Adult Care Homes
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Search Adult Care Homes ProvidersWhat are Adult Care Homes?
Adult Care Homes are smaller, licensed residential settings that provide personal care services in a home-like environment. Unlike larger Assisted Living communities that may house 50 to 200 or more residents on a campus with shared common areas, dining halls, and activity centers, Adult Care Homes operate in converted single-family residences and typically serve between 4 and 12 residents depending on the state.
Not every state classifies Adult Care Homes as a separate category from Assisted Living. Some states license them under the same umbrella, while others have entirely distinct licensing categories with different rules. The number of residents allowed in each home also varies by state. Oregon licenses Adult Foster Homes for up to five residents. Washington State allows Adult Family Homes to serve up to eight. California permits Residential Care Facilities for the Elderly to house up to six residents in smaller settings and up to 15 or more in larger licensed homes. North Carolina sets the line at six for a Family Care Home. Because these numbers and definitions change from state to state, it is important to check your state's specific licensing requirements. (Source: National Center for Assisted Living, Assisted Living State Regulatory Review)
What all Adult Care Homes share, regardless of terminology, is their residential nature. They look and feel like a regular home in a regular neighborhood. You may drive past one every day without realizing it. Residents share a living room, eat meals together at a dining table, and have access to a yard or garden. Staff members live in or rotate through the home on a 24-hour basis. This is fundamentally different from a large congregate campus with elevators, long hallways, and dozens of staff members moving through common areas.
Common Names for Adult Care Homes
States use a variety of terms for what is essentially the same type of residential care. As you research options in your community, knowing these terms will help you identify all available settings:
Adult Family Home (Washington, Wisconsin) Adult Foster Home (Oregon) Residential Care Home (Hawaii, North Carolina) Family Care Home (North Carolina, for homes with 2 to 6 residents) Residential Care Facility for the Elderly or RCFE (California) Adult Care Home (general term used in many states) Rest Home (used historically in some New England states) Personal Care Home (Georgia, Pennsylvania)
These are not nursing homes. Nursing homes, more accurately called Skilled Nursing Facilities, provide a higher level of medical care with licensed nurses on staff around the clock. Adult Care Homes provide personal care and supervision in a residential setting. The distinction matters for both the type of care available and the cost.
Adult Care Homes vs. Assisted Living: Key Differences
While both Adult Care Homes and Assisted Living communities provide personal care and supervision, several important differences set them apart:
Setting: Adult Care Homes operate in residential neighborhoods in converted homes. Assisted Living communities are purpose-built facilities, often with multiple wings or buildings on a larger campus.
Size: Adult Care Homes typically serve 4 to 12 residents. Assisted Living communities may house 50 to 200+ residents.
Staffing: Adult Care Homes often have the owner or operator living on-site or present daily, with a small team of caregivers. Assisted Living communities have larger, more specialized staff teams including activity directors, dining services, and sometimes on-site therapists.
Amenities: Assisted Living communities typically offer structured activity calendars, fitness rooms, beauty salons, transportation services, and multiple dining options. Adult Care Homes offer a simpler, more domestic experience with home-cooked meals and informal activities.
Cost: Adult Care Homes are often less expensive than Assisted Living communities, though this varies significantly by state and location.
Both settings can provide excellent care. The right choice depends on the individual's preferences, care needs, and budget.
Benefits of Adult Care Homes
Adult Care Homes offer a set of advantages that are difficult to replicate in larger care settings. For many older adults, the transition from their own home to a care setting is one of the most significant changes in their lives. A smaller, home-like environment can make that transition smoother and less overwhelming.
Small, Home-Like Setting
The most immediate difference families notice is the environment. Adult Care Homes look and feel like homes because they are homes. There are no long institutional hallways, overhead paging systems, or large lobbies. Residents live in a setting that closely resembles what they are accustomed to, which can reduce confusion, anxiety, and the feeling of being "placed" in a facility. This is particularly beneficial for residents with dementia or cognitive changes, who may become more disoriented in large, unfamiliar environments.
Higher Staff-to-Resident Ratios
With only 4 to 12 residents, caregivers in Adult Care Homes can provide significantly more individual attention than staff in larger communities. A caregiver responsible for 5 residents can learn each person's habits, preferences, and early warning signs of health changes in ways that are much harder to achieve when caring for 20 or 30 residents at a time. This close relationship between caregiver and resident is one of the strongest advantages of the care home model.
Personalized Routines
In larger communities, meals, activities, and schedules must accommodate dozens or even hundreds of residents. In an Adult Care Home, routines can adapt around the people who live there. If a resident prefers breakfast at 9:30 instead of 7:00, that is often possible. If someone wants to sit in the garden instead of joining a group activity, there is flexibility for that. Daily life follows the rhythms of the residents rather than the schedule of a large operation.
Meaningful Community
Residents in Adult Care Homes often form close bonds with one another and with their caregivers. Sharing meals at a family-style table, spending time in the living room together, and interacting daily with the same small group of people creates genuine relationships. For residents who may feel lonely or isolated, this close-knit community can be deeply meaningful.
Home-Cooked Meals
Meals in Adult Care Homes are typically prepared on-site in the home's kitchen, often by the operator or a dedicated cook. Menus can be adjusted to accommodate dietary needs, cultural preferences, and individual tastes. Residents may even contribute to meal planning or help with light food preparation, which supports engagement and a sense of purpose.
Often More Affordable
Adult Care Homes are frequently less expensive than larger Assisted Living communities, particularly in states where the cost of congregate senior living is high. Lower overhead costs, smaller staff teams, and the absence of large-campus amenities contribute to more accessible pricing for many families. However, costs vary significantly by state and by the level of care required, so it is important to compare options in your specific area.
Continuity of Care
Because staff turnover in smaller homes can be lower than in large facilities, residents often receive care from the same people over extended periods. This continuity allows caregivers to notice subtle changes in health or behavior that might be missed in a setting with frequent staff rotation. Families also benefit from building an ongoing relationship with the people caring for their loved one.
How to Pay for Adult Care Homes
Understanding how to pay for an Adult Care Home is one of the most important steps in the planning process. Several payment options exist, and most families use a combination of sources. Here is what you need to know about each.
Private Pay -- YES
Private pay is the most common way families pay for Adult Care Homes. This includes any combination of personal savings, retirement accounts, pension payments, Social Security income, and contributions from family members. Many families also use proceeds from the sale of a home to fund care costs.
If you are paying privately, planning ahead is critical. Calculate how long available funds will last at the monthly rate you are considering, and factor in potential increases over time. A financial advisor or elder law attorney who specializes in senior care can help you build a realistic funding plan.
Medicare -- NO
Medicare does not pay for Adult Care Homes, Assisted Living, or any long-term residential care setting. Medicare is designed to cover short-term medical needs such as hospital stays, skilled nursing rehabilitation following a qualifying hospital stay (up to 100 days), and home health services.
This is one of the most common misconceptions families encounter when researching senior care options. Do not assume Medicare will cover the cost of a care home. (Source: Medicare.gov)
Medicaid -- MAYBE
Medicaid may help pay for Adult Care Home services in some states, but coverage varies significantly. Medicaid is a joint federal and state program that provides health coverage to low-income individuals, including some older adults and people with disabilities.
Each state administers its own Medicaid program with different eligibility rules, income and asset limits, and levels of coverage for residential care. Some states offer Home and Community-Based Services (HCBS) waivers that can help cover the cost of care in Adult Care Homes. Other states may pay the care home directly through their Medicaid program.
Important things to know about Medicaid and Adult Care Homes:
Eligibility is based on income, assets, household size, and medical need. Many states have waiting lists for HCBS waiver programs. The amount Medicaid reimburses a care home may be lower than the private pay rate, which means not all homes accept Medicaid residents. If you are unsure whether you or your loved one qualifies, apply. Eligibility requirements can be more flexible than many people assume. Contact your state's Medicaid office or visit medicaid.gov for state-specific information. (Source: Medicaid.gov)
Long-Term Care Insurance -- MAYBE
Long-term care insurance can be an excellent resource for paying for an Adult Care Home, but only if you already have a policy in place. These policies help cover the costs of chronic care needs when a person can no longer perform a certain number of activities of daily living independently.
Key considerations:
Policies purchased when a person is in their 50s or 60s are generally the most cost-effective. The U.S. Department of Health and Human Services estimates that nearly 70% of people turning 65 today will need some form of long-term care in their lifetime. (Source: ACL/U.S. Department of Health and Human Services) Each policy has different benefit triggers, daily or monthly maximums, and elimination periods. Review your policy carefully or contact your insurance provider to understand what is covered. Not all long-term care insurance policies cover Adult Care Homes specifically. Confirm that your policy includes "residential care" or "adult foster home" coverage.
Veteran Aid and Attendance -- MAYBE
The VA Aid and Attendance benefit is available to qualifying veterans and surviving spouses who need assistance with activities of daily living. This benefit provides a monthly pension supplement that can be applied toward the cost of an Adult Care Home.
As of 2024, the maximum monthly Aid and Attendance benefit amounts are approximately:
Veteran with no dependents: up to $2,229 per month Veteran with a spouse or dependent: up to $2,642 per month Surviving spouse of a veteran: up to $1,432 per month
(Source: U.S. Department of Veterans Affairs. Note: benefit amounts are adjusted annually. Verify current rates at va.gov.)
Eligibility requirements include military service during a wartime period, meeting income and asset thresholds, and demonstrating a medical need for assistance. An accredited VA claims agent or veterans service organization can help determine eligibility and assist with the application process.
Other Potential Payment Sources
Reverse mortgage: Homeowners 62 and older may be able to use a reverse mortgage to generate funds for care.
Life insurance policy conversion: Some life insurance policies can be converted to a long-term care benefit or sold through a life settlement.
Bridge loans: Short-term financing options that can cover care costs while waiting for a home to sell or other funds to become available.
State and local assistance programs: Some states and counties offer supplemental programs for low-income seniors. Your local Area Agency on Aging can help identify programs in your area.
What to Expect in an Adult Care Home
Life in an Adult Care Home is structured around a domestic routine that feels more like living in someone's home than being in a facility. Understanding what daily life looks like can help families set appropriate expectations and identify the right fit.
Daily Routine
A typical day in an Adult Care Home follows a comfortable, flexible rhythm. Residents wake and get ready for the day with assistance as needed. Breakfast is prepared in the home's kitchen, and residents eat together at the dining table. The morning may include light activities, time in the living room or garden, or personal routines like reading, watching television, or visiting with other residents.
Lunch and dinner follow a similar pattern, with home-cooked meals served family-style. Between meals, caregivers assist with personal care needs, medication management, and any scheduled appointments. Evenings are typically relaxed, with residents winding down in shared common areas before bedtime.
The key difference from larger communities is the pace. There is no need to follow a rigid activity calendar or eat in a large dining hall on a fixed schedule. Daily life adapts to the people living in the home.
Care and Support Services
Caregivers in Adult Care Homes typically assist with a wide range of daily needs:
Personal care: bathing, grooming, oral hygiene, and dressing
Mobility support: transfers, walking assistance, and fall prevention
Medication management: reminders, administration, and coordination with pharmacies and physicians
Meal preparation: three daily meals plus snacks, tailored to dietary needs
Housekeeping: laundry, cleaning, and general home maintenance
Toileting and incontinence care
Cognitive support: redirection, cueing, and routine reinforcement for residents with memory challenges
Behavior management: calm, consistent responses to anxiety, agitation, or confusion
Activities and Engagement
Activities in Adult Care Homes tend to be informal and resident-driven rather than scheduled on a printed calendar. Common activities include:
Card games, puzzles, and board games
Gardening or spending time outdoors
Watching television or movies together
Visits from family members and friends
Music, crafts, or other personal interests
Short outings or walks in the neighborhood (when appropriate)
Some Adult Care Homes bring in outside visitors such as pet therapy animals, musicians, or hairdressers. Others coordinate with local senior centers or religious organizations for social connection. The variety of activities depends on the home's operator and the interests of the residents.
Specialized Care
Some Adult Care Homes specialize in particular populations or care needs:
Dementia and memory care: Homes with secured environments and staff trained in dementia care techniques can serve residents who might otherwise need a dedicated memory care unit in a larger community.
Mobility-limited residents: Some homes are equipped with wheelchair ramps, hospital beds, and Hoyer lifts to support residents with significant physical limitations.
Mental health and behavioral needs: Certain homes are licensed to serve adults with mental health conditions, developmental disabilities, or substance use recovery needs.
Younger adults with disabilities: Adult Care Homes are not exclusively for seniors. Some states license homes to serve adults of any age who need residential care and supervision.
When touring homes, ask specifically whether the home is equipped and licensed to serve your loved one's particular needs. Not every home is a fit for every resident, and an honest assessment upfront prevents a difficult transition later.
Meals and Nutrition
Meals are one of the highlights of life in an Adult Care Home. Because the home's kitchen is right there, meals are often prepared fresh with input from residents. Many operators accommodate dietary restrictions including diabetic diets, low-sodium requirements, food allergies, and cultural or religious dietary preferences.
Eating together at a shared table is both practical and social. It provides a natural structure to the day and encourages conversation and connection among residents. For residents who need assistance with eating, caregivers are present and attentive during mealtimes.
Licensing and Regulations
Adult Care Homes across the United States operate under a patchwork of state and local regulations that vary significantly in their requirements, terminology, and oversight standards. Unlike Skilled Nursing Facilities, which are regulated at the federal level by the Centers for Medicare and Medicaid Services (CMS), Adult Care Homes fall primarily under state jurisdiction. There is no single federal licensing standard for these smaller residential care settings.
This means that the rules governing everything from the number of residents allowed, to staff training requirements, to inspection schedules are determined by your state's licensing agency. Understanding your state's regulatory framework is essential when evaluating care options.
What States Typically Regulate
While specific requirements vary, most state licensing programs for Adult Care Homes address the following areas:
Maximum number of residents: States set specific limits on how many people a home may serve. This can range from 3 (Texas) to 12 or more (North Carolina, California) depending on the license type.
Operator qualifications: Most states require operators to pass criminal background checks, complete initial training, and maintain ongoing education. Some states require a minimum amount of direct care experience before granting a license. (Source: NCAL Assisted Living State Regulatory Review)
Staffing requirements: Regulations typically address minimum staffing ratios, training for caregivers, and whether an awake caregiver must be present overnight.
Care planning: Most states require an individualized care assessment and written care plan for each resident, reviewed and updated at regular intervals.
Physical environment: State rules address safety features including fire detection and suppression, wheelchair accessibility, bedroom size minimums, and the overall condition of the home.
Medication management: Rules vary on who is allowed to administer medications and what level of oversight is required.
Inspections: Most states conduct regular inspections, which may be announced or unannounced. Inspection frequency varies from annually to every 15 to 24 months depending on the state and the home's compliance history.
Examples of State Variation
A few examples illustrate just how different regulations can be from one state to the next:
Oregon: Adult Foster Homes are licensed to serve up to five residents and are regulated by the Department of Human Services. Operators must complete an eight-hour orientation, pass a qualifying exam, complete ongoing training, and demonstrate at least one year of direct care experience. Homes serve older adults, people with physical disabilities, developmental disabilities, and those with mental health or addiction needs. (Source: Oregon Department of Human Services)
Washington: Adult Family Homes may serve up to eight residents and are regulated by the Department of Social and Health Services (DSHS). Operators must complete a minimum of 80 hours of training, and the home must pass a background check and physical inspection before licensure. DSHS conducts unannounced inspections roughly every 15 months. (Source: Washington DSHS Residential Care Services; Adult Family Home Council)
California: Residential Care Facilities for the Elderly (RCFEs) are licensed by the California Department of Social Services. Small homes serve up to six residents, while larger facilities may serve more. The state's Adult Care Licensing Program monitors compliance with health, safety, and quality standards. (Source: California Department of Social Services, Adult Care Licensing Program)
Texas: Adult Foster Care providers may serve no more than three individuals and must obtain a Type C Assisted Living license from the Texas Health and Human Services Commission (HHSC). Larger facilities follow different licensing rules under TAC Title 26, Chapter 553. (Source: Texas Health and Human Services Commission)
New York: The Department of Health licenses Adult Care Facilities in three categories: Adult Homes serving five or more residents, Enriched Housing Programs, and Residences for Adults. Facilities may also seek additional certification as Assisted Living Residences, Enhanced Assisted Living Residences, or Special Needs Assisted Living Residences. (Source: New York State Department of Health)
How to Verify Licensing
When evaluating an Adult Care Home, take these steps to verify its licensing and compliance:
Ask the operator directly for their current license number and the name of the licensing agency.
Contact your state's licensing or regulatory agency to confirm the home's license is active and in good standing.
Request inspection reports. Most states make inspection results available to the public, either online or upon request. Review these reports for patterns of violations or concerns.
Ask about any citations, complaints, or corrective actions in the past two years.
Check whether the home has had any "stop-placement" orders, which prevent new admissions and can signal serious compliance issues.
The Role of the Long-Term Care Ombudsman
Every state has a Long-Term Care Ombudsman Program, required under the federal Older Americans Act. Ombudsmen are independent advocates for residents of nursing homes, assisted living, board and care homes, and similar adult care facilities. They investigate complaints, help resolve disputes, provide information about care options, and advocate for improvements in the long-term care system.
In fiscal year 2023, Ombudsman programs across the country worked to resolve more than 200,000 complaints and resolved or partially resolved 71% of those complaints to the satisfaction of the resident or family member. (Source: Administration for Community Living, Long-Term Care Ombudsman Program)
If you have concerns about the care or conditions in an Adult Care Home, contact your local or state Long-Term Care Ombudsman. You can find your local Ombudsman through the Eldercare Locator at 1-800-677-1116 or at ltcombudsman.org.
Choosing an Adult Care Home
Because Adult Care Homes vary widely in quality, services, and philosophy, choosing the right one requires careful research and in-person evaluation. A home that is perfect for one person may not be the right fit for another. Here is how to approach the search systematically.
Start with Your Loved One's Needs
Before touring any homes, make a clear list of your loved one's care needs, preferences, and priorities. Consider:
What level of personal care assistance do they need? (bathing, dressing, mobility, toileting) Do they have a medical condition that requires specialized knowledge? (dementia, Parkinson's, diabetes management) What are their social preferences? (Do they prefer a quiet environment or more social interaction?) Are there dietary needs or restrictions? How important is proximity to family, medical providers, or a specific community? What is your realistic monthly budget, including potential increases as care needs change?
Having this list will help you evaluate each home against your specific requirements rather than making general impressions.
Visit in Person
There is no substitute for an in-person visit, and visiting more than once is even better. Try to visit at different times of day, including during a mealtime. Things to observe:
Cleanliness: Is the home clean and well-maintained? Look beyond the main living areas. Check the kitchen, bathrooms, bedrooms, and outdoor spaces. Note whether doorknobs are loose, carpets are frayed, or there are trip hazards.
Atmosphere: Does the home feel warm and comfortable, or does it feel tense or institutional? Pay attention to how residents seem. Are they engaged, comfortable, and at ease?
Smell: Persistent unpleasant odors can indicate inadequate cleaning or incontinence care.
Safety: Look for handrails in hallways and bathrooms, smoke detectors, fire extinguishers, and clear pathways free of clutter.
Meet the Caregivers
The people providing care are the most important factor in your loved one's daily experience. During your visit:
Ask about staff qualifications, training, and certifications. Find out what initial and ongoing training caregivers receive.
Ask about staff turnover. High turnover can disrupt care continuity and is sometimes a sign of management or workplace issues.
Observe how staff interact with residents. Are they patient, warm, and respectful? Do they call residents by name and seem to know their preferences?
Ask who is on duty overnight and whether overnight staff are awake or sleeping. For residents with nighttime care needs, awake overnight staff are essential.
Understand the Costs
Get a detailed, written breakdown of all costs before making a decision:
What is the base monthly rate, and what does it include? Are there additional charges for higher levels of care, incontinence supplies, medication management, or transportation? Is there a move-in fee, and is any portion of it refundable? How and when are rate increases communicated? What happens if your loved one's care needs increase significantly? At what point would the home require a move to a higher level of care?
Check Licensing and Inspection Records
Verify that the home is properly licensed by your state's licensing agency. Request and review recent inspection reports. Look for:
Patterns of repeated violations
Citations related to medication errors, staffing shortages, or resident safety
How quickly the home corrected any issues identified during inspections Whether the home has ever been subject to fines, sanctions, or stop-placement orders
Talk to Current Families
Ask the operator if you can speak with family members of current residents. Their firsthand perspective is invaluable. Questions to ask:
How long has your loved one been living here? Have there been any issues with care, and how were they resolved? How responsive is the operator when you have concerns? Would you choose this home again?
Ask the Right Questions
Here is a checklist of key questions to ask during your tour:
How many residents currently live here, and what is the maximum licensed capacity? What are the operator's qualifications and how long have they been running the home? What is the caregiver-to-resident ratio during the day? At night? What happens in a medical emergency? How are medications managed, stored, and administered? Are residents allowed to bring personal furniture, decorations, or pets? What is the discharge policy? Under what circumstances would a resident need to leave? Can my loved one continue living here if their care needs increase? How are family members kept informed about changes in their loved one's health or care?
Trust Your Instincts
After gathering information, compare your observations and gut feeling across the homes you visited. If you feel comfortable with the environment, confident in the caregivers, and at ease with the operator, that is a strong signal. If something feels off, even if you cannot pinpoint exactly what, keep looking. Your loved one's comfort and safety are the most important factors, and finding the right home is worth the extra time and effort.
Resources & Links
Government Resources
Eldercare Locator is a nationwide service that connects older Americans and their caregivers with trustworthy local support resources. Connect with services such as meals, home care, transportation, caregiver education, or respite from caregiving responsibilities. The Eldercare Locator is a public service of the Administration on Aging (AoA), an agency of the U.S. Administration for Community Living. You can also reach them by phone at 1-800-677-1116.
Medicare provides a search feature to find and compare providers near you. While Medicare does not pay for Adult Care Homes, it covers other services your loved one may need including physician visits, prescription drugs, skilled nursing rehabilitation, and home health services. Find and compare plans in your area and determine if you qualify for premium savings.
Medicaid offers information on how to apply for Medicaid, eligibility criteria, links to local state offices, and additional resources. Because Medicaid rules for residential care vary by state, start with your state's Medicaid office to understand what coverage may be available.
Administration for Community Living oversees programs that support older adults, people with disabilities, and family caregivers. ACL administers the Older Americans Act, which funds services including the Long-Term Care Ombudsman Program, senior nutrition programs, caregiver support, and community-based services.
Long-Term Care Ombudsman Program provides independent advocates for residents of nursing homes, assisted living, and adult care homes in every state. Ombudsmen investigate complaints, help resolve problems, and provide information about choosing care settings and understanding resident rights. Find your local Ombudsman through the Eldercare Locator or at ltcombudsman.org.
U.S. Department of Veterans Affairs administers benefits for qualifying veterans and surviving spouses, including the Aid and Attendance pension benefit that can help pay for Adult Care Home care. Contact your local VA office or visit va.gov/pension/aid-attendance-housebound for eligibility information and application assistance.
Nonprofit and Advocacy Resources
The Alzheimer’s Association is the leading voluntary health organization in Alzheimer's care, support, and research. Whether you are living with Alzheimer's or caring for someone with the disease, information and resources are available including a 24/7 helpline at 1-800-272-3900.
National Center for Assisted Living / NCAL is part of the American Health Care Association and represents assisted living providers nationally. NCAL publishes the annual Assisted Living State Regulatory Review, which summarizes licensing requirements for every state, and provides consumer resources for families researching care options.
AARP Caregiving Resources (aarp.org/caregiving) offers guides, tools, and information for family caregivers including help with evaluating care options, understanding resident rights, navigating insurance and benefits, and managing the emotional demands of caregiving.
National Consumer Voice for Quality Long-Term Care advocates for quality care and quality of life for consumers in all long-term care settings. They provide resources on residents' rights, information on filing complaints, and connections to state advocacy organizations.
National Academy of Elder Law Attorneys / NAELA provides a directory of attorneys who specialize in elder law, including Medicaid planning, veterans benefits, guardianship, and estate planning for seniors and their families.
BenefitsCheckUp is a service of the National Council on Aging that helps older adults find and apply for benefit programs that can help pay for medications, health care, food, utilities, and more. Answer a short questionnaire to identify programs you may qualify for.
CareAvailability.com Search and compare Adult Care Homes in your area with provider details, location information, and direct contact options. [internal link to directory]
How Much Does an Adult Care Home Cost?
The cost of an Adult Care Home depends on your geographic location, the level of care your loved one requires, and the specific services and amenities included. Because Adult Care Homes are smaller and have lower overhead than large Assisted Living communities, they are often more affordable, but pricing can range widely.
National Cost Overview
Adult Care Homes typically cost between $2,000 and $6,000 per month, depending on the state and the care needs of the resident. Some homes in higher-cost states like California, Washington, and Massachusetts may charge $6,000 to $8,000 or more per month for residents with complex needs.
For comparison, the national median cost of Assisted Living in 2024 was $5,900 per month, or $70,800 annually. A private room in a Skilled Nursing Facility had a national median cost of $10,646 per month, or $127,750 per year. Adult Care Homes generally fall below the Assisted Living median, making them one of the more affordable options for 24-hour supervised residential care. (Source: CareScout/Genworth Cost of Care Survey, 2024)
What Affects the Cost
Several factors influence what you will pay for an Adult Care Home:
Geographic location: Costs tend to be lower in southern and midwestern states and higher on the west coast, northeast, and in major metropolitan areas.
Level of care: Residents who need more hands-on assistance with daily activities, medication management, or specialized care such as memory support will generally pay higher rates. Many homes use a tiered pricing system or charge a base rate plus additional fees based on a care assessment.
Room type: A private room typically costs more than a shared room. Some homes offer only private rooms while others have shared options.
Included services: Some homes include all meals, laundry, housekeeping, and basic personal care in a single monthly rate. Others charge separately for higher levels of care, incontinence supplies, or transportation.
Regional Cost Examples
Costs for residential care vary significantly across the country. Here are some general examples:
Southern states (Alabama, Mississippi, Arkansas, Georgia): $1,800 to $3,500 per month Midwestern states (Iowa, Kansas, Nebraska, Indiana): $2,000 to $4,000 per month Western states (Oregon, Washington, California): $3,500 to $7,000+ per month Northeastern states (New York, Massachusetts, Connecticut): $4,000 to $8,000+ per month
These are general ranges and actual costs will vary by community and individual care needs. For the most accurate comparison in your area, use the CareScout Cost of Care tool at carescout.com/cost-of-care or contact homes directly for current pricing. (Source: CareScout/Genworth Cost of Care Survey, 2024)
Move-In Fees and Additional Costs
Many Adult Care Homes charge a one-time move-in or community fee, which can range from a few hundred dollars to one or two months' rent. Ask about this upfront so you can plan for the full cost of transitioning your loved one.
Some additional costs that may not be included in the base monthly rate:
Higher levels of personal care beyond the base assessment Incontinence supplies Specialized dietary needs Transportation to medical appointments Personal laundry beyond basic service Medications and pharmacy costs (typically separate)
Always ask for a detailed breakdown of what is and is not included in the quoted monthly rate. A home that quotes $3,000 per month with everything included may ultimately cost less than one quoting $2,500 with multiple add-on charges.
Citations and Source References
The following sources are cited in this article.
- National Center for Assisted Living (NCAL). Assisted Living State Regulatory Review. 2024. ahcancal.org/Assisted-Living/Policy/Pages/state-regulations.aspx
- CareScout / Genworth Financial. Cost of Care Survey 2024: National Median Data. 2024. carescout.com/cost-of-care
- CareScout / Genworth Financial. 2025 Cost of Care Survey Results. 2025. investor.genworth.com/news-events/press-releases/detail/1054/carescout-releases-2025-cost-of-care-survey-results
- U.S. Department of Health and Human Services. How Much Care Will You Need? Administration for Community Living. 2024. acl.gov/ltc/basic-needs/how-much-care-will-you-need
- Centers for Medicare and Medicaid Services. What Medicare Covers. 2024. medicare.gov/what-medicare-covers
- Centers for Medicare and Medicaid Services. Medicaid Eligibility. 2024. medicaid.gov/medicaid/eligibility/index.html
- Centers for Medicare and Medicaid Services. Home and Community-Based Services. 2024. medicaid.gov/medicaid/home-community-based-services/index.html
- U.S. Department of Veterans Affairs. Aid and Attendance and Housebound Benefits. 2024. va.gov/pension/aid-attendance-housebound
- Administration for Community Living. Long-Term Care Ombudsman Program. 2024. acl.gov/programs/Protecting-Rights-and-Preventing-Abuse/Long-term-Care-Ombudsman-Program
- Administration for Community Living. Eldercare Locator. 2024. eldercare.acl.gov
- U.S. Government Accountability Office. Long-Term Care: Information on the
Frequently Asked Questions
Common Questions About Adult Care Homes
What is an Adult Care Home?
An Adult Care Home is a smaller, licensed residential setting that provides personal care and 24-hour supervision to a limited number of residents, typically between 4 and 12 people. These homes operate in converted single-family residences in regular neighborhoods and offer a home-like alternative to larger Assisted Living communities. They may also be called Adult Foster Homes, Board and Care Homes, Residential Care Homes, or Family Care Homes depending on the state.
How are Adult Care Homes licensed?
Adult Care Homes are licensed at the state level, not the federal level. Each state has its own licensing agency, requirements, and inspection process. Most states require operators to complete training, pass background checks, and maintain specific standards for staffing, safety, care planning, and the physical environment. Licensing requirements differ significantly between states, so check with your state's regulatory agency for specific rules. The National Center for Assisted Living publishes an annual state-by-state regulatory review at ahcancal.org. (Source: NCAL Assisted Living State Regulatory Review)
When is the right time to consider an Adult Care Home?
The right time varies for every family, but common signs include: difficulty managing daily activities like bathing, dressing, or meal preparation safely at home; increasing isolation or loneliness; frequent falls or safety concerns; caregiver burnout among family members providing unpaid care; and a medical condition that requires more consistent supervision than can be provided at home. Starting your research before a crisis gives you time to find the best fit rather than making a rushed decision during an emergency.
What should I look for when visiting an Adult Care Home?
Pay attention to cleanliness, resident demeanor, staff interactions, and the overall atmosphere. Visit during a mealtime to observe the food and how residents are supported. Check that safety features are in place including handrails, smoke detectors, and clear pathways. Meet the caregivers and ask about their training, experience, and how long they have worked there. Ask about overnight staffing and whether awake staff are present 24 hours. Speak with families of current residents if possible.
Can someone with dementia live in an Adult Care Home?
Many Adult Care Homes serve residents with dementia or memory loss, and some homes specialize in dementia care. The small, familiar environment of a care home can actually benefit residents with cognitive changes by reducing confusion and overstimulation. However, not all homes are equipped or licensed for dementia care. Ask about the staff's dementia training, whether the home has secured exits to prevent wandering, and what level of cognitive impairment the home can safely accommodate.
Can my loved one bring personal belongings to an Adult Care Home?
Most Adult Care Homes allow and encourage residents to bring personal items including furniture, photographs, bedding, and decorations for their room. These familiar items help create a sense of home and can ease the transition. Ask each home about their specific policies, including any restrictions on furniture size or electrical items. Some homes may also allow small pets, though this varies.
What happens if my loved one's care needs increase?
This is one of the most important questions to ask before choosing a home. Some Adult Care Homes can accommodate increasing care needs, including residents who become more dependent on assistance with mobility, toileting, or cognitive support. Others have limits on the level of care they can provide and may require a resident to transition to a higher level of care such as a Skilled Nursing Facility. Ask specifically about the home's discharge policy and at what point they would recommend a different care setting.
Are Adult Care Homes safe?
Licensed Adult Care Homes are regulated and inspected by state agencies to ensure they meet health and safety standards. However, quality varies from home to home. Families should verify that a home is properly licensed, review inspection reports for any patterns of violations, and visit the home in person before making a decision. If you have concerns about care quality or safety, your state's Long-Term Care Ombudsman can investigate complaints and advocate for residents.
Can veterans receive benefits to help pay for an Adult Care Home?
Yes, qualifying veterans and surviving spouses may be eligible for the VA Aid and Attendance benefit, which provides a monthly pension supplement that can be applied toward Adult Care Home costs. As of 2024, the maximum benefit is approximately $2,229 per month for a veteran without dependents, $2,642 for a veteran with a spouse or dependent, and $1,432 for a surviving spouse. Eligibility depends on military service, income, assets, and medical need. Contact your local VA office or visit va.gov for application information. (Source: U.S. Department of Veterans Affairs)
How much does an Adult Care Home cost?
Adult Care Homes typically cost between $2,000 and $6,000 per month, though prices can be higher in metropolitan areas and coastal states. Costs are influenced by geographic location, the resident's care needs, room type, and what services are included in the monthly rate. Many Adult Care Homes are less expensive than Assisted Living communities, which had a national median cost of $5,900 per month in 2024. (Source: CareScout/Genworth Cost of Care Survey, 2024)
How is an Adult Care Home different from Assisted Living?
The primary differences are size, setting, and amenities. Adult Care Homes serve a small number of residents (usually 4 to 12) in a residential home, while Assisted Living communities may house 50 to 200+ residents on a larger campus with structured activities, dining halls, and common areas. Both provide personal care and supervision, but Adult Care Homes offer a more intimate, family-like environment. Adult Care Homes are often less expensive than Assisted Living.
How is an Adult Care Home different from a Nursing Home?
Nursing Homes, more accurately called Skilled Nursing Facilities (SNFs), provide 24-hour medical care from licensed nurses and are designed for people with complex health conditions requiring ongoing clinical supervision. Adult Care Homes provide personal care and supervision but not skilled medical care. The cost of a Skilled Nursing Facility is significantly higher, with a national median of over $10,600 per month for a private room in 2024 compared to $2,000 to $6,000 per month for most Adult Care Homes. (Source: CareScout/Genworth Cost of Care Survey, 2024)
Does Medicare pay for Adult Care Homes?
No. Medicare does not pay for Adult Care Homes, Assisted Living, or any long-term residential care setting. Medicare covers short-term medical needs including hospital stays, skilled nursing rehabilitation (up to 100 days following a qualifying hospital stay), and home health services. This is one of the most common misconceptions in senior care planning. (Source: Medicare.gov)
Does Medicaid pay for Adult Care Homes?
Medicaid may help cover the cost of an Adult Care Home in some states, but coverage varies. Each state administers its own Medicaid program with different eligibility rules and coverage levels. Some states offer Home and Community-Based Services (HCBS) waivers that can help pay for residential care. Not all Adult Care Homes accept Medicaid, and the reimbursement rate may be lower than the private pay rate. Contact your state's Medicaid office or visit medicaid.gov for specific eligibility information.
How do I find Adult Care Homes near me?
Start by searching CareAvailability.com for Adult Care Homes, Board and Care Homes, and Adult Foster Homes in your area. You can also contact the Eldercare Locator at 1-800-677-1116 or eldercare.acl.gov for help locating care options. Your local Area Agency on Aging is another excellent resource for finding licensed homes and understanding what is available in your community. Your state's licensing agency may also maintain a public directory of licensed homes that you can search online.
Cost Comparison
Adult Care Homes Costs Across the U.S.
Most Affordable States
Cost data sourced from Genworth/CareScout survey. Actual costs vary by facility and care level.
Popular Cities
Top Cities for Adult Care Homes
Phoenix
Arizona (AZ)
Pop. 1,650,070
Charlotte
North Carolina (NC)
Pop. 911,311
Seattle
Washington (WA)
Pop. 777,000
Oklahoma City
Oklahoma (OK)
Pop. 681,054
Portland
Oregon (OR)
Pop. 630,498
Detroit
Michigan (MI)
Pop. 620,376
Louisville
Kentucky (KY)
Pop. 618,733
Baltimore
Maryland (MD)
Pop. 585,708
Milwaukee
Wisconsin (WI)
Pop. 563,305
Albuquerque
New Mexico (NM)
Pop. 560,274
Tucson
Arizona (AZ)
Pop. 547,239
Sacramento
California (CA)
Pop. 526,384
Coverage Map
Adult Care Homes by State
Select a state to view cities and providers.
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Other Senior Living & Care Types
Assisted Living
Residential communities offering help with daily activities, meals, and medication management.
Learn moreMemory Care
Specialized care for individuals living with Alzheimer's or other forms of dementia.
Learn moreIndependent Living
Active retirement communities for seniors who want maintenance-free living.
Learn moreSkilled Nursing
Facilities providing 24-hour nursing care for complex medical needs.
Learn moreHome Care
Non-medical assistance with daily living activities delivered in your home.
Learn moreHome Health
Licensed medical care provided by nurses and therapists in your home.
Learn moreHospice Care
Comfort-focused care for individuals with terminal illness and their families.
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