Adult Care Homes- Personal Care Homes- Board & Care... What's the difference?

by Amie Clark, Co Founder- The Senior List.com
(Beaverton, Oregon, USA)

As it turns out, there are many differences, and as many similarities. These homes are single family residences that are licensed to provide care services for frail seniors and adults. In some cases, the homes do not have to be licensed at all. The number of residents per home ranges from 1-6, depending on the state licensing requirements. Care services at this level can vary, but typically fit a higher level of care than can be provided in assisted living communities, but don't require full 24 hour nursing care. The advantages of this level of care are consistent care givers, home-cooked food, high staff to resident staffing ratios, and a home-like environment. Typically the costs are less than other levels of care that provide the same services.


While these homes are a great option for many residents, there are some disadvantages. Due to the small number of residents, it is difficult for providers to maintain a full activities program for the residents. The care home may not provide the same social aspect as an assisted living or residential care community. They may not be able to provide transportation, hair-care services, or visiting podiatrists. Care homes are operated by individuals, not corporations who have specific policies and procedures for staff to follow. Many care homes are not able to provide night-time care, as the caregivers are sleeping during the night as well. This is not to say that care homes can't assist toileting at night or be available for emergencies, but consistent, extended night-time care is difficult to maintain. Care homes may also have great difficulty with a resident who is actively exit-seeking.

Lets explore the care home options in Oregon, Washington, and California.



Oregon: Adult Care Homes:
Must be licensed by the state who provides inspections on a yearly basis. Homes may provide care for up to five residents in the home. Homes are licensed and classified on three levels, from one to three depending on the level of care provided, number of caregivers, and experience of providers. There are even homes that are licensed to provide care for residents on ventilators. The cost for an adult care home in Oregon ranges anywhere from $2000-$4000. Medicaid does pay for some adult care home costs.


Washington: Adult Care Homes, Adult Family Homes:
Must be licensed by the state, very similar to Oregon expectations and regulations, yearly inspections, etc... May have up to six residents per home. Levels range from 1-4, depending on the level of care required. Most Adult Family Homes have a Medicaid contract. In addition, the state of Washington requires any home that contracts with Medicaid to carry additional liability insurance. The costs seem a bit higher than Oregon, $2800-$4500 for most residents, $3000-$5000 for homes with licensed providers (RN, PT, etc...) and heavy care (hoyer-lift, hospice, end of life). Adult Family Homes in Washington may also be licensed for one adult day care resident in addition to six full-time residents.



California: Board and Care:
Must be licensed by the state and are inspected. There are a variety of sizes of homes in California and rooms can be shared or private. Homes can receive specialized waivers to provide care for those on hospice, Alzheimer's disease, and ventilators. Board and Care homes in California can be secure (locked) to provide care for residents who wander. The cost for a Board and Care home range from $1200-$6000 per month, depending on location in the state and amenities offered. Few Board and Care homes accept Medi-Cal.

By Amie Clark, Co Founder The Senior List.com

Many thanks to contributors of this article:

Bobbi Trifon, ElderHomeFinders
Claudia Belindean, A Caring Choice