Adult family homes (adult foster care homes)

What an adult family home is

An adult family home is a small residential home where a caregiver or care team supports a limited number of adults. You may also hear the terms adult foster care home or board-and-care home. The name and rules can vary by state.

These homes are usually located in regular neighborhoods, not large campuses. That can make them feel quieter, more familiar, and easier to navigate for some people.

HearthRow is not a care home, care provider, medical professional, or government agency. We are a free matching and information service. We help families find licensed or certified adult family homes to look at and compare.

Who this kind of home may work well for

Adult family homes can be a good fit for older adults or disabled adults who need help with daily life in a setting that feels smaller and more personal. That might include help with meals, bathing, dressing, reminders, mobility, or supervision, depending on the home's license and staffing.

Some families prefer this model because there are fewer residents, more routine, and closer day-to-day contact with the caregiver. For a loved one who feels stressed in a large building, a smaller home may feel more comfortable.

Every home is different. The services offered, staff training, house layout, language spoken, and level of care all vary widely by state and by home. Always confirm what a specific home can and cannot provide.

How it differs from a larger facility

The biggest difference is size. A large assisted living community may have many residents, shared dining areas, activity calendars, and several staff roles. An adult family home usually has fewer residents and a more household-style routine.

That smaller size can mean more personal attention and a calmer setting. It can also mean fewer amenities, fewer organized activities, and less flexibility if a resident's needs change. Neither option is automatically better. It depends on the person, the home, and the level of support needed.

When comparing options, it helps to think about what matters most:
- A quiet, family-style setting or a larger community
- More one-on-one attention or more built-in activities
- A simple home layout or a building with more services on site
- Language, food, culture, and daily routine

You can read more about common support needs and what homes may offer on our services page.

What care and support may be included

Many adult family homes help with everyday care, but the exact services depend on the state rules and the home's license or certification. Some homes provide basic personal care only. Others may be approved for residents with higher support needs.

Typical support may include meals, housekeeping, laundry, help with bathing and dressing, medication assistance allowed under state rules, and supervision. Some homes can coordinate with outside home health, hospice, or therapy providers, but that depends on the situation and local rules.

Because this is not medical advice, it is important to ask the home directly whether they can safely meet your loved one's needs. You should also confirm details with your loved one's doctor and your state's licensing agency before making a decision.

Costs and Medicaid: what families should know

Costs vary widely by state, location, room type, and level of help needed. As a typical estimate, many adult family homes charge a monthly private-pay amount for room and board, and the total may be higher when more personal care is needed. These are only general estimates, not quotes.

In many states, room-and-board is usually paid privately. Medicaid waivers may help with the personal-care part for people who qualify, but the rules are different in each state. Medicaid information is separate from our matching service, and eligibility is determined by your state and program rules.

If cost is a big concern, start with our general costs guide, then check your state's Medicaid office or licensing agency for current details. Always ask each home for a clear written explanation of what is included and what may cost extra.

How HearthRow helps

We help you find licensed or certified adult family homes to consider near you. We can connect you with homes so you can ask questions, compare options, and decide what feels right for your family. Our service is free to families, and you are never under any obligation.

Some homes pay HearthRow a flat fee when we connect them with a family. It never changes what you pay. We do not provide care, and we do not guarantee placement, availability, pricing, or outcomes.

Before choosing any home, always:
- Confirm the home's current state license or certification yourself
- Tour the home in person if possible
- Ask about staffing, services, languages spoken, meals, house rules, and move-out policies
- Confirm with the home, your loved one's doctor, and your state's licensing agency that the setting fits your loved one's needs

If you want help getting started, you can get matched with homes to explore.