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Choosing the Right Group Home Placement

I have been a mental health professional for over 20 years. I provide case management services for people with developmental disabilities.

Group home placement: how to decide

Group home placement: how to decide

How to Find a Group Home

Moving a loved one into a group home can be a stressful experience. I have found that the parents/caregivers often experience more stress during this transition than the individual that is actually moving into the group home. The choice to move someone into a group home can stem from a variety of circumstances. The most common reason from my experience is that the parents have reached an age where they can no longer provide adequate care due to their age and/or medical conditions. Some parents make the decision based on behavioral difficulties or medical needs that they can no longer handle.

The Role of Case Managers

No matter what the reason, the decision to place a family member in a group home is a stressful and scary time. Families often have limited knowledge of the disability system and have difficulty determining which group home is best for them. That’s when the case manager or service coordinator becomes a key component in the process. Although the choice is ultimately up to the client and the family, the case manager can offer suggestions based on their experience. I will discuss some of the most important issues families should take into consideration when choosing a group home. This is by no means an all-inclusive list.

Neighborhood on a cul-de-sac

Neighborhood on a cul-de-sac

Location, Location, Location

Just like any of us looking for a new home, location is very important. Many prefer a location close to family so they can be available to come by in an emergency. Some may prefer a location close to the nearest hospital. It also makes a difference if the home is located in a more private location such as a cul-de-sac (dead end) as opposed to a location near a busy street. This definitely makes a difference if there is a tendency to run off or wander from the residence.


Staff Experience

Don’t be afraid to ask questions regarding the experience of the staff providing care. All staff should be certified in CPR and First Aid. They should also be certified in medication administration. Staff should also be certified in approved behavioral management techniques and be able to respond appropriately during a crisis.

Staff to client ratio is also important. This is an area where many group homes tend to cut corners in order to save money. A home with limited staff is just a disaster waiting to happen. A medical emergency or a physically aggressive client with limited staff can lead to an inadequate level of care or result in serious injuries to staff and clients. Inadequate staffing can also result in citations from the licensing board. Speaking of licensure, many states provide public access to provider violations on the internet. It never hurts to check for violations. A violation or citation does not necessarily mean that they provide poor service. Of course, it all depends on the type of violation.

Bathroom with handicap walk-in shower, safety grab bar, and shower seat

Bathroom with handicap walk-in shower, safety grab bar, and shower seat


It is important to make sure that the group home meets your unique needs. These needs include items such as wheelchair accessibility, specialized showers, safety bars, and stair lifts. Other special considerations are bedrooms on the first floor for those who have difficulty moving around. I also favor homes that have multiple master bedrooms. This allows more residents to have privacy instead of sharing a bathroom with other residents. After all, this is their personal space.

I also emphasize privacy when it comes to bedrooms. One of my personal pet peeves is when group homes want to have two adults in one bedroom. Anyone over the age of 18 should not have to share a room in a private residence (just my opinion). This is especially the case if the resident is paying $500-$700 a month on average for rent. When I see this, the first thing that comes to mind is that this home is putting money over quality of care.

Other Residents

It’s also important that there is a good match with the other residents that live in the home. Most of the families I work with prefer homes where all of the residents are the same gender. Some homes offer co-ed or mixed-gender homes, but they tend to be rare due to the obvious liability involved. In my opinion, it’s a better idea to have a home with all females and one with all males. If the agency is only going to have one home, they should make a decision one way or another.

Personality differences are important as well. It’s always a good idea to make sure that the new resident will be able to get along with the other established residents. Some agencies have different group homes based on behaviors and medical issues. In this case, staff that have more expertise in behavior management can work with residents with challenging behaviors, while staff that have more experience with the medically fragile can provide more specialized support for those with more extensive medical needs.

A resident happy with his group home

A resident happy with his group home

Community Integration

Ask about activities that they do as a group. It’s important that the residents are doing more than just sitting around watching television. The goal is to help residents work on independent living skills and community integration. It’s also a good idea to inquire about their ability to accommodate individual activities. Some people like to go to church or other activities during the week that are separate from the other residents. Agencies should be taking a person-centered approach to assist people with achieving their goals as much as possible.

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It's a Big Decision

These suggestions are just some of the major areas I examine when I’m helping families through the selection process. This is a major decision and is often the first time away from family for any extended period of time. As service coordinators, it’s our responsibility to give families as many options as possible to they can make the most informed choice. New group homes seem to be opening up every year and it’s important that we as experienced clinicians help them sift through a complicated and an increasingly competitive disability system.

This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2014 Martin D Gardner


Martin D Gardner (author) from Virginia Beach on March 05, 2014:

Thanks for your input DDE and Georzetta.

Devika Primić from Dubrovnik, Croatia on March 05, 2014:

Well approached and an informative hub with helpful points.

Georzetta Ratcliffe from Pennsylvania on March 01, 2014:

Very good information. I really like your emphasis on privacy in group homes. These folks aren't inmates and shouldn't be treated as such.

Martin D Gardner (author) from Virginia Beach on February 27, 2014:

Thanks. I appreciate the comments. Group homes can be very profitable when done right.

Cecile Portilla from West Orange, New Jersey on February 27, 2014:

Very informative. My friend is thinking of starting a group home. This info will be useful!

Martin D Gardner (author) from Virginia Beach on February 27, 2014:

Thanks. I'm glad it was helpful.

Denise W Anderson from Bismarck, North Dakota on February 27, 2014:

Thanks for this very informative hub. This is a difficult thing to have to do, but one that those of us having family members with disabilities often think about. It is one of the those "what if" bridges that we hope and pray that we never have to cross. The more information we can get prior to that time, the better!

Martin D Gardner (author) from Virginia Beach on February 25, 2014:

Thanks MsDora!

Dora Weithers from The Caribbean on February 25, 2014:

All the areas you mention are very important. If one is unsatisfactory, it can affect the entire experience. Voted Up!

Martin D Gardner (author) from Virginia Beach on February 24, 2014:

Thanks for commenting. The wait list is frustrating to deal with here in VA. There are simply not enough Medicaid Waivers for the people in urgent need. Then of course more people are added to the list every month. It seems like a never ending battle.

Nancy from Florida on February 24, 2014:

Thank you for putting this up. I am a mom of an adult daughter with autism. I would curious to know about your perspective on waiting list issues.

Martin D Gardner (author) from Virginia Beach on February 24, 2014:

Thanks for the feedback. I'm slowly getting the hang of this.

Diane DeVillers from eugene oregon on February 24, 2014:

This is a well written hub, well placed text, pic, a sense of calm which families really need. Great suggestions and the books scattered among it , gives the reader a sense of knowledge. Keep up the good work, even consider adding more capsules as time goes by to add to the hub.

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