Private Home Nursing

Hello,

I am trying to find out if there are RN's, retired or otherwise, who run their own practices from inside their own homes to give care to skilled-care level elderly people. I was told this exists in the state of Florida. This was mentioned to me as a solution for elderly who don't have the financial resources to go into a nursing facility or to hire private care within their own homes. Has anyone heard of this?

Thanks! :)

I've never owned a home such as you describe however a dear friend of mine did. When my friend became ill and was unable to run these houses herself I pitched in to help.

It isn't as easy as most people think. Most getting into it think they are an RN therefore obviously, they could provide good care. Most don't realize the basics. First of all laws in different states vary. I can only give you issues to think about, you'll have to call your local licensing authority to determine what the requirements are where you are. Usually it is the Department of Health Services that does the licensing.

You need a home, one tyipically with a sprinkler system and full fire alarm with an alarm board. If the house doesn't already have that you are talking somewhere around $15,000 or more just for that. You need a house DHS (or the licensing authority.. I'll refer to it as DHS for the sake of this post) approves of and that means wheelchair acceptable. The hallways have to be "X" inches wide. I'm talking a private home here, not a SNF type facility. If you buy an existing licensed home that doesn't have basic fire safety (sprinklers) don't bank on it being grandfathered in. The previous owner can grandfather it in, you won't. You'll be buying the whole alarm system just because you are a new owner and grandfathering in requirements may or may not apply to you.

Depending on the level of care you'll need 24 hour staff. Not sleeping staff but awake staff.

Insurance is tough to come by... depending on the exact level of care.

Your kitchen will have to meet specific standards.

Filling beds is NOT as easy as you think. Keep in mind, you are only about the 4,496,958,284,940th person to think of this great idea. Let's say you have four patients in your home, 1 moves out, 2 die, you have one person left and three shifts of employees that you still have to keep for that one person. I won't even go into issues involving staff. Oye veh...

It's one thing when patients don't get along w/each other in a SNF type facility, it's a whole new ballgame in a small private home where going to the other end of the house is only a few feet away vs. way on the other end of a SNF. They don't like their housemate and they move. Or the family moves them.

Then you have DHS inspections, menus that pass DHS standards (that's usually pretty easy), family members to deal with, medical appointments, podiatry care, entertainment, .. oh, back to menus, when people are paying cash money for their care they demand verrrry good food. It isn't like in a hospital where people moan and groan about it. It's different when people write that check with your name on it, they expect certain types of meals.

Your fees; that's a whole other ballgame. You want SNF level patients in a residental home setting and you are talking having to charge them quite a bit. Most don't want to pay that much, if they can afford that level of care without Medicare helping them then they usually have someone come into their own home and take care of them.

I could go on and on and on but it still wouldn't cover everything. People start seeing $$ and they think "X" dollars is really great money assuming they fill all the beds. Then they discover expenses you just never imagined.

It's verrry hard work, rewards are few and far between, and the money... it's not all that great after you pay the bills.

However, remember... every state varies in their laws. Maybe they make life easier for you in your part of the country, but not here.

Your information was extremely helpful. The only thing I'm left wondering is...do these types of homes still exist anywhere? Do you know of any? I was told there are some in Florida.

Thanks again for all your input...much appreciated :)

Your information was extremely helpful. The only thing I'm left wondering is...do these types of homes still exist anywhere? Do you know of any? I was told there are some in Florida.

Thanks again for all your input...much appreciated :)

It's funny because I became a realtor in 1999, and my first assignment was to look for several of these homes for my first client, they are called ALF's Adult Living Facilities, and since they are real estate property, they are sold by realtors... just contact a local Florida Real Estate Agent and tell them that you are looking for an ALF with such and such quanity of beds, rooms, etc...

p.s. I am going to nursing school in August, once I get my experience, this is going to be my first project... owning an ALF

BYE

There are some in Alabama. The most sucessful is ran by a lady and her husband. They are both at home with them at all times. If they leave, they get thier daughter to sit for them. It is demanding, but very rewarding when you keep someone who is terrified of nursing homes from having to go to one. :)

I had two friends who had ALFs in their home in FL. With 5 clients or less they did not even need a license. Everyone seemed very happy, clients and owners. Go to Nursing Entrepreneurs discussions on this site and you will get a lot of support for starting your own business.

Everyone has been so helpful with my inquiries on this site! :)

Thank you all so much for all your input!!! I truly appreciate your help!

Your information was extremely helpful. The only thing I'm left wondering is...do these types of homes still exist anywhere? Do you know of any? I was told there are some in Florida.

Thanks again for all your input...much appreciated :)

These homes exist in every state, I suspect. Some are very good and some are not.

If I were you I would do this, call the licensing authority (usually Department of Health Services) and tell them you want to place grandma in one of these homes. Find out all the levels of care available in your state and determine which one you are interested in. Then ask them for a list of all their licensed homes within that level of care. This should be free because you just want to find a place to put dear dear old grandma and DHS doesn't usually want to charge for helping you to find good placement. In my state they can email you a list of all the homes they inspect.

Pick out a few of these homes and just go look at them. Act as though you are placing grandma and see what they have to offer, what the house feels like, what kind of staff do they have, and find out what they charge. Then that will give you an idea of what you can charge. It will at least give you a starting point.

Remember, various levels of care have various staffing requirements. Keep that in mind when you determine which level of care you want to provide.