I'm considering opening my home to an individual that needs long term care.

I would think long and hard about turning my home into a long term nursing home and that’s basically what you would be doing. I don’t know anything about you, how old you are, if you will have help, ect, but I know I’m 65 full time caregiver and it’s a lot! And to have two in your home!!! Well some people are alot stronger than others! If you are one of those God bless you for that! What ever your decision, I wish you the best!

The end of life hospice care home where my mom died was a private home that a non profit hospice provider used.

It wasn’t a ‘group home.’ The home was built to be used for hospice patients nearing death. It was a beautiful home.

There were only three residents. In my state, if there are four or more residents, the state would have to be involved.

There were four bedrooms, one for each person and a guest room if a family member wanted to stay overnight.

The home had a large living room, kitchen and library. Each bedroom had a private patio. Plus, a large patio in the back of the home.

Because there were only three beds, no state regulations had to be followed.

My mother received excellent care. The aides are hired from an agency. They worked in three shifts.

RN’s were provided by hospice. So was clergy and a social worker.

The hospice provider held fundraisers throughout the year in the community.

You will have to hire sufficient staff. Do you have plans to hire nurses as well?

You might want to speak to a death doula. Some people are utilizing their services to help them plan their end of life decisions.

As your question is “Is this type of arrangement even legal?”, you need to ask a lawyer, not us. I’m a lawyer, and I have no idea about the answer. I don’t even know where you are, and different places have different regulations. I'm quite sure that yours will be different from where I am!

We can give ‘warnings’ about how hard it is likely to be on a personal basis, but you need to check the legality yourself. Sure you can go ahead and risk it, but you are risking a great deal if it goes wrong. It might be useful to check whether your home insurance will cover it, or if you are able to obtain other insurance for the arrangement. If you can't, you probably have your answer without going any further.

In my state (MN) a caregiver is never considered "independent", they are always an employee of the person who is paying them, even PT. A written contract doesn't change this in the eyes of the state government. You need to check the laws in your state, and those that deal with what constitutes a "facility" business. You could be subject to all sorts of regulations and oversight, taxes, mandated insurances, and compliance burdens.

You sure you're not suggesting opening a group home?

What are you not considering?

1. 1 person cannot manage the care of 2 adults needing 24/7 care alone - are you planning to hire and PAY at least one other person to assist you? One is BARE MINIMUM - you would really need like 4 at least. You might be able to do it for a short period - but no breaks, no vacation time, no time away at all, no free time, no freedom - it is not sustainable.
2. You say there is no problem with the "legal paperwork" - have you considered that your homeowner's insurance would have to be updated to cover the people that are essentially tenants in your home and paying you to take care of them? Your homeowners might not even approve the changes or want to cover it due to the risk involved. And you NOT want to do anything in your home that your HO won't cover - because that can be a very painful lesson. You don't want to "act first, ask forgiveness later" - you won't get it.
3. What happens when one needs to go one direction to an appt and the other needs to go the complete opposite?
4. What happens if one has an emergency and has to go to the ER - who is going to stay with the other?
5. What happens if you have an emergency? Who is going to cover for you?
6. What will happen if you just get run of the mill sick - a cold or flu - and need a few days off to rest?
7. What about visitors?
8. Who will coordinate doctors appointments, and other appts?
9. How will payments be handled? Insurance coverages? Medicaid? Private Pay? Who will handle the payments, their finances?
10. Once they move to your home - they become tenants - which means if you have problems you can't just kick them out .They have to be evicted through due process because they have tenants rights.
11. Are you planning to cook multiple types of meals daily? Will they pay you enough to cover the additional expenses in food, water consumption, electricity/gas consumption? What if one likes a cold room and the other a warm room?
12. Are you going to limit them to how much stuff they can bring? What rooms they are allowed to be in?

I could go on - but as others have said NO, DON'T DO IT!! You won't think of all of the potential issues until it is too late. If they are private pay, what happens if they don't pay? Or run out of money?

There are just too many variables. It is one thing to go into someone's home as a caregiver by the hour, there is a start and end time - and even that is an incredibly difficult job. But if you turn your home into a nursing home - and believe me - my FIL's home was one of those homes before he moved to an actual SNF - you will have to have so many things added to make life easier. My last count of safety bars in his house was like 15 throughout the house, plus the chair lift, lift elevator, hospital bed, toilet risers, grabbers, scooters, walkers, wheelchairs, etc that enabled him to live in his own home for a longer time. Are you going to outfit your home to accommodate all of those possible needs? At what expense and who will pay for it?

You will probably need to install cameras for your safety and theirs.

Would it not be easier - if you want to be a caregiver - to find a private hire or agency job?

Dear God, NO.

Your first post you stated: "So essentially, My home would become a private nursing home."

Please check laws and regulations specific to your state.

No. This is not a good idea. In fact, it is a terrible idea. I don't doubt you on your word that you're an excellent caregiver. So get a job as a homecare worker. At least you will be able to go home after your shift.

I was a homecare worker for 25 years and let me tell you about it. Most of the time it's absolutely disgusting. You are changing adult diapers, bathing clients (often having to fight with them to do this), cleaning up "accidents", and feeding them which is usually just as disgusting. Then there's the other parts. The orneriness, the entitlement, the running around, the doctor's appointments, and the abusive behaviors that caregivers so often have to contend with. Now add the misery, negativity, and gloom and doom we also get.

The good news is you get to go home at the end of your shift.

If you turn your home into a nursing home, you do not get to.

I am going to speak very plainly here because I want to emphasize just how bad an idea this is.

Ask yourself. Do you want to live in a place that smells of sh*t and piss 24 hours a day? Or one that stinks of B.O. because the residents of your home refuse to wash up or change their clothes?

My guess is you don't want to.

Do you have any carpeting in your home? If you do it will have to be pulled up.
Do you have any furniture with upholstery that isn't made of vinyl that can be sprayed with cleaner and wiped off? You'll have to get rid of that too or cover it with plastic covers.
Carpeting, upholstered furniture and nursing home residents are not a good mix.
Do you have any pets? They may also have to go because your resident may not get along with them.
Will there be children around?

I'm not even going to get into how you will make sure you'r epaid every month or making sure that a family doesn't cut and run once they get their "loved one" into your care. I don't need to talk about this because I think I've made my point about what a terrible idea this is and others on the thread have made the financial arguments already.

This is a terrible idea. Please don't do it.

Also check local laws about zoning and your neighborhood. There maybe restrictions on business use. There are in mine. Parking for aides and health care provider may be restricted. Overnight parking for non residents etc

Joann29 Is spot on about seeing a lawyer.
She is right about eviction
I think back to the number of times that I have seen someone on this site mention an "ER Dump" and I can only imagine a family getting together money to pay for a month at your "Home" and never to be seen or heard from again.

I hate to be crass but maybe limit your "residents" to those on Hospice. That way the typical length of time would be 6 months give or take. It would also limit the "nursing care" as there would be no IV's, in most cases no "tubes"

After dealing with my Husband I can not imagine caring for more than 1 person with dementia at a time.
I can't imagine trying to change bedding, briefs and clothes on more than 1 person at a time.

I think there maybe a limit on residents. Like a child daycare. I can care for 5 children before I need to be licensed. I would talk to a lawyer. I definitely would have a contract outlining what you will do. And when you feel the care goes beyond your ability. A clause saying no pay no can stay. See how you can get around the eviction laws. You will be running a business. You will need to deduct payroll taxes. Especially for aides u hire. IRS does not recognize aides as self-employed. Me, I would not do it. Too much responsibility for someone who is pretty much a stranger.

Are you going to be the only one doing the caregiving?

Are you prepared to be awake various times in the night, with no respite?

The problems will be state and federal regulations, primarily.

I am taking it as a given that you fully understand elder care and would enjoy doing it. In fact HAVE DONE IT.

I would tell you that a Forum of caregivers who for the most part did caregiving in their own homes you may get less info here than if you were to honestly ask/pay for a few hours time with people running a Board and Care "six-pack" as they call then. These folks often provide a truly home-like atmosphere for their residents because in fact they often ARE homes and are run by entire families often enough.
I would ask if you can volunteer a few days a week. I would ask if they would be willing to discuss how they deal with State and Federal regulations, bookkeeping, ADA laws, rules, regulations.

Good luck to you.
Would love to see updates.

*Fire inspection. You may need a sprinkler system
*Local Building inspection and compliance with codes.
*Health Department. You will need a Food Service certificate and your kitchen will need to be inspected and it will have to comply with Sate and County, City regulations.
*Medicare inspections.
*State Inspections.
*Insurance, Liability.

Is your home actually set up to be a care facility? Is it handicap accessible? Are there large enough bathrooms for 2 people, maybe 3 and equipment? Are there wide doorways, wide halls, stairs, carpet?

And this is not even touching on being a sole caregiver.
Read some of the comments and caregiving is not easy and to do this yourself is a challenge.
While your intentions are admirable this may be a very daunting and expensive endeavor.