Starting a Personal Care Home

Personal Care Homes, also called Assisted Living Facilities, are residential homes or apartments for senior citizens or individuals with intellectual disabilities, cognitive disabilities or “mental retardation”. These Personal Care Homes are designed to provide shelter, 3 nutritious meals a day, laundry services, hygiene assistance, ADL’s, and transportation. Some offer activities like arts and crafts, exercise, church services, outdoor trips, movie night, etc.

Personal Care Homes are often recommended to Senior Citizens by their children, physicians, family members, social workers, hospital discharge planners, or themselves. Most seniors who are having difficulty staying home alone are ideal candidates for this program. Some find that they are falling more and becoming a danger to themselves. Others might find that they are forgetful, confused or disoriented at times. Still others desire the social interaction with their peers in a safe, clean, and loving environment.

Nowadays, adult children are unable to care for their aging parents due to their own busy schedules, lack of financial resources, or due to the long distance that separates them from their parents. Personal Care Homes offer a great alternative to living without their own family. In some states like Georgia, a Personal Care Home can have as few as 6 residents in the home which offer much more one on one interaction and care. Most of the residents have their own room in which they can bring personal touches from home such as pictures for the wall, curtains, bed linens, toiletries, and some small furniture.

Residential services to those with “mental retardation” or more appropriately, “developmental disabilities or intellectual disabilities” are a great option for those adults, ages 19 and over, who desire to live alone or whose family is ready for them to make a transition to more independence. Although, living in a Personal Care Home is not living alone, it offers support and guidance to those who have always lived with a family member or in an institution for many years. It is extremely important that the staff at the Personal Care Home are especially sensitive to this population who have often experienced abuse, neglect and institutionalized living for most of their life. The transition period may take longer than it would for a Senior Citizen, so great care and patience must be a priority and no tolerance for neglectful, harsh or abusive language or actions should be accepted by the Personal Care Home management.

Individuals with intellectual disabilities often attend programs during the day time hours to learn new skills and often have jobs with real employers providing real pay. These jobs may be menial or tedious for some, but for this population bagging groceries, stuffing envelopes, gathering shopping carts, putting small plastic pieces together in a factory are rewarding and stimulating jobs to have.

Of course, like everything else, there is a financial cost associated with Personal Care Homes. Most seniors use their pensions, retirement or social security income to pay the cost for this service. The fees for Senior Citizens range greatly from Personal Care Home to Personal Care Home. In Georgia, for instance, a small PCH of 6 residents may charge anywhere from $1,300 per month to $2,000 per month. The price is sometimes determined by the location of the home, the size of the room (private or semi-private) and the services offered. Some PCH owners make special concessions to those who cannot pay the full price. Others use State programs like Medicaid funded programs that can supplement the cost if the Senior meets their eligibility requirements. The owner of the PCH will need to apply with the Medicaid program (SOURCE or CCSP etc)  in order to be a Provider for this service. Usually each state will have a Department of Human Resources, Department of Community Health or Department of Behavior and Developmental Disabilities) or something similar that can provide information on how to become a medicaid provider for residential services for the elder population.

Often, the individual with a developmental disability already has a Medicaid Waiver which grants them a certain amount of funding toward residential services. It is the waiver that allows payment to the Personal Care Home provider. This population often has a Support Coordinator or a Case Manager who helps them to make life choices and help apply for Medicaid Waivers and other programs suitable for their individual needs. They even help the individual choose which PCH they want to reside in. Again, the PCH owner has to apply with the State in order to become a Medicaid Provider for this population and to receive payment for the services. The applicant must be qualified to become a medicated provider or he or she will have to hire qualified professionals to help with this endeavor.

Of course, the state is the first place to contact when you are ready to explore opening a PCH. This work is not easy, it requires a 24 hour commitment and loving care for those that live there. It is constant cooking, cleaning, bathing, laundry and loving interaction. It’s also helping with doctor appointments, medication compliance and coordination of services.

The State will send out a booklet providing the guidelines and rules on Personal Care Homes. In Georgia, it is the Health Care Regulatory services who will send out all the information you need to get started or you may have to go to their website for an application. Use these guidelines to write your own home’s Policy and Procedures. Create the standard that you want in your home.

My advice is to write the Policy and Procedures before getting a home. This allows time to write without feeling pressured. If you get a house first, you will have to pay on a mortgage or rent while you are putting your Policies together. Also, start purchasing the furniture before you get a house. If you begin to accumulate what you need now, just store it until you are ready to move in. Many owners purchase their furniture from second-hand stores, garage sales or even from friends. Have church members, family members, coworkers and friends donate furniture to you. Be sure to tell them what you need or you’ll end up with lot of stuff you don’t need.

Some PCH owners purchase their homes for this business, while other do a lease-purchase which allows them to pay as they go. Others find success in renting a house as long as the owner is aware of what you will be using the house for and signing an affidavit that supports the agreement. Still some use the home they live in as both a PCH and their family home.

This information is just enough to get the ideas flowing. Please respond to this blog, offer insight, corrections, updates and other information that one can use in starting a Personal Care Home. Your comments are most appreciated.

I will share more information as we go along.  Let me know what topics you are most interested in.

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