Adult Day Services Rules and Regulations

Each state has its own set of requirements

One of the key factors in helping people to age in place is making sure the social aspects of care are provided in the community. Adult day care or adult day services (ADS) are a major piece of the care puzzle for those older adults with physical or mental challenges who wish to remain at home and still have a high quality of life. With increased importance comes increased scrutiny, including an increasing number of requirements for both staff and facilities. From the point of view of families and the seniors, the fact that they love this is, of course, a plus.

A caretaker with a group of seniors
Morsa Images / Getty Images

Licensing, Certification, and Other Requirements

The majority of states require licensure, certification, or both. According to the Department of Health and Human Services:

  • 26 states require licensure only;
  • 10 states require certification only;
  • 4 states require both licensure and certification; and
  • 11 states do not require licensure or certification.

“Certification” means that the individual adult day services program has been evaluated and approved relative to standards set by the state government. These standards vary depending upon whether the program is an adult day health service or a social ADS program.

Licensing procedures vary from state to state, with different requirements based on the type of services provided. For example, a day care program that serves adults with dementia will have to meet specific guidelines, as must a program that operates both day and night.

States that neither license nor certify generally require publicly funded ADS providers to enter into official agreements with a state agency, specifying that they will comply with mandated requirements.

With the growth of the aging population, specific standards will continue to evolve.

Definitions of Adult Day Services

States vary considerably in the terms they use for ADS. Adult day health care is defined as a supervised daytime program providing skilled nursing and rehabilitative therapy services in addition to core services provided in adult day care.

Definitions of adult day services generally incorporate a statement about their purpose, the number of people who can be served, and limits on the number of hours a person may be served.

Staffing Requirements

States vary with regard to the number of staff required. All states require specific types of staff for ADS programs. The major difference in requirements between adult day care and adult day health care is the latter must have licensed nurses available in some capacity. The National Adult Day Services Association offers a full list of state-by-state requirements.

1 Source
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Department of Health & Human Services. Regulatory review of adult day services: final report, 2014 edition.

By Anthony Cirillo
Anthony Cirillo, FACHE, ABC, is a writer, consultant, and professional speaker who helps family caregivers and individuals make educated aging decisions.