For seniors who cannot age in place or simply prefer not to, adult family homes offer a popular and intimate alternative. These privately run facilities, which often go by the name group homes, are typically situated within large single-family houses where roughly half a dozen residents share common living spaces. They provide a distinct, home-like environment that stands in contrast to the institutional feel of larger assisted living facilities.
While precise statistics on the number of adult family homes in the U.S. are difficult to pin down, the CDC estimates there are over 30,000 spread across most states. As you explore housing alternatives for yourself or a loved one, these homes are certainly worth investigating.
They are an ideal fit for some seniors, though they may not be the right choice for everyone.
Our overview of adult family homes relies heavily on an insightful AARP article by contributor Sally Abrahms. Abrahms draws from her personal experience as a caregiver for her own parents and in-laws to provide a grounded perspective. Since the original AARP report was published in 2022, we have updated the financial data to reflect 2025 and 2026 cost figures.
An Alternative When Aging in Place Isn’t the Right Choice
Abrahms notes that while most people desire to age at home, physical or financial realities often make that impossible. Rather than moving to a massive assisted living community or a skilled nursing facility, seniors can find a local alternative nestled right in their own neighborhoods.
These options are known by various names depending on your location. Abrahms explains that you might hear them called adult family homes, board and care homes, residential assisted living, or residential care homes. In fact, states use more than 30 different terms to license these arrangements. A simple way to think of it is assisted living, but inside a house.
Smaller Group Homes are an “Under the Radar” Option
Because these small facilities are usually tucked away in quiet residential neighborhoods, they frequently go unnoticed by the general public. Abrahms writes that in many states, these homes remain an option that often slips under the radar.
This lack of visibility is largely because group homes serve so few residents compared to major assisted living centers. For example, in Wisconsin, adult family homes make up about half of the assisted living providers but account for less than 15 percent of all assisted living beds statewide.
Adult Family Homes Offer a Range of Assisted Living Services
For seniors who require daily assistance, residential care homes serve as a robust alternative to large-scale centers. Staff members provide essential help with personal needs, including bathing, dressing, eating, medication management, and toileting. They are also positioned to respond quickly to emergencies.
Furthermore, some states license group homes to provide broader levels of care, including independent living. It is vital for potential residents and their families to perform due diligence to understand exactly what level of care is included in a specific home’s license.
State Regulations and Terminology Vary Across the U.S.
The naming conventions for these homes vary significantly by state. While every state permits some form of adult residential care, some states regulate these facilities very lightly. Conversely, states like Washington and Oregon have implemented more stringent guidelines for operators.
Families navigating the marketplace will encounter several different labels. Residential Care Home is a broad term for small, private facilities offering personal care in a family-style setting. Adult Foster Care typically refers to arrangements where a caregiver lives in the same home as the residents.
In the southern and eastern United States, you are more likely to see the term Personal Care Homes. Some states stick with Board and Care Home, while many people use the phrase Group Home as a general catch-all for small-scale residential care.
States License Adult Family Homes as Assisted Living Communities
Regardless of the name, group homes are licensed by states under the same requirements as any other assisted living community. They typically house between five and ten people, though some states allow up to twenty. Staff members who provide direct care must undergo mandated annual training.
Where state regulations are in place, residents must have formal care plans, and employees must maintain detailed care records. Most group homes are owned by private individuals, though some are part of larger companies. In many cases, the staff lives in the house, sometimes with their own families.
These homes often offer unique features, such as allowing pets or providing multilingual staff. Some homes specialize in memory care or specific disease management. Crucially, there is always a staff member on-site 24 hours a day.
One Big Selling Point: Cost of Care is Usually Less
Cost is often a deciding factor for families choosing an adult family home. These homes generally charge less than larger assisted living communities because they do not offer expensive amenities like on-site beauty salons or art classes. However, homes specializing in dementia care are usually more expensive due to the need for additional safety measures.
Residents generally pay for these services out of pocket, but those with long-term care insurance can often apply their benefits to group home costs. Additionally, some homes hold Medicaid contracts or serve veterans who qualify for Aid and Attendance benefits.
Specific Charges Vary Widely State by State
Because the original AARP article was written a few years ago, we compared those figures with the 2025 Genworth Cost of Care Survey. It is important to note that adult family home costs are often grouped with larger assisted living facilities in national data, making direct comparisons difficult.
According to Genworth, the average annual cost of a shared room in a skilled nursing facility hit $114,975 in 2025, up significantly from $95,000 in 2021. Private nursing rooms rose to $129,575. Assisted living averages $74,400 per year, which is 38 percent higher than the 2021 average of $54,000.
In the State of Washington, data from the Adult Family Home Council shows an average annual cost of $54,000 for a shared room and $60,000 for a private room. For those looking at other regions, A Place for Mom provides a helpful state-by-state comparison table.
You may also find our previous article on paying for long-term care useful for exploring coverage options.
Living in an Adult Family Home Feels Different
Life in an adult family home is a departure from the experience of a large facility. The lower price point, higher staff-to-client ratio, and family-oriented atmosphere are what distinguish this option. In Florida, for example, these homes are strictly limited to no more than five residents.
Abrahms points out that these differences were especially clear during the COVID pandemic. Smaller homes generally did not confine residents to their rooms and were often able to continue allowing family visits when larger facilities were locked down.
Some Advantages of Adult Family Homes
The benefits of group homes center on personalized care. With fewer residents to monitor, staff can more easily detect subtle physical or emotional changes in a senior. The intimate setting also makes socialization with other residents and staff feel more natural.
For those with dementia, the smaller environment is often a much better fit. Meals are typically home-cooked and can be customized to individual tastes. Many of these homes also provide local transportation for shopping or medical appointments.
Some Disadvantages of “Small Scale” Adult Living
The small size that provides many benefits can also be a drawback for some. Living in a house with only a few people may not fit the social needs of every older adult. With so few residents, there are naturally fewer opportunities to find compatible friends.
Residents also miss out on the extensive amenities and scheduled activities that large communities provide. Privacy can also be an issue; living in close quarters is more like boarding in a private home than having a private apartment. Furthermore, while staff is present 24/7, there is typically no physician or nurse stationed on-site. Seniors requiring complex medical attention may eventually need to move to a nursing home.
Before You Decide, Do Your Homework
Abrahms concludes her article with a breakdown of several things to ask and qualities to observe when you’re considering an adult family home. We lack the space to include them here, so we suggest you check out her AARP article. “This is a major move,” Abrahms reminds us, “so you’ll want to look at places more than once and at different times of the day.”
Most of the tips are self-evident and focus on how the residence feels. Is it warm and relaxed? Are residents alert and welcoming? What happens on a typical day? Does the staff organize activities? What are the house rules? Talking with families of residents is always a good idea.
But a vital place to start your search is with your state. (In Washington, it’s the Department of Social and Health Services.) “Make sure state officials have licensed the home,” Abrahms warns. “Depending on where you live, that might be a department of health, social services or aging services. While you’re at it, see if the agency’s website lists any formal complaints against the home.”
This checklist for vetting assisted living facilities is also a helpful tool. Also, A Place for Mom offers a tool that lets you search by state for regulations governing assisted living facilities.
Generally, says AARP, you’ll need to inquire about the facility’s owners—who they are and how long they have been in business. Ask about the staff-to-resident ratio and whether a nurse is on staff or on call.
Obviously, cleanliness and safety will be paramount. “Ask to see an inspection report and complaints against the home,” Abrahms advises—“officials are required to show you.” Also, make sure you find out in writing what benefits come with the monthly fee and whether there will be surcharges for things like laundry, internet access, or local transportation.
Finally, Abrahms reminds us, “Don’t forget the most important question of all: Can you see yourself, or can your loved ones see themselves, living here? Does it feel like the right fit? If you’re not sure, take a look at other group homes. One of them is likely to feel the most like home.”
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