Adult Day Care Regulations in Pennsylvania

Who regulates adult day care in Pennsylvania

The Pennsylvania Department of Aging licenses adult day centers, which state rules call older adult daily living centers. Its Division of Licensing, in the Bureau of Quality Assurance, handles applications and inspections under 6 Pa. Code Chapter 11.

The Department of Human Services (DHS) runs the Medicaid side through its Office of Long-Term Living (OLTL).

Types of adult day programs in Pennsylvania

Under § 11.3, an older adult daily living center serves four or more clients who are not relatives of the operator, at the same time, for part of a 24-hour day. Clients have a functional impairment and are 60 or older, or 18 or older with post-stroke dementia, Parkinsonism or a dementia-related disease.

Chapter 11 uses one license type rather than separate social and medical categories. Every center must provide or arrange personal care, nursing, social services, therapeutic activities, nutrition and emergency care (§ 11.123). Summer recreation programs, camping programs, socialization clubs and nursing home adult day programs that serve only their own clients are exempt (§ 11.2).

Adult training facilities, for adults with disabilities 59 or younger, follow a separate DHS rule, 55 Pa. Code Chapter 2380. Under a January 2026 DHS announcement (ODPANN 26-013), one that serves four or more people who meet the Chapter 11 client definition also needs a Chapter 11 license.

How to get licensed in Pennsylvania

1. Get criminal history background checks for the operator before applying. Staff checks must be requested before hire.
2. Confirm your certificate of occupancy has use group I-4, which the Department requires.
3. Complete the checklists and forms on the application page: AGL-02 (Application for License), AGL-07 (Provider Self Certification and Civil Rights Compliance) and AGL-08 (Center Operations and Demographics), plus your policies and procedures.
4. Email the packet. New applications are accepted only by email.
5. After approval, a licensing representative inspects the site, generally within 3 to 6 weeks of acceptance. An interim license follows if the applicant is suitable, the premises are safe and substantial compliance is likely.
6. Have your director complete the online director training. New directors must finish it within 3 months.

Interim and provisional licenses last up to 6 months, and a regular license up to 12 months. The Department inspects every center at least once every 12 months (§ 11.241).

Key requirements

• Staffing ratio: at least one program staff person for every seven clients at all times (§ 11.39).
• Nursing: the center must obtain the services of a Pennsylvania-licensed RN, or an LPN working under a licensed professional nurse or physician. The nurse can be staff, a consultant or another arrangement (§ 11.35).
• Director: a bachelor's degree plus two years of social or health services experience, or a high school diploma or GED plus three years of experience (§ 11.34).
• Space: at least 50 square feet of indoor program space per client, not counting lavatories, dining areas, kitchens or hallways unless documented as program space for at least half of each program day (§ 11.52).
• Health and safety: annual client physicals, care plan reviews every six months, fire drills twice a year and quarterly fire safety training.
• Medications: licensed professionals give medications that clients do not self-administer. Non-medical staff who pass the DHS Medications Administration Course may give oral, topical, eye and eardrop prescription medications.

Medicaid funding for adult day in Pennsylvania

Once licensed, a center may apply to become a Medical Assistance (Medicaid) provider. Two OLTL programs cover adult daily living services.

Community HealthChoices (CHC) serves adults 21 and older who have both Medicare and Medicaid or who qualify for Medicaid long-term services and supports. It runs under a 1915(c) waiver paired with a 1915(b) managed care waiver. Three plans cover every zone and receive monthly capitation payments from DHS, so centers are paid through those plans. The CHC waiver names AmeriHealth Caritas, PA Health & Wellness and UPMC Community HealthChoices; confirm current plans with DHS. The current waiver amendment took effect July 1, 2026.

The OBRA Waiver is a 1915(c) waiver for people ages 18 to 59 with a severe developmental physical disability who need an ICF/ORC level of care. Adult Daily Living is a covered service. Its renewal took effect July 1, 2026, and its listed contact is OLTL's Bureau of Fee-for-Service Programs.

Billing basics

OLTL's waiver fee schedule (effective January 1, 2022) lists Adult Daily Living as procedure code S5102, billed per day, with modifiers for a half day (U5), enhanced day (U4) and enhanced half day (U3). Check the current schedule, and confirm codes and claim rules with each CHC plan.

For fee-for-service programs, OLTL's HCBS Provider Handbook (January 2014) says service coordinators enter service authorizations, and claims submitted through PROMISe, the DHS claims system, are checked against them. Confirm current fee-for-service procedures with OLTL's Bureau of Fee-for-Service Programs.

The DHS electronic visit verification (EVV) page lists the waiver services that must use EVV, such as Personal Assistance Services. Adult Daily Living is not on that list.

Other ways centers are paid

The Department of Aging says a licensed center may contract with its local Area Agency on Aging or a veterans association, though contracts do not guarantee referrals. Centers are responsible for marketing to private-pay clients.

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

• Adult Day Center Frequently Asked Questions
• Apply for Adult Day Center Licensing
• 6 Pa. Code Chapter 11: Older Adult Daily Living Centers
• Adult Day Center Directory
• Community HealthChoices
• CHC Waiver Documents
• OBRA Waiver
• Pennsylvania Adult Day Services Association

Frequently asked questions

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

Yes, if you serve four or more clients who are not your relatives at the same time for part of a day. The Department of Aging issues these licenses under 6 Pa. Code Chapter 11.

Does Pennsylvania Medicaid pay for adult day care?

Yes. Adult daily living services are covered for eligible members of Community HealthChoices, paid through its managed care plans, and for OBRA Waiver participants ages 18 to 59.

Who inspects adult day centers in Pennsylvania?

The Department of Aging's Division of Licensing inspects new centers before issuing an interim license and inspects every center at least once every 12 months.

Is social adult day care regulated in Pennsylvania?

There is no separate social adult day license. Any center serving four or more unrelated clients at once needs a Chapter 11 license, while socialization clubs are exempt.