What Is Adult Foster Care (AFC)?

An Adult Foster Care home — commonly called an AFC home — is a specific type of licensed senior living setting that provides 24/7 care and supervision to no more than six residents who live on the premises. Unlike large assisted living facilities or nursing homes, an AFC home operates in a true residential setting: a real house, in a real neighborhood, where seniors live as part of a genuine household.

AFC homes must be licensed by the State of Michigan. This licensing requirement ensures that homes meet mandatory standards for staffing, safety, nutrition, and documentation — and that they remain subject to ongoing oversight. A licensed AFC home is never left unmonitored or unstaffed.

The defining characteristic of an AFC home is its small size. With a maximum of six residents, every person receives individualized attention. Caregivers know each resident by name, by preference, and by history. No resident is simply a room number.

AFC homes are best suited for seniors who need consistent, hands-on care but who would benefit from — and thrive in — a home-like environment rather than a clinical or institutional one. Common residents include:

• Seniors with Alzheimer's disease or other forms of dementia
• Adults with complex medical needs that exceed what can be managed at home
• Seniors who have experienced falls, strokes, or other acute health events
• Adults with cognitive decline who still value independence, dignity, and social connection
• Individuals whose family caregivers have reached their capacity and need a trusted alternative

Some decisions also arise when a senior no longer has close family and care falls to a trustee or durable power of attorney. In those cases, an AFC home offers a supervised, documented, and genuinely caring option for placement.

Every prospective resident undergoes an assessment before admission to ensure the AFC home is a good physical and social fit — both for the individual and for the existing household community.

Michigan law requires a minimum staffing ratio of 1 caregiver to 6 residents at all times. In practice, quality AFC homes routinely exceed this — daytime ratios of 2 staff to 6 residents are common, and the licensees (the owners who hold the AFC license) are typically present at the home regularly in addition to care staff.

This level of presence creates what the AFC model calls collaborative care: multiple people who know each resident deeply are involved in daily decisions. No two residents have identical care plans — preferences, aversions, daily rhythms, and health needs are all factored in and updated continuously.

For families, this means something profound: your loved one is never 1 of 100 residents. They are 1 of 6. The entire staff — owners included — knows their name, their story, and their needs.

Most AFC homes in Michigan operate on a private pay basis, meaning families pay directly out of pocket rather than through insurance. Monthly costs vary depending on the level of care required, the location, and the home — but typically range from $3,500 to $6,500 per month in Livingston County.

This cost generally includes room, board, all meals, medications management, and all care services. There are rarely large add-on fees for things that would be common in larger facilities.

Some AFC homes accept Michigan Medicaid waiver programs (such as MI Choice or the PACE program) for eligible residents. Long-term care insurance policies may also cover AFC placement — check your policy's definition of “qualified care facility.” Veterans benefits (Aid & Attendance) are another resource worth exploring.