ADULT DAY SERVICES PROVIDER IN COLORADO

Fatumata Kaba
1 day ago
3 min read

PROMOTING SOCIAL ENGAGEMENT, DAILY SUPPORT, AND SUPERVISED CARE FOR ADULTS IN A COMMUNITY-BASED SETTING

Adult Day Services in Colorado offer structured, non-residential programs that provide supervision, assistance with daily living, and social engagement for adults who are elderly or have disabilities. These services are reimbursed under Colorado’s Medicaid Home and Community-Based Services (HCBS) Waivers, including the Elderly, Blind, and Disabled (EBD) waiver and the Brain Injury (BI) waiver.

1. GOVERNING AGENCIES

Agency: Colorado Department of Health Care Policy and Financing (HCPF)

Role: Authorizes and reimburses Adult Day Services through Medicaid and HCBS waivers

Agency: Colorado Department of Public Health and Environment (CDPHE)

Role: Licenses Adult Day Care Facilities and ensures compliance with state health and safety regulations

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight to ensure Adult Day Services meet HCBS standards

2. ADULT DAY SERVICE OVERVIEW

Adult Day Services support individuals who may need supervision or assistance during the day while allowing them to return home in the evenings. These programs provide person-centered care that promotes independence and social inclusion.

Approved providers may deliver:

Assistance with activities of daily living (ADLs)
Medication administration and health monitoring (under nursing supervision)
Social, recreational, and therapeutic activities
Meals and snacks according to dietary needs
Supervision and safety monitoring
Transportation to and from the center (if included in service plan)
Documentation of attendance and individual progress

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Colorado Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Obtain an Adult Day Care Facility license from the Colorado Department of Public Health and Environment (CDPHE)
Enroll as a Medicaid provider through the Gainwell Technologies Medicaid Provider Portal
Maintain compliance with HCBS settings rule, including community integration and participant choice
Ensure facility meets accessibility, safety, and staffing standards

4. PROVIDER ENROLLMENT PROCESS

Step 1: Facility Licensing through CDPHE

Submit floor plan, safety procedures, staffing plans, and emergency policies
Pass inspection and receive Adult Day Facility license

Step 2: Medicaid Enrollment with HCPF

Apply through the Gainwell Provider Portal
Submit business documentation, license, and service description for HCBS Adult Day Services

Step 3: Coordinate with Case Management Agencies (CMAs)

Establish referral network with local CMAs for HCBS waiver participants

5. REQUIRED DOCUMENTATION

Articles of Incorporation or business registration
IRS EIN Letter
NPI confirmation
CDPHE Adult Day Facility license
Colorado Medicaid provider ID
Policy & procedure manual including:
- Admission criteria and intake procedures
- Daily activity schedules and individualized service plans
- Staff supervision and training logs
- Medication administration and documentation policies
- Participant rights and consent forms
- Emergency preparedness and incident reporting procedures
- Nutrition, infection control, and cleanliness protocols
- Community integration activities and transportation logs

6. STAFFING REQUIREMENTS

Role: Program Director

Requirements: Experience in health or human services, supervisory skills, familiarity with HCBS rules

Role: Activity Coordinator / Direct Care Staff

Requirements:

High school diploma or GED
Background check and CPR/First Aid certification
Experience working with older adults or individuals with disabilities preferred

Role: Nurse (if providing medication administration or health monitoring)

Requirements: Colorado RN or LPN license

Training Requirements for All Staff:

Adult day care operations and person-centered planning
HIPAA and participant rights
Medication administration and infection control
Emergency response and abuse prevention
Ongoing staff development and annual reviews

7. MEDICAID WAIVER SERVICES

Adult Day Services are reimbursed under:

HCBS-EBD (Elderly, Blind, and Disabled) Waiver
HCBS-BI (Brain Injury) Waiver
Other Medicaid-funded long-term care programs based on assessed need

Approved providers may deliver:

Half-day or full-day structured care
Activity-based programming and skill-building
Nursing support (if authorized)
Meals, transportation, and documentation as required by waiver guidelines

8. TIMELINE TO LAUNCH

Phase: Business Formation

Timeline: 1–2 weeks

Phase: Facility Licensing with CDPHE

Timeline: 60–90 days

Phase: Medicaid Enrollment (Gainwell Portal)

Timeline: 30–60 days

Phase: Facility Readiness and Referral Activation

Timeline: Ongoing

9. CONTACT INFORMATION

Colorado Department of Health Care Policy and Financing (HCPF)

Email: hcpf_hcbs_questions@state.co.us

Website: https://hcpf.colorado.gov

Colorado Department of Public Health and Environment (CDPHE)

Phone: (303) 692-2800

Website: https://cdphe.colorado.gov

Colorado Medicaid Provider Enrollment (Gainwell Technologies)

Website: https://portal.co.gov

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — COLORADO ADULT DAY SERVICES PROVIDER

We help healthcare professionals and organizations launch licensed, Medicaid-compliant Adult Day Programs to support aging and disabled populations in community-based settings.

Scope of Work: