With the demand increasing for more residential care facilities to serve the elderly, more people are considering opening their own to serve a small group. With some renovations, or maybe just modest modifications, a property can be outfitted to serve the needs of elderly residents.

If you are considering the possibility of opening your own residential care facility, here are some things to consider. First, it is important to understand that such facilities require state regulation to ensure they meet licensing requirements. You should review these requirements carefully before taking action on any plans, including determining what type of assisted living license may be required.

Second, you should understand the level of care each potential resident will need and determine whether you will be able to meet these needs appropriately. There are a number of things to consider when thinking about getting into the business of residential care for the elderly. Let’s review some key issues that you should consider.

What are residential care facilities for the elderly?

Residential Care Facilities for the Elderly (RCFE) are residences that serve people who are 60 and older and need some level of care. Residential care facilities for the elderly offer residents a room, food, housekeeping and personal care services that can include basic activities like personal hygiene, dressing, eating and getting around. Facilities are staffed around the clock to help monitor residents and typically also provide some level of medication services for residents by helping to store and distribute them.

The type of care and supervision that a residential care facility offers is usually for older people who determine they cannot live by themselves, but do not require more intensive nursing care around the clock. The residential care facility is not considered a medical facility, and therefore does not typically offer doctors, nursing, nursing assistants or medical staff within the facility. They may, however, help patients arrange visits to medical providers.

These facilities are also known as assisted-living facilities, board-and-care homes, and rest homes. They are licensed and inspected by the state, and must meet certain care and safety standards established by the state.

What type of facility should you open?

If you are considering opening your own residential care facility, you first must decide what type of facility you want to open. You can decide to open an “assisted living” facility, the type of residential facility that provides independent living options for older residents. These can include individual apartments that are similar to regular apartments within a managed facility complex. This type of facility offers limited services, based on the interests of residents and what type of assistance they may need.

You may also decide to open a residential board-and-care facility, the type of facility that offers residents more options for personal care services, which can include personal assistance daily with dressing, eating and bathing.

What type of property is appropriate for a residential care facility?

The ideal property to serve as a residential care facility depends on the type of facility that you plan to open. You can rent or buy, or perhaps use an existing property that you already own. It is important that the property is suitable and has enough space. For example, a residential board-and-care facility that can host between six and 15 residents in shared rooms may work well in a single-family home converted into a residential care facility.

A maximum of two people are allowed to share a single bedroom, so a residential home with a minimum of three bedrooms is required. A home with more bedrooms would be able to accommodate more than six residents.

It is possible you will have to renovate or modify the home in order to obtain the necessary permit to open a residential care facility. These permits require that the facility pass inspection for fire safety. The restrooms must have bars for residents to grab near all of the toilets, showers, and bathtubs. The facility’s size must comply with the regulations of the government agency that regulates it. 

Other furnishings required in such properties include flame-retardant bedding, like mattresses and pillows; and one bed, chair, chest of drawers, nightstand, and reading light for each resident. Check with the government agency that regulates the facilities for more information about property requirements.

What type of training is required to open a residential care facility?

As an owner and administrator of a residential care facility, you are required to take an 80–hour certification program, pass a simple state exam, and obtain 40 hours of continuing education every two years. Your staff must receive at least 40 hours of training at the facility within the first year of employment, including 20 hours of training before working independently with residents and 20 hours within the first four weeks of employment. They will need at least 20 hours of training annually after completing their first year of employment. Dementia care training is required for all RCFE staff. Additional training is needed for staff who help residents with their medication. 

What other requirements are there for staffing?

As the owner and administrator of a residential care facility, you will be required to hire, insure and obtain bonds for your staff. You will have to ensure that there is at least one staff member on-site at all times, 24 hours a day. Depending on the level of assistance you are offering residents, you may have to increase staffing, although there are no specific staffing quotas required for such facilities. All employees hired in residential care facilities must have criminal checks conducted on their backgrounds.

How do you obtain a license for a residential care facility?

Before you open a residential care facility, you will be required to obtain a license for it. You should first obtain a surety bond. Then collect all of the necessary documents that you will need to send with your application. These will include an affidavit regarding client cash resources, a monthly operating statement, budget information, staff information and records, and a fire inspection report. For more information about what is required to apply for a license, you can seek the assistance of reputable services that aid in acquiring an assisted living license.

Get ready to open your residential care facility

Once you have completed all of the steps of identifying the type of facility you want to open, obtained and prepared the property, hired the staff, and obtained the license, you are ready to open your residential care facility. Now you can accept residents and begin day-to-day operations. Remember you must be prepared at any time to undergo inspections from regulatory authorities that are responsible for licensing such facilities. You should also work closely with staff to ensure that all of your residents’ needs are being met and make adjustments as necessary in staffing and services.