A boarding home for adults is a residential housing arrangement that combines lodging and meals with a low level of supportive services. This non-medical model is designed for individuals who are independent but require a stable living environment and some basic assistance. The goal is to provide a setting that fosters community and safety for residents who do not need professional medical care found in larger institutions. Terminology for these homes varies by state, often including names like residential care homes, adult foster homes, or board and care homes.
Defining the Residential Boarding Home Model
The model is characterized by its small scale, often operating out of a single-family house within a residential neighborhood. These homes typically serve a small number of unrelated adults, creating a higher staff-to-resident ratio than larger facilities. This setting aims to replicate a home-like atmosphere, offering shared common spaces and a communal dining experience.
Residents suitable for this arrangement are generally elderly individuals, those with stable mental health conditions, or people with a physical disability who retain functional independence. They must be capable of self-evacuation in an emergency and do not require extensive personal care assistance. The model is frequently sought out by people on fixed or lower incomes because it is often a more affordable option compared to licensed assisted living communities.
Scope of Assistance and Service Limitations
The core offerings of a boarding home are room and board, including three daily meals and snacks, along with basic amenities like housekeeping and laundry services. Supportive services focus on instrumental activities of daily living (IADLs) and general supervision. Staff may offer oversight of the resident’s well-being, provide transportation assistance for appointments, and aid with tasks like grocery shopping or money management.
A limitation is the distinction between assistance with self-administered medication and medication administration. Staff may provide medication reminders, such as prompting a resident to take their own pills or opening the container. They are prohibited from performing the medical act of administering medication, which includes tasks like injecting insulin or managing complex wound care. Boarding homes are not permitted to provide extensive personal care services, such as full assistance with bathing, dressing, or feeding, as these require different licensing and staff qualifications.
Regulatory Structures and Operational Standards
Regulation of adult boarding homes is handled at the state and local levels, resulting in variation in requirements and oversight across jurisdictions. Many states delegate responsibility to local municipalities to enforce specific standards, often requiring a local permit or certification to operate legally. These operational standards ensure the basic health and safety of the residents.
Common areas of regulation include fire safety, sanitation standards, and the physical condition of the facility, such as minimum room sizes and communal space availability. Guidelines also mandate staff background checks to protect vulnerable residents, and they may require staff training in areas like resident rights and emergency procedures.
Boarding Homes Compared to Licensed Care Facilities
The difference between a boarding home and a licensed care facility, such as an Assisted Living Facility (ALF), lies in the level of personal and medical care provided. ALFs are typically larger establishments with a wider range of amenities and a mandate to provide personal care services, including hands-on assistance with activities of daily living. Boarding homes are smaller, residential settings that focus on room, board, and supervision, not comprehensive personal care.
Skilled Nursing Facilities (SNFs) represent the highest tier of medicalized residential care, offering 24-hour licensed nursing services and intensive medical oversight. The staffing in an SNF includes registered nurses and licensed practical nurses, whereas boarding homes rely on unlicensed staff for supervision and basic support. Regulatory oversight for ALFs and SNFs is far more stringent than the safety and sanitation standards that govern boarding homes. Residents move to an ALF or SNF when their needs exceed the non-medical scope of a boarding home, such as requiring regular medication administration or complex physical assistance.