Adult Day Services Rules and Regulations

Each State Has Its Own Set of Requirements for Adult Day Programs

adult day care
Adult Day Care provides the social aspect of care needed for aging in place. Getty Images

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 they love this is, of course, a plus.

Licensing, Certification, and Other Requirements

The majority of states require licensure, certification, or both. According to the US 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 Department of Human Services. 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 growing 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.

In general, adult day services may serve a wide range of people with a variety of different issues. According to a survey by Met Life, most people in adult day services are women, and the vast majority are over 65. In addition:

  • The three most prevalent conditions experienced by ADS participants are dementia (47%), hypertension/high blood pressure (46%), and physical disability (42%).
  • About a third of participants experienced cardiovascular disease (34%) and diabetes (31%).
  • Chronic mental health issues were experienced by 25% of participants and 20% had a developmental disability.

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.

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