Anatomy of a Well Run Residential Care Home (aka Group Home)

Post date: May 18, 2014 3:19:42 AM

May 17, 2014 Martha Batista, President & CEO

We have visited hundreds of Residential Care Homes (group homes) in the Valley and have come to appreciate those that offer exceptional care and are run like a fine Swiss time piece. So, what is the anatomy of a well-run group home? Just like a healthy and fit person must focus on several aspects of life to achieve wellness (diet, exercise, meditation, etc.), a well-run and thriving group home exhibits unique characteristics in its owner, manager, caregivers, processes and other critical indicators.

The Owner

A well run group home has a very involved owner who is not just concerned about the business aspects of the group home, but is integrated and knowledgeable about everything that happens on a daily basis. We prefer an owner that is not a caregiver. The reason is because a caregiver should primarily only do one thing…care for the residents. The owner has a lot more responsibilities that cannot easily be done if she is busy providing the care. An involved owner makes frequent visits to the home, talks to residents and their families, takes the time to meet with perspective residents, continuously develops the skills of the caregivers, follows changes in regulations that effects the operations of the home, and strategizes and plans for how the services of the home can be improved.

The Manager

The manager could also be the owner. A manager is usually in place when an owner owns multiple group homes, or the owner is more involved in the marketing aspects of the business. We find that managers of a well-run group home are very involved and present in the operations of the home. The manager ensures that certain processes are in place and that caregivers are trained and knowledgeable about these processes. They handle escalated family and resident issues as they arise. They make sure that the home has what it needs to provide its services, from the food to cleaning supplies to incontinent products.

The Caregivers

Caregivers of a well-run group home are certified, trained and receive on-going training and development feedback. Also, it is understood (by owners and managers) that caregivers are “where the rubber meets the road”. At the end of the day, the caregivers are the ones that provide the “product” that the family or resident is buying. If is not good, the home will not survive. They are the ones that have the most contact with the resident and the family. Caregivers of a well-run group home are appreciated, respected, well rewarded, and never treated as low-paying employees. We like caregivers who have tenure in the home (this also indicates that the owner/manager is doing a good job maintaining a stable caregiving team). The main responsibility of a caregiver is providing care, not cleaning, not cooking, and not shopping for food. A home with multiple caregiving shifts or with a support staff, like a cook or administrative assistant, allows for these other essential but non-caregiving tasks to be done by someone else than the caregivers.


The existence of established processes is the fourth dimension of a well-run group home. Processes such as what to do in an emergency, handling resident or family complaints, investigating a fall or a medication mishap, ordering medications, handing off from one caregiver shift to another, etc. are well understood by everyone involved in the operations of a group home. The flow of information is critical for the well-being of the residents.

Other indicators

Deficiencies –Arizona conducts annual surveys of the licensed communities and homes in the state and publishes the “deficiencies” found. The number of deficiencies is an indicator of how well a home is operating and managed. A high number (10 or more) may indicate lack of good management. However, one must also pay close attention to what the deficiencies were. A deficiency dealing with medication management is much worse that a deficiency dealing with some sort of documentation (in our opinion). In addition, one must also pay attention to how long it took the home to fix those deficiencies. A home that took care of the issues in a timely matter is much better managed than one that took months to resolve the issues.

Physical aspects of the home – does the home appear well taken care of? Is it clean? Is it clutter free? Are there unpleasant smells? A well maintained, clean and clutter free home indicates management’s attention to detail that can extend to everything else done in the home, including how medications are managed to how residents are cared for.

Insurance – One of the most important questions (among many) that we ask a group home’s owner or manager is if the home carries liability insurance. If the answer is no, we encourage them to buy this insurance. It is important that the home be protected against unfortunate events that may cause it to be financially unstable.

These are just a few of things we look for when we visit a residential group home.

For more information: please call 480-788-8680