Adult Day Care in Georgia

All states: adult day services map

Georgia adult day services at a glance

Last verified against state sources: 2026-10-21.

How is adult day care regulated in Georgia?

Georgia licenses every adult day center through the Georgia Department of Community Health (DCH), Healthcare Facility Regulation Division (HFRD), in its Personal Care Home Program. One set of rules covers two models: adult day care, which is a social model, and adult day health services, which is a medical model. Medicaid pays for adult day health through the Elderly and Disabled Waiver and for adult day services through the Independent Care Waiver Program.

Three layers of rules can apply to a Georgia center, and each comes from a different agency:

• Licensing (DCH HFRD). The Rules and Regulations for Adult Day Centers, Ga. Comp. R. & Regs. Chapter 111-8-1, adopted under the Adult Day Center for Aging Adults Licensure Act (O.C.G.A. 49-6-80 and following). General licensing and enforcement rules are in Chapter 111-8-25, and background check rules are in Chapter 111-8-12. These rules apply to every center, whatever the payer.
• Medicaid (DCH). DCH is also Georgia's Medicaid agency. Adult day health is a service of the Elderly and Disabled Waiver Program (EDWP), which runs through two models called CCSP (Community Care Services Program) and SOURCE. Area Agencies on Aging screen people who apply. DCH publishes the provider manuals on its GAMMIS provider manuals page.
• Other funding (DHS Division of Aging Services). The Georgia Department of Human Services, Division of Aging Services (DAS), funds adult day through 12 Area Agencies on Aging. Programs that take this money follow DAS Manual 5300, Section 302.

Adult day care vs adult day health. The licensing rules define adult day care as a plan of services under a social model and adult day health services as a plan under a medical model (111-8-1-.04). Both models provide supervision, social and leisure programming and group and individual activities. Adult day health centers also run an ongoing therapeutic program (nursing, health monitoring, medication administration, and physical, occupational and speech therapy), must have a registered nurse who assesses each participant, need a medical exam before admission, and have a director with a bachelor's degree or four years of related experience.

Other models. The rules also allow a mobile adult day center that serves up to five off-site locations. Programs that serve only people with developmental disabilities are outside both definitions. The DAS manual uses a third term, Alzheimer's day care, for either model serving people of any age with dementia, but we did not find a separate dementia license in the licensing rules.

Where the layers overlap, DCH licensing sets the floor for every center. The DAS manual is stricter for the programs it funds, on staffing, hours, training and record keeping.

Do you need a license to open an adult day center in Georgia?

Yes, if your program will serve three or more aging adults for pay. DCH licenses both social model and medical model centers, whether participants pay privately, through Medicaid or some other way. You need the license before you open.

Exemptions. Under 111-8-1-.03, a license is not needed for operators who take no payment, operators serving only one or two paying participants, day habilitation programs serving only people with developmental disabilities, and qualifying respite care programs.

How to apply. DCH posts the Adult Day Center Application Packet (updated July 13, 2026) on its Licensure Forms and Applications page, and applications go through the HFRD online intake. Under 111-8-1-.05, the application includes:

• The approved application form and the fee.
• Proof of your right to occupy the property and a sketch of the floor plan.
• An identification affidavit and, for a business entity, proof that it legally exists. The packet includes a notarized affidavit of citizenship or lawful presence.
• Fire safety approval, water and sewage approval, and zoning approval. A current water bill is enough if the site is on public water and sewer. Otherwise the county environmentalist completes the water and septic report.
• A list of other adult day centers you operate.
• Vehicle insurance and registration if you will provide transportation.

Fees. The DCH Schedule of Licensure Activity Fees sets the annual license fee at $250 for a social model center and $350 for a medical model center. A $300 processing fee is due with a new application, a change of ownership, a change in service level or a name change. An application required after DCH investigates a complaint about an unlicensed center costs $550. Fees are paid to DCH and are generally not refundable.

Certificate of need. We did not find a certificate of need requirement or a moratorium for adult day centers in Chapter 111-8-1. DCH pages mention certificate of need only for long term care facilities. Confirm with HFRD before you sign a lease.

One license per site. Each center needs its own application and license, and regular and mobile centers each pay a separate fee. A license cannot be assigned or transferred to another owner or another location. The license states the maximum number of participants per day and must be posted.

Buying a center. A change in ownership, location, name, maximum participants or services must be reported with a new application, and the old license is returned (111-8-1-.06). HFRD's change of ownership guidance asks providers to notify the department at least 30 days before an ownership change. That page does not name adult day centers specifically, so confirm the timing with HFRD early in any purchase.

Renewal and inspections. An annual license fee applies. DCH inspects each center before licensure and periodically after that (111-8-1-.26). The rule sets no interval, but the Personal Care Home Program says it makes unannounced compliance inspections about every 11 to 15 months. DCH may excuse a center from periodic inspections if it is accredited by an approved body that uses substantially similar standards.

What are the staffing rules for adult day centers in Georgia?

Georgia licensing rules require at least 1 direct service staff member for every 8 participants in every center, and only staff who provide direct services count. Programs funded by the Division of Aging Services must also staff 1 per 4 for severely impaired participants. We did not find a separate ratio for people with dementia, and we could not confirm whether the Medicaid adult day health manual sets its own ratio.

• Licensing (DCH): no less than 1:8, and staffing must meet participant needs and plans of care (111-8-1-.13). Staffing must also increase as the number of participants who cannot walk rises, and must allow a prompt evacuation.
• Medicaid (Elderly and Disabled Waiver): not confirmed. The adult day health manual could not be opened.
• Funding (DAS): 1 direct service staff per 8 participants who are not severely impaired and 1 per 4 who are, in addition to administrative staff (DAS Manual 5300, Section 302). DAS measures impairment with an assessment called the DON-R, so the 1:4 ratio depends on functional need, not on a dementia diagnosis.

Minimum staff on site. A director runs day-to-day operations, with a designated supervisor in charge when the director is away. At least one staff member with current first aid and CPR certification must be in the center at all times. DAS-funded programs need at least one staff member on site whenever participants are present, and DAS-funded adult day health programs need an RN or LPN present at all times.

Who counts toward the ratio. Under the licensing rules, clerical, office, maintenance and food service staff do not count. The DAS manual counts the administrator, licensed nurses and activities staff as direct service staff for its own ratio.

Nurses and director. In adult day health centers, an RN assesses each participant and develops and supervises the plan of care within three business days of admission. Any LPN must be supervised by an RN who can be reached when off site, therapies must be given by qualified staff, and nurses need a Georgia license. The adult day health director needs a bachelor's degree or four years of related experience. In DAS-funded programs where an LPN provides the nursing, an RN consultant must be on site at least four hours a week. Social model centers have no nurse requirement in the licensing rules.

Training. Under the licensing rules, all employees and contractors complete training within 90 days on ten topics, including CPR, infection control, recognizing abuse, participant rights, influenza vaccination, and Alzheimer's and dementia care. No number of hours is set. DAS-funded programs add orientation within two weeks, 18 hours of training within 60 days, and then 3 hours each quarter or 12 hours a year, and assistants must be at least 18.

Background checks and health screening. Under 111-8-1-.14, as amended effective July 29, 2026, fingerprint criminal records checks under Chapter 111-8-12 are required for the owner before licensure, for a director before hiring, and for employees with direct access to participants before they start. Employees must be screened for tuberculosis following CDC guidance before they begin work.

What does an adult day center in Georgia have to provide?

Every licensed Georgia center provides supervision, social and leisure programming, and individual and group activities, and serves a meal and snacks if it is open more than four hours or at mealtimes. Each participant needs at least 35 square feet of usable floor space. Adult day health centers add nursing, health monitoring, medication administration and therapies.

Hours. Each center sets its own core hours and days of operation, and a participant may not attend more than 14 hours in a 24-hour period (111-8-1-.08 and .15). DAS-funded programs must run at least five continuous hours a day, not counting transportation time.

Meals. Centers open more than four hours a day or during mealtimes serve a nutritious meal plus mid-morning and mid-afternoon snacks. Adult day health meals must supply one-third of daily nutritional needs from menus approved by a dietitian or RN, and centers licensed for 24 or more participants need a food service permit (111-8-1-.18). DAS-funded programs serve lunch between 11:00 a.m. and 1:00 p.m. to participants who attend four or more hours, from dietitian menus.

Medications. Help with self-administered medication is optional. Without an RN, LPN or proxy caregiver on staff, participants take their own medications, and staff may only remind them, check labels and help open containers. Injections require a nurse or proxy caregiver (111-8-1-.19).

Transportation. Transportation is optional. Center vehicles need assigned seats, seatbelts, a first aid kit, a fire extinguisher, a two-way communication device and a trip roster, and the driver or an attendant must be trained in seizure care, first aid and CPR (111-8-1-.20).

Space and capacity. Under 111-8-1-.10:

• At least 35 square feet of usable floor space per participant. Hallways, bathrooms, lockers, storage, staff rooms and other areas participants do not use do not count.
• Licensed capacity is set from usable floor space and the fire authority's occupancy load.
• At least one toilet for every 12 participants.
• Rest areas as needed, activity and dining areas, a private area for first aid or personal care, and a private bathing unit in adult day health centers or any center that helps with bathing.
• Rooms kept between 70 and 85 degrees F.

Written policies. Before licensure a center needs written policies in 14 areas (111-8-1-.08), including:

• The services offered (adult day care, adult day health or both), the participants served, and an Alzheimer's Disclosure Form where it applies.
• The number and qualifications of staff and volunteers.
• Days and hours of operation, fees, refunds and voluntary contributions.
• Serious incidents, medical emergencies, standard precautions, and excluding people who are ill or whose behavior is a concern.
• Medication storage and handling, and smoking.
• Voluntary and involuntary discharge criteria and notice.
• A complaint policy that resolves complaints within seven business days.

Centers also need personnel policies, a volunteer screening policy, infection control policies reviewed at least yearly, and an annual quality improvement plan with a written report (111-8-1-.24 and .25).

Safety. The disaster preparedness plan uses the DCH format, is filed with DCH and the local emergency management agency, is rehearsed and is reviewed at least once a year. Fire drills are held at least every quarter. The license, evacuation plans and emergency numbers must be posted. DAS-funded programs also hold annual tornado drills and run a yearly evaluation with satisfaction surveys.

What rules protect participants in Georgia adult day centers?

Georgia requires an in-person interview, proof of freedom from active tuberculosis, a signed participant agreement and a sex offender registry search before services begin. The plan of care must be in place within three business days of admission, and a center must give 14 days' written notice before a non-emergency discharge. Serious incidents are reported to DCH by the next business day.

Before enrollment. Under 111-8-1-.15, the director must:

• Hold an in-person interview and get a statement of any limits on the person's participation.
• Get evidence that the person is free of active TB, from a skin test or chest x-ray within the last 12 months.
• Get a signed participant agreement.
• Search the National Sex Offender Registry.

Adult day health centers also need a medical exam report signed by a physician, nurse practitioner or physician assistant within six months before admission, plus physician orders for any therapies.

Participant agreement. The agreement covers the services, fees and extra charges, the days and hours the person will attend, payment arrangements and any third-party payers, admission and discharge criteria, refunds, holidays and what happens when the center closes in an emergency. Participants get 30 days' written notice of major changes to the agreement or fees.

Plan of care. The plan of care must be carried out within three business days of admission and reviewed at least twice a year. Adult day health centers document each participant's progress at least every quarter.

Discharge. A non-emergency discharge requires 14 days' written notice. An emergency discharge is allowed when continued attendance would endanger the participant or others (111-8-1-.22).

Rights and complaints. Participants get a list of rights that cannot be waived, including the right to complain to HFRD, and the center must have a complaint process (111-8-1-.17).

Attendance and records. Centers keep a daily attendance record listing participants by name, plus activity schedules, menus, fee records and a serious incident log. The licensing rule does not require sign-in and sign-out times. All records are kept at least three years (111-8-1-.16). DAS-funded programs keep participant records at least six years after discharge and personnel records six years.

Incidents. Deaths, rape, serious injury that needs medical care, suspected abuse, neglect or exploitation, and a participant missing more than 30 minutes are reported to DCH by the next business day. The center then completes a written internal investigation within five business days. A death at the center is reported to law enforcement right away and to DCH within 24 hours (111-8-1-.23).

Funding program rules. DAS-funded programs serve adults 60 and older and their caregivers and assess impairment with the DON-R and MoCA tools. DAS-funded social model programs may not serve people who are bed-bound or whose behavior staff cannot safely manage. People on the Elderly and Disabled Waiver must meet nursing facility level of care and receive a waiver service each calendar month to stay eligible (DFCS Medicaid Policy 2131).

How does Medicaid pay for adult day in Georgia?

Georgia Medicaid pays for adult day health through the Elderly and Disabled Waiver, in its CCSP and SOURCE models, and for adult day services through the Independent Care Waiver Program. Elderly and Disabled Waiver adult day health is billed per day, under S5102 for a full day and S5101 for a partial day, with a TF modifier for Level II care. We could not confirm the current daily rates.

Elderly and Disabled Waiver (EDWP). This 1915(c) waiver serves people 65 and older and people with physical disabilities who meet nursing facility level of care. Its current federal approval (waiver 0112.R08.00) runs from November 9, 2022 to November 8, 2027. It lists adult day health and adult day health therapies (occupational, physical and speech). The waiver runs in two models:

• CCSP. The Area Agency on Aging screens applicants, and a care coordination agency assesses them when funds are available.
• SOURCE. SOURCE sites also act as primary care case managers for their members. SOURCE uses the same adult day health manual and rate notices as CCSP.

Billing codes and units. DCH's revised Elderly and Disabled Waiver rate notice (2018) lists adult day health per day:

• S5102: full day, Level I. S5102 TF: full day, Level II.
• S5101: partial day, Level I. S5101 TF: partial day, Level II.
• Adult day health therapies are billed per visit. We did not find the code in the notices we read.

Later DCH notices keep the same Level 1 and Level 2, full and partial day structure. DCH proposed a rate increase in 2024, and we could not confirm whether it was adopted (see the last section), so ask DCH or the manual for the current rate.

Independent Care Waiver Program (ICWP). This 1915(c) waiver serves adults 21 to 64 with physical disabilities or traumatic brain injury who meet hospital or nursing facility level of care, and Alliant Georgia Medical Care Foundation handles applications (Georgia Medicaid waiver programs). Adult day services are paid as a full day (more than 5 hours) or half day (3 to 5 hours). We did not find the ICWP codes or rates.

Transportation. We did not find whether either waiver pays for transportation to adult day separately.

Attendance documentation. The licensing rules require a daily attendance record by name, without times. DAS-funded programs must record when each participant started and left each day, and drivers record arrival and departure for center transport. We did not find a Medicaid rule on attendance records or electronic tracking for adult day, so ask DCH what it expects on claims.

Can a private-pay adult day center operate in Georgia without Medicaid?

Yes, a center can be fully private pay, but it still needs a DCH license if it serves three or more aging adults for pay. The licensing rules apply the same way whoever pays. A business without a license may not present itself as an adult day center.

What an unlicensed program can do. A program that takes no payment, or serves only one or two paying participants, falls outside the license requirement. So do day habilitation programs serving only people with developmental disabilities and qualifying respite programs (111-8-1-.03).

Protections for private-pay participants. Every participant gets a written agreement listing fees and extra charges, a refund policy, 30 days' notice of fee changes, a complaint process and a list of rights, including the right to complain to HFRD. We did not find a rule that bars centers from treating people differently by how they pay.

Other funding.

• Division of Aging Services. DAS funds adult day services through 12 Area Agencies on Aging using Older Americans Act money, state general revenue and pooled funds. Providers set their unit costs with the DAS Uniform Cost Methodology. The DAS manual also suggests its standards for fee-for-service programs (DAS Manual 5300, Section 302). Your local Area Agency on Aging can tell you what is available in your region.
• Veterans. The U.S. Department of Veterans Affairs offers Adult Day Health Care to enrolled veterans who meet clinical criteria, through VA medical centers, State Veterans Homes or community organizations. A copay may apply. We did not find Georgia-specific VA contracts.

The market. DCH does not publish a separate count of licensed adult day centers. Its Personal Care Home Program reports 2,910 facilities across personal care homes, assisted living, community living arrangements and adult day centers combined. HFRD (404-657-5700) or the state's GaMap2Care facility search may be able to give a current adult day count. We did not find an active Georgia adult day association.

What is changing next for adult day in Georgia?

As of our last check on October 21, 2026, we did not find an announced change to Georgia's adult day licensing rules or a confirmed change to Medicaid adult day payment. One date to watch is November 8, 2027, when the Elderly and Disabled Waiver's current federal approval ends, so a renewal is due by then. Two earlier announcements are still unresolved.

• Elderly and Disabled Waiver renewal, due by November 8, 2027. The current approval of the waiver that pays for adult day health (CCSP and SOURCE) expires on that date (CMS waiver record). A renewal can change services, rates or provider rules, so watch for a DCH public notice.
• Personnel rule amended, July 29, 2026 (in effect). DCH amended Rule 111-8-1-.14, which covers personnel, background checks and employee health screening (Georgia rules). The Board approved it May 14, 2026, after which it was filed July 9 and took effect July 29, 2026.
• Proposed adult day health rate increase (not confirmed). In a public notice, DCH proposed new Elderly and Disabled Waiver adult day health rates from its 2023 rate study, pending Board and CMS approval. The proposal would raise Level 1 from $36.89 to $50.14 for a half day and from $61.49 to $82.49 for a full day, Level 2 from $46.13 to $66.22 for a half day and from $76.86 to $108.23 for a full day, and therapies from $48.81 to $105.98 per visit. The proposed start date has passed, and we could not confirm whether these rates were adopted. Ask DCH which rates apply now.
• PACE expansion (not confirmed). DCH ran a procurement in 2025 to add PACE (Program of All-Inclusive Care for the Elderly) service areas. The DCH PACE page shows no award or start dates, and we could not confirm which PACE organizations operate in Georgia now.

Georgia adult day sources

• Ga. Comp. R. & Regs. Chapter 111-8-1: Rules and Regulations for Adult Day Centers
• Georgia Rules and Regulations: Department of Community Health rule filings (Chapter 111)
• DCH Healthcare Facility Regulation: Personal Care Homes (includes adult day centers)
• DCH HFRD: Licensure Forms and Applications
• DCH: Schedule of Licensure Activity Fees
• DHS Division of Aging Services: Manual 5300, Section 302 Adult Day Care / Day Health Services
• CMS: Georgia waiver fact sheets (Elderly and Disabled Waiver, ICWP)
• CMS: Georgia Elderly and Disabled Waiver record
• DCH: Revised Elderly and Disabled Waiver rate increase notice
• DCH: Elderly and Disabled Waiver Program amendment public notice

Related reading

• The Compliance Curve: Why Adult Day Services Should Learn from Home Care Before They Have To
• How to Differentiate Your Adult Day Care Center: A Guide for Operators
• Effective Transportation Tracking for Elder Day Centers
• Podcast: How Adult Day Services Let You Serve 50 Clients with Just 8 Staff
• Adult day services in every state (map)
• Adult Day Care Services and Reference Guide

Other states that license or certify every adult day center

California, Delaware, Florida, Hawaii, Iowa, Kansas, Maine, Missouri, Montana, Nebraska, Nevada, New Mexico, North Carolina, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Wyoming. See every state on the adult day services map.

Page history

• October 21, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for adult day centers, covering attendance, care plans, transportation and billing. If you would like to talk about running your center, contact Ankota or read more about Ankota's adult day care software.