Adult day care is a community program where adults who need supervision or help with daily activities spend the day with activities, meals and sometimes health services, while family caregivers work or rest. Medicare does not pay for it. Medicaid can pay in some states, and so can VA programs and private funds.
This guide covers what a center does, who uses one, how it differs from care at home and how to compare centers. Carevo does not run adult day centers or choose one for you.
What adult day care is and how it works
CDC defines an adult day services center as a community-based center, generally open on weekdays, that provides long-term care services to adults with disabilities. The services in that definition are structured activities, health monitoring, socialization and help with activities of daily living. CDC lists those as bathing, dressing, transferring in and out of a chair, toileting and eating.
CDC's FastStats page counts 3,100 adult day services centers in 2022, with 197,700 participants on any given day.
Centers differ in how much health care they offer. VA's own program describes social activities, peer support, companionship and recreation, with health services such as nursing and therapy available. Some centers are mainly social. Others have nurses on site. Ask which kind you are looking at.
Who adult day care helps
VA says its Adult Day Health Care suits Veterans who need help with daily activities such as bathing, dressing or fixing meals, who are isolated, or whose caregiver is experiencing burden. The same groups use community adult day centers.
The family caregiver is the other half. VA says its program can give family caregivers respite and help Veterans and caregivers build skills for managing care at home. MedlinePlus lists adult day services and respite services among the options for families caring for someone with Alzheimer's disease.
This guide cannot say whether a center suits a particular person. Ask the person's doctor, and visit with them if you can.
Who attends adult day centers
CDC's 2016 National Study of Long-Term Care Providers, reported in Data Brief 296, compared participants at nonprofit and for-profit centers. Participants at nonprofit centers more often needed help with bathing, dressing, toileting, transferring and eating, and were more likely to have Alzheimer's disease or an intellectual or developmental disability. More for-profit center participants had diabetes, depression, heart disease or severe mental illness. Centers differ, so a center's mix of participants may not match your relative's needs. Ask who currently attends and how staff meet different needs on the same day.
What adult day care includes and leaves out
What you get depends on the center. In CDC's definition, the core is activities, monitoring, socialization and help with daily living. Ask each center in writing whether these are included in the price:
- Meals and snacks, and special diets
- Help with toileting, eating and transfers
- Medicine reminders or administration, and who is licensed to give them
- Nursing on site, and during which hours
- Therapy, such as physical or occupational therapy
- Transportation. VA says transportation assistance may be available depending on location
- Activities for people with memory loss
Adult day care does not include overnight care. If a person needs help in the evenings and at night, you will need another solution, such as home care, respite care or a residential option like assisted living.
Adult day care vs nearby care options
- Home care. A caregiver comes to your house, one on one. A center is group care outside the home, with company, which some people prefer and some do not.
- Respite care. Adult day care often works as respite for a family caregiver. Respite also covers short stays and in-home breaks.
- Dementia care at home. In-home help for people living with memory loss. Many families combine a few days at a center with caregivers at home.
- Assisted living and memory care. These are residences. A day center is a place you go and come home from.
- Home health care. Skilled care at home ordered by a doctor. Medicare.gov says you can still attend adult day care and be homebound for these benefits.
Who pays for adult day care
Medicare. Medicare.gov says Medicare does not pay for long-term care, which it describes as mostly help with basic personal tasks of everyday life. You pay all costs for non-covered services. Home health benefits are separate: Medicare.gov says you can still qualify as homebound if you go to adult day care. See what Medicare pays for.
Medicaid. Medicaid.gov lists adult day health among the services that can be covered under a home and community-based services waiver. Waivers are set by states, cover specific groups and have caps. In CDC's 2016 National Study of Long-Term Care Providers, 58% of participants at nonprofit centers and 73% at for-profit centers had some or all of their long-term care services paid by Medicaid in the 30 days before the survey. That is a 2016 figure and does not tell you what your state does today. Check the programs page and Medicaid.
VA. VA Adult Day Health Care can be provided at VA medical centers, State Veterans Homes or community organizations. VA says a copay may be charged based on service-connected disability status and financial information. To find the amount, contact your VA social worker or case manager, who completes VA Form 10-10EC. See VA benefits.
Long-term care insurance and private pay. Some policies pay for adult day services. Read the policy and ask the insurer in writing. Many families pay privately. See long-term care insurance and private pay.
What drives the cost of adult day care
We do not quote an average. The sources available to us do not give one that fits every state, and adult day services are priced in different ways. Factors that change the bill:
- Whether the center charges by the day, the half-day or the hour
- The number of days you attend
- Whether meals, transportation and nursing are in the price
- The level of help the person needs
- Whether Medicaid, VA or insurance pays
- Registration fees, deposits and charges for absences or late pickup
Use the care cost comparison to compare a center's price with other options, and ask for a written fee schedule.
Who oversees adult day centers
CMS does not publish star ratings for adult day services, and our listings carry none. Rules about licensing differ by state, and the sources we read do not set a national standard. So ask the center which agency licenses or certifies it, and ask that agency whether the center holds a current licence and has any inspection or complaint records.
If a Medicaid program or VA pays for the person's care at a center, ask that program how it checks the center. For local help finding services, call the Eldercare Locator on 1-800-677-1116. See our care ratings by state and methodology for how we use federal data and where there is none.
How to choose an adult day center
- Decide what the person needs: company and activities, help with daily tasks, nursing or all three.
- Phone two or three centers, and ask for the fee schedule and daily schedule.
- Visit with the person if possible, ideally for a trial day.
- Ask about staff-to-participant ratio, and who is on site when the nurse is not.
- Check transport and pickup, particularly for someone who needs help getting in and out.
- Check the licence with the state.
Questions to ask each day center
- What is the daily schedule, and what happens at meals?
- What staff are on site, and what are their qualifications?
- How do you handle a participant who is anxious, wanders or has a fall?
- How are medicines handled?
- Is there a nurse, and when?
- What are the charges, and what do absences cost?
- Do you provide transport, and are there limits on distance or wheelchair users?
- Can we try a day before we commit?
Making the first weeks at a center work
A new routine can be hard for the person and for you. Ask the center about a trial day, a gradual start with a few hours, and how staff greet a new participant. Tell staff about habits, favorite activities, fears and triggers in writing. Plan for the first few mornings. Keep a note of how the person seems when they come home, and share it with the staff. If the first center is not a fit, try another before you give up on the idea.
Red flags when you visit a center
- A center that cannot say who licenses it
- No written fee schedule
- Participants sitting with nothing to do, or unattended
- Staff who cannot describe how they handle falls, toileting or medicine
- Transport that is described as available but with no details
- Pressure to enroll on the first visit
About the centers listed below
Carevo is a directory and connection platform. It does not run adult day centers, assess whether the service suits a person or vouch for any center. The lists below come from public data. Check each center yourself, and use get matched if you want help finding options near you.