who require supervision and assistance with daily tasks. This residential model, sometimes known as a Residential Care Facility for the Elderly (RCFE), provides a non-institutional environment for seniors who can no longer live safely or independently at home. It serves as a bridge between living independently and requiring the higher level of medical care found in a nursing home. The setting offers a comfortable, family-like atmosphere while ensuring personal needs are met around the clock.
Defining Board and Care Homes
Board and Care Homes provide non-medical residential care in a small-scale setting. These facilities are often standard residential houses converted and licensed to care for a limited number of seniors, typically six to ten residents. This small capacity fosters a more intimate, home-like atmosphere, distinguishing it from larger institutional settings. Licensing regulations mandate 24-hour supervision and personal care services.
The operational model centers on non-medical support, meaning the staff consists primarily of unlicensed caregivers rather than licensed nurses or medical professionals. While they assist residents with daily needs, they are not equipped to provide complex skilled nursing services such as intravenous therapy or ventilator care. The environment is regulated to ensure safety and quality of life, focusing on a comfortable living arrangement with shared common areas and sometimes shared bedrooms.
Services and Resident Profile
The core service provided is assistance with Activities of Daily Living (ADLs), including personal hygiene tasks like bathing, dressing, and grooming. Residents also receive support with mobility and transferring, such as moving from a bed to a chair. Comprehensive services typically include freshly prepared meals and snacks, scheduled housekeeping, and laundry services included in the monthly fee.
Staff also provide essential supervision and coordination of care, including medication management, which involves reminders and assistance with self-administration. The typical resident profile is a senior who needs daily, hands-on support but remains medically stable. Individuals must not require continuous medical monitoring or complex procedures, making the setting ideal for those whose needs are primarily related to personal care and supervision.
Distinguishing Board and Care from Assisted Living
The primary difference between a Board and Care Home and an Assisted Living Facility (ALF) lies in size and setting. Board and Care facilities are significantly smaller, housing fewer than 10 residents, often in a single-family home within a residential neighborhood. In contrast, ALFs are typically larger, purpose-built communities that can accommodate 25 to over 150 residents. This difference in scale affects the level of privacy and the overall environment.
ALFs usually offer private apartments or units with kitchenettes, while Board and Care Homes often feature shared rooms and common living spaces, promoting a closer, communal lifestyle. Although both provide similar non-medical ADL assistance, the smaller Board and Care model often results in a higher caregiver-to-resident ratio, offering more personalized attention. Both types of residences differ from Skilled Nursing Facilities (SNFs), which are licensed medical facilities providing 24-hour skilled nursing care and rehabilitation services.
Financing the Cost of Care
Board and Care services are primarily financed through private pay arrangements, using the resident’s personal funds, savings, or retirement income. Since these are considered residential and non-medical services, standard Medicare coverage does not cover the expenses for room and board or personal care. Costs vary widely depending on location, the level of care required, and whether the room is private or shared.
Alternative funding sources can help offset the financial burden, including long-term care insurance policies designed to cover custodial care services. Veterans and their spouses may also qualify for the VA Aid and Attendance benefit, a special monthly pension that helps pay for long-term care. While Medicaid does not cover room and board, many states offer Home and Community-Based Services (HCBS) waivers that may cover the cost of personal care services for eligible individuals.