Reflection on the “Niche” Served by Board and Care Homes. It seems clear that board and care homes do, in fact, fit in the “niche” between residential settings with few services and nursing homes. Moreover, while there is “overlap” between board and care homes and these two other modalities at either end of the continuum, it is apparent that board and care homes provide a distinct service.
In terms of services, board and care homes provided more care and services than congregate apartments and boarding houses. However, even with the addition of services provided by home health agencies, visiting nurses, and others, the average board and care home provided fewer skilled and rehabilitative services, less routine monitoring, assessment and care planning, and less nursing and restorative care than nursing homes. The fact that less than a quarter of the board and care homes had a full- or part-time RN or LPN on staff emphasizes the difference in services. Furthermore, most board and care homes, as noted, were unable or unwilling to provide nursing services for an illness that lasted longer than 14 days, and a substantial proportion reported being unable to handle even a temporary need for nursing care.