Board and Care Homes for Seniors
Board and care homes offer assistance with everyday tasks in a small, homelike environment.
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When it comes to housing, making decisions for a spouse, loved one, or even yourself regarding long-term care can be overwhelming. You can choose from many types of senior care facilities available today: assisted living, independent living, nursing homes, continuing care retirement communities, and more. But what if you’re looking for a smaller and more personalized option that just offers assistance with everyday tasks in a home-like setting?
One of the lesser-known options for seniors is a board and care facility. Board and care homes, a term frequently used in California and Nevada, are also called residential care facilities across the U.S. Residential care facilities encompass various types of residential living arrangements including small residential care homes.
When choosing this or any other senior facility, consider the type of environment, assistance, amenities, and medical staffing needed. Some facilities provide more privacy, like apartment complexes. Some facilities like nursing homes offer more round-the-clock nursing care. Board and care facilities are like assisted living communities, but smaller and with less amenities. In this guide, we’ll discuss board and care homes, the services they offer, their costs, and more.
Table of Contents
What Are Board and Care or Residential Care Homes?
Board and care homes are small in scale and provide residents with a room, board, and assistance with bathing, grooming, and other common activities of daily living (ADLs). Many enjoy the familial setting as it’s more intimate. These sites can offer both shared and private rooms, with private rooms being more expensive. On-site amenities differ as well.
Our free housing and care finder uses your unique needs to curate a list of the best options in your area.
Senior residences range in size. State laws will determine what type of help and service these locations can offer. Board and care facilities should always be licensed by the state.
Pro Tip: The smaller size of board and care homes provides a significant advantage: a lower staff-to-resident ratio. The ratio is especially relevant as staffing shortages in long-term care facilities across the country remain a vexing concern, especially when an increasing number of seniors need long-term care.1
How Is a Board and Care Facility Different From Other Senior Care Options?
Care at senior centers ranges widely to accommodate the needs of individual residents. For example, board and care facilities don’t always have medical staff available. While trained workers are present at the location — your loved one is not left alone — the location might not have registered nursing staff on site. So consider your medical needs, as this significantly differentiates a board and care home from a nursing home that offers 24/7 nursing care.
Also, consider the amenities. While board and care homes may provide communal areas for socializing, home-cooked meals, assistance with medication management, and help with everyday tasks, they generally can’t match the amenities that assisted living locations offer. Assisted living facilities often feature restaurant-style dining, fitness rooms, beauty salons, pools, clubs, and organized social activities.
What Services Do Board and Care Homes Provide?
Most of these small group homes will provide the following services:
- Housekeeping services, including general cleaning of the resident's rooms and bathrooms.
- Laundry assistance.
- Transportation to and from appointments. In addition, residents might be offered transportation for group outings like trips to malls, events, and churches.
- Meals.
- Medication management is commonly offered. Most locations can help with planning and reminders to take medication. However, those dispensing medication must have proper certification. If this is a service you need, be sure to ask if the location is licensed to provide it.
Did You Know? State-specific requirements for facilities influence what meals are offered in board and care homes, according to the National Center for Assisted Living (NCAL) annual “Assisted Living State Regulatory Review.” This ensures compliance with nutritional guidelines and resident dietary needs.2
What Are the Benefits of Board and Care Homes?
The biggest benefit of board and care homes is that everything is more personalized. If you live in a care facility with less than 10 to 20 people, you’ll receive more attention and can get to know others more easily than at an assisted living facility that houses hundreds of residents. Fewer residents and a lower staff-to-resident ratio can create a friendlier environment and an opportunity for more customized care. Many residents gain a strong sense of community. The smaller size fosters a close relationship among residents and between staff and residents.
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How Much Does Board and Care Cost?
Board and care residence costs aren’t factored into Genworth’s national database. Therefore, comparing their cost with the costs of assisted living facilities and nursing homes is challenging.
Generally, board and care homes are more affordable than their counterparts. They have lower overhead costs due to their smaller scale and their focus on essential personal care services. Their costs are usually less than that of assisted living facilities, which are heavy on amenities, and nursing homes, which are saddled with providing extensive medical staffing and medical equipment.
A comparison is also hard as costs for assisted living centers and nursing homes vary widely by location (urban areas tend to be more expensive), the level of care required (dementia care can impact costs), the specific amenities and services offered, and the quality of the facility (higher-quality facilities with better staff-to-resident ratios and more modern amenities will generally be more expensive).
Pro Tip: Check out our senior care and housing costs guide to see current costs for assisted living, nursing home, memory care, adult day care, respite care, continuing care, and hospice care so you know the pricing ballpark in today’s market.
How Can I Pay for Board and Care?
According to the National Institute on Aging, you will likely be responsible for paying to reside at a board and care home. Individuals usually subsidize their residency through their Social Security funds or retirement funds.
Long-term care insurance can help pay for board and care homes, but it all depends on the policy and specific facility in question.
Medicare does not cover board and care homes. (They pay when medical assistance is involved and necessary.) Medicaid may provide some coverage, but you need to check on your eligibility and the rules of the state in which you reside.
Where Can I Find Board and Care Options?
Board and care homes can be found in many states. Families can locate this type of residential care facility through various resources, including state-specific long-term care ombudsman programs, local Area Agencies on Aging (AAAs), and through online searches and sources. You can also use our senior living directory to find local options.
How to Choose a Board and Care Location
Before choosing any location, verify that the sites maintain proper licensing and certification through the state. You can check with your Department of Health and Department of Social Services to locate specific board and care facilities near you and to learn more about any complaints or concerns lodged at these locations.
Most importantly, visit the location. Stop by unexpectedly to see what is happening. It’s essential to visit the facility, meet the staff, and learn more about the residential care plans. You should also look into safety and emergency protocols that are set up. Gather as much information as you can before you make such an important decision.
McKnights Senior Living. (2024). The answer to tackling the staffing crisis: start with the culture.
AHCA NCAL. (2024). State Regulatory Resources.
