ADULT DAY HEALTH SERVICES PROVIDER IN GEORGIA

OFFERING HEALTHCARE, SOCIALIZATION, AND SUPPORT IN A COMMUNITY SETTING FOR ADULTS WITH DISABILITIES OR CHRONIC CONDITIONS

Adult Day Health Services in Georgia provide structured daytime programs offering nursing support, personal care, therapies, and social activities for individuals with disabilities, aging-related needs, or chronic health conditions. These services are authorized under Georgia’s Medicaid Home and Community-Based Services (HCBS) waiver programs and the State Medicaid Plan, helping participants maintain independence while offering caregiver respite.

​​​1. GOVERNING AGENCIES

Agency: Georgia Department of Community Health (DCH)

Role: Oversees licensing, Medicaid enrollment, service authorization, and reimbursement for Adult Day Health Services

Agency: Georgia Department of Human Services (DHS) – Division of Aging Services (for some non-Medicaid funding streams)

Role: Supports community-based aging and disability service programs, including day services

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight, ensuring Adult Day Health Services meet Medicaid HCBS requirements

2. ADULT DAY HEALTH SERVICE OVERVIEW

Adult Day Health Services combine health services, personal care, and recreational activities in a protective group setting during daytime hours.

Approved providers may deliver:

• Nursing services, including medication administration and health monitoring

• Physical, occupational, and speech therapy (as authorized)

• Personal care assistance (e.g., toileting, grooming, eating support)

• Nutritional services, including meal preparation and feeding assistance

• Social and recreational activities to promote community engagement

• Health education and wellness activities

• Transportation services to and from the center (optional, where authorized)

Services are designed to maintain or improve participants’ health, prevent institutionalization, and offer support to family caregivers.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register your business with the Georgia Secretary of State

• Obtain EIN from the IRS and NPI (Type 2)

• Obtain Adult Day Health Center License through DCH’s Healthcare Facility Regulation Division (HFRD)

• Maintain general liability, professional liability, and property insurance

• Employ qualified licensed nurses (Registered Nurses or Licensed Practical Nurses) for clinical oversight

• Develop comprehensive participant care, safety, and emergency preparedness policies

4. DCH PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Submit application for Adult Day Health Center License through HFRD

• Submit a Letter of Intent and provider application for Medicaid enrollment

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, insurance documentation, staffing plans, and clinical protocols

• Provide floor plans, life safety inspections, emergency response plans, and participant service models

• Include sample daily schedules, health monitoring plans, and transportation coordination (if applicable)

Program Readiness Review:

• DCH conducts site inspections for safety, accessibility, and staffing compliance

• DBHDD or Medicaid survey teams may review service delivery readiness

Approval & Medicaid Enrollment:

• Upon licensure and inspection approval, finalize Medicaid enrollment through GAMMIS

• Configure billing codes specific to Adult Day Health Services

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Georgia Secretary of State)

• IRS EIN confirmation

• NPI confirmation

• Adult Day Health Center License (DCH HFRD)

• Proof of liability and property insurance

• DCH-Compliant Policy & Procedure Manual including:

  • Participant intake, assessment, and individualized service planning

  • Medication administration, nursing services, and health monitoring procedures

  • Personal care assistance protocols

  • Daily programming for socialization, recreation, and therapies

  • HIPAA confidentiality, participant rights, and grievance resolution policies

  • Emergency preparedness, fire evacuation, and disaster recovery plans

  • Staff credentialing, background checks, and annual competency evaluations

  • Medicaid billing, service authorization tracking, and quality assurance systems

6. STAFFING REQUIREMENTS

Role: Program Director / Administrator

Requirements: Bachelor’s degree in human services, healthcare management, or nursing preferred; experience managing day programs; background screening clearance

Role: Registered Nurse (RN) / Licensed Practical Nurse (LPN)

Requirements: Active Georgia nursing license; experience in community health preferred; background screening clearance

Role: Direct Care Workers / Personal Care Aides

Requirements: High school diploma or GED; CPR/First Aid certification required; background screening clearance

Role: Activity Coordinator (optional but recommended)

Requirements: Experience in recreational therapy or activity programming; background screening clearance

All staff must complete:

• HIPAA confidentiality and participant rights training

• Abuse prevention and emergency response training

• Infection control and medication administration training

• Annual training refreshers for clinical and personal care competencies

7. MEDICAID WAIVER SERVICES

The following Georgia Medicaid Waivers and Programs authorize Adult Day Health Services:

• Elderly and Disabled Waiver Program (EDWP)

• SOURCE Program (Service Options Using Resources in a Community Environment)

• Comprehensive Supports Waiver Program (COMP) (for developmental disabilities, limited to specific models)

• New Options Waiver Program (NOW) (for developmental disabilities, limited to specific models)

Approved providers may deliver:

• Health monitoring and nursing services

• Therapeutic activities and socialization support

• Personal care and nutritional services

• Transportation (if part of the authorized service package)

8. TIMELINE TO LAUNCH

Phase: Business Formation and Licensing Application

Timeline: 2–3 months (depending on site readiness)

Phase: Facility Site Readiness, Inspections, and Licensure Approval

Timeline: 3–6 months

Phase: Staff Hiring, Credentialing, and Program Development

Timeline: 30–60 days

Phase: Medicaid Enrollment and Billing System Configuration

Timeline: 45–60 days

9. CONTACT INFORMATION

Georgia Department of Community Health (DCH) – Healthcare Facility Regulation Division (HFRD)

Website: https://dch.georgia.gov/divisionsoffices/hfrd

Georgia Department of Community Health (DCH) – Medicaid Division

Website: https://dch.georgia.gov/

Georgia Medicaid Management Information System (GAMMIS)

Website: https://www.mmis.georgia.gov/

Georgia Department of Human Services – Division of Aging Services

Website: https://aging.georgia.gov/

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — GEORGIA ADULT DAY HEALTH SERVICES PROVIDER

WCG supports day program agencies, healthcare providers, and senior service organizations in launching Medicaid-compliant Adult Day Health Services under Georgia’s HCBS and Medicaid State Plan programs.

​​​​​​​​​​​​​​​​​​​​​​​​​​​Scope of Work:

• Business registration and EIN/NPI setup

• Adult Day Health Center licensing and Medicaid enrollment support

• Development of Adult Day Health Services Policy & Procedure Manual

• Staff credentialing templates and participant intake documentation

• Medicaid billing system setup and claims management

• Website, domain, and email setup

• Daily activity planning templates and service documentation forms

• Emergency preparedness, incident reporting, and infection control systems

• Quality assurance programs for service delivery monitoring

• Community networking and referral partnership development

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