What Is a Group Home? Senior Care in Group Homes

Many older adults are interested in building community but dread the idea of living in an institutional setting. Even with recent improvements in assisted living and independent living options, some seniors still hesitate to leave the home setting behind. 

However, group homes offer a happy middle-ground option. They provide similar care to assisted living facilities, but with a key difference: care happens in a smaller, home-like setting. 

This home environment can help older adults create tight-knit connections, receive long-term care, and still enjoy the privacy and comfort benefits of a home without the burdens of homeownership or daily upkeep.

In this article, we'll explain how group homes work, how much they cost, and how they're different from other types of long-term care so you can determine if they're the right option for you or your loved one. 

What Is A Group Home for Seniors?

Group homes are residential facilities that offer long-term care in a more home-like setting. Care is similar to that found in an assisted living facility, yet the environment is most similar to a personal home.

Group homes go by many different names, including: 

• Adult family care home.

• Board and care home.

• Residential assisted living.

• Residential care home or residential care facility.

While group homes provide similar levels of care as assisted living facilities, they have a few key differences. The biggest difference is the setting. In an assisted living facility, a resident may rent an apartment or condo or live within a larger facility or community of seniors.

A group home, on the other hand, allows seniors to live in a small community of older adults, renting rooms within a large home. Seniors share communal spaces within the house, such as the kitchen, living room, and outdoor areas.

Group homes are often built and designed to be senior communities. This means they look a little different from your standard home, including larger rooms, safety features, and communal spaces for socialization.

Living in a Group Home: What to Expect Day-to-Day

One of the biggest concerns about group homes is what day-to-day life is like. Many people worry about a lack of privacy or independence. This is especially true of individuals who have lived alone in a full-size home for most of their lives.

Luckily, group homes offer the privacy and independence seniors crave. When you move into a group home, you'll have a choice of a shared or private room. Most places will also let you tour the facility and pick your preferred room if they have multiple available.

Residents are expected to be able to live mostly independently, and each person will have a personalized long-term care plan. There isn't a set schedule at group homes; however, group meals and social activities will usually happen at the same times each day.

Residents are free to do what they please with their day. Whether that involves socializing, going on walks, spending time with family, taking trips into town, or staying in to do crafts, Just like living at home, seniors are able to do what they want as long as it isn't hurting anyone.

Group homes allow residents to stay in a group home for as long as they'd like. Stays are treated similarly to assisted living, where residents stay at home until they choose to leave, need a higher level of care, or pass away.

Most group homes are run by private owners, meaning every home has a unique vibe, culture, and rules. In most cases, group homes are capped at 5 to 10 people, although larger homes may accommodate up to 20 people at a time. 

Some owners may also be more involved in care, living alongside seniors to help build community, resolve problems quickly, and provide care or support services when needed.

However, don't let owner involvement scare you. Privately owned group homes must meet state licensing requirements and have the proper staff and space to accommodate their residents. Group homes are just as viable as assisted living facilities, and the smaller environment often allows for more personalized care connections.

Some group homes can even support residents who need moderate to higher levels of assistance, including memory care, if licensed to do so. The availability of higher levels of care depends on the group home's licenses, state requirements, and the presence of awake overnight staff. 

What Services and Amenities Do Group Homes Offer?

Group homes offer the same types of services as an assisted living facility. This includes help with long-term care, supervision, and activities of daily living (ADLs) such as bathing, dressing, and transferring. 

Each resident in a group home has a personalized care plan that includes any supportive services they might need and the schedule they need. For example, this plan would include what medications they take and how often they need to take them. 

Staff are required to document the care plan and its effectiveness so that adjustments can be made in the future to improve the quality of life for all residents.

Caregivers and helpers also take care of the community's basic needs, such as cooking, cleaning, and housekeeping. Providing meals and chores makes it easier for residents to focus on doing what they love and enjoy instead of exerting energy on mindless tasks. 

Some group homes also offer transportation to and from town for events, movies, shopping, or medical appointments. Some specialized group homes may also have therapy programs, intensive care offerings, or hospice care. 

Group homes offer many opportunities for socialization, recreation, and community-building, including events, backyard gardens, movies, games, baking nights, and more. Most group homes also offer group trips into town for events, day trips to nature attractions and museums, or to visit the senior center. 

Staffing at Group Homes: Who’s Responsible for Resident Care?

Group homes are required to meet staffing requirements, which vary in every state.

In general, this means meeting a specific staff-to-resident ratio and having a certain number of staff members available at all times. It could also mean having a Registered Nurse (RN) or other licensed professional on call at all times. 

Similar types of staff work at group homes as assisted living, such as

• Registered nurses (RNs)

• Licensed practical nurses (LPNs)

• Certified nursing assistants (CNAs)

• General caregivers

• Case managers or care coordinators

Group homes often have personal connections to other health professionals in the area, such as therapists, doctors, and other specialists. Many homes provide transportation to these services or have a health professional visit the group home regularly to provide care to many residents at once.

In addition to caregivers, group homes also have helpers who do chores such as cleaning, laundry, cooking, and general housekeeping. 

How Much Does A Group Home Cost?

The cost of a group home varies significantly depending on factors such as size, location, services, and amenities. 

The cost is estimated to be around $3,000 per month on average, but the general range typically falls between $2,000 and $6,000 per month. However, this can vary greatly depending on your area and the services and amenities offered at the group home. 

Most group homes include rent, utilities, long-term care services, meals, and basic housekeeping in the monthly cost. Extravagant amenities and intensive care services may incur additional charges. For example, group homes generally do not cover therapeutic services or spa treatments.

These are your trade-offs when choosing a group home over an assisted living facility. Larger care facilities and communities may offer amenities like spas, gyms, or salons within the community. 

Group homes, being much smaller, often don’t provide these extra features. If these amenities are important to you, choosing a long-term care environment that offers these services and possibly includes them in the monthly cost may be more cost-effective and convenient.

Does Insurance Pay for a Group Home?

Like most forms of long-term care, group homes are not covered under traditional health insurance plans or Medicare. Instead, these types of insurance may cover medical charges incurred at a group home, such as a therapy or doctor's appointment.

Room and board at a group home is covered under:

• Long-Term Care Insurance

• Medicaid

• Veterans Affairs

Does Long-Term Care Insurance Cover Group Homes?

Long-Term Care Insurance is a private insurance option that offers comprehensive coverage of long-term care services, and provides financial security to your retirement plan. 

Most Long-Term Care Insurance policies cover the cost of group homes, including room and board and personal care services. However, every policy is different, and it's important to check your policy's details for preventive language. 

A Long-Term Care Insurance specialist can help you determine if your policy covers group homes and help you file a claim to get necessary care services. 

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If you don't have an LTC Insurance policy, a specialist can help you get one. You cannot qualify for a new Long-Term care Insurance policy if you already need care, so it is best to plan before care needs occur. 

Does Medicaid Cover Group Homes?

Medicaid is a federal health insurance program administered by states. Coverage can vary greatly from state to state, so it's important to take nationwide Medicaid information with a grain of salt and consult your state's Medicaid page or a Medicaid expert before making important care decisions.

Medicaid does not typically cover room and board in a group home but may cover care services if provided through an HCBS waiver in a licensed facility. 

Home and Community-Based Services (HCBS) waivers are a Medicaid program that covers alternative methods of long-term care to keep older adults out of nursing homes and within their communities for as long as possible.

Unlike standard Medicaid, HCBS waivers are not an entitlement program, meaning coverage is limited. In most cases, individuals must meet financial and long-term care requirements to be eligible. HCBS waiver programs often have waitlists and are state-specific in availability and eligibility.

Medicaid also only covers care provided in a Medicaid-certified facility. This means HCBS waivers will only cover care provided in a Medicaid-eligible group home. This can make it more difficult to get coverage for your preferred choice of care. 

Does Veterans Affairs (VA) Cover Group Homes?

Veterans Affairs benefits generally do not cover the cost of room and board in a group home; however, they may cover the long-term care services provided within that facility. In addition, Aid and Attendance (A&A) may increase your monthly pension benefits if you’re eligible to help you cover care costs. 

If you intend to cover the cost of a group home with Veterans Affairs, please reach out to a trusted VA representative. A professional can help you get the most benefits available for your situation and help ensure benefits cover care when you expect them to. 

How To Find the Best Group Home

The best thing you can do to find the best group home for you or your loved one is to visit the facility in person and get a feel for the residents, staff, environment, and overall culture of the group home. 

Every home works differently depending on the management, the needs of the residents, and the facility's focus. The only way to figure out if it’s a good fit for you is to discuss your concerns with the intake staff and current residents. 

When you visit the family and discuss options with the staff, here are a few things you should look for: 

• Staff-to-resident ratio: Ask them what their ratio is. A good ratio is one staff member for every three to five residents. 

• Licensing and certifications: Each state has different licensing requirements for group homes; before moving in, ensure your group home meets those requirements. 

• Safety features: Group homes are supposed to be designed with safety in mind. Look out for grab bars, wheelchair accessibility, emergency call systems, and other fall prevention measures. 

• Resident satisfaction: It’s important to talk to other residents and staff to understand what the group home is like. These discussions could help you uncover potential problems. 

• Activities and socialization: Group homes are supposed to offer social opportunities, events, and recreational activities for residents. Make sure your group home is offering activities you’d find enjoyable. 

• Meals: Most group homes prepare food for residents. It's important to check the quality of the food and whether the group home can meet your dietary needs or restrictions. 

• Long-term care service offerings and focuses: If you have a specific condition, it’s important to determine what services are and are not covered and offered at the group home. Some group homes specialize in specific conditions, while others offer more general options; it’s important to see if your group home can and will meet your needs.

• Overall environment: Do you like the size and location of the house? Is it in a safe area? Would you feel safe at night or walking around the neighborhood? Is it walkable or on a main road? 

• Read reviews: Group homes are required to meet certain state requirements, which often include an inspection and complaint history. It’s important to read these reviews and histories before committing to a facility. 

Frequently Asked Questions About Group Homes

We’ve covered many important topics in this article, but you may still have a few lingering questions. Below, we’ll answer some of the most asked questions about group homes. 

What's The Difference Between a Group Home and a Nursing Home?

Group homes and nursing homes do not share many similarities; they differ in many areas, including:

• Setting: Group homes are large houses repurposed for older adults and community living; the number of residents is often limited to 5 to 10. Nursing homes are institutional or facility settings that house and care for anywhere from 20 to 200 residents, depending on the facility size.  

• Independence: Group homes are oriented towards independent living and privacy; residents are free to do as they please as long as they adhere to community rules. Nursing homes are for individuals who cannot live independently and need round-the-clock care. While residents are free to do what they want, limitations often exist based on their care needs.

• Level of care: Group homes offer personalized care plans and focus on helping with daily living activities. Nursing homes are for those with continuous or intensive care needs. Care may include both custodial and medical services.

• Staff: Group homes are smaller care environments and often have fewer staff yet higher staff-to-resident ratios. Nursing homes are larger facilities with a big staff of nurses and caregivers. Nursing homes may also have therapists, specialists, and doctors.  

What's The Difference Between a Group Home and an Assisted Living Facility?

Group homes can be best described as an alternative option to assisted living facilities. Residents usually receive the same level of care as they would in an assisted living; the key difference is the setting.

Here are their main differences:

• Setting: Group homes are large houses with 5 to 10 residents, offering a tight-knit community. Assisted living facilities can range greatly in size from 20 to over 100 residents. There are many types of assisted living settings, such as apartments, condos, and townhomes.

• Amenities: Group homes offer socialization and community-building opportunities. While they have the privacy benefits of living in a house, they do not always have many amenities expected in an assisted living facility. Assisted living communities may offer clubs, sports, recreational areas, spas, gardens, pools, and other amenities that group homes just don't have the space for.

• Staff: Group homes and assisted living facilities often have similar types of caregivers; the only difference is that assisted living facilities are often much larger and staff more caregivers. However, staff-to-resident ratios may be higher in a group home.

The biggest difference between a group home and an assisted living facility is the size of the community and the amenities offered. If you prefer a large community with many amenities, living in an assisted living facility may be more cost-effective than a group home. 

Does Medicare Cover the Cost of a Group Home?

Medicare does not cover the cost of a group home. Medicare is an entitlement health insurance program for individuals aged 65 and older. However, just like traditional, employer-sponsored health insurance, Medicare does not cover custodial or personal care needs. 

What Are the Disadvantages of a Group Home?

Many of the “disadvantages” of a group home or any long-term care facility depend on your long-term care preferences. 

For example, some say the disadvantages of a group home would be the small community size, while others would find that beneficial. 

One objective downside is that group homes offer fewer group activities, amenities, and specialized care services compared to larger senior communities. 

Individuals with dementia, Alzheimer's disease, or other cognitive impairments may also find group homes to be disadvantageous as most group homes aren't suitable for dementia residents long-term (unless the home specializes in memory care.)

There are some licensed memory care group homes that can be appropriate for people with light to moderate dementia. If you plan on going with this option, ensure the facility has secured access, dementia-trained staff, and the appropriate licenses. 

Can a Group Home Kick Someone Out?

Group homes can “kick someone out,” but there's typically a legal process to do so. 

Residents agree to follow certain rules when they move into a group home; if residents repeatedly break these terms or rules (for example, not paying for their room and board dues or behavioral problems), they can face legal implications. Involuntary discharge rules vary by state; however, residents must be given written notice and due process in many cases.

Residents may also be asked to leave if the group home can no longer meet their medical needs. 

For example, if someone develops dementia, the group home may encourage that resident and their family to choose a facility that offers specialized memory care; this is especially true if the resident is becoming aggressive, excessively confused, or poses a danger to other residents. 

However, in these circumstances, the group home would likely help the resident find alternative care. Residents don't just get kicked out immediately; there is a lengthy process involved that protects the facility and the residents. 

Are Group Homes a Good Option for Those with Alzheimer’s Disease or Dementia?

Some group homes focus exclusively on memory care; these would be suitable for someone with Alzheimer’s disease or dementia. 

However, a majority of group homes focus on general long-term care. These homes expect residents to live independently and often do not provide specialized memory care. This means most group homes are not a preferable option for those with cognitive decline. 

Are Pets Allowed in a Group Home?

Pet policies will vary; each group home has different rules. However, pets are generally welcomed in senior communities as they offer many quality-of-life benefits.

However, each group home is different. If you have a pet you’d like to take with you, it’s essential to ask your chosen group home if they will allow it. Some group homes have size, breed, or care capacity requirements.

Are Group Homes Licensed and Regulated?

Group homes offer the same level of care and professionalism found in a larger community. They're required to have licensed and certified staff members capable of providing high-quality long-term care.  

Group homes must be licensed and regularly inspected by their state’s Department of Health or Aging Services. You can often review inspection reports or violation histories online through your state’s licensing agency.

What’s the Visitation Policy at Group Homes?

Group homes allow visitation during the daylight hours. Each group home has a different visitation policy. Some may request more notice than others, while others have flexible policies allowing visits at odd hours. 

Is a Group Home Right for You or Your Loved One?

A group home may be right for you or your loved one if you prefer to live amongst a small community of like-minded people. Group homes offer a chore-free lifestyle, long-term care services, and safety measures that can help seniors maintain a high quality of life into old age despite long-term care needs. 

A group home may not be a great choice for you if you prefer a larger community, want your own apartment, amenities like clubs, sports, or spas, or need a level of care greater than a group home could provide.

Regardless of the type of care facility you choose, LTC News's Long-Term Care Directory can help you search for a high-quality long-term care facility or provider. This directory contains thousands of care providers from all across the United States, helping you compare all your options close to home.

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LTC News also has resources on other types of long-term care, Long-Term Care Insurance, and caregiving:

• The Long-Term Care Spectrum: From Independent Living to Skilled Nursing - This article discusses different types of long-term care options so you can choose the one that best aligns with your care needs and preferences.

• Who Needs Long-Term Care? - Whether you will need care or not is a bit of a trick question because anyone can need long-term care at any point in their lives. This article provides insights into who may be more at risk of needing care and how to tell if you already need it.