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Oregon Senior Referral Agency Association Raising Industry Standards since 2004

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What Is An Adult Care Home? – Part 1

What Is An Adult Care Home? – Part 1

October 7, 2017 By Sande George 6 Comments

Adult Care Homes, also called Adult Foster Homes, [ACH or AFH] are single family residences offering care to senior adults. They provide a home-like care setting.

Care homes are usually located in residential neighborhoods and look like any other family home. The difference is that the home is licensed to care for older adults who are not family relatives.

A Little History of Adult Care Homes

Historically, our frail elderly lived with family, friends, and neighbors – often with several generations under one roof. Housing and care arrangements were informal.

After WWII, nursing homes, formerly “poor houses”, began providing care to the very poor, frail and disabled within a community.

In the 1960’s, significant government oversight and regulation of nursing homes was set. Laws enforced compliance with safety codes. The government began funding care through Medicare and Medicaid. Nursing homes became a highly regulated industry and care became institutional.

Nursing homes became institutional

During the 70’s and 80’s, the informal care provided by families and neighbors shifted. Because care homes provided less institutional care than nursing homes, they became more prevalent. Care home became a direct competition to nursing homes and so an industry was established.

Government regulation, oversight, and supervision expanded too.  Adult care homes today are regulated almost as much as nursing homes.

Care homes are limited in how many elders can live in the home. In Oregon, the limit is five residents.

A resident is an elder who’s not directly related to the provider. Limiting the number of residents helps maintain the home-like, family atmosphere of care homes.

Care providers live in the home and give personal help and medical care to their elderly residents. Residents can never be left unattended – a caregiver must be in the home at all times. Adult care homes provide closer supervision because of the smaller environment. Caregivers can respond quicker to resident needs.

In comparison, larger facilities have a higher ratio of residents to caregivers; each caregiver has more residents they’re directly responsible for.

Adult Care Home Licensing and Inspections

Each care home has one primary business owner and operator. Owners are liable and responsible for compliance with all rules and regulations. Some homes are operated by registered nurses or other medical professionals, but it’s not required.

Owners are not required to live in the home or always be present. They may even own more than one home. But owners must be available by phone in case of emergency.

Owners may employ qualified caregivers and resident managers – who are required to live in the home.

Again, the state wants care homes to maintain a home-like environment which means limited shift workers. When caregivers or care providers live on premises there’s a greater sense of bonding and family atmosphere. 

The State licenses both the home and the owner

  • Homes must meet structural and safety requirements.
  • Care providers must meet certain standards such as documented caregiving experience, pass criminal background checks, complete basic training and pass an exam in English. Yearly continuing education is required to maintain a care provider’s license.

Adult Care Home Licensing and Inspections

All homes are inspected and licensed by the Department of Human Services on a yearly basis. The inspection is unannounced and conducted by a licensor or other assigned State/County employee.

Inspections include: 

  • a review of all resident records,
  • medication administration logs,
  •  physician orders,
  • written care plans,
  • change of condition notes,
  • contracts, etc

In addition, the inspector will ensure the home’s structural safety compliance, medications are locked, hazardous materials properly stored, water temperature is correct, and much more.

The licensor may even conduct a fire drill. In Oregon, caregivers must demonstrate they’re able to vacate all residents within 3 minutes in event of a fire.

Adult Care Home Custom Construction

Homes vary in size, aesthetics, and amenities. Homes may offer private or shared bedrooms. Private bedrooms may have a private en-suite half-bath. In older, converted homes, the bathrooms are often shared. A separate shower room is standard and used for scheduled bathing.

In the last decade, newly constructed custom-built care homes have changed the ACH market. These homes have all the latest innovations: roll-in showers, call systems, security systems, private bedrooms with private bathrooms and aesthetic features.

The larger, new construction and amenities meet the higher expectations of today’s consumer.

However, homes with all the latest and greatest amenities don’t necessarily provide better care. They may, in fact, reduce the “family factor”.

Basics Services Provided in Care Homes

  • Homes must provide room and board as part of the month to month rent.
  •  Base rent is comparable to assisted living and residential care rates.
  • Care and personal services are an additional monthly rate and can increase as care needs increase.
  • The maximum amount of care a home provides depends on their personal limits and their licensing level set by the State.

Types of Payment Accepted in Adult Care Homes

Medicare does not pay for adult care homes.

Payment for the monthly charges in an Adult Care Home are: private pay, long-term care insurance, and possibly supplemental Veteran’s benefits (Veteran benefits are not enough to cover 100% of rent + care).

Some homes accept Medicaid. (a State & Federal low-income assistance program – see article and video, Medicare vs Medicaid)

Important Note! Understand Medicaid

  • Understand Medicaid when considering an adult care home.
  • Owners can choose to maintain a contract with the State and accept Medicaid reimbursement.
  • The State sets the reimbursement rate. It’s much lower than the open market rate. 
  •  Family can not "supplement" to make up the difference between Private pay market rate and the Medicaid reimbursement rate. It's illegal and considered Medicaid fraud.

If a care home has a Medicaid contract,  they are not obligated to accept new residents currently on Medicaid.

Homes often have a contract so that their long-term clients, who run out of private money, can continue living in their home. 

Read the contract regarding Medicaid carefully. Contact an OSRAA agent for help.

Summary

Adult Care Homes offer a viable alternative to the larger assisted living and nursing home facilities. Is a care home the right option for you or a loved one? The same reasons making a care home the right choice for one person can be the same reasons it's the wrong choice for another.

Call an OSRAA member if you’re considering an adult care home for yourself or a loved one. Get expert guidance, information, and peace of mind.

Members Directory

See Part 2 about the Pros and Cons of Adult Care Homes:
“What Is An Adult Care Home? Part 2”

 You’ll gain insight about specifics of care provided and the personality of residents best suited to care homes.

Filed Under: Adult Care Homes, Long Term Care, Senior Housing Tagged With: housing

Let’s Share Housing:  Thinking Outside the Box

Let’s Share Housing: Thinking Outside the Box

June 20, 2016 By Michele Fiasca 2 Comments

let's share housing
© Can Stock Photo Inc

With Boomers rounding the corner on their “Golden Years” and so many not financially prepared, how do we invent a lifestyle that is both affordable and engaging? Whether devastated by the recession or just plain failed to save, the result is the same. Millions of Boomers don’t have enough money to make ends meet and the options look bleak; work ‘til I drop…maybe, but live with my kids… never!

But wait a minute here…try thinking outside the box. How about the idea of pooling resources and sharing your life with others by matching yourself with compatible housemates? That way each party lives for a fraction of the cost and can actually afford to think about retirement. What might be possible if those housemates actually thought of themselves as community and elected to age together and support one another as a lifestyle choice? Welcome to a new model for aging! Let’s Share Housing is a tool for matching homeowners with compatible housemates or the opportunity to meet other home seekers interested in renting a place together.

Let’s Share Housing: A New Approach to the Sharing Economy

Now I realize this idea flies in the face of the “American Dream”, you know the one… where everyone has their own home, their own car and their own lawn mower? The one that keeps you on the treadmill of work, work, work, so that when you do finally have a day off all you do is recuperate so you can go back to work again? How about taking life easier NOW, by sharing? Wow, what a concept!

So what might the benefits be? How about that trip of a lifetime you’ve been dying to take but could never get away… well now you can! Or what about all those leisure activities you would just love to do but never have the time…well, now you do! Maybe you are passionate about volunteering or have some great idea that you’ve always wanted to develop into a little business of your own. Let’s Share may be your answer!

How about having folks to socialize with right where you live? And who says you have to live with other Boomers? Maybe you’d prefer having some younger or older folks around to share your life with! The possibilities are limited only by your imagination.

Shared housing offers us the opportunity to be proactive and create our own futures. You can group yourselves any way you choose…artists, musicians, organic gardeners, etc. etc. Maybe you don’t like to cook so your dream is to live with someone who does! If you like lots of alone time how about finding someone who still works full time so you could have the house to yourself all day? What do you want…what would make your life more enjoyable and less stressful? Be creative; let your imagination run wild!

Want to know more? Come join us for a Meetup here in Portland OR. You can find us at Meetup.com/Lets-Share-Housing/. We will be launching our website within the next few months and you can sign up on our landing page right now at LetsShareHousing.com to receive an email alert when we launch.

Hey there…happy sharing and cheers to a new way of life! Live better together…

Filed Under: Blog Tagged With: housing

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