Adult Day Care

Adult Day Care Background Information

Definitions: Adult Day Care vs. Adult Day Health Care

Similar to children’s day care, adult day care (ADC) provides frail seniors and persons with Alzheimer’s with supervision and care in a structured setting during daytime hours allowing their primary caregivers to work or take a break from their caregiving responsibilities. There are two primary types of adult day care programs.  Adult social day care offers basic health services, meals and activities while adult day health care (ADHC) provides intensive health services for individuals that might otherwise need to reside in a skilled nursing community. Some centers offer both types of care and there some centers that specialize in Alzheimer’s or dementia care, referred to as Alzheimer’s Day Care.  Many centers provide transportation to and from the center.

Regulation of Adult Day Care

All adult day cares are required to have state licenses and are regulated to provide certain types of services. Most staff members receive background checks and many are certified social workers. In addition many states regulate the staff-to-patient ratio and the minimum staff available at any time.

How Adult Day Care Works

Once you’ve determined your specific care requirements, contact a center by phone for an initial conversation matching your needs with their services.  Most families then proceed to visit the center twice, first without the individual in need of care and then again later with their loved one.  At that point, if all parties feel comfortable with the center, it is common to conduct a week-long trial of their services before making any longer term contractual agreement with the center.

Paying For Adult Day Care

Medicare’s Benefits

Similar to assisted living, there is a common misperception that Medicare will pay for adult day care.  Unfortunately, this is not the case.

Medicaid

In most states, Medicaid will pay for adult day care and / or adult day health care.  This is especially true if an individual would otherwise require full-time nursing home care.  Each state has several Home and Community Based Services (HCBS) Medicaid Waivers.  These waivers help individuals remain living in their homes and communities by providing the necessary support services.  Very often, this includes adult day care and transportation assistance to and from the community.  See a complete list of Medicaid waivers which cover adult day care, read more about Medicaid’s eligibility requirements or determine if you or your loved one will require assistance becoming eligible for Medicaid.

Veterans Administration

The VA will pay for adult day health care but not adult day care.  Adult day health care is included in VHA Medical Benefits Package, however one cannot simply enroll in a program, they first must be assessed and found to have a clinical for the level of care and supervision provided in adult day health care centers.  While the VA will provide assistance, they may not necessarily pay for 100% of the cost.  Depending on the individual resources and level of need, a co-payment may be required.

Other Assistance Programs for Adult Day Care

Many states have non-Medicaid assistance programs; sometimes referred to as nursing home diversion programs.  These programs are intended to prevent or delay the placement of elderly state residents in nursing homes.  To that end, many of these programs will pay for or help with the cost of daytime supervision in a group environment.  This is especially true for individuals with Alzheimer’s or dementia.  A list of non-Medicaid, state assistance programs and can be found here.  These include links to the programs’ eligibility requirements and the services which are covered.

Paying Out-of-Pocket for Adult Day Care

Should a family be unable to find financial assistance for adult day care, it is worth noting the cost of adult day care is almost always tax deductible.  It can be included as a Medical and Dental expense.  Alternatively, if your loved one is your dependent, the costs can be deductible under the Dependent Care Credit.

Costs of Adult Day Care

Adult day care and adult day health care are, without question, the most economic way to provide supervision and personal care for an elderly loved one on a daily basis.  When compared with home care for an equal number of hours, adult day care usually costs at least 50% less.  Nationwide in 2014, the average daily rate for adult day care is $65.  It is worth noting that most centers bill in half-day or 4 hour increments.

The table below contains the average daily cost for each specific state.  The information is sorted alphabetically and also from least to most expensive.