As the population ages and caregiving demands increase, more families are looking for safe, reliable, and compassionate places to support their loved ones during the day. Adult day care centers provide a vital solution—offering care, supervision, social interaction, and health-related services to seniors and adults with disabilities while giving their families peace of mind.
If you’re considering starting an adult day care, you’re not just launching a business—you’re becoming a pillar in your community. But this industry is highly regulated and requires thorough planning, compassion, and a professional approach.
In this guide, we’ll walk you through how to start an adult day care, including licensing, funding, operations, staffing, and more.
1. Understand the Purpose of an Adult Day Care
Adult day cares are non-residential facilities that provide structured programs and services for older adults or those with disabilities. Clients usually attend during daytime hours and return home in the evening.
Types of adult day cares:
- Social Day Care: Focuses on recreational activities, socialization, and meals.
- Adult Day Health Care (ADHC): Offers medical care, therapy, and supervision for those with chronic health conditions or dementia.
- Specialized Day Cares: Tailored to clients with Alzheimer’s, Parkinson’s, or developmental disabilities.
Understanding which type you want to open will shape everything—from licensing to staffing.
2. Research Licensing and Legal Requirements
Adult day cares are regulated at the state level, and each state has its own requirements.
Common licensing steps include:
- Submitting an application to your state’s Department of Health or Aging Services.
- Passing background checks and health screenings.
- Meeting zoning, fire, and health codes.
- Undergoing onsite inspections.
- Providing proof of liability insurance and a written program plan.
Check for any additional certifications or credentials required if you plan to provide medical services (like medication administration, therapy, or nursing care).
Pro Tip: Contact your state’s regulatory agency early to avoid costly mistakes.
3. Create a Business Plan
An adult day care is both a mission-driven service and a business venture. A strong business plan helps you organize your goals, attract funding, and ensure financial sustainability.
Your Business Plan Should Include:
- Mission and Vision
- Services Offered: Will you provide meals, transportation, medical care, activities?
- Target Population: Seniors, veterans, disabled adults, dementia patients?
- Location Strategy
- Pricing Model: Will you accept Medicaid, VA benefits, or only private pay?
- Staffing Needs
- Startup and Operational Costs
- Marketing Strategy
- Financial Projections
Consider partnering with local hospitals, senior centers, or caregiving organizations for referrals and community support.
4. Choose the Right Location
Your facility must meet specific zoning, safety, and accessibility requirements. It should be:
- Centrally located for ease of transportation.
- ADA compliant (ramps, wide doorways, accessible restrooms).
- Equipped with safety features (non-slip flooring, grab bars, emergency exits).
- Spacious enough to host group activities, dining, rest areas, and staff offices.
If possible, find a facility with an outdoor area for fresh air and mobility exercises.
5. Build Out Your Services
Adult day care services vary depending on your license and target population.
Common Services:
- Hot meals and snacks
- Personal care (toileting, grooming)
- Physical and occupational therapy
- Medication management
- Cognitive stimulation (games, crafts, memory exercises)
- Transportation to and from the center
- Support groups for caregivers
If you’re offering medical services, you’ll need to hire licensed professionals like nurses, therapists, or social workers and follow strict documentation and HIPAA guidelines.
6. Estimate Startup Costs
Starting an adult day care is more affordable than a residential facility but still requires a significant investment.
Startup Costs May Include:
- Facility lease or purchase
- Renovations and accessibility upgrades
- Furniture and equipment (recliners, beds, dining tables)
- Kitchen appliances
- Office supplies and computers
- Licensing and legal fees
- Insurance
- Initial payroll
- Marketing and branding
Estimated Range: $50,000 – $250,000 depending on size, location, and services.
Look into grants, SBA loans, or community development funding. Some nonprofit organizations and veteran groups also provide financial support.
7. Hire and Train Qualified Staff
Quality care requires compassionate, trained professionals. Your team might include:
- Program Director (you, or a hired manager)
- Certified Nursing Assistants (CNAs)
- Licensed Practical Nurses (LPNs) or RNs
- Activity Coordinators
- Social Workers or Counselors
- Administrative Staff
- Drivers
All staff should undergo:
- Background checks
- CPR/First Aid certification
- HIPAA compliance training
- Continuing education (especially for dementia care or elder abuse prevention)
8. Develop Daily Programming and Activities
A great adult day care balances safety, health, and meaningful engagement.
Sample Daily Schedule:
- 9:00 AM: Arrival & Morning Coffee
- 9:30 AM: Group Exercise or Stretching
- 10:00 AM: Memory Games or Word Puzzles
- 11:00 AM: Art or Music Therapy
- 12:00 PM: Lunch
- 1:00 PM: Quiet Time/Nap/TV
- 2:00 PM: Bingo, Crafts, or Guest Speakers
- 3:00 PM: Snack & Social Hour
- 4:00 PM: Departure/Transportation Home
Include cultural celebrations, outdoor walks, and therapy animals to keep things fresh and joyful.
9. Create Policies and Procedures
Clear policies protect your clients, staff, and business.
Must-Have Policies:
- Admission and discharge criteria
- Emergency and evacuation plans
- Incident reporting procedures
- Medication management
- Meal plans and dietary restrictions
- Client rights and privacy
- Transportation safety
- Staff-to-client ratio (usually 1:6 or 1:8)
Develop a Client Handbook and a Staff Manual, and make sure both are regularly updated.
10. Get Insurance and Legal Protection
You’ll need multiple layers of protection:
- General Liability Insurance
- Professional Liability (Malpractice)
- Commercial Property Insurance
- Workers’ Compensation
- Abuse and Molestation Insurance
- Commercial Auto Insurance (if providing transportation)
Also, consult with an attorney to draft:
- Consent forms
- Client agreements
- Employment contracts
- HIPAA-compliant privacy documents
11. Set Pricing and Understand Funding Options
Most adult day care clients pay through one of the following:
- Private Pay (out-of-pocket)
- Medicaid Waiver Programs
- Veterans Affairs (VA) Benefits
- Long-Term Care Insurance
- Sliding Scale Based on Income
Research what’s available in your state and ensure you’re set up for third-party billing if applicable.
Pricing typically ranges from $60–$120 per day, depending on location and services provided.
12. Market Your Adult Day Care
Unlike child care, adult day services are often chosen by caregivers or adult children, not the clients themselves. Your marketing should focus on safety, dignity, health, and peace of mind.
Strategies:
- Build a professional website with testimonials and a virtual tour.
- Partner with hospitals, clinics, home health agencies, and senior centers.
- Attend local health fairs or caregiver expos.
- Run targeted Facebook ads or Google Ads.
- Offer open houses and trial days.
Emphasize your unique selling points—specialized care, bilingual staff, transportation, or a strong therapy program.
13. Build Relationships with Families and the Community
Adult day care is a people-first business. Trust and transparency go a long way.
Offer:
- Monthly family meetings
- Caregiver support groups
- Regular progress reports
- Open communication channels (email, text updates, calls)
Create a culture of compassion, professionalism, and fun. Word-of-mouth will be your strongest marketing tool.
14. Evaluate and Improve Constantly
Once your center is up and running:
- Conduct regular client and family satisfaction surveys.
- Monitor health and behavioral changes with staff reports.
- Track finances and review budgets monthly.
- Maintain state compliance and prepare for surprise inspections.
- Adjust your services based on client needs and feedback.
Stay current with trends in elder care, dementia programming, and regulatory changes. Invest in staff development to retain high-quality caregivers.
Final Thoughts
Starting an adult day care is more than opening a business—it’s opening a space where people feel safe, respected, and valued. With careful planning, compassionate staff, and strong community ties, your center can thrive and make a lasting impact.
It’s a demanding industry, but for those who are called to serve, the rewards are immense—both emotionally and financially.
