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Florida’s growing population of older adults is prompting many families to explore long-term care options that feel more personal and less institutional. One model gaining attention is the Adult Family Care Home, or AFCH, which are small, agency-licensed residences where disabled adults and frail elders live with a caregiver in a true family-style environment.
The number of Floridians aged 65 and older is expected to rise to 6 million by 2030, according to state projections. With nearly one in five older adults nationally reporting a preference for “home-like” care settings over traditional facilities, AFCHs are becoming an increasingly important part of the long-term care landscape.
A Family-Centered Alternative
Unlike assisted living facilities, Adult Family Care Homes are required to have the licensed provider living on-site. These homes, which are owned or rented by the caregiver may house no more than five residents, allowing for a level of individual attention that larger facilities cannot provide.
Florida’s Agency for Health Care Administration (AHCA) licenses and regulates all AFCHs. Homes must comply with local zoning rules and meet state standards aimed at helping residents remain as independent as possible while avoiding unnecessary placement in nursing homes.
Under Florida law, an AFCH provides room, board and 24-hour personal care. This includes help with daily activities such as bathing and dressing, supervision, medication assistance, health monitoring and social activities.
To ensure access for residents who rely on state financial assistance, each home must designate at least one space for a person receiving optional state supplementation.
Who Can Live in an AFCH
Residents must be at least 18 and able to evacuate the home independently during an emergency. They must also be free of communicable diseases, capable of performing daily activities with help, and not require 24-hour nursing care unless enrolled in hospice.
Before moving in, every resident must undergo a face-to-face medical exam by a licensed health professional. Annual exams—or evaluations after a significant health change—are mandatory.
New residents must receive the home’s house rules, the state-mandated Resident Bill of Rights and instructions for filing complaints with AHCA or other agencies.
Among their rights, residents are guaranteed a safe living environment free from abuse or neglect, access to personal belongings, private communication, management of personal finances, the ability to room with a spouse and freedom from chemical and physical restraints.
Each resident also signs a written residency agreement outlining rates, services and at least a 30-day notice requirement for any fee increase.
Standards for Providers
To qualify as an AFCH provider, a person must be at least 21, reside in the home and complete required state training. Topics include recognizing abuse and neglect, monitoring resident health and meeting the needs of older adults and disabled individuals.
Licenses are effective for two years and cannot be transferred to another person or property.
AFCHs may advertise their services, but they are prohibited from using terms such as “nursing home” or “assisted living facility.” All advertising must include the words “Adult Family-Care Home” and the provider’s license number.
Why AFCHs Are Gaining Attention
Advocates for small-scale long-term care say AFCHs offer a balance of independence and support in a setting that feels more like home than a facility. For families, the limited resident capacity may translate to more personal attention and stronger interpersonal relationships.
With more older adults seeking alternatives to institutional care, and with Florida’s senior population expected to surge in the coming decade, AFCHs may continue to play an expanding role in the state’s care system.
Jamaal R. Jones is a Health Law Attorney at Jones Health Law P.A. where he represents healthcare practitioners and facilities in healthcare transactions, regulatory compliance, and licensing matters, healthcare litigation. He is an adjunct professor with the University of Tennessee where he teaches health law compliance. Jamaal is the Immediate Past-Chair of the Health Law Section of the Florida Bar and Vice Chair of Physician Organization Practice Group for the American Health Lawyer’s Association. He also has a YouTube page and Podcast aptly called “Jones Health Law” where he discusses healthcare law issues and interviews healthcare practitioners. (305) 877-5054; @joneshealthlaw; jrj@joneshealthlaw.com
