A century ago, "old folks homes" were just that - homes which housed the elderly. People either opened up their homes to take in elderly clients or in select cases, the wealthy gifted their large homes and mansions to elder-care foundations. The days of easily turning a house into a residential care business are gone. Today, there are numerous regulations over assisted living facilities which include building codes, staffing requirements and licensing. Depending on your house, neighborhood and state, it may not be possible to convert your house into an assisted living facility. If it is, be prepared for a lengthy conversion process.
How to Turn Your Home Into an Assisted Living Facility
Check the zoning of your property with your city or county. Assisted living facilities are businesses and may not be allowed in residential zones. If your municipality allows you to convert your home into a business, inquire about the application process for a local business license.
Research your state laws and regulations on assisted living facility licensing. Most states place assisted living licensing under a department related to health or social services. In Texas, the Department of Aging and Disability Services oversees assisted living. In California it's the Department of Social Services and in Washington State it's the Department of Social and Health Services.
Study the regulations on facility space, structural and safety requirements and compare them to your home. Identify the modifications, renovations and installations you will need to comply with the codes.
Secure financing sufficient to make physical changes to your home as well as to hire the clinical and support staff required under state law. Assume it will take at least six months before revenues build enough to break even. If you have even one resident, you have to comply with state staffing requirements - which may make your business unprofitable for awhile.
Hire a contractor with experience in assisted living facilities, skilled nursing facilities or other health care structures. Get several estimates before proceeding with work that will transform your home into a licensed assisted living facility. Check with your contractor as well as your municipality about any building permits that might be required for the work.
Apply to your state for licensure as an assisted living facility. Depending on the state you may need to present blueprints and a business plan in addition to your application form and fees. Expect the state to schedule a site inspection shortly after you file your application. The inspection will either result in a list of modifications you will need to make or an issued license.
Hire or contract required staff which usually include a nurse who visits a certain number of hours per week. States usually have staff-to-patient ratios which you will need to maintain as you accept residents.
- Washington Department of Social and Health Services: Information for Boarding Home Providers
- California Department of Social Services: Community Care Licensing Division
- Realty Times: Converting Your Home Into a Long-Term Care Asset
- Texas Department of Aging and Disability Services: How to Become an ALF Provider
- Genworth. "Cost of Care Trends and Insights." Accessed Oct. 25, 2020.
- U.S. Centers for Medicare & Medicaid Services. "What Part A covers." Accessed Oct. 25, 2020.
- Social Security Administration. "Supplemental Security Income (SSI) in California," Page 2. Accessed Oct. 25, 2020.
- U.S. Department of Veteran Affairs. "Enhanced or Special Monthly Pension Aid and Attendance or Housebound," Pages 1-2. Accessed Oct. 25, 2020.
- U.S. Department of Veteran Affairs. "VA pension rates for Veterans." Accessed Oct. 25, 2020.
Eric Feigenbaum started his career in print journalism, becoming editor-in-chief of "The Daily" of the University of Washington during college and afterward working at two major newspapers. He later did many print and Web projects including re-brandings for major companies and catalog production.