Group home is the phrase people use, not always the phrase Medicaid bills. It means a shared house where a small number of people with disabilities live and staff rotate through shifts. How many people, and what license hangs on the door, is a state rule. Three or four is a familiar picture. It is not a federal definition.
The service on the claim is often residential habilitation, or a state-specific name that means staff support in a residence the provider agency operates. The agency, or a related housing organization, typically controls the house. Residents live there under a lease or an occupancy agreement that may not look like an ordinary tenant lease. That housing detail is the difference between a group home and supported living, where the person holds the home and the staff come to it.
A group home is not automatically an ICF/IID. Most waiver-funded group homes are community services. An intermediate care facility can occupy a small house and still be the institutional benefit, with a QIDP and active-treatment rules. The floor plan will not tell you which one you are in. The license and the funding stream will.
Staffing is shift work. Overnights, weekends, and the hour when someone calls out are the operation. A wage floor hits a group home differently than it hits a one-hour in-home visit, because the house has to be covered even when the billable day is already fully staffed on paper.
Families and neighbors say group home. Waiver manuals say a residential service. Stories on this desk use the everyday word and then name the benefit, because a rate cut to residential habilitation and a rate cut to institutions are different decisions.