Understanding the Cost of Board and Care Homes

If you've researched board and care homes (sometimes known as group homes or even residential care homes) you may have decided that they're an intriguing senior living option for yourself or a loved one. Cozy and convivial, these smaller assisted living communities comprise almost sixty percent of the senior living landscape and are often more affordable than their larger, amenity-laden counterparts.

This being said, questions about costs and fees are likely to pop up as you start to compare options. Fortunately, board and care homes are often very affordable, especially when compared to other types of both senior care and residential living. Let's take a quick look at the similarities - and differences - between board and care facilities and traditional assisted living.

Assisted living facilities vs board and care homes: what's the difference?

Both assisted living and board and care homes are both long-term care options for older adults who need daily support as they age. While they both provide a supportive living environment, there are key differences between the two.

Assisted living facilities are typically larger and offer private or shared apartments with access to communal dining rooms, recreational areas, and 24-hour non-medical support staff. Many offer robust activity and social event calendars, as well as organized trips or outings. The staff will usually help residents with daily living tasks, such as bathing, dressing, and medication management.

In contrast, board and care homes are usually smaller, more intimate settings that provide a homelike atmosphere with a higher caregiver-to-resident ratio. These care homes are often located within residential neighborhoods and accommodate fewer residents, typically 6 to 10 people. Residents tend to form close bonds and act as "family", when family isn't able to be there. Board and care homes focus on personal attention and ensure that the unique needs of every resident are met by their trained staff.

Caregiving services in board and care homes are typically more comprehensive than those provided in assisted living facilities. They cater to individuals who require a higher level of assistance with day-to-day activities, or who may need constant supervision due to cognitive or physical impairments or medical care.

You'll want to keep this higher level of care and support as you evaluate cost - in many cases families will find a higher level of care-based value in board and care homes.

Average monthly cost for board and care style senior living

If you're considering a residential care home, you'll be pleased to learn that the price tag for these senior living communities is typically far lower than the price of a larger assisted living facility.

Actual costs for a board and care homes depend largely on where you live. Costs typically range from roughly  $3,500 to $4,500 per month, although in some areas, the price tag for private rooms can be as low as $2,000 or even $1,500 per month.

If your loved one requires dementia care, you can expect the costs to rise slightly, with average costs hovering in the $5,000 to $6,000 range. (Sidenote: we've got a great article on the benefits of board and care homes for dementia patients).

Another factor that affects your cost is the type of accommodations you or your loved one might want. As with almost every other senior living solution, a private room is going to be a bit more costly, while a shared bedroom allows you to lower your costs somewhat.

Lastly, if your loved one is expected to require increased care over time, you should expect costs to rise. This is typical because increased need for care services is more expensive.

Variables involved in the cost of board and care

You'll notice that the costs listed above are stated in terms of ranges. What are the variables that affect where your costs might fall in that range? There are three major factors:

• Where you live: If you choose a board and care home in a state or city where the cost of living is generally high, you can expect to be quoted costs on the high end of the range.
• Private or shared room: Sharing a private bedroom with a roommate won't cut your board and care costs exactly in half, but it will reduce them significantly.
• Other needed services. Dementia care typically runs a little higher than the cost of standard board and care services. In addition, some residential care homes may charge extra for incontinence care and supplies, and for transportation.

It's important to take these factors into consideration when budgeting for assisted living communities

How board and care homes work

Based on the name of these senior residential care facilities, you can probably gather that board and care homes provide accommodations and meals within a residential care setting. However, they don't provide the medical services offered at a skilled nursing facility, which is the primary reason they're so affordable.

Board and care homes are often residential houses that have been retrofitted to accommodate senior life, as opposed to larger facilities built specifically for older adults for that purpose. Many are located in residential neighborhoods and look just like a traditional home.

In these residential care homes, residents can carry on with their lives as independently as possible without the hassles of home maintenance or meal preparation. Because of their small size, the board and care staff provide special services and a personalized living experience within a secure and comfortable environment.

A note on activities of daily living

As with many assisted living communities, there are many activities of daily living which may be provided. Some of the most common include:

• Bathing
• Dressing
• Incontinence care
• Grooming

If you or your loved one needs a little help with the activities of daily living, a board and care home can be a more personalized and intimate choice compared to a larger assisted living facility.

Financing board and care homes

Do board and care homes accept Medicare?

The short answer is no, Medicare does not cover the cost of assisted living in general, and that includes board and care homes. In most cases, you're expected to pay the costs for board and care homes yourself, as they're not covered by standard health insurance or by Medicare. If you have a long-term care insurance policy, read it carefully and ask questions of your insurer, since it may cover residential and personal care home costs.

Seniors leaving their homes sometimes sell their former residences to help with their ongoing medical care and bills. Reverse mortgages can also provide funding, as can home equity lines of credit. If you have a life insurance policy, you may be able to settle it, convert it, or take a loan against it to help pay for expenses not covered by Medicare.

Do board and care home accept Medicaid?

In general, Medicaid does not cover the cost of board and care homes. However, low-income residents may be able to get some financial help for specific care-related costs from their state's Medicaid programs if they're eligible. It's important to remember that not all board and care homes accept Medicaid.

Often the resident must require skilled nursing care to qualify to provide assistance for assisted living services, which board and care homes typically don't offer. Check with your state to see if it offers state aid for residential home care that isn't linked to Medicaid.

Do Veterans receive financial support for assisted living?

In some cases, low-income veterans can get at least some of their residential care fees covered by the Veterans Administration's Aid and Attendance program. While a few board and care homes will accept residents who receive Supplemental Security Income (SSI), many ask the residents or their families to pay more in additional fees than SSI assistance will cover since the SSI payments are extremely low.

Planning ahead and doing your own home front research can help you discover the options available to you or your loved one when it comes time to transition from a nursing home to a board and care home or other senior living option.

Board and care or assisted living community? How to find the best fit

Choosing the perfect board and care home for your loved one is a deeply personal and important decision. Researching options, understanding insurance coverage, and considering the needs and preferences of your loved one, you can navigate this process with confidence.

Remember to prioritize comfort, safety, and overall well-being above all else. Trust your instincts and don't hesitate to seek guidance from professionals in the field. With patience, dedication, and a heartfelt commitment to your or your loved one's happiness, you'll find a board and care home that feels like a true home—a place where they will be cared for and supported in their journey.