Guide

Senior care in Puerto Rico: care homes, égidas and CAMPEA

Updated October 15, 2026 · Reviewed against official sources

If your mom lives on the island and you live in Orlando or the Bronx, you'll hear words that don't show up in the state guides. Here we explain what each one means. To see licensed places, visit our Puerto Rico directory.

The words used on the island

Law 94 of 1977 (Ley de Establecimientos para Personas de Edad Avanzada, the law on care facilities for older adults) defines these places and gives the Department of the Family the job of licensing them. The same law also talks about "programas de cuido de envejecientes" (care programs for older adults).

The hogar de cuido: 24-hour care

Under Law 94, the license lasts up to 2 years and must be posted where the public can see it. With some exceptions, staff must have a training certificate in caring for older adults and courses in CPR and first aid. Each home has its own written rules covering admission, visiting hours and the family's responsibilities: ask for them and take your time reading them before you sign.

The Department of the Family inspects these care homes every three months or more often. Since Law 148 of 2025, it checks that they have a water cistern for at least 5 days, a generator or solar panels, medicine and food for at least 20 days, and an emergency plan, with an inspection before hurricane season. It's a good question to ask on your visit: well-prepared homes are happy to explain it.

Bring our visit checklist and read how to choose a care home: almost all of the questions work on the island too.

The hogar sustituto: a family setting

It's a family's home that takes in a few older adults and gives them close, personal attention. On your visit, ask who provides care at night, who fills in if the caregiver gets sick, how medications are given and what happens if your loved one needs more help over time.

The Administration for Families and Children (Administración de Familias y Niños, ADFAN) also offers the Servicio de Cuidado Sustituto (substitute care service) for people 60 and older who live alone, need 24-hour care and have no relatives who can take care of them. It requires a socioeconomic evaluation.

Who needs a license? The law makes an exception for people who care for one or two older adults, or for their own relatives. If someone offers to care for your mom along with other people, ask in a relaxed, natural way how many people they care for and whether they have a license.

The égida: housing, not care

An égida is an apartment complex for older adults who can take care of themselves. Some receive public funds: in 2018, the Puerto Rico Treasury Department (Hacienda) reported a payment to 58 égidas with funds from the rental housing program for older adults run by the Puerto Rico Department of Housing (Departamento de la Vivienda). That program, under Law 173 of 1996, can pay part of the rent for people 60 and older with low incomes, in certified projects.

Because it's housing, an égida doesn't necessarily offer help with bathing or medications. Ask what services are included, whether there's a waiting list and what income they require. It can be combined with help at home or with an activity center. The island also has assisted living housing projects certified by the Department of Housing (Law 244 of 2003), with personal care services for people who need help with daily living but not ongoing medical care.

Daytime care: day care centers and CAMPEA

ADFAN runs nine multi-activity centers for older adults, called Centros de Actividades Múltiples para Personas de Edad Avanzada (CAMPEA), in Aguadilla, Aguada, Arecibo, Bayamón, Cidra, Guayama, Juana Díaz, Lares and Yabucoa. They serve people 60 and older who qualify, with transportation, breakfast, lunch and a snack, nursing, a service plan with a social worker, and recreational, cultural and faith activities. They also bring meals to the homes of people who can't attend. For information, call the Adult Services Program (Programa de Servicios a Adultos): 787-625-4900.

There are other day centers licensed by the Department of the Family; search for them by municipality in the official search tool. Also read our guide to adult day centers.

How to check the license

Use the Department of the Family's search tool for licensed facilities to search by name, region or municipality; it shows each license's expiration date. The law requires that registry to also show each facility's capacity, services and monthly room and board fee. At admission, the home must give the family the form to request an inspection, and Law 121 of 2019 (Carta de Derechos de los Adultos Mayores, the Bill of Rights for Older Adults) requires residents' rights to be posted where people can see them.

How care is paid for in Puerto Rico

• Medicare pays for a short rehab stay after a hospital stay, not long-term care. See rehab after a hospital stay.
• Plan Vital (Medicaid): it's run by ASES, and eligibility is decided by the Department of Health's Medicaid Program. According to MACPAC, the federal commission that advises Congress, the island's Medicaid has not covered nursing facility stays. Since July 1, 2024, it does include home health and hospice for adults. Check with your plan to confirm what your loved one is entitled to.
• Medicare Platino: combines Medicare and Medicaid for people 65 and older who have Parts A and B, are eligible for Medicaid and are enrolled in Plan Vital, among other requirements.
• Your loved one's own income: Social Security, pensions and savings; ask for the monthly fee in writing. If your loved one is a veteran, read Aid and Attendance.
• ADFAN: besides Cuidado Sustituto, it offers Auxiliar en el Hogar (a home aide service), a temporary in-home service for people who can't take care of themselves and have no relatives to care for them. You apply at local Department of the Family offices.

See all your options in how to pay for long-term care.

Support for caregivers

If you care for your dad or mom without pay, you can sign up for the Registro de Cuidadores Informales (Informal Caregivers Registry, Law 82 of 2023) at cuidadoresinformales.familia.pr.gov, with a medical certification for the person you care for and a certificate showing you have no criminal record. According to the Department of the Family, the registry lets you ask for schedule changes at work, receive your loved one's health information with their consent and take training courses.

Who to call

• Office of the Ombudsman for the Elderly (Oficina del Procurador de las Personas de Edad Avanzada, OPPEA): (787) 721-6121; Ponce (787) 841-1180, Guayama (787) 866-6971, Mayagüez (787) 986-7105. It is also the island's long-term care ombudsman (Procurador de los Residentes en Establecimientos de Cuidado de Larga Duración).
• Adult Services Program (ADFAN): 787-625-4900. Family Guidance and Support Line (Línea de Orientación y Apoyo Familiar): 787-977-8022 or 1-888-359-7777.
• Medicaid Program: 787-641-4224, 8:00 a.m. to 6:00 p.m., free call. ASES: (787) 474-3300, option 1.
• Department of Health (licenses for long-term care units, hospices and home health agencies): 787-765-2929.
• If you're worried about an older adult's safety, the Department of the Family's Emergency Line answers at 787-749-1333 (metro area) and 1-800-981-8333 (rest of the island). In an emergency, call 911.

💬Frequently asked questions

Is an égida the same as a hogar de cuido?

No. An égida is housing for people who can take care of themselves. A hogar de cuido provides personal care 24 hours a day and is licensed by the Department of the Family.

Does Plan Vital pay for a hogar de cuido?

In general, it doesn't pay for long stays. Ask your plan and the Medicaid Program about home health and hospice, which were added in 2024.

My mom lives in Puerto Rico and I live in Florida. How can I help her?

Call OPPEA and the Adult Services Program, and ask someone you trust to visit places while you join them by video call. Read caring from a distance and get the power of attorney and advance directives ready. To look for options, try our guided search.

This guide is for information only and is not legal, medical or financial advice. Programs and phone numbers can change; confirm them before you visit.

Sources

• Puerto Rico Office of Management and Budget, Law 94 of 1977, Ley de Establecimientos para Personas de Edad Avanzada (rev. April 14, 2026): https://bvirtualogp.pr.gov/ogp/Bvirtual/leyesreferencia/PDF/Personas%20de%20Edad%20Avanzada/94-1977/94-1977.pdf (accessed October 15, 2026)
• Puerto Rico Office of Management and Budget, Law 173 of 1996, rent subsidy for low-income older adults (rev. April 15, 2024): https://bvirtualogp.pr.gov/ogp/Bvirtual/leyesreferencia/PDF/173-1996.pdf (accessed October 15, 2026)
• Puerto Rico Office of Management and Budget, Law 244 of 2003, assisted living housing projects: https://bvirtualogp.pr.gov/ogp/Bvirtual/leyesreferencia/PDF/Vivienda/244-2003/244-2003.pdf (accessed October 15, 2026)
• Puerto Rico Treasury Department, press release on the payment to égidas (January 3, 2018): https://hacienda.pr.gov/node/3674 (accessed October 15, 2026)
• ADFAN, Adult Services: https://adfan.pr.gov/AdministracionesAuxiliares/ServiciosEdadAvanzada/Pages/default.aspx (accessed October 15, 2026)
• ADFAN, CAMPEA brochure (2025): https://adfan.pr.gov/AdministracionesAuxiliares/ServiciosEdadAvanzada/Opusculos%20ADFAN/2025%20-%20Brochure%20-%20CAMPEA.pdf (accessed October 15, 2026)
• ADFAN, Servicio de Cuidado Sustituto brochure (2025): https://adfan.pr.gov/AdministracionesAuxiliares/ServiciosEdadAvanzada/Opusculos%20ADFAN/2025%20-%20Brochure%20-%20Cuidado%20Sustituto.pdf (accessed October 15, 2026)
• ADFAN, Auxiliar en el Hogar service brochure (2025): https://adfan.pr.gov/AdministracionesAuxiliares/ServiciosEdadAvanzada/Opusculos%20ADFAN/2025%20-%20Servicio%20de%20Auxiliar%20en%20el%20Hogar.pdf (accessed October 15, 2026)
• ADFAN, brochure on how to choose a long-term care facility: https://adfan.pr.gov/AdministracionesAuxiliares/ServiciosEdadAvanzada/Opusculos%20ADFAN/2025-%20Brochure%20-%20Cuidado%20Prolongado.pdf (accessed October 15, 2026)
• ADFAN, Informal Caregivers Registry brochure (Law 82 of 2023): https://adfan.pr.gov/AdministracionesAuxiliares/ServiciosEdadAvanzada/Opusculos%20ADFAN/2025%20-%20Registro%20de%20Cuidadores%20Informales.pdf (accessed October 15, 2026)
• Department of the Family, search tool for licensed facilities: https://sulme.familia.pr.gov/mapaPublico (accessed October 15, 2026)
• OPPEA, Who we are: https://oppea.pr.gov/quienes-somos (accessed October 15, 2026)
• ASES, Plan Vital: https://www.ases.pr.gov/plan-vital (accessed October 15, 2026)
• ASES, Medicare Platino: https://www.ases.pr.gov/medicare-platino (accessed October 15, 2026)
• CMS, Puerto Rico State Plan Amendment 24-0009 (home health and hospice, effective July 1, 2024): https://www.medicaid.gov/medicaid/spa/downloads/PR-24-0009.pdf (accessed October 15, 2026)
• MACPAC, Medicaid and CHIP in Puerto Rico (February 2021): https://www.macpac.gov/wp-content/uploads/2020/08/Medicaid-and-CHIP-in-Puerto-Rico.pdf (accessed October 15, 2026)
• Puerto Rico Department of Health, Health Facilities Division: https://www.salud.pr.gov/CMS/187 (accessed October 15, 2026)
• Medicare.gov, Skilled nursing facility care: https://www.medicare.gov/coverage/skilled-nursing-facility-care (accessed October 15, 2026)

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This is general information, not medical, legal or financial advice. Rules vary by state and by year: confirm with the official agency that applies to you.

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