Starting a care business in Florida

The Assisted Living Unit issues the residential and day licenses. Housing, meals and one personal service for more than 24 hours to a single unrelated adult requires an assisted living facility license, and each day of unlicensed operation is a separate third-degree felony. Extended congregate care, limited nursing services and limited mental health are categories of care on an ALF license, not separate facility types, and chapter 2026-102 creates a memory care services license once AHCA adopts its rules, due by June 1, 2027. ALF administrator core training now sits in AHCA rule chapter 59A-36. An adult family-care home takes up to five residents in a house the licensee owns or rents and lives in, and day services to three or more unrelated adults need an adult day care center license, with an optional Specialized Alzheimer's Services designation.

Home care splits between two units by what your workers do and how they are engaged. The Long Term Care Services Unit handles the homemaker and companion registration, $50.75 for two years as published on October 12, 2026, which allows companionship and household help but no hands-on care, in counties of a single one of 11 service areas. Bathing, dressing or nursing by your own staff needs a home health agency license from the Laboratory and In-Home Services Unit, and skilled agencies must be accredited within 120 days of applying. The same unit licenses nurse registries, which place caregivers who work as independent contractors. Medicare is a separate federal step: CMS imposed a six-month nationwide moratorium on Medicare enrollment of new home health agencies from May 13, 2026, extendable in six-month increments, and a Florida license does not get around it.

Medicaid pays for assisted living, adult family-care homes, adult day health care and companion and homemaker services through the Statewide Medicaid Managed Care Long-Term Care plans. Enrollees must be eligible for Medicaid, be 65 or older or 18 or older with a disability, and be found by the Department of Elder Affairs' CARES unit to need nursing-facility level of care. AHCA's June 12, 2026 Medicaid integrity announcement said it had imposed enrollment moratoriums on high-risk provider categories including adult day care providers. Elder Affairs also provides the one-hour dementia course that s. 430.5025 requires within 30 days of hire for workers in adult day care centers, adult family-care homes and homemaker and companion services. The Agency for Persons with Disabilities licenses group homes and adult day training programs for people with developmental disabilities under s. 393.067; an APD contractor giving companion services only to people with a developmental disability is exempt from AHCA registration.

On the child side, any child care facility caring for more than five unrelated children for pay needs a license, and DCF charges $1 per child of capacity, minimum $25 and maximum $100. A family child care home, the statutory name since July 1, 2026, may simply register with DCF each year, except in 15 counties whose ordinances require a license. Subsidies run through the Department of Education's Division of Early Learning and 30 local early learning coalitions: School Readiness accepts licensed centers and both registered and licensed homes, while VPK does not accept registered homes. Gold Seal Quality Care, also a Department of Education program, gives accredited providers a property tax exemption and a School Readiness rate differential of at least 20%.

Florida's certificate of need covers only skilled nursing facilities, hospices and intermediate care facilities for the developmentally disabled, so none of these businesses needs one. AHCA's published fees run above the statutory base amounts (an adult family-care home pays $226.34 for two years against a $200 base) because the law lets AHCA raise fees each year by up to the change in the Consumer Price Index.