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How to Start a Board & Care Home

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As long as the population continues to age, there will always be a need for care facilities for elderly and disabled individuals. The needs of these individuals will vary depending, it can be anywhere between intensive full-time to minor assistance for the people being cared for. Board & care homes are available for a wide range of people, from those who are mentally ill to those who are physically challenged, such as elderly and disabled folks.

In order to start a board & care home, you will need to have a great eye for detail and know the laws and regulations. Opening a boarding home would help to increase employment and care opportunities.


Step One: First, you will need to consider how many clients you'll want to be able to take care of -what's your max? Some Board & care homes accommodate only four to six residents at one time, while others are known for taking care of a more substantial amount.

Step Two: Now, you will need to find out who you would like to offer your care services to. This means you will have to choose whether you want to help senior citizens, physically disabled and/or mentally challenged. You can help one, two or all if you please, but most only specialize in one type of need. It's a good idea to get in touch with the social services department in your county to speak with social workers about your business plan. They will be able to offer you advice and suggestions regarding your board & care home. You should also consider whether you want to offer long-term or short-term care.

Step Three: How will your board & care home operate on a daily basis? Will you be offering assistance with daily activities? And what level of assistance will your crew members offer residents? Will your board home offer medical services? If so, you will need to hire a medical staff that is licensed and knowledgeable in that area. You can develop support systems within your community from medical clinics, community centers, classes and continuing education programs. Also, see if there is public transportation available for the residents who may use it.

Step Four: Hiring your staff members is the next step. If you will be hiring medical personnel, you will need to ensure that they maintain state certificates and licenses. Your state's health department administers the licenses for medical practitioners. Anyone who applies for a medical position at your boarding home, you will need to ensure that you verify their license to practice in your state. In some states, even the non-medical staff members will have to have certification. Make sure to find out who needs licensing and what the requirements are to work the positions that you're trying to fill. You can find this information out by contacting the human services or human resources department at your state's department of social services, or DSS.

Step Five: Get to know the license requirements for beginning a board and care home. Each state has its own regulations, so get familiar with your state's laws and rules. You can find this out by contacting DSS. Any forms that are needed can be obtained from the licensing division of DSS website. You can go here to apply for a license to run your boarding and care house as well. You will be asked questions about the location the home will be, how big you plan for it to be, sources of funds and your plans for staffing the home. It is required that you attach zoning and building code approvals relevant to your home. Last, you will need to prove that your board and care home meets all requirements regarding safety features and handicapped access.

Step Six: Now, is the time to build your care home. First, you will need to apply for a business license within the county you'll be operating the home in. You can obtain this from your county or municipal government office -the license is related to operating a residential care facility. You'll need a zoning approval from the county or municipal government office as well.

Step Seven: Registering your care home with Social Security Administration and Medicaid is the next step. This will make you eligible for accepting residents who have Supplemental Social Security benefits and Medicaid. Many SSI and Medicaid clients are referred to state-licensed board and care homes, so make sure to list your home with insurance companies. When referring clients to a facility, insurance companies rely on Medicaid approval.

Step Eight: Administrative accounting and financial procedures will need to be set up for your home. It is important that you know how you will bill your clients and their insurance companies, or other government agency that pays for the resident's care within your facility. You will need to register your home with the IRS for tax purposes and with the State Treasury Department for state taxes. Then you can get an EIN, Employee Identification Number, from the IRS for each of your employees.

Step Nine: Now, that your business is set to go, you will need to begin looking for residents. Start advertising your home and alerting your state's DSS office and Medicaid office. You can also let insurance companies now about your home as well. Placing ads in newspapers and health related magazines could also help out. Hanging up flyers in community centers, doctor's offices, churches, hospitals and other places where potential clients and their families may see it.

Step Ten: Learn about the requirements for staff training in your state. In some states, it is required that annual sessions are held for retraining purposes for your staff. You can find accredited courses at DSS for your employees.
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