As a paramedic who has been in hundreds of AFHs, definitely not automatic. Many are run by families who made an investment in looking after grandma, ramps, etc

As a paramedic who has been in hundreds of AFHs, definitely not automatic. Many are run by families who made an investment in looking after grandma, ramps, etc. and realized they could make some more money by bringing in a few other people. This tends to have polarizing results. Best case, they take care of and love the other residents like grandma. Worst case, the other residents are absolutely third class citizen who are subsidizing the family and grandma while hovering just this side of neglect.