LIVING SOLUTIONS: Residential Care Homes & Hospice

March 2026

I had heard of residential care homes(RCH) but it wasn’t until I was looking for an appropriate place for my Mom and Dad that I came to learn about RCH or group homes.

In our immediate neighborhood we have 6 care homes. A care home is a privately owned home where individuals live together, each person usually has their own room, some have an ensuite bathroom, some share bathrooms. All meals are community. Nurses come to check on you periodically but if there is a problem they will visit more frequently. One or two caregivers are present during the day and night depending on the number of residents. Residents may have a variety of health issues such as dementia or motor problems. I know of a care home that had all 90 year men who were all in good health. It can run the spectrum.

I had the opportunity to chat with my friend, Kathy Hileman, a Licensed Clinical Social Worker. Kathy has many years of professional experience in both care/group homes and hospice. For the past few years she has also had a very personal experience.

I invited her to share her story. This is a frank discussion about residential care homes and hospice.

Universal Design is a great help when choosing a residential care home. The UD features to be aware of are flexible, intuitive, safe, easy to use and minimal effort. The same UD features in a traditional home will apply to any residential care home.

UD Checklist for Residential Care Homes & Hospice

Safety: are there procedures in place for safety, ie: fire, tornadoes, hurricanes, health etc. , is the resident safe in the space. Food safety handled properly for resident. The outdoors is accessible either visually or physically.

Space: resident has at least 6’ of turning space in their rooms, enough personal space for their things, for visitors and their family.

Caregivers: sufficient number of caregivers; support and training of caregivers.

Care Team: when on Hospice access to doctors, nurses, therapists, chaplains, and certified nursing aides(CNA). CNA’s help the individual with personal hygiene and grooming.

Care Team: In residential care homes is there outside support for social and physical activities? Access to medical care? What amenities are offered?

Independence: Will the resident be able to continue to be mobile and have opportunities for independence in not only their personal space but also the public areas of the residential home? Are there internet, cable packages, lifts for bathing/showering, appropriate entrances/exits in the home allowing for independence?

There are additional resources listed under the “More” category for Living Solutions. When using a business to assist you in finding residential care homes, you may ask if the business is a member in the National Placement & Referral Alliance (NPRA).

Private Residential Care homes in Texas can be licensed thru Texas Health and Human Services based on the number of residents, whether they can evacuate the building, the type of home and building safety features. Fewer residents can mean they are not state licensed. You need to know your state regulations and ask what type of license A or B the facility has.