By Maria Chen, CSA · July 3, 2026
Two different licenses, two different kinds of home
When families begin looking at residential senior care in South Florida, they usually start with one phrase in mind: "assisted living." But Florida actually licenses two distinct types of residential care through the Agency for Health Care Administration (AHCA), and the difference between them shapes everything about daily life, cost, and the feel of the place. The first is the adult family care home (AFCH) — a small, home-based setting for up to five residents where the provider lives on site. The second is the assisted living facility (ALF) — which can range from a handful of residents to several hundred, and which carries its own tiers of specialty licensing.
Understanding that distinction early saves families weeks of confusion. A large-branded community with a marble lobby and a converted single-family house on a quiet Kendall street can both be legitimate, AHCA-licensed places for your parent to live — but they are licensed under different rules, staffed differently, priced differently, and suited to different people. This guide walks through both, using Florida's actual licensing framework, and shows how families across Miami-Dade, Broward, and Palm Beach weigh one against the other.
Adult family care homes: small, personal, provider-in-residence
An adult family care home is exactly what the name suggests — a private residence, owned or rented by the provider, where that provider lives alongside the people in their care. Florida law caps an AFCH at no more than five residents, and the licensed capacity of each home is set by AHCA based on the service needs of the residents and the provider's ability to meet them. Because the provider lives in the home, the model is built around a small, consistent, family-style relationship rather than shift-based institutional staffing.
For the right person, this is a genuinely different experience. Meals are cooked in a real kitchen, often to the household's own cultural traditions — which is one reason AFCHs are so popular in Hialeah, Little Havana, Westchester, and Doral, where a Cuban, Nicaraguan, Venezuelan, or Colombian household can care for a parent in the food, language, and rhythms they grew up with. The ratio of caregivers to residents is inherently high, there's rarely any "lobby" or turnover of unfamiliar faces, and a resident who is anxious, frail, or living with early dementia may settle far more comfortably into a quiet home than into a 120-bed community.
The trade-offs are real too. A five-resident home does not have an activities director, a fitness room, a beauty salon, or an on-site nurse around the clock. If your parent thrives on programming, outings, and a large social calendar, a small home can feel isolating. And because AFCHs advertise very little — most fill entirely by word of mouth — families often can't find the good ones on their own. That's precisely the gap a local advisor fills. Many of these homes are also an excellent cultural and Spanish-speaking care match, which matters enormously in South Florida.
Assisted living facilities: scale, services, and specialty licenses
Anyone who intends to provide room, board, and personal care for more than five older or disabled adults must hold an assisted living facility license. ALFs span an enormous range — from a six-bed converted home to a resort-style community with hundreds of apartments — and every one of them must hold a standard license at minimum. On top of that, Florida issues three specialty licenses that let a facility serve residents with higher needs:
Extended Congregate Care (ECC). An ECC license lets an ALF provide services beyond the standard scope, including more frequent nursing assessments and total assistance with the activities of daily living. In practical terms, an ECC facility can keep a resident whose needs have increased rather than discharging them — an important consideration if you want to avoid a second move later.
Limited Nursing Services (LNS). An LNS license allows a facility to provide a defined set of nursing services, more extensive than a standard ALF, delivered under each resident's service plan. This can cover things like certain injections, catheter or colostomy care, and more involved wound care.
Limited Mental Health (LMH). A standard ALF that serves three or more residents receiving mental health services must obtain an LMH license and provide supports designed for those residents' needs.
Florida is also in the process of creating a new Memory Care Services specialty license, with AHCA rules expected to be finalized in 2027 — a sign that the state is tightening standards specifically around dementia care. Until then, secured memory care in Florida is generally delivered within ALFs under existing licenses. When you tour any assisted living community in Miami, one of the most useful questions you can ask is which of these licenses the facility holds — it tells you, in a single answer, how far the community can support your parent as needs change.
What each costs across Miami-Dade, Broward & Palm Beach
Cost is often where the two models separate most clearly. Small adult family care homes are frequently the most affordable residential option in South Florida, typically running $2,500 to $5,500 a month all-in, because there's no large facility overhead and care is delivered by the resident household. That affordability, combined with cultural fit, is why AFCHs are such a mainstay of Hispanic communities across Miami-Dade.
Assisted living facilities generally run $3,500 to $7,500 a month, with premium communities — especially in Boca Raton, coastal Delray Beach, and Aventura — exceeding $8,000, and memory care adding roughly $1,000 to $2,000 on top. The higher price buys scale: full-time activities, dining venues, transportation, on-site therapy, and the ability (with the right specialty license) to serve heavier care needs without a move. Our full breakdown of 2026 senior care costs across South Florida goes deeper on the ranges.
One caution that applies to both: advertised "starting at" rates almost never reflect the all-in cost once care-level add-ons are included. Whether you're looking at a five-bed home or a large community, always get a written quote that lists every line item and the provider's rate-increase history. And remember that Florida Medicaid does not pay for room and board in either setting — though the SMMC Long-Term Care program can help cover the care portion for eligible residents in participating homes and facilities.
How to choose between an AFCH and an ALF
There's no universally "better" option — only the better fit for a particular parent. A few honest questions usually make the choice clear.
What does your parent actually enjoy? Someone who was always social, active, and out in the world often blooms in a larger community with a full calendar. Someone who is more private, easily overwhelmed, or comforted by a quiet household frequently does better in an adult family care home.
How much care is needed now, and where is it heading? If your parent needs help mainly with daily tasks and companionship, an AFCH or a standard ALF both work. If needs are already high — or clearly progressing — an ALF with an ECC or LNS license, or a strong memory care setting, can prevent a disruptive second move. For memory loss specifically, ask how the setting handles wandering, exit-seeking, and evening agitation.
Does language and food matter? In South Florida this is rarely a minor detail. If being cared for in Spanish, Haitian Creole, or Portuguese — and eating familiar food — will determine whether your parent feels at home, a culturally matched AFCH is often unbeatable, though many larger ALFs in Miami-Dade also staff bilingually.
What's the budget, and how long must it last? An AFCH may stretch a family's resources further, which matters when you're planning a multi-year runway. An ALF may cost more but bundle services you'd otherwise pay for separately. Either way, plan the funding honestly before you fall in love with a place. If a stay at home with support is still on the table, our in-home care overview is worth reading alongside this.
Verify the license before you sign — for either type
Whichever direction you lean, the last step before any decision is the same: verify the provider with the state. Both AFCHs and ALFs are licensed and inspected by AHCA, and their license status, inspection history, and any violations are public on FloridaHealthFinder (the state's consumer-facing quality portal). A legitimate, well-run five-bed home and a legitimate 200-bed community will both have a clean, current license you can look up by name.
Confirm the license type (and any specialty licenses), check the inspection record for recent deficiencies, and ask the provider directly about anything you see. If a home or community is evasive about its license, or you can't find it on the state system, treat that as a stop sign. This one check protects families from the small number of unlicensed operations that occasionally appear — especially among informal "board and care" arrangements that skip the AFCH license entirely.
If you'd like a second set of eyes, that's exactly what we do. Our advisors know which small homes and which communities across Miami, Fort Lauderdale, and the rest of South Florida are well-run, appropriately licensed, and a genuine fit — and our Florida resources hub collects the state tools you'll want in one place.
Which model is right for your family?
The families we help rarely arrive knowing whether they want a small adult family care home or a larger assisted living community — and they shouldn't have to. The two models look so different on paper that many people assume one is "real" senior care and the other isn't, when in fact both are AHCA-licensed and both can be excellent. What matters is the match: a private, culturally familiar five-resident home is a gift for one parent and a lonely place for another; a lively 150-apartment community is a joy for one person and overwhelming for the next. Because the best adult family care homes almost never advertise, and because assisted living communities won't always tell you plainly which specialty license they hold or how they price care add-ons, families searching alone tend to see only part of the picture. Our advisors serve Miami-Dade, Broward, and Palm Beach, and we hold current knowledge of both the small homes and the larger communities — including which ones speak your parent's language, cook the food they grew up with, hold the right license for their care level, and have real availability right now. The service is free to families because we're paid by provider partners only when a placement is made. If you're weighing a small home against a community and aren't sure which way to go, that's the exact question we're built to answer. Tell us about your situation and we'll bring you two or three vetted options — in English or Spanish.