We also heard from nearly all state-level informants that some operators routinely shifted residents from one address to another if an APS worker, other advocate, or potential regulator showed up at the facility asking questions. Estimates of the prevalence of unlicensed residential care homes are lacking for most states. Other charges included: murder, sex trafficking, sexual abuse from staff or other residents who were registered sex offenders, racketeering, forced labor, and fire setting by residents with severe and persistent mental illness. Currently at the state level, the primary strategy used in Georgia to identify unlicensed care homes is through complaints, including complaints from neighbors, residents, residents' family members, and hospitals serving residents of unlicensed care homes. One key informant from Pennsylvania spoke about the difficulty in handling reports of neglect or abuse in legally unlicensed care homes: "we will have repeated incidences, or alleged incidences [at legally unlicensed residential care homes] and we don't report to anyone [any agency or the state] either. Key informants described the way the teams function. Florida publishes a listing of unlicensed homes but it does not correspond with the media reports of the number of unlicensed care homes identified by state inspectors. typically provide meals, laundry, housekeeping, medication
I am interested in opening a personal care home in Texas and having difficulty with knowing which application and requirements to look for. If the illegally unlicensed personal care home can be deemed unsafe, code enforcement has the authority to condemn the building and shut the illegal operation down. That makes it difficult for the licensing agencies to understand what's going on because they don't have the information and aren't privy to it.". Multiple key informants also spoke about the lack of affordable housing in Allegheny County. The regional and state licensure offices are closely involved in this process. For example, a care home with three persons with at least one personal care need might also house three people with personal care needs whose community housing arrangement is covered by the U.S. Department of Veterans Affairs.