ADULT DAY CARE SERVICES PROVIDER IN MARYLAND

PROMOTING WELLNESS, SAFETY, AND SOCIAL CONNECTIONS FOR OLDER ADULTS AND MEDICALLY FRAGILE INDIVIDUALS IN A COMMUNITY SETTING

Adult Day Care Services, formerly known as Adult Medical Day Care (AMDC) in Maryland, offers structured, daytime care for adults with physical, cognitive, or medical conditions who benefit from health monitoring, social engagement, and personal care while living in the community. Services are licensed by the Office of Health Care Quality (OHCQ) and may be funded through Medicaid’s Community Options Waiver or Community First Choice (CFC).

https://video.wixstatic.com/video/dcc8e4_5fe2552d035543c8b623c2dd710e8080/1080p/mp4/file.mp4

1. GOVERNING AGENCIES

Agency: Maryland Office of Health Care Quality (OHCQ)

Role: Licenses and inspects Adult Medical Day Care centers

Agency: Maryland Medicaid / Long Term Services & Supports (LTSS)

Role: Provides reimbursement through the Community Options Waiver and the CFC program

Agency: Maryland Department of Health (MDH)

Role: Oversees medical eligibility and program standards

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight of Medicaid-funded adult day services

2. ADULT DAY CARE SERVICE OVERVIEW

Adult Medical Day Care (AMDC) provides:

• Skilled nursing and medication administration

• Personal care (bathing, toileting, grooming)

• Health monitoring and chronic disease management

• Therapeutic recreation and cognitive activities

• Social work and case management services

• Nutritious meals and snacks

• Door-to-door transportation (optional but common)

Services must meet medical necessity criteria and align with the participant’s individualized service plan (ISP).

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

To operate legally in Maryland, Adult Day Care providers must:

• Obtain licensure as an Adult Medical Day Care Center from OHCQ

• Comply with COMAR 10.12.04 regulations for AMDC

• Operate in a facility that meets accessibility, fire safety, and health code requirements

• Employ a Registered Nurse, Program Director, and sufficient certified staff

• Submit to annual inspections and quality reviews

4. OHCQ LICENSING PROCESS

Step 1: Business Registration

• Register business with SDAT

• Obtain EIN, NPI, and Medicaid provider number

Step 2: Facility Setup

• Lease or purchase a site that meets zoning, space, and accessibility standards

• Develop floor plan, meal prep area, activity space, and rest areas

Step 3: Pre-Licensure Application to OHCQ

• Submit application, floor plans, fire marshal approval, staff list, and operating policies

Step 4: OHCQ Site Inspection

• Schedule and pass the pre-licensure survey inspection

Step 5: Begin Operations Upon Licensure

• Market services to case managers and referral networks (hospitals, Area Agencies on Aging)

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or LLC registration

• IRS EIN and NPI confirmation

• Lease agreement and floor plans

• OHCQ application and checklist

• Medicaid enrollment (ePREP)

• Policy & procedure manual including:

  • Medical and nursing protocols

  • Medication administration policies (with MAR logs)

  • Nutrition and meal safety procedures

  • Behavioral support, emergency evacuation, and safety plans

  • Client intake, assessment, and consent forms

  • Staff training records and job descriptions

  • Transportation safety and vehicle maintenance policies (if provided)

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN)

Requirements: Onsite daily; supervises health services and medication administration

Role: Program Director

Requirements: Bachelor's degree in human services or related field and 3+ years of management experience

Role: Activity Coordinator

Requirements: Background in therapeutic recreation or group facilitation

Role: Certified Nursing Assistants (CNAs) or Geriatric Nursing Assistants (GNAs)

Requirements: Certified and trained in personal care and emergency procedures

Role: Social Worker (optional, highly recommended)**

Role: Driver (if transportation is provided)

7. MEDICAID WAIVER SERVICES

Adult Medical Day Care is funded under:

• Community Options Waiver – For adults meeting nursing facility level of care

• Community First Choice (CFC) – For Medicaid recipients needing personal and health services to remain in the community

Services must be pre-authorized by Medicaid and may include:

• Daily nursing oversight

• Personal assistance

• Social work services

• Structured recreation

• Meals and transportation

8. TIMELINE TO LAUNCH

Phase: Business Formation & Facility Acquisition

Timeline: 2–4 weeks

Phase: Policy Development and Staff Hiring

Timeline: 3–5 weeks

Phase: OHCQ Application and Inspection

Timeline: 8–12 weeks

Phase: Medicaid Enrollment & Participant Referrals

Timeline: Ongoing

9. CONTACT INFORMATION

Maryland Office of Health Care Quality (OHCQ)

Website: https://health.maryland.gov/ohcq

Phone: (410) 402-8217

Regulations: COMAR 10.12.04

Maryland Medicaid (ePREP Enrollment)

Website: https://eprep.health.maryland.gov

Maryland Department of Assessments and Taxation (SDAT)

Website: https://egov.maryland.gov/BusinessExpress

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — MARYLAND ADULT DAY CARE PROVIDER

We support compassionate professionals in launching licensed Adult Day Care centers that offer both medical and social care in community settings.

Scope of Work:

• Business formation (LLC, EIN, NPI)

• OHCQ Adult Day Care licensure support

• Policy & procedure manual development for AMDC compliance

• Staff onboarding and credentialing trackers

• Participant intake forms and care plans

• Fire safety compliance and inspection checklists

• Medicaid billing setup and LTSS Maryland registration

• Referral outreach tools for case managers and discharge planners

• Website, HIPAA email, and digital documentation systems

Continue To Our Client Portal To Get Started

Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.