Adult Day Care Regulations in Florida

Who regulates adult day care in Florida

The Agency for Health Care Administration (AHCA) licenses adult day care centers through the Assisted Living Unit of its Bureau of Health Facility Regulation. AHCA also runs Florida Medicaid.

The licensing law is Part III of Chapter 429, Florida Statutes, plus the general licensing provisions in Part II of Chapter 408. Operating standards are in Chapter 59A-16, Florida Administrative Code.

Types of adult day programs in Florida

Florida has one license type, the adult day care center. Under section 429.901, F.S., that means any building or part of a building that provides basic services for part of a day to three or more adults age 18 or older who are not related to the owner or operator by blood or marriage and who need those services. There are no separate social and medical licenses.

• Specialized Alzheimer's services designation: a licensed center that meets extra dementia care standards can earn this designation under section 429.918, F.S.
• Programs in other licensed facilities: licensed assisted living facilities, hospitals and nursing homes can serve nonresidents during the day without a separate license, unless they hold themselves out as an adult day care center (section 429.905, F.S.).
• Adult Day Health Care: the Medicaid long-term care service name, not a separate license.

How to get licensed in Florida

1. Submit the Adult Day Care Center application (AHCA Form 3180-1004) and related forms from the AHCA applications for licensure page, online or on paper.
2. Describe the participants you will serve and your services, and include proof of adequate liability insurance (section 429.909, F.S.).
3. Complete level 2 background screening for required personnel (section 429.919, F.S.).
4. Write a comprehensive emergency management plan for review by your local emergency management agency.
5. Demonstrate compliance during inspection. AHCA must approve or deny a complete application within 60 days (section 408.806, F.S.).

A standard license lasts two years (section 408.808, F.S.). Renewals are due 60 to 120 days before expiration, and since September 5, 2024 AHCA no longer accepts mailed renewals. Each separate premises needs its own license (section 429.907, F.S.).

Key requirements

• Staffing: one direct service staff member for every six participants at all times, and at least two staff on site, one with current first aid and CPR certification (rule 59A-16.102).
• Medications: participants who cannot self-administer need a Florida-licensed staff member who can administer medication.
• Space: centers first licensed after November 9, 1995 need at least 45 square feet of net floor area per participant (rule 59A-16.109).
• Program: planned activities available at least 60 percent of open hours (rule 59A-16.104), and posted hours of at least five hours per day on weekdays of operation.
• Records and emergencies: a participant data sheet within 45 days before or 24 hours after admission, a written emergency plan submitted annually to local emergency management, monthly staff fire drills and quarterly participant drills (rule 59A-16.107).
• Dementia training: rules 59A-16.110 and 59A-16.111 were repealed effective March 5, 2024. Staff now follow section 430.5025, F.S.: 1 hour within 30 days for staff who provide personal care or have regular participant contact, and 3 more hours within 7 months for staff who provide personal care.
• Specialized Alzheimer's centers: one direct service staff member for every five participants with dementia, and an RN or LPN on site at least 75 percent of open hours each day.

Medicaid funding for adult day in Florida

Florida Medicaid covers Adult Day Health Care through the Statewide Medicaid Managed Care (SMMC) Long-Term Care program, which runs under a 1915(b) waiver and the 1915(c) Florida Long-Term Care waiver (AHCA federal authorities). Members must meet nursing facility level of care and Medicaid financial eligibility.

Members get services through LTC managed care plans and their networks of contracted providers. Providers must be licensed adult day care centers or licensed assisted living facilities (LTC Program Coverage Policy, March 2017). Plans must verify on site that a provider meets home and community-based settings requirements, and may not reimburse members' care at a noncompliant provider (LTC contract Exhibit II-B, July 2026).

Billing basics

• The member's LTC plan pays for Adult Day Health Care, so get each plan's billing requirements when you contract.
• The SMMC LTC Program Coverage Policy (March 2017, still incorporated by rule 59G-4.192) lists S5100 for adult day health care, without units or modifiers; each plan sets its own billing rules.
• The plan must authorize services before delivery.
• The federal electronic visit verification (EVV) rule covers personal care and home health services that require an in-home visit. We found no Florida source applying it to adult day health care.

Other ways centers are paid

Centers can charge participants directly, with a signed fee agreement. Under Florida's Community Care for the Elderly Act, lead agencies must coordinate services that include adult day care and respite care (section 430.203, F.S.). Section 430.502, F.S. authorizes model day care and respite programs for people with Alzheimer's disease or related memory disorders. Enrolled veterans who meet VA eligibility and clinical criteria can get adult day health care through the VA, which may be provided at VA medical centers, State Veterans Homes or community organizations.

Official resources

• AHCA Adult Day Care Center
• AHCA Applications for Licensure
• Chapter 429, Part III, Florida Statutes
• Chapter 59A-16, Florida Administrative Code
• SMMC Long-Term Care Program
• SMMC Long-Term Care Program Coverage Policy
• VA Adult Day Health Care

Frequently asked questions

Do I need a license to open an adult day center in Florida?

Yes, an AHCA license is required to operate an adult day care center. Licensed assisted living facilities, hospitals and nursing homes can serve nonresidents without one unless they hold themselves out as an adult day care center.

Does Florida Medicaid pay for adult day care?

Yes. Adult Day Health Care is covered in the SMMC Long-Term Care program, where managed care plans authorize the service and pay the licensed centers in their networks.

Who inspects adult day centers in Florida?

AHCA. Its inspections are unannounced, and relicensure inspections are generally every two years unless law or rule says otherwise (section 408.811, F.S.).

Is social adult day care regulated in Florida?

Yes. Florida does not license social and medical adult day separately, so any program that meets the adult day care center definition needs an AHCA license.