Starting a Boarding Home

Nurses General Nursing

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I've got a 2500 square foot house with four bedrooms and two bathrooms on 17 acres. We are going to move this summer (back to our old farm) but I don't really want to sell this property. I would like to find a way to keep it to pass onto my children. I wondered if I could take in some boarders and run it like an assisted living facility.

Of course, anything like this has tons of red tape. We are going to have to rebuild the deck anyway (and fix a bunch of things the goobers who built and sold this house didn't do) but I figure if we were rebuilding the deck we could add a w/c ramp while we're at it.

What kinds of licenses would I have to get? What kinds of expenses should I expect? I know dependable hired help can be hard to find, I would expect to be the one over here cooking meals and washing clothes and helping with baths most of the time. I would have some standards, of course (must be ambulatory with or without a cane or walker and no psych patients). I figure I would lay everything out to the people up front and they can take it or leave it and if they don't like it they can leave. If I would be required to run like a chicken to please people like the state requires the nursing home to do I wouldn't do it.

Anyway, does anyone have any experience with this? I have toyed with the idea for years but don't know if it would be worth the hassle. Is there any money to be made here? I would think I could have two to each bedroom.

i don't know about the expenses but with four bedrooms you would be in a bind unless you had all four filled pretty much all the time

you would might be required to have licensed care [rn/lpn] --you would count for one shift--insurance, an accounting service, diet supervision, transport to md etc,

don't want to be a wet blanket but this sounds like an expensive undertaking

maybe if your house was large enough for a few more it might be more profitable

Well...the master bedroom is 20 by 20, maybe I could cram a few more in there, like a flop house.

Specializes in Vents, Telemetry, Home Care, Home infusion.

look up on your state department of healths website regulations for home and community based services, personal care homes and domiciliary care homes.

pa home and community based services

services covering a wide range of needs are available allowing individuals to remain in their communities and homes. these services include home health care; personal care, providing assistance with bathing, dressing, eating, grooming, toileting, etc.; health support services such as housekeeping, shopping assistance, laundry and mending; respite care (caregiver relief); transportation and other routine household chores as necessary to maintain a consumer's health, safety and ability to remain in the home; home-delivered meals prepared at a central location and delivered to a person's home.

for a detailes on services in your local area, contact your local area agency on aging

pa regs:

domiciliary care (dom care) : clients live in residence with provider; must be onsite or have assistant onsite 24/7 ---just like family with dependant children :) limited to three individuals in the home.

the domiciliary care or "dom care" program was created as part of act 70 of june 1978 by the commonwealth of pennsylvania to provide a homelike living arrangement in the community for adults age 18 and older who need assistance with activities of daily living and are unable to live independently. dom care providers open up their homes to individuals who need supervision, support and encouragement in a family-like setting.

dom care residents are matched to homes that best meet their special needs, preferences, and interests. dom care homes are smaller than the traditional personal care home in that home providers care for no more than three dom care residents. unlike larger personal care homes, dom care homes are the individual provider's home. they are inspected annually to ensure they meet health and safety standards. if the home and provider passes this inspection, they become "certified".

personal care home frequently asked questions are residential facilities that offer personal care services, assistance and supervision to four or more persons.

are personal care homes licensed and regulated?

yes. all personal care homes are licensed by the pennsylvania department of public welfare. personal care homes also meet state and local health, fire and safety laws and regulations.

the personal care home regulations are available at the following link:

http://www.pacode.com/secure/data/055/chapter2600/chap2600toc.html

the personal care home licensing measurement instrument (lmi) is available at:

GoLytely, I would really encourage you to find out the laws that pertain to your state regarding board and care homes. They really are different in each state. For example, comparing licensing regulation for Domiciliary Care/Family AFC Homes in MI to PA (in the post by NRSKARENRN) you are allowed to have up to 6 residents in MI vs only 3 in PA.

The quote below is from the following MI website http://www.mfia.state.mi.us/olmweb/ex/ASM/376.pdf

ADULT FOSTER CARE FAMILY HOME - 400.703 Sec. 3(5)

"Adult foster care family home" means a private residence with the

approved capacity to receive not more than 6 adults who shall be

provided foster care for 5 or more days a week and for 2 or more

consecutive weeks. The adult foster care family home licensee

shall be a member of the household and an occupant of the residence.

• ADULT FOSTER CARE SMALL GROUP HOME - 400.703 Sec.

3(7)

"Adult foster care small group home" means an adult foster care

facility with the approved capacity to receive not more than 12

adults who shall be provided foster care.

Note: A six bed home can be licensed as either a family or small

group home depending on whether or not the licensee is an occupant

of the residence and a member of the household.

Also, in MI the amout of residents (6 or less) you can have in a Family AFC home is based on two things: the square footage of your bedrooms/house and the total number of people living in the house (that includes you, your spouse, children, residents). I just wanted to point out that there are big differences in licensing between the states. Two of my friends have a board and care home in diff states, one in CA and another in OR and their regualtions are very diff than MI (much more stringent than MI).

I'd be more than happy to answer any questions you have regarding board and care homes, since this seems to be my only area of expertise on this board:). I'm graduating in May 2009 with a BSN and have no clinical exerience so I can't contribute too much on practical advice in nursing:) But in terms of rules and reguations, your state licensing office is your best bet. Good luck and take care!

Daniela

Specializes in retired from healthcare.

A long time ago I worked in a boarding house. It was supposed to have six residents.

The owners of it did not bring me any food to prepare for the residents and demanded that I keep it a secret

when the state came to invistigate us.

They were only paying me about $112 a week and were denying me the right to a 24-hour day off even though I was there 24/7.

I was doing medications, meal prep, house cleaning and a little hands-on patient care. I did not deserve to be payed so little when they promised me about $200/week and 24 hours off and when I only had an eight-hour time slot off every week.

Prior to this, I was getting about $350/week to take care of one lady in her home.

I reported them to the Bureau of Labor and was shocked to hear them say my complaint was not confidential and that the abuse I took was not against any laws.

The state worker who talked to me said, "I know she is not getting food in here. I don't care what her excuses are." Some people I talked with called it slavery.

I always thought I would be better at managing this place than the owners.

Specializes in retired from healthcare.

I have been wondering how much it would cost to build a w/c accessable house if I was only planning to

take care of one or two patients. I would like to know if there is any state funding that would help me with this.

I met a woman and her husband who were both RNs, who had a small nursing facility in their home.

They bought a four bedroom rancher with a complete basement. They lived in the basement, and the upstairs was the facility. They took all their meals commonly with the residents. They had some part time help (2 RNs and a CNA) but did most of the work themselves. There were two bathrooms upstairs, and they had five residents...a married couple and three single people. They kept people from the moment they needed some type of care until they died.

They had three children, all under the age of 6. They started the facility before having kids. They said it was like living with 5 grandparents, and they loved it.

What about respite care or a bed and breakfast suitable for those needing nursing care?

Specializes in ICU and Home Health.

1. You do make a lot of money. I charged $2,500/month for my first few clients and then up to $3,500/mo depending on how much care they needed and/or how much they could afford to pay.

Can I go a little in depth on this one. Lets say you want to keep your Mon-Fri RN job but hire someone to be there.

Lets say you hire a CNA and pay them $12/hour x 24 hours x 30 days a month. Your monthly payroll will be $8640.

Now, if you are licensed to have 6 or less, you would need to have 4 Patients always just to cover the CNA . At your $2500 rate.

According to the CCLD here in Ca. "

85065 PERSONNEL REQUIREMENTS (Continued) 85065

(4) Where the facility can demonstrate that its clients are self-directed to the extent that they are able

to plan, organize and conduct the facility's activity program themselves, the licensing agency

shall be permitted to waive these requirements.

85065.5 DAY STAFF-CLIENT RATIO 85065.5

(a) Whenever a client who relies upon others to perform all activities of daily living is present, the

following minimum staffing requirements shall be met:

(1) For Regional Center clients, staffing shall be maintained as specified by the Regional Center but

no less than one direct care staff to three such clients.

(2) For all other clients, there shall be a staff-client ratio of no less than one direct care staff to three

such clients.

85065.6 NIGHT SUPERVISION 85065.6

(a) Night supervisory staff shall meet the personnel requirements specified in Section 80065, and the

requirements below.

(b) Employees providing night supervision from 10:00 p.m. to 7:00 a.m., as specified in © through (f)

below, shall be available to assist in the care and supervision of clients in the event of an emergency,

and shall have received training in the following:

(1) The facility's planned emergency procedures.

(2) First aid, as specified in Section 80075.

© In facilities providing care and supervision for 15 or fewer clients, there shall be at least one person on

call on the premises.

"

Can you help me see things from a different angle because I am interested in purchasing a foreclosed property for the pupose of starting an Adult Board and Care in my area.

Thank You

Best bet is to hire several live-in staff and they can alternate their days off; much cheaper. Also, you will have to consider if you need two staff per shift or one (depends on residents' level of care needs, including if two person transfer etc).

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