Graduation Year


Document Type




Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

School of Aging Studies

Major Professor

Kathryn Hyer, Ph.D., MPP

Committee Member

Debra Dobbs, Ph.D.

Committee Member

Hongdao Meng, MD, MPH, Ph.D.

Committee Member

Victor Molinari, Ph.D.

Committee Member

John R. Bowblis, Ph.D.


Aging, Long-term Care Policy, Market Structure


Assisted living facilities (ALFs) have become a large provider of long-term care in the United States. Their expansion has been met with interest from older adults who desire to be independent yet receive some services and from state legislators who recently have attempted to increase access. Studies in long-term care have focused extensively on nursing homes, but recent research has examined the effects of ALFs on the long-term care market. Research has been lacking in understanding the unique markets of ALFs. Describing themselves as “communities” and offering multiple options for housing, ALFs have targeted independent and wealthier older adults who want the comforts of personal homes and the social supports of hotel-like settings. While research has examined whether ALFs have met these goals set for residents, no studies have examined the economic and political factors that affect the ALF market and the ability for ALFs to continue operation. The current dissertation will examine these factors in three studies on Florida ALFs. The first study will observe the external factors that affect the entry of ALFs into markets. The second study will investigate the organizational, quality, and external factors that affect closure. The third study will examine the response of Florida ALFs to a 2015 Florida law that changed the requirements of the mental health license for ALFs. The study will track the licensure change and closure of Florida ALF.