The short answer: An adult family-care home (AFCH) is a private home where the licensed provider lives and cares for no more than five older or disabled adults who aren't relatives. An assisted living facility (ALF) can range from a six-bed house to a 300-apartment campus, with a staff rather than a live-in provider, and can hold specialty licenses for more nursing care. Both are licensed by Florida's Agency for Health Care Administration (AHCA), but under different rules.
If you've been searching for "care homes" or "senior group homes," those aren't official Florida license names. What you're usually looking at is either an adult family-care home or a small assisted living facility, and the difference matters.
What exactly is an adult family-care home?
Florida law defines it as "a full-time, family-type living arrangement, in a private home, under which a person who owns or rents the home provides room, board, and personal care, on a 24-hour basis, for no more than five disabled adults or frail elders who are not relatives" (s. 429.65).
Key points:
- The provider lives there. "The adult family-care home provider must live in the home" (s. 429.63).
- Five residents at most, and the provider's own disabled or frail relatives living in the home count toward that limit.
- Who can live there: "frail elders" aged 60 or older and "disabled adults" aged 18 to 59.
- The stated purpose is to help residents "delay or avoid placement in a nursing home or other institution."
How does it compare with assisted living?
| Adult family-care home | Assisted living facility | |
|---|---|---|
| Florida law | Ch. 429, Part II; rule 59A-37 | Ch. 429, Part I; rule 59A-36 |
| Size | Up to 5 residents | No upper limit; many have 6 or fewer, some over 100 |
| Who runs it | A provider who lives in the home, plus a relief person | An administrator and staff on shifts |
| Specialty licenses | None | ECC, LNS, LMH and, from 2026, memory care |
| Provider or administrator training | 12 hours before opening, then 3 hours a year | 26 hours of core training plus a competency test |
| Can keep a resident who needs 24-hour nursing? | No, unless enrolled in hospice | No, unless enrolled in hospice |
| License fee (every 2 years) | $200 | $300 plus $50 per resident |
Sources: s. 429.67, s. 429.07, rule 59A-37, rule 59A-36.011.
What care does an adult family-care home provide?
Under s. 429.73, an AFCH must provide room and board, help with daily activities such as bathing and dressing, assistance with medication, supervision, health monitoring, and social and leisure activities. Nursing care can be provided or arranged so a resident can age in place.
There are firm limits. A resident must not be bedridden (except for up to 7 days during a temporary illness), must not need 24-hour nursing supervision, must not have stage 3 or 4 pressure sores, and must not need chemical or physical restraints (rule 59A-37.004). As in assisted living, a resident enrolled in hospice can stay even if they need 24-hour nursing care.
Who checks on these homes?
AHCA licenses every AFCH. The provider must be at least 21, live in the home, complete a 12-hour basic training program before taking residents, and do 3 hours of continuing education each year. The provider and relief person need first aid and CPR certification, and the provider, the relief person and every adult who lives in the household must pass a Level 2 background screening (s. 429.67; rule 59A-37.007).
Inspections are unannounced, and AHCA also inspects when it receives a complaint.
Which is better for my parent?
It depends on what your parent needs most.
An adult family-care home may suit someone who:
- does best in a quiet household with the same caregiver every day;
- needs help with daily activities and medications, but not ongoing nursing;
- would feel lost in a large building or a busy dining room.
An assisted living facility may suit someone who:
- wants more activities, outings and other residents to socialize with;
- may need more nursing over time; only an ALF can hold Extended Congregate Care or Limited Nursing Services licenses, which let residents stay as needs grow;
- needs staff awake overnight (required in facilities with 17 or more residents) rather than a provider who sleeps in the home.
Small assisted living homes sit in between. AssistedLivingFacility.com directory data shows 1,446 of Florida's 3,006 licensed assisted living facilities (48%) are licensed for six or fewer residents as of October 2026. So many of the small homes families find online are licensed as assisted living facilities, which follow the full assisted living rules, rather than as adult family-care homes. Our guide to large vs. small assisted living facilities compares the two in more depth.
How do families pay?
The options are much the same as for assisted living:
- Private pay: savings, pensions, Social Security or the sale of a home.
- Optional State Supplementation (OSS), a monthly payment from the Florida Department of Children and Families for low-income residents, can be used in an AFCH. Every adult family-care home must keep at least one licensed space for an OSS resident (with an exception for some older homes) (s. 429.67).
- Medicaid Long-Term Care: Florida law requires Medicaid long-term care plan networks to include adult family-care homes (s. 409.982). Our guide to whether Medicaid pays for assisted living in Florida explains eligibility.
- VA Aid and Attendance and long-term care insurance, depending on the policy terms.
How many adult family-care homes are there?
Far fewer than assisted living facilities. The most recent official count we could find was 337 licensed adult family-care homes in February 2019 (Florida House bill analysis), compared with about 2,985 licensed assisted living facilities in February 2026. Statewide, small assisted living homes of six or fewer beds (1,446 in our directory) far outnumber adult family-care homes.
Are "group homes" and "care homes" the same thing?
Not officially. In Florida:
- Adult family-care home and assisted living facility are the official licensed settings for older adults.
- A group home facility is a different license for people with developmental disabilities, overseen by the Agency for Persons with Disabilities.
- A community residential home is a zoning term for homes with 7 to 14 unrelated residents.
- "Care home" and "senior group home" are everyday phrases, not license types.
One useful tip: Florida's rules require an adult family-care home's advertising to include the words "adult family-care home" and the home's license number (rule 59A-37.003). If a listing doesn't say what it is licensed as, ask.
How do I check a home's license?
Search the home by name, county or license number on the state's FloridaHealthFinder website and choose the right facility type (Adult Family Care Home or Assisted Living Facility). The profile shows the license status and inspection reports. You can also call AHCA's consumer line at 1-888-419-3456.
To compare small assisted living homes near you, browse by city in our Florida directory. In Jacksonville, for example, 15 of the 64 licensed assisted living facilities have six or fewer beds; in Miami it's 471 of 576.
