The Realities of Owning An Assisted Living Home

When I first started our site, over 8 years ago, I never really pictured that the topic of opening and owning an assisted living facility or home would be one of the most discussed, and popular topics on our site.

In hindsight, I can understand why.  So many baby-boomers retiring, so there is a market for new homes, and beds, and it can be a good business opportunity for those who have the experience and drive to do so.

Right out of the gate, I want to point out for anyone starting the process, or is thinking about starting an assisted living home, please take a look at our “How To Start An Assisted Living Facility” page, which has hundreds of comments, videos, administrator interviews, and tips on opening a facility.

For this section, I wanted to touch on something that I am not sure many aspiring facility owners fully absorb, or realize about the senior care business.   I’ve interviewed may assisted living homeowners, and I have visited numerous facilities (I do video tours for facility owners), and I’ve noticed that there are some common, sometimes stark realities of owning and operating a residential care home, or senior care business.   Ignoring these realities, or not fully exploring them mentally, or even spiritually before making the commitment can, and will most likely lead to failure.  Embracing these realities, working with and internalizing them will help you with your success.

The realities of owning an assisted living home

I am making the assumption, too, that most people reading this are looking to open a smaller, residential home.  Larger, more corporate facilities are usually owned by numerous people, entities, and their staff are paid employees, with no ownership. Large facilities, however, are where people often get the experience, and inspiration to go it alone, and open their own care home.

The Realities of Owning An Assisted Living Home:

1) The first, most common impression I have had as I have interviewed facility owners, and visited with them, is that they are often tired, and overworked.   For most residential care home owners, or small assisted living facility owners/operators, there are no weekends, no holidays, and few days off.  Often-times, these facility owners live in the same homes that their residents do, and attend to issues, demands, and crises 24 hours a day.   The owners are the eyes and ears of the facility, and leaving the property, even for a day, or a few hours, can be challenging.

2) I’ve visited with many facility owners who are married, and who operate their homes jointly with a spouse.   This can be a great, bonding experience, but it can also present many challenges for a relationship.  There’s little privacy, little opportunity for downtime or intimacy, and it’s hard to separate work from your personal existence, and relationships.

3) You’ll likely, as an assisted living home-owner, have to deal with death and loss more often than most people.   Your residents will become like family to you, and sadly, there will be loss from time to time.

4)  You’ll need a strong stomach for odors, yucky sights, and a strong constitution for behavior issues, moaning and screaming, crying, and mental instability.   Yes, you may have residents who wear adult diapers, and who void themselves regularly, and who need help ‘cleaning up’ several times a day.  I’ve visited homes where residents moan and wail periodically, due to their dementias, or who act aggressively.  You, the facility owner, may be blamed for things you didn’t do, simply because the Alzheimer’s-ridden mind of one of your residents ‘imagined’ something that didn’t happen.

You’ll also need to be prepared for when a resident passes.   Some people can handle witnessing such an event.  I have always had much difficulty with it, and can’t imagine seeing it on a regular basis.  You’ll need to assess whether you can handle this.

5) The resident that you accept into your home at first may not be the same resident a year later.   A senior, or perhaps someone with beginning-stage Alzheimer’s may move in with relatively few problems or issues, and may be easy to handle and manage, but as his or her condition progresses, they may become very challenging to handle as time goes by.     There’s a big difference between a senior who has occasional memory lapses, to a resident who has forgotten how to use the bathroom.

6) You’ll, at times, have to deal with ‘crazy’ family members.   Often times, it is the families who feel a sense of ‘loss of control’ when a loved-one is placed into a care facility, and if anything goes wrong, real or perceived, they can come out ‘swinging’ – even if they are mistaken or if it is unfounded.   You may have do deal with ‘Helicopter Children’ who come by the facility or home at all times of the day (or night) to check on mom or dad.

7) Of course, with everything you have on your mind about making sure your residents are cared for, you’ll need to worry about paying the bills, making sure you have a marketing plan, and ensuring that your beds stay filled.   Things happen, water-heaters break, and expensive repairs and state-mandated fixes or additions are all part of the deal.   Expect the unexpected, and although you will have a budget to work with, your numbers will be occasionally blown out of the water by pipes breaking on a holiday weekend, or several beds becoming vacant unexpectedly.

8) You have plenty of competition.  The assisted living market is booming, and it seems like every time I blink, a new care home opens.  I do ‘google alerts’ for assisted living, and almost every day I learn about new facilities and homes opening their doors.

The competition can be fierce, and you’ll need to get used to referral companies using your information to try to place ‘clients’ into your home, for a fee, of course.   You’ll need to have a web presence, ideally facility videos and tours, testimonials, ad placements on search engines, and most likely a printed advertising campaign, with brochures and marketing materials.

So why do it?

I’ve painted a less than pretty picture of what life might be like owning an assisted living home.  Yes, it is all-consuming, and stressful, and leaves little scraps for you in terms of a personal life.

However, the one thing that I noticed that trumps items 1-8 above that I found that most of the facility owners and administrators I have spoken to share:  A profound sense of satisfaction.

Caring for our seniors is a noble, important, and challenging task, and those facility owners who manage to do it with unconditional love and commitment, and at the same time make an honest and decent living out of it – they have all seemed to me to be incredibly satisfied, and fulfilled on a level that many other professions probably won’t offer.

My number one tip for anyone thinking about embarking on the adventure of owning a senior care home:  Hire, and surround yourself with awesome people that you trust, and care for.   Knowing that if you have to leave your facility for a few hours, or to possibly take a day off – that business will be taken care of, and your residents will be in good hands.   Your residents will become your family, and so will the people working for you, and with you.

28 thoughts on “The Realities of Owning An Assisted Living Home

  1. Missy

    I have nothing but the deepest respect for anyone caring for seniors, a family member, or a loved one, whether in a professional capacity or not. It’s all-consuming work. Your realities are spot-on, and if you can conquer those, it can be an absolutely rewarding experience and career.

  2. Ann Mullen

    I would suggest that before people get into a business like that that they shadow people in different facilities to get an intimate feel for some of things you discussed that might sound bad, but don’t prepare a person for the reality.

    Then I think the potential business person needs to sit down with owners and look at what the business side of the work looks like.

    Remembering that no one is good at all things, I like your final paragraph about finding others who can handle different parts of the tasks.

    Good article.

  3. David Post author

    Ann, thanks for your reply. I think that a few times, talking to facility owners, they looked sort of ‘shell shocked’ at times with the enormity of what is involved with running their business, topped with the emotional aspect. I think you are so right..shadowing, or almost apprentice-ing with a facility owner should almost be a prerequisite. Jumping into this business, and having seniors move into your home, and then deciding later you’re over your over your head is not good or fair to anyone.

  4. Celeste

    Thanks for the comments David. I own a private home facility with 4 beds and have experienced personnel to assist me with getting it off the ground. However, shadowing an owner is a very good idea and I’d like to take on an opportunity to do so, but I know some owners would probably feel a new facility owner shadowing would pose a bit of threat in terms of more competition in the area. Therefore, asking for an opportunity to shadow sounds great, but a bit unrealistic I feel. Your thoughts are appreciated!


  5. David Post author

    Hi Celeste, thanks for the reply, and congratulations on getting your home off of the ground and running!
    I think my suggestion of shadowing is still a good one, depending on where you live. For example, I live in the Denver area, and many of the facilities I have visited and interviewed are in towns just outside of Denver, 10-15, 20 miles away, where the threat of competition isn’t very significant. So, if you live in a bigger city, then spending time, and making the effort to travel outside of your ‘territory’ could be the ticket. I have found that many facility owners are very chatty and love to talk. Building that trust with them may take a few emails. But yes, if you are in a town or city with a tight market, it may not be as realistic unless you are willing to go a little further down the road..


  6. Carrie

    If you plan on going into this field my best advice is that you take care of yourself. It takes an enormous amount of energy and stamina. Good luck!

  7. Susan Gamble

    Really great post. Just wanted to mention that if anyone is looking for a more contemporary take on assisted living services, you should take a look at Home Instead Senior Care. Home Instead is revolutionizing the assisted living and home care industries by offering unique in-home assisted living services. Now seniors can remain in the comfort of their own homes, and families can benefit from competitive prices for these wonderful services.

  8. Kristal

    Great article! My husband and I are seriously considering opening an assisted living facility. I am a registered nurse and worked in a long term facility for 4 years. I am now currently a home health nurse. I see the great need for good and honest homes for our seniors and have a desire to follow our plan. God willing, we will be successful in doing do. Thank you for the tips. I will definitely keep them all in mind

  9. David Post author

    Kristal, best of luck in opening your facility. Good, Honest Homes – I like how you say that. Hopefully you can get the word out and fill your beds, which is one of the biggest initial challenges. Wishing you great success!

  10. David Post author

    I’ve worked with and networked with a few folks from Home Instead. Seems like a great organization!

  11. Jessica

    Great article, David! My mom has worked at an assisted living facility for the past 15 years. She absolutely loves what she does and she does an amazing job. She works specifically with individuals with cognitive and physical disabilities. My fiance and I are considering opening an assisted living facility but would lean towards individuals with disabilities that require 24-hour care; rather than senior citizens. I have a Masters in Mental and Physical disabilities so this is something I’m very passionate about. David, can you provide me any information regarding homes specifically for those with disabilities, i.e., mental retardation, cerebral palsy, etc? Are these homes and the laws that govern them the same as those for senior citizens? Thank you in advance!

  12. David Post author

    Jessica, thanks for the note. Yours is a tough question, since every state is different in what they require, how they define assisted living, licensure, etc. I would first direct you to where this information would be found in your state’s Department on Aging, or Department of Social Services, or Department of Health. They usually have .pdf’s and detailed documents with most of the requirements to get you started.

  13. David

    Good afternoon,
    I am looking into the idea of opening my ranch home to senior living possibilities. I too am getting up there and need out of the construction industry. It is a 6 bedroom home with tennis courts large pool and walking space on the property. Are there limits to occupants per room and what amenities should be offered? Food laundry, transportation etc. What is the going rate in Southern California for a room rate?

  14. Sarah

    Thank you for this. I remember my time volunteering in a nursing home when I was 18. This is exactly what I remember, except of course I never had to deal with a death personally, I definitely did hear about a couple of deaths during my time there. This experience has stayed with me. I am planning to open my own to help those adults who have developmental delays transition from school to adult living, and provide a safe environment for those who need a permanent place to live.

  15. David Post author

    Sarah, thank you for commenting and sharing your experiences. I want to wish you the best of luck in opening your home. It is great that you had the experience early on, so you have an idea of what you’re getting into.

  16. Rachel

    I enjoyed reading your article. I have worked in several nursing homes and assisted living facilities. I graduated from school a year ago for Health Service Management. I love taking care of people but also like the business side of things. About 8 months ago I worked as a Staffing Coordinator for a care agency. I was not properly trained and was thrown into the job. My weakness with this job were the phones and instead of mentoring me and coaching me, they threw me on the phones to see how I could handle it. I made mistakes and could not get over my nervous habit. They fired me about a month later. Ever since then I have been afraid to pursue my degree. Today, I was thinking about starting my own assisted living facility. No more than eight residents in a home. I would not want to live in the same home. My sister and I are considering working together. This is my passion and I want to make a difference. I do not have any ideas on how to get started or what to do first. Do you have any suggestions?

  17. Tim Enloe


    My mother and I had planned on converting her home on 6 plus acres into a small active senior living facility with each resident having a garden plot. They would also be able to watch horses, goats, and cows graze in our pastures.. Sadly, I lost Mom three weeks ago and am not sure if I should hold true to our vision or just sell out due to property in the area going for sizeable amounts.

    I realize that with any business, one has to put substantial money upfront, but am unsure when the return will hit. I have also worked in senior living communities as well.

    Any suggestions you can provided would be appreciated.


    Tim Enloe
    770 653 0552

  18. Irene Liu

    David, I would like to open an assisted living facility since my mom geting older but i have no experience in health field. I am considering more than 24beds. is there any franchise on the market you will suggest?


  19. Marie Noel

    I am considering opening an assisted living facility in the State of Florida but would lean
    towards individuals with disabilities that require 24-hour care; I have a Masters
    in Nursing I have been working in long term care working with individuals with disabilities is something I’m very passionate about. Can you please provide me with any information regarding opening a home and the laws that govern them specifically for those with disabilities, i.e., dementia, Alzheimer etc.
    Thank you in advance!
    Marie Noel

  20. Nike

    I am planning to start my own ALF and I don’t know if purchasing an older house that is built in the 70s will pass fire safety inspection and if I can use deed restricted subdivision. I will appreciate your advise. Facility will be in Spring area.

  21. David Post author

    Great question, and not sure…I think you’d have to contact the fire department about how to make sure it will pass.

  22. Priorityplacement

    I am thinking about opening a helped living office in the State of Florida however would incline

    towards people with inabilities that require 24-hour care; I have a Masters

    in Nursing I have been working in long haul care working with people with handicaps is something I’m extremely enthusiastic about. Would you be able to please give me any data in regards to opening a home and the laws that represent them particularly for those with inabilities, i.e., dementia, Alzheimer and so on.

    Much thanks to you ahead of time!

  23. Josh Harms

    I am not looking to get into running an assisted living facility, but I work as a realtor in a community where the condo associations want one built. The condo community itself is fairly small with only about 300 residents, but nearly 75% of the are over the age of 60. There is a lot that the condo associations have designated specifically for assisted living and I would assume could handle about 40 beds if a business was so inclined to build. I am struggling to find businesses that wants to venture because they feel the demographic is too small. Who am I looking for to fill this need for these people?

  24. curtissa frazier

    I’ve been a CNA since I was 19 I’m now 34. I love what I do. I’ve recently been researching opening up a assisted living facility in my home, caring for about 3 or 4 individuals. I’m stuck on where to begin.

  25. David Post author

    I’d start with learning about your state’s application process and regulations. You can view most of them from the sidebar of our how to page here:

  26. Janee Murray

    Awesome article! My Mother is a CNA and loves her job, her clients adore her <3. I always tell her that she should open her own care home and she is finally considering it! Seeing as how I'm the only tech savvy person in the family I'm doing all I can to help her out and get her started. This article is great for someone who is trying to starting at the begging and trying to soak up all the knowledge possible. Thank you.

  27. Eliza

    I’m currently trying to begin the process of opening my very own adult care facility, but specializing with those with mental illnesses. I have shadowed someone who owns 6 ACF’s and I’ve been doing my research as to what is needs to get my business up going. I don’t have much hands on experience with this, but I do have a minor in psychology and there is a need for those with mental illnesses. Any advice, tips, etc. for me, being this’ll be my first and I’m stepping out on faith.

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