ADULT DAY SERVICES PROVIDER IN NORTH DAKOTA

SUPPORTING SOCIAL ENGAGEMENT AND PERSONAL WELL-BEING IN A SAFE, STRUCTURED ENVIRONMENT

Adult Day Services in North Dakota provide daytime care and social engagement for adults with disabilities, chronic illnesses, or age-related challenges. These services offer a safe, structured environment where individuals can participate in recreational, social, and therapeutic activities while receiving personal care and supervision. Adult Day Services are authorized under North Dakota Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: North Dakota Department of Human Services (NDDHS)

Role: Administers Medicaid waiver funding for Adult Day Services and oversees provider enrollment, service authorization, and reimbursement.

Agency: North Dakota Medical Services Division (MSD)

Role: Manages Medicaid waiver services and oversees Medicaid provider participation.

Agency: North Dakota Division of Aging Services

Role: Provides oversight for adult day services targeting elderly individuals and adults with disabilities.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight to ensure Medicaid-funded Adult Day Services meet quality, safety, and person-centered care standards.

2. ADULT DAY SERVICES OVERVIEW

Adult Day Services provide social, therapeutic, and health-related support in a community-based setting, offering a break for caregivers while ensuring participants' safety and well-being.

Approved providers may deliver:

• Social and Recreational Activities: Group outings, games, crafts, and music therapy.

• Health Monitoring: Tracking vital signs, medication administration, and wellness checks.

• Personal Care Assistance: Bathing, grooming, toileting, and mobility support.

• Therapeutic Activities: Physical and occupational therapy sessions.

• Nutritional Support: Meal preparation and feeding assistance tailored to dietary needs.

• Memory Care Programs: Cognitive exercises and activities for individuals with dementia.

• Behavioral Support: Techniques to manage challenging behaviors and promote positive interactions.

• Transportation Coordination: Assisting with transport to and from the adult day center.

• Caregiver Support: Providing updates on client well-being and progress.

• Documentation: Maintaining detailed records of daily attendance, activities, and care provided.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register the business entity with the North Dakota Secretary of State.

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

• Enroll as a Medicaid Waiver Adult Day Services provider via the North Dakota Medicaid Management Information System (MMIS).

• Maintain general liability and professional liability insurance.

• Develop policies for activity planning, personal care, and health monitoring.

• Ensure staff complete required background checks, health screenings, and training in adult day care.

4. NORTH DAKOTA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Complete the Provider Enrollment Application via the North Dakota MMIS for Adult Day Services under HCBS waivers.

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, adult day care policies, and staff training documentation.

Program Readiness Review:

• NDDHS and MSD evaluate provider readiness, including care protocols, safety standards, and staff qualifications.

Approval & Medicaid Enrollment:

• Upon approval, providers are authorized to bill Medicaid for Adult Day Services using designated billing codes.

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (North Dakota Secretary of State)

• IRS EIN confirmation

• NPI confirmation

• Proof of general and professional liability insurance

• Adult Day Services Policy & Procedure Manual including:

  • Social and therapeutic activity planning protocols

  • Personal care and health monitoring guidelines

  • Staff credentialing, background checks, and ongoing training records

  • Documentation standards for activity tracking and Medicaid billing

  • HIPAA compliance, participant rights, and grievance handling

  • Safety, infection control, and hygiene practices

  • Emergency response and crisis management plans

  • Quality assurance and compliance monitoring

6. STAFFING REQUIREMENTS

Role: Adult Day Program Director

Requirements: Bachelor’s or Master’s degree in social work, healthcare administration, or gerontology; experience in adult day care management.

Role: Activity Coordinators

Requirements: Experience in recreational therapy, group facilitation, and social engagement activities.

Role: Personal Care Aides (PCAs)

Requirements: Certification in direct care or personal assistance; experience with adults or seniors with disabilities.

Role: Registered Nurses (RNs)

Requirements: State licensure; experience in health monitoring and chronic disease management.

All staff must complete:

• Training in activity planning, safety protocols, and client interaction

• HIPAA compliance and participant rights education

• Annual competency evaluations and ongoing professional development

• Safety, emergency response, and infection control training

• Documentation and record-keeping best practices

7. MEDICAID WAIVER PROGRAMS

Adult Day Services are available under the following North Dakota Medicaid Waivers:

• Aged and Disabled Waiver

• Technology Dependent Waiver

• Developmental Disabilities Waiver

• Home and Community-Based Services (HCBS) Waiver

8. TIMELINE TO LAUNCH

Phase: Business Formation and Compliance Preparation

Timeline: 1–2 months

Phase: Staff Hiring, Credentialing, and Program Development

Timeline: 2–3 months

Phase: North Dakota Medicaid Provider Enrollment and Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing Setup and Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

North Dakota Department of Human Services (NDDHS)

Website: https://www.nd.gov/dhs/

North Dakota Medicaid Management Information System (MMIS)

Website: https://www.nd.gov/dhs/services/medicalserv/medicaid/

North Dakota Division of Health Benefits (NC Medicaid)

Website: https://www.nd.gov/dhs/services/medicalserv/medicaid/

Centers for Medicare & Medicaid Services (CMS)

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

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NORTH DAKOTA ADULT DAY SERVICES PROVIDER

WCG supports agencies in launching Medicaid-compliant Adult Day Services in North Dakota, offering:

Scope of Work:

• Business registration, Medicaid enrollment, and licensing assistance

• Policy manual development for activity planning and client safety

• Staff credentialing, training program templates, and compliance documentation

• Medicaid billing setup and audit-prepared financial management

• Branding, website development, and client outreach strategies

• Quality assurance systems for adult day care and compliance monitoring

• Collaboration with healthcare providers and community organizations

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.