ADULT DAY HEALTH SERVICES PROVIDER IN INDIANA

SUPPORTING HEALTH, WELLNESS, AND COMMUNITY CONNECTIONS FOR ADULTS THROUGH STRUCTURED DAYTIME CARE

Adult Day Health Services in Indiana provide medically supervised daytime care, personal support, therapeutic activities, and social engagement to adults with disabilities, chronic illnesses, or aging-related needs. These services are authorized under Indiana Medicaid Home and Community-Based Services (HCBS) Waiver programs, helping participants maintain independence, prevent institutionalization, and promote health and social inclusion.

1. GOVERNING AGENCIES

Agency: Indiana Family and Social Services Administration (FSSA) — Division of Aging and Division of Disability and Rehabilitative Services (DDRS)

Role: Oversees Adult Day Health Service provider standards, participant protections, quality monitoring, and program administration under Medicaid Waivers

Agency: Indiana Office of Medicaid Policy and Planning (OMPP)

Role: Administers Medicaid funding for Adult Day Health Services and manages provider enrollment and billing processes

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight, ensuring Adult Day Health Services meet HCBS Settings Rule, person-centered planning, and quality service delivery standards

2. ADULT DAY HEALTH SERVICE OVERVIEW

Adult Day Health Services offer medically supervised daytime programs focused on maintaining and improving participants' health, functional status, and quality of life through coordinated healthcare and supportive services.

Approved providers may deliver:

• Skilled nursing services such as medication administration, vital signs monitoring, and chronic disease management

• Personal care assistance with Activities of Daily Living (ADLs), including bathing, grooming, toileting, and eating

• Therapy support services such as physical, occupational, and speech therapy, and maintenance exercises

• Therapeutic activities, recreation, and socialization programs to reduce isolation and promote mental well-being

• Nutritional services including meals, hydration, and special diet accommodations

• Transportation coordination to and from the day health center

• Case management and caregiver support services

All services must be based on an individualized plan of care developed collaboratively with the participant, healthcare professionals, and case managers.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business entity with the Indiana Secretary of State

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

• Obtain Adult Day Service Certification through FSSA if participating in Medicaid-funded services

• Maintain general liability, professional liability, and workers’ compensation insurance

• Meet local and state health department licensing requirements (if meals and nursing services are provided)

• Develop comprehensive policies for healthcare services, participant protection, emergency preparedness, infection control, and service documentation

• Ensure staff meet background screening, licensure, certification, and ongoing training standards

4. INDIANA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Submit Provider Enrollment Application through the Indiana Medicaid Provider Portal for Adult Day Health Services under the Aged & Disabled Waiver or other relevant waivers

Application and Documentation Submission:

• Provide Articles of Incorporation, EIN/NPI confirmation, facility information (floor plans, safety compliance), staff licensure and training documentation, operational policies, and insurance certificates

Program Readiness Review:

• FSSA and/or local survey agencies review program readiness, including facility safety, service plans, healthcare oversight, staff ratios, and participant protections

Approval & Medicaid Enrollment:

• Upon approval, providers are assigned billing codes for Adult Day Health Services based on service hours, healthcare supervision, and participant care levels

5. REQUIRED DOCUMENTATION

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

• IRS EIN confirmation

• NPI confirmation

• Facility licenses, food service permits (if applicable)

• Proof of general liability, professional liability, and workers’ compensation insurance

• Adult Day Health Services Policy & Procedure Manual, including:

  • Participant intake, assessment, and individualized service planning procedures

  • Skilled nursing services, medication administration protocols, and health monitoring procedures

  • Activity programming, therapy maintenance, and community engagement activities

  • Infection control, emergency preparedness, fire safety, and disaster response plans

  • Participant rights protections, HIPAA compliance, and grievance policies

  • Staff credentialing, licensure, background checks, training records, and competency validations

  • Medicaid billing, service tracking, and audit readiness documentation

6. STAFFING REQUIREMENTS

Role: Program Director / Administrator

Requirements: Bachelor’s degree in healthcare, nursing, social work, or related field preferred; administrative experience; background clearance

Role: Registered Nurse (RN) / Health Services Coordinator

Requirements: Active Indiana RN license; clinical supervision and participant health oversight responsibilities

Role: Activity Director / Recreation Specialist

Requirements: Certification or experience in therapeutic recreation, activity coordination, or gerontology preferred

Role: Direct Care Workers / Personal Care Aides

Requirements: High school diploma or GED minimum; CPR/First Aid certification; training in ADL assistance, infection control, and participant safety; background screening clearance

All staff must complete:

• Abuse, neglect, and exploitation prevention training

• HIPAA confidentiality and participant rights training

• Infection control and emergency procedures training

• Skills training for dementia care, behavioral health supports, and health-related monitoring

• Annual competency evaluations and continuing education

7. MEDICAID WAIVER PROGRAMS

Adult Day Health Services are available under the following Indiana Medicaid Waivers:

• Aged and Disabled (A&D) Waiver

• Traumatic Brain Injury (TBI) Waiver

Approved providers may deliver:

• Structured, medically supervised daytime services

• Nursing and personal care assistance

• Nutritional services, including special diet accommodations

• Therapeutic activity programming and socialization support

• Caregiver respite and support coordination

8. TIMELINE TO LAUNCH

Phase: Business Formation, Facility Setup, and Compliance Preparation

Timeline: 2–4 months

Phase: Staff Hiring, Credentialing, and Adult Day Program Development

Timeline: 2–3 months

Phase: Indiana Medicaid Enrollment and FSSA Certification/Survey

Timeline: 60–90 days

Phase: Medicaid Billing Setup and Adult Day Health Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

Indiana Family and Social Services Administration (FSSA) — Division of Aging

Website: https://www.in.gov/fssa/da/

Indiana Medicaid — Provider Enrollment Portal

Website: https://www.in.gov/medicaid/providers/

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov/

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

WCG assists adult day health centers, senior service organizations, and community healthcare agencies in launching Medicaid-compliant Adult Day Health Services across Indiana.

Scope of Work:

• Business registration, facility setup guidance, Medicaid enrollment, and certification support

• Development of Adult Day Health Services Policy & Procedure Manual

• Staff credentialing templates, service tracking forms, and healthcare documentation systems

• Medicaid billing system setup and audit-ready claims management

• Website, domain, and professional branding setup

• Structured program curriculum development, including therapeutic activities and healthcare integration

• Quality assurance systems for participant safety monitoring, outcomes tracking, and satisfaction surveys

• Strategic partnership development with hospitals, case management agencies, and community organizations

Continue To Our Client Portal To Get Started

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