Two-Person Transfers and Hoyer Lifts: Which Care Homes Accept Them

If your parent can no longer stand or bear weight, moving them from bed to wheelchair takes either two caregivers or a mechanical patient lift, often called a Hoyer lift. That single need narrows the list of care homes quickly. Many families are told “we can’t take two-person transfers” again and again, and start to think a nursing home is the only choice.

It usually is not. Some care homes in San Diego, including many small board and care homes, are set up for heavy transfers. This guide explains what two-person transfers and Hoyer lift board and care really involve, which settings accept them, how California rules and fire clearances come into play, what it costs, and the questions that reveal whether a home can do it safely.

What Is a Two-Person Transfer?

A two-person transfer is when two caregivers are needed to move a person safely between bed, chair, wheelchair, toilet or shower chair. It is required when someone cannot bear weight, cannot help with the move, is very heavy for their frame, or is at high risk of injury, and it protects both the resident and staff.

Common reasons a parent needs two-person transfers:

• Stroke with weakness or paralysis on one side
• Late-stage Parkinson’s disease, multiple sclerosis or ALS
• Advanced dementia with loss of the ability to stand or follow directions
• Recovery from a hip fracture or other surgery with weight-bearing limits
• Severe weakness after a long hospital stay
• Amputation, obesity or contractures that make transfers unsafe for one person

Transfers are one of the core activities of daily living that care homes assess, and the level of help needed has a big effect on which homes can accept your parent and what the rate will be.

What Is a Hoyer Lift and How Is It Used in Board and Care?

A Hoyer lift is a mechanical patient lift that uses a fabric sling and a hydraulic or electric arm to raise a person and move them between bed and chair. “Hoyer” is a brand name used generically. In Hoyer lift board and care settings, two trained caregivers operate the lift together for safety.

How a lift transfer usually works:

1. The caregivers roll your parent side to side to place the sling underneath them.
2. They attach the sling loops to the lift’s spreader bar.
3. One caregiver operates the lift while the other guides and supports your parent.
4. Your parent is lifted, moved over the wheelchair or bed, and lowered gently.
5. The sling is removed or left in place, depending on the type and the care plan.

There are several types of lifts:

• Manual hydraulic lifts, pumped by hand
• Electric (battery) floor lifts, which are easier and smoother for caregivers
• Sit-to-stand lifts, for people who can bear some weight and hold on
• Ceiling lifts, mounted on a track, more common in nursing homes and specially built homes

Medicare Part B generally covers a patient lift as durable medical equipment when a doctor orders it as medically necessary, though your parent may owe coinsurance. Many board and care homes already own a lift; others ask the family to arrange one through a medical supply company.

Which Care Homes Accept Hoyer Lifts and Two-Person Transfers?

Skilled nursing facilities accept Hoyer lifts and two-person transfers routinely. Among assisted living and board and care homes, it depends on the home’s staffing, fire clearance and experience. In San Diego, a number of 6-bed board and care homes specialize in heavy care and accept lift transfers; many large assisted living communities do not.

How each setting usually handles it:

• Nursing homes (SNFs). Almost always accept lift transfers and have the staff and equipment. See our page on nursing homes in San Diego.
• Board and care homes. Many accept them, especially homes that care for residents on hospice, with late-stage dementia, or after strokes. The key is having two caregivers available whenever a transfer is needed, including at night.
• Large assisted living communities. Many limit residents to one-person assistance because care is spread across many residents and long hallways. Some accept two-person transfers for an added fee.
• Memory care communities. Varies widely. Ask specifically.
• In-home care. Possible with two caregivers or a trained family member plus one caregiver, but around-the-clock two-person coverage at home is very expensive.

For many families, a board and care home that accepts Hoyer lifts is the sweet spot: a home-like setting, one-on-one attention, and a lower total cost than 24-hour home care.

California Rules: Nonambulatory and Bedridden Status

In California, residents who need a lift or two people to transfer are usually classified as nonambulatory, and some are considered bedridden. A board and care home can only accept them if its fire clearance allows, and bedridden residents have extra legal requirements under Health and Safety Code Section 1569.72.

What the classifications mean:

• Nonambulatory. A person who cannot leave the building without help in an emergency. Most residents who need a lift fall here. The home needs a fire clearance that covers nonambulatory residents.
• Bedridden. Under Section 1569.72, a person who needs help turning or repositioning in bed, or cannot get in and out of bed on their own, is considered bedridden. Residents who cannot transfer independently but do not need help turning in bed are treated as nonambulatory.
• Fire clearance. A home may keep bedridden residents only with an appropriate fire clearance, and it must notify the local fire authority within 48 hours of admitting or retaining one.
• Temporary vs. long-term. Outside hospice, bedridden status lasting more than 14 days generally needs written notice to licensing, a physician’s statement, and licensing approval.

The doctor records your parent’s status on the LIC 602A physician’s report, including whether they can transfer independently. Our guide to ambulatory vs. non-ambulatory status in California care homes explains why this classification matters so much.

Staffing: The Real Question Behind Two-Person Transfers

The most important question is not whether a home owns a Hoyer lift but whether two trained caregivers are present every time your parent needs to move, day and night. A home with one caregiver on some shifts cannot safely do two-person transfers during those hours, no matter what equipment it has.

Think through your parent’s day:

• Getting up in the morning and back to bed at night
• Moving to and from the toilet or commode several times a day
• Showers or bed baths
• Meals in a wheelchair or at the table
• Repositioning and incontinence care overnight
• Emergencies, such as a fall or a fire evacuation

Each of those moments needs two people if your parent is a two-person transfer. Ask the home to walk you through its staffing schedule shift by shift. In a 6-bed home, many owners schedule two caregivers during the day and evening, and some keep two overnight when they care for several heavy-care residents.

How Much Do Hoyer Lift and Two-Person Transfer Care Cost?

In San Diego in 2026, board and care homes typically cost about $5,500 to $9,500 per month. Residents who need Hoyer lifts or two-person transfers are usually at the upper end of that range, especially in a private room. Large assisted living communities that accept heavy transfers often charge a high care level on top of rent.

What affects the price:

• Room type. Private rooms often cost $1,000 to $2,000 more per month than shared rooms, and lifts need space to maneuver.
• Other care needs. Incontinence, feeding help, diabetes and dementia add to the rate.
• Night needs. Residents who need two-person help overnight require more staff on the night shift.
• Location. Coastal areas tend to cost more than East County and North County inland.

Compare that with 24-hour in-home care with two caregivers on duty, which can cost several times as much. For a parent who needs two-person transfers, a well-staffed board and care home is often the most affordable safe option. Our guide to what is included in a board and care monthly rate explains what to ask about extras.

Questions to Ask Before Choosing a Home

Before choosing a home for a parent who needs a Hoyer lift or two-person transfers, ask specific questions about equipment, training, staffing on every shift, fire clearance, and how the home handles emergencies. Confident, detailed answers and current residents with similar needs are the best signs a home can do it safely.

Questions to ask:

• Do you currently care for residents who need a Hoyer lift or two-person transfers?
• Does your fire clearance allow nonambulatory and bedridden residents?
• Do you own a lift, or will we need to provide one? Is it electric or manual?
• How many caregivers are on duty on each shift, including overnight? Is the night staff awake?
• How are caregivers trained to use the lift? Who trained them, and when?
• How often do you reposition residents who spend long hours in bed or a wheelchair?
• What is your plan to evacuate nonambulatory residents in a fire or emergency?
• Do you have a hospice waiver, in case my parent’s needs progress?
• What will the monthly rate be, and what could change it?

Watch a transfer if possible. With the resident’s permission, some homes will let you see how staff use the lift. Smooth, calm, respectful handling tells you more than any answer.

Common Situations: Stroke, Hip Fracture and Late-Stage Dementia

Families most often need Hoyer lift or two-person transfer care after a stroke, after a hip fracture that does not fully heal, or in late-stage dementia or neurological disease. Each situation has its own path, and the right home depends on whether your parent is expected to improve, stay the same or decline.

How it often plays out:

• After a stroke or hip fracture. Your parent may leave rehab still needing two-person help. A board and care home with visiting physical therapy can be a good next step, and needs may lessen over time. See our guide on care options after a hip fracture.
• Late-stage dementia. Transfers become harder as the disease progresses. Choose a home that can keep your parent through the end of life. Our post on board and care for late-stage dementia covers this.
• Progressive neurological disease. Conditions like ALS and MS often need heavy transfers. See our guides to ALS care options and wheelchair users choosing between assisted living and board and care.

For example, a family in El Cajon caring for a father who had a stroke might find that two nearby board and care homes in El Cajon keep two caregivers on every shift and already use electric lifts, while the large assisted living community they toured first could only offer one-person help.

How Elder Answers Helps

Finding a home that accepts Hoyer lifts and two-person transfers is one of the hardest placements, and it is where local knowledge matters most. Elder Answers has helped San Diego families for well over a decade, and our advisors personally visit the homes we recommend, so we know which ones have the staffing, equipment and fire clearance to do heavy transfers safely.

Our service is free for families because care homes pay us after a resident moves in, and the rate you pay does not change. We share your information only with homes you choose, and urgent moves can often happen within a few days. Contact Elder Answers or start with our guide to board and care homes in San Diego.

Frequently Asked Questions About Hoyer Lifts and Two-Person Transfers

Do board and care homes accept residents who need a Hoyer lift?

Many do. Board and care homes that accept Hoyer lifts must have a fire clearance for nonambulatory residents, trained caregivers, and two staff available for every transfer. Ask whether the home already cares for residents with similar needs and how it staffs each shift.

Why won’t some assisted living communities accept two-person transfers?

Large communities often staff for one-person assistance spread across many residents. Having two caregivers available at every transfer, day and night, is hard in that model. Some accept it for an added care fee; many do not.

Does Medicare pay for a Hoyer lift?

Medicare Part B generally covers a patient lift as durable medical equipment when a doctor orders it as medically necessary, with your parent paying any coinsurance. Medicare does not pay the care home’s monthly rate.

Is a person who needs a Hoyer lift considered bedridden in California?

Not always. Under Health and Safety Code Section 1569.72, a person is bedridden if they need help turning or repositioning in bed or cannot get in and out of bed on their own. Someone who cannot transfer alone but can reposition in bed is treated as nonambulatory.

How much more does two-person transfer care cost?

In San Diego, board and care homes typically cost about $5,500 to $9,500 per month in 2026, and residents who need two-person transfers or a Hoyer lift are usually at the upper end. Private rooms add more. Large communities often charge a high care level on top of rent.

Can a resident who needs a Hoyer lift stay in a board and care home on hospice?

Yes, if the home has a hospice waiver and the right fire clearance. Hospice can also provide equipment such as a hospital bed and lift, and hospice aides can help with personal care.

Is it safe for one caregiver to use a Hoyer lift?

Most safety guidance and lift manufacturers recommend two trained caregivers for floor-based sling lifts. If your parent’s care plan calls for two-person transfers, ask the home to confirm two people will be present every time.

What should I bring if my parent uses a Hoyer lift?

Ask the home first. If it does not provide one, you may need to bring the lift, slings in the correct size, a wheelchair with appropriate cushion, and a hospital bed. Bring the doctor’s orders so equipment can be billed to Medicare where eligible.