These included homes for clients who were non-ambulatory, clients who had profound health issues and one home for dd-so. Besides living and healthcare expenses, the agencies had regulatory overhead imposed by 3 different governing agencies.
Even with all of this, the clients had lives with daily offsite activities, jobs, public events, theme parks, etc.
The per-client budgets of these group homes were tiny compared to nursing homes. They were funded by client SS disability payments, supplemented by some modest public funding.
These homes where founded and administered by boards made up of the client's families. Importantly, they were non-profit; they lacked the massive overhead that comes with shareholder obligations and executive salaries+perks.
They've been providing superior care for over 4 decades. After I left, they began to experience a persistent risk of funding cuts. These were driven by a major hospital chain executive who became governor and then state senator.