Group homes are a common residential option for adults with developmental disabilities who need support with activities of daily living. About 15 percent of adults with intellectual and developmental disabilities receiving publicly funded services live in group homes. Choosing the right one requires more than a tour — it requires a thorough set of questions.

Services and Care

  • What types of disabilities or support needs does the facility specialize in?
  • What activities of daily living (ADLs) do staff assist with — bathing, dressing, meal preparation, medication management?
  • What is the staff-to-resident ratio during day and overnight shifts?
  • What training and certifications do direct support professionals hold?
  • How are individualized support plans developed and updated?
  • How are medical or behavioral emergencies handled?

Cost and Funding

  • What is the total monthly cost, including all fees?
  • Is this a private-pay facility or does it accept Medicaid waiver funding?
  • Does your state offer a Home and Community-Based Services (HCBS) Medicaid waiver that covers this facility?
  • What is the process if a resident’s funding source changes?

Quality and Safety

  • What is the staff turnover rate?
  • How does the facility handle complaints from residents or families?
  • Has the facility received any licensing violations or state citations? (Most states maintain public inspection records.)
  • Can you speak with current residents’ families about their experience?

Autonomy and Community

  • What choices do residents have over their daily schedules, meals, and activities?
  • Can residents access community activities, volunteer opportunities, or religious services?
  • What is the visitation policy for family members?
  • How are residents matched with housemates?

Choosing a group home is one of the most consequential decisions in a long-term care plan. From a financial planning perspective, the funding structure — whether Medicaid waiver, SSI, or private pay — affects the entire downstream plan for the family’s estate, the SNT, and the individual’s benefits eligibility.