Adult day services in Minnesota are licensed programs that operate for less than 24 hours a day and give functionally impaired adults a coordinated set of health, social, and nutritional services so they can keep living at home. That definition comes from Minn. Stat. § 245A.02, subd. 2a, which covers adult day care, adult day services, and family adult day services in a single sentence. The Department of Human Services (DHS) licenses centers under ch. 245A and Minn. R. 9555.9600 to 9555.9730.
A typical participant is an older adult, an adult with a disability, or a person living with dementia whose family caregiver works during the day. Most attend under the Elderly Waiver or a disability waiver after an assessment by the county, Tribe, or health plan; others pay privately.
This guide covers what the service is and is not, who attends, what a day includes, who pays, how enrollment works, and the 2026 pause. Licensing detail is in the adult day services license guide.
What counts as adult day services under Minnesota law
Section 245A.02, subd. 2a describes an individualized and coordinated set of health, social, and nutritional services directed at maintaining or improving the participants' capabilities for self-care. A program where adults gather mainly for socialization, education, supervision, caregiver respite, religious expression, exercise, or meals is expressly excluded, even if it runs all day.
The people served are "functionally impaired adults." Minn. R. 9555.9600, subp. 14 defines that as an adult who has substantial difficulty with one or more essential major activities of daily living, or a disorder of thought or mood that significantly impairs judgment, behavior, or the ability to cope with ordinary demands, and who requires support to maintain independence in the community.
Minnesota has two license types:
| Adult day care or adult day services center | Family adult day services | |
|---|---|---|
| Rules | Ch. 245A and Minn. R. 9555.9600 to 9555.9730 | Minn. Stat. § 245A.143 |
| Setting | A facility other than a participant's home or the operator's residence | The license holder's primary residence |
| Capacity | Licensed capacity stated on the license | No more than eight adults at one time |
| Staffing | One staff per eight participants capable of self-preservation, one per five who are not | Second staff person whenever six, seven, or eight participants are present |
| Plan of care | Preliminary plan within 30 days, plan of care within 90 days, quarterly review | Service plan revised on a change in needs or annually, whichever is sooner |
"Adult day care" and "adult day services" are the same thing in Minnesota law; Rule 9555.9600, subp. 4 uses the two center names interchangeably.
Adult day services vs adult day health, DT&H, and 245D day support
Only the first two services in this table are adult day services under ch. 245A.
| Service | Governing law | Who it is for |
|---|---|---|
| Adult day services center | Ch. 245A; Minn. R. 9555.9600 to 9555.9730 | Functionally impaired adults, most often older adults and people with dementia |
| Family adult day services | § 245A.143 | Same population, up to eight adults in a provider's home |
| Adult day health | Not a Minnesota license category; a term used nationally and by the VA | Veterans and others in states or programs that use the term |
| Day training and habilitation (DT&H) | Minn. Stat. §§ 252.41 to 252.46; Minn. R. 9525.1200 to 9525.1330 | Adults with developmental disabilities, as part of "day services for adults with disabilities" under § 252.41, subd. 3 |
| Day support services | Defined in Minnesota's federally approved disability waiver plans; delivered by ch. 245D license holders as an intensive support service under § 245D.03, subd. 1(c) | Adults on the disability waivers |
Minn. Stat. § 252.41, subd. 3 groups day support services, prevocational services, structured day services, adult day services, and day training and habilitation together as "day services for adults with disabilities," but each is delivered by a vendor licensed under its own chapter. A Rule 9555 center provides adult day services; it does not provide DT&H or 245D day support unless it holds those licenses too. The What is 245D? guide explains the 245D side.
Adult day health is the term the Department of Veterans Affairs uses for its Adult Day Health Care benefit for enrolled veterans who are eligible for community care and meet clinical criteria, with a possible copay. In Minnesota the provider still needs the ch. 245A license.
Who attends adult day services
Three groups make up most enrollment:
- Older adults who need help with activities of daily living, are isolated at home, or have a caregiver who works or needs relief, usually funded by the Elderly Waiver or Alternative Care.
- Adults with physical, developmental, or acquired disabilities on the CADI, DD, BI, or CAC waivers, where adult day services is one of several day service options.
- People living with dementia or another disorder of thought or mood that meets the functional impairment definition. Centers must decide at admission whether each participant is capable of taking appropriate action for self-preservation under emergency conditions, because that designation sets the staffing ratio; the staffing ratios and training guide explains how.
Every participant must be 18 or older (Rule 9555.9600, subp. 2), and the intake screening under Rule 9555.9700 confirms the center can meet the person's needs before admission.
What a day at an adult day center includes
Rule 9555.9710 lists the services a licensed center must provide:
- Plan of care activities. Each participant has a written plan of care with measurable objectives, developed within 90 days of admission and reviewed quarterly. Daily activities are planned monthly and include socialization, personal interests such as arts, crafts, and music, and activities that build knowledge, language, and conceptual skills. See the plan of care guide.
- Meals and snacks. A participant at the center for more than four and a half hours must be served a meal meeting one-third of the recommended dietary allowances. Snacks are offered morning and afternoon, menus are developed with a registered dietitian, and menu records are kept for at least six months.
- Health monitoring and medication assistance. A registered nurse consults monthly. Health services include monitoring, wellness education, referrals, a self-administration policy, and supervised medication assistance by trained staff.
- Structured exercise. A daily program developed with a registered physical therapist and reviewed quarterly, for participants whose physician approves it.
- Help with activities of daily living such as dressing, grooming, and eating.
- Social services. Interviews with the participant and caregiver at admission, a family and social history, and referrals.
- Transportation. Travel time in a center vehicle between home and the center is capped at 90 minutes one way. Waiver transportation is authorized and billed separately.
Compliance note: the meal, exercise, nursing consultation, and activity requirements are licensing rules. A center that cannot show a monthly activity plan, a dietitian-approved menu, and a nurse consultation log is out of compliance regardless of how full its calendar looks.
How adult day services are paid for
Adult day services are a waiver service: Medicaid pays only for people a lead agency has assessed and authorized.
| Payer | Who qualifies | What is covered |
|---|---|---|
| Elderly Waiver (EW) | People 65 and older who meet nursing facility level of care and Medical Assistance eligibility | Adult day services, adult day services bath, waiver transportation |
| Alternative Care (AC) | People 65 and older who would be eligible for Medical Assistance within 135 days of nursing facility admission (§ 256B.0913, subd. 2) | Adult day services and adult day services bath (§ 256B.0913, subd. 5) |
| CADI, DD, BI, and CAC waivers | People with disabilities who meet each waiver's level of care | Adult day services as one day service option |
| Private pay | Anyone the center admits | Whatever the service agreement states |
| VA Adult Day Health Care | Enrolled veterans eligible for community care who meet clinical criteria | Adult day health care; a copay may apply |
Providers bill a full day of six or more hours as S5102 and shorter days in 15-minute units as S5100; transportation to and from the site is T2003 with modifier UC. Rates come from the Disability Waiver Rate System or the Elderly Waiver rate tables and change over time, so this guide does not state them. The billing and attendance records guide covers the codes and the attendance record behind each claim.
How a family finds and enrolls in a program
For waiver-funded adult day services, enrollment runs through the lead agency, not the center.
- Request an assessment. Under Minn. Stat. § 256B.0911, a lead agency (a county, or a Tribe or health plan under contract with DHS, subd. 10) provides long-term care consultation. A MnCHOICES certified assessor conducts the assessment (subd. 14) and determines waiver eligibility and level of care (subd. 11).
- Receive the support plan. The assessment summary and support plan must be completed no more than 60 calendar days after the assessment visit (subd. 29), listing assessed needs, options, risks, referrals, and caregiver supports.
- Choose a licensed center. The center should be able to show its current DHS license and its operating days and hours.
- Complete the center's intake screening. Rule 9555.9700, subp. 1 requires the center to screen the person, interview the participant and caregiver where possible, and communicate the outcome within five working days.
- Sign the admission paperwork. Rule 9555.9660 requires an application with emergency contacts, a medical report dated within three months before or 30 days after admission, and a signed service agreement covering payment and services.
- Start services under the lead agency's authorization. The case manager issues a service agreement naming the service, units, and dates. The center completes the preliminary service plan within 30 days and the full plan of care within 90 days.
Private-pay families skip steps 1, 2, and 6 but still go through screening and admission.
The pause on new adult day centers
As of September 2026, two pauses affect the supply of adult day services in Minnesota. DHS announced in December 2025 that it would stop accepting new adult day center license applications on February 1, 2026 for an anticipated 24 months, through January 31, 2028, and canceled pending applications. Counties, managed care organizations, and Tribal Nations may submit exception requests where access requires a new license.
Separately, adult day services is one of 13 Medicaid services in the provider enrollment freeze that began January 27, 2026 and was extended through January 27, 2027. Existing licensed and enrolled programs keep operating and accepting participants. The Minnesota Revalidate and enrollment freeze guide covers what existing providers must do.
How Trustora helps
Trustora is one platform for ARMHS, 245D, PCA/CFSS, EIDBI, and adult day services, so an agency running an adult day center alongside other Minnesota programs keeps every participant record in one system. The adult day module holds the intake screening, the 30-day preliminary service plan, the 90-day plan of care with quarterly review alerts, and the daily attendance record with arrival and departure times that waiver billing rests on.
Attendance becomes the right code automatically, S5102 for a day of six or more hours and S5100 units for shorter days, and the pre-claim gate checks each line against the lead agency's service agreement before the claim goes out. See the platform overview for the adult day workflow.