Adult Day Care in Idaho

All states: adult day services map

Idaho adult day services at a glance

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

How is adult day care regulated in Idaho?

Idaho does not have a state license for free-standing adult day centers. We did not find an adult day chapter among the Idaho Department of Health and Welfare (DHW) licensing rules. The main rules come from Idaho Medicaid, which calls the service adult day health and sets provider standards through enrollment, a provider agreement and required training. The Idaho Commission on Aging also pays for adult day care through contracts.

Three layers of rules can apply to an Idaho adult day program, and each comes from a different agency:

• Medicaid (DHW Division of Medicaid). IDAPA 16.03.26, Medicaid Plan Benefits, sets the rules for adult day health paid by the Aged and Disabled (A&D) waiver, run by the Bureau of Long Term Care, and the Adult Developmental Disabilities (DD) waiver, run by the Bureau of Developmental Disability Services. Providers also follow the Idaho Medicaid provider handbooks and sign a provider agreement with Adult Day Health Additional Terms.
• Licensing (DHW Division of Licensing and Certification). This layer applies only when day care is offered inside a certified family home (IDAPA 16.03.19.180) or a residential assisted living facility (IDAPA 16.03.22.156). Both rules call it hourly adult care. For the Adult DD waiver, facility-based adult day health must also meet the building and health rules for developmental disabilities agencies in IDAPA 16.03.21 (IDAPA 16.03.26.614.11).
• Other funding (Idaho Commission on Aging). Idaho Code 67-5006(5) defines adult day care, and IDAPA 15.01.01.013 lets the Commission contract for it under its program manual.

Adult day care vs adult day health. Idaho does not split these into separate license types. Medicaid uses only the term adult day health, which it defines as a supervised, structured service outside the participant's home, in a community setting, that includes health services, social services, recreation, supervision for safety and help with activities of daily living such as bathing, dressing and eating (IDAPA 16.03.26.542.01). The Adult DD waiver uses the same definition. The Commission on Aging uses the name adult day care, and its rule says adult day health versions add services such as rehabilitation and medication assistance. We did not find a separate dementia program model in any Idaho rule.

Who can provide adult day health. Under the A&D waiver, an adult day health agency, a certified family home, a developmental disabilities agency or a residential assisted living facility can provide it, as long as it has signed the Adult Day Health Additional Terms provider agreement (Idaho Medicaid HCBS and LTSS provider handbook).

Where the layers overlap, Medicaid is the only layer we found with provider standards for a free-standing program. Licensing rules add their own requirements only when the program runs inside a certified family home or an assisted living facility.

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

We did not find an Idaho license for a free-standing adult day center. To bill Medicaid, you enroll with Idaho Medicaid, sign the provider agreement with the Adult Day Health Additional Terms, and complete training with the Bureau of Long Term Care. If your program runs inside a certified family home or an assisted living facility, that home's certificate or facility's license rules apply as well.

Enrolling as a Medicaid provider. DHW explains the steps on its Long Term Care Provider Enrollment page:

• Enroll through idmedicaid.com before you bill.
• Sign the Idaho Medicaid provider agreement with the Adult Day Health Additional Terms.
• Be trained by a Bureau of Long Term Care Quality Assurance Specialist before your application is approved and before you provide any A&D waiver services.

We could not read the current Adult Day Health Additional Terms form, because the link to it on idmedicaid.com no longer works. It may contain staffing, safety or facility requirements, so ask the Bureau of Long Term Care for a copy before you plan your center.

Certified family homes. A certified family home that wants to provide adult day health must hold a Certified Family Home Certificate from Licensing and Certification and sign the Adult Day Care (Adult Day Health) Additional Terms form (Idaho Medicaid Certified Family Homes handbook). The provider must notify the Department when adult day health is provided in a certified family home other than the participant's own residence (IDAPA 16.03.26.544.10). Certified family homes are inspected the year after first certification and at least every 24 months after that, and a home renewing by desk review sends its documents at least 30 days before the certificate expires (IDAPA 16.03.19.111).

Assisted living facilities and DD agencies. A licensed residential assisted living facility may offer hourly adult care under IDAPA 16.03.22.156. Facility-based adult day health for the Adult DD waiver must meet the building and health rules for developmental disabilities agencies (IDAPA 16.03.21).

Quality reviews. DHW runs quality assurance reviews of A&D waiver providers. Providers must respond to review results within 45 days and carry out a quality improvement plan when problems are found (IDAPA 16.03.26.544.04). We did not find how often a free-standing adult day health agency is reviewed.

What we did not find. We did not find application fees, local permit, fire or occupancy steps, a certificate of need or moratorium, a per-site enrollment rule, or change of ownership rules for adult day health. If you are buying a center that bills Medicaid, ask the Bureau of Long Term Care how enrollment and the provider agreement move to a new owner.

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

We did not find a staff-to-participant ratio for adult day in any Idaho rule we read, at any layer. Idaho Medicaid instead requires direct care training through the Idaho Provider Training Matrix, criminal background checks, and staff who are free from communicable disease. We did not find a separate ratio for participants with dementia.

• Licensing (DHW Licensing and Certification): no ratio specified. An assisted living facility offering hourly adult care must staff for the whole facility, counting both hourly participants and residents (IDAPA 16.03.22.156.06).
• Medicaid, A&D waiver: no ratio specified. Providers must meet the Idaho Provider Training Matrix and the direct care staff standards in the CMS-approved A&D waiver, by formal training or demonstrated competency (IDAPA 16.03.26.544.03).
• Medicaid, Adult DD waiver: no ratio specified. Providers must give oversight and help at the level the participant's plan requires (IDAPA 16.03.26.614.11).
• Other funding (Commission on Aging): we could not read the program manual that sets standards for Commission-funded adult day care, so we did not find a ratio at this layer.

Training. The Provider Training Matrix covers general skills (communication, infection control, confidentiality, documentation and participant rights), personal and attendant care tasks, homemaker tasks, and participant-specific skills that an agency registered nurse verifies. Agencies that use the Department-approved online training modules keep the completion certificates instead of writing their own curriculum. We did not find a minimum number of training hours.

Background checks. Adult day health agencies are among the providers whose staff and contractors must clear the DHW criminal history and background check rules in IDAPA 16.05.06. Agencies must report later convictions, charges or protection investigations to the Department right away (IDAPA 16.03.26.003). Clearances, denials and results are kept for five years after employment ends (Idaho Medicaid General Information and Requirements for Providers).

Health screening. Both waivers require adult day health providers to be free from communicable disease. We did not find a TB test or vaccination requirement.

What we did not find. We did not find a minimum number of staff on site, rules on who counts toward staffing, qualifications for a director, nurse, activity or social services staff, or a CPR or first aid requirement. The CMS-approved A&D waiver and the Additional Terms form may set more detail, but we could not read either one. Ask the Bureau of Long Term Care what staffing it expects.

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

Medicaid-funded adult day health in Idaho must include health services, social services, recreation, supervision for safety and help with daily living activities. Transportation is not part of the service. We did not find space, restroom, meal or hours-of-operation standards for a free-standing center.

Required services. The Medicaid definition lists health services, social services, recreation, supervision for safety and help with activities of daily living needed for the person to function at their best. Room and board are not covered (IDAPA 16.03.26.542.01). Adult day health must also meet the federal home and community-based settings rules described in the Idaho Medicaid HCBS and LTSS provider handbook.

Transportation. Non-medical transportation is a separate A&D waiver service, and provider mileage to and from the service location is not paid (IDAPA 16.03.26.545.01).

Hours limits.

• Adult DD waiver: adult day health is limited to 30 hours a week. Adult day health and developmental therapy together may not go over 30 hours a week, and with supported employment added, the total may not go over 40 hours a week.
• Assisted living facilities: hourly adult care may not go over 14 hours in a row in any 24-hour period (IDAPA 16.03.22.156.04).

Certified family homes. A certified family home may not bill adult day health for its own residents who already receive paid adult residential care or residential habilitation.

Assisted living capacity. In an assisted living facility, a bed used overnight by a person in hourly adult care does not count as a licensed bed, and hourly care may grow only as far as it does not disrupt the facility's operations.

Written policies. The only required policy lists we found apply to programs inside other licensed settings:

• An assisted living facility offering hourly adult care needs written policies on the services offered, who may be accepted, cost, hours, medication assistance, staffing, accommodations and documentation (IDAPA 16.03.22.156).
• A certified family home offering hourly adult care must review its emergency preparedness plan with the person who signed the enrollment contract, give them a written copy, and hold emergency drills at least monthly (IDAPA 16.03.19.180.03).

What we did not find. For a free-standing adult day health agency, we did not find a capacity formula, square feet per participant, a restroom ratio, rest area rules, meal or nutrition rules, activity standards beyond the Medicaid definition, minimum days or hours of operation, or a list of required written policies.

What rules protect participants in Idaho adult day programs?

For Medicaid participants, DHW, not the center, does the assessment and writes and approves the service plan, and the plan is renewed every year. The provider checks eligibility and prior authorization on each date of service, records each service with time in and time out, has the participant sign the record, and keeps records for five years. We did not find discharge rules or required enrollment agreement contents.

Who can enroll. A&D waiver participants must meet nursing facility level of care. The waiver serves adults 65 and older and adults 18 to 64 with physical or other disabilities (CMS waiver fact sheet). Adult DD waiver participants must meet that waiver's eligibility rules.

Service plan. Under IDAPA 16.03.26.543.01, the Department assesses the participant, writes and approves the individual service plan, and authorizes each service by type, scope and amount. A new plan is required every year, and services can start no earlier than the date the participant signs the plan. Before each service, the provider checks the participant's eligibility and prior authorization for adult day health on that date and keeps proof of the check.

Changes in condition. Providers must record significant changes in a participant's condition and notify the Department, the medical provider, the case manager and the family (IDAPA 16.03.26.543.03). We did not find a deadline for that notice.

Attendance and records.

• Medicaid: each service record shows the date, the services provided, the participant's response including any change in condition, and the time in and time out. The participant signs it unless the Department finds they cannot (IDAPA 16.03.26.543.02.a).
• Medicaid: records of services billed are kept at least five years from the date of service.
• Certified family homes: daily records of each participant and resident served, with arrival and departure times, the staff who gave care with their arrival and departure times, and the hourly rate charged to private-pay participants (IDAPA 16.03.19.180.02).

What we did not find. We did not find a required physician order, physical exam or TB screening before enrollment, required contents for an enrollment agreement, discharge reasons or notice periods, or incident reporting deadlines specific to adult day health. Families should ask the program for its written admission, discharge and fee policies, and operators should ask the Bureau of Long Term Care what it expects.

How does Medicaid pay for adult day in Idaho?

Idaho Medicaid pays for adult day health through two waivers, the Aged and Disabled (A&D) waiver and the Adult Developmental Disabilities (DD) waiver. Providers bill code S5100 in 15-minute units, and every service must be prior authorized. We did not find a published S5100 rate, so ask Idaho Medicaid for the current fee schedule.

A&D waiver. This 1915(c) waiver (number 1076.R07.00, approved for April 1, 2023 to March 31, 2028) is run by the DHW Bureau of Long Term Care, which prior authorizes adult day health. It serves people who meet nursing facility level of care (CMS waiver listing).

Adult DD waiver. This 1915(c) waiver (number 0076.R07.00) is run by the DHW Bureau of Developmental Disability Services, which prior authorizes adult day health. Adult day health is capped at 30 hours a week, with combined caps alongside developmental therapy and supported employment, and it is not paid separately for participants in high or intense supported living (IDAPA 16.03.26.612).

• Billing code and unit: S5100, per 15 minutes, in both waivers (Certified Family Homes handbook).
• Place of service: adult day health may be billed only with place of service 12 (home) or 99 (other, community).
• Rate: not confirmed. We did not find the current S5100 rate in a published fee schedule.
• Authorization: services must be in the Department's approved plan and prior authorized before they are delivered.

Transportation. Under the A&D waiver, non-medical transportation is a separate service, and provider mileage to and from the service location is not paid. We did not find how transportation is handled for adult day under the Adult DD waiver.

Managed care for people with Medicare and Medicaid. Adults over 21 who have both Medicare and Medicaid may be in the Medicare Medicaid Coordinated Plan (MMCP), which is voluntary, or Idaho Medicaid Plus (IMPlus), which is required in 34 counties. Both are offered by Molina Healthcare of Idaho and UnitedHealthcare Community Plan of Idaho (DHW Medicare-Medicaid members page). We did not find a statement that these plans pay for adult day health directly, so ask each plan.

Attendance documentation. Billing rests on the signed service record described above: date, services, the participant's response, and time in and time out. Records that only list attendance checks, procedure codes and units of time are not enough. Idaho's electronic visit verification rule lists attendant care, homemaker and respite, not adult day health (IDAPA 16.03.26.545.02), and we did not find any electronic attendance system required for adult day health.

PACE. We did not find whether a PACE program (the Program of All-Inclusive Care for the Elderly) operates in Idaho. Ask Idaho Medicaid.

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

We did not find an Idaho rule that requires a private-pay adult day center to hold a state license, unless the program runs inside a certified family home or an assisted living facility. That reading rests on the absence of a licensing rule, so confirm it with DHW before you open. We also did not find any rule on what a program without a license may or may not do, such as personal care or help with medications.

Rules that apply whatever the payer. The certified family home and assisted living rules apply to every hourly adult care participant, not just Medicaid participants. A certified family home must record the hourly rate charged to each private-pay participant, and an assisted living facility offering hourly adult care must have a written cost policy (IDAPA 16.03.22.156). We did not find other consumer protections for private-pay adult day participants, such as required contract terms or fee disclosures.

Other funding.

• Idaho Commission on Aging. Adult day care is one of the home and community-based services the Commission may contract for, under state Senior Services Act and Older Americans Act programs and an approved program manual (IDAPA 15.01.01.013). The Commission works through Idaho's Area Agencies on Aging, so your local Area Agency on Aging can tell you what is offered in your region.
• Veterans. The U.S. Department of Veterans Affairs offers Adult Day Health Care to enrolled veterans who meet clinical and community care rules, at VA medical centers, State Veterans Homes or community organizations where it is offered. Copays may apply. We did not find an Idaho-specific VA adult day contract or site list.

The market. We did not find a state count of adult day centers, and we did not find an Idaho adult day services association.

What is changing next for adult day in Idaho?

Idaho plans to move Medicaid to comprehensive managed care, now targeted for January 1, 2030. Whether adult day health is part of the move has not been published. Two other changes are already in effect.

• Planned move to managed care (announced, not final). Under House Bill 345 (2025), DHW plans to move Medicaid from fee-for-service to comprehensive managed care with three managed care organizations. The current target is January 1, 2030, and that date could change. DHW says a procurement blackout begins December 1, 2026, with the request for proposals expected later in 2027. Whether long-term services and supports, including adult day health, will be included is still being decided (DHW managed care page).
• New Medicaid benefits rule, July 1, 2025. IDAPA 16.03.26, Medicaid Plan Benefits, replaced the former Basic and Enhanced Plan chapters (16.03.09 and 16.03.10), including the adult day health rules for both waivers. Older guides that cite 16.03.10 are out of date.
• Second dual-eligible plan, January 1, 2026. UnitedHealthcare Community Plan of Idaho began offering MMCP alongside Molina.

Idaho adult day sources

• Idaho DHW: Long Term Care Provider Enrollment and General Information
• IDAPA 16.03.26.542: A&D waiver adult day health definition
• IDAPA 16.03.26.543: A&D waiver service plans and records
• IDAPA 16.03.26.544: A&D waiver provider qualifications
• IDAPA 16.03.26.614: Adult DD waiver provider qualifications
• Idaho Medicaid Provider Handbook: HCBS and LTSS
• Idaho Medicaid Provider Handbook: Certified Family Homes
• IDAPA Title 16 (Department of Health and Welfare) chapter list
• IDAPA 15.01.01.013: Commission on Aging services, including adult day care
• Idaho DHW: Medicaid managed care

Related reading

• The Compliance Curve: Why Adult Day Services Should Learn from Home Care Before They Have To
• Simplifying Payments with Electronic Billing for Adult Day Care
• Effective Transportation Tracking for Elder Day Centers
• Podcast: Adding Adult Day Services to Home Care Brings Synergy and Margins
• Adult day services in every state (map)
• Adult Day Care Services and Reference Guide

Other states with no state adult day license

Alabama, Alaska, Colorado, Connecticut, District of Columbia, Illinois, Indiana, Kentucky, Maryland, Massachusetts, Michigan, Mississippi, New Jersey, New York, North Dakota, Ohio, Oregon, South Dakota, Vermont, Washington, West Virginia, Wisconsin. 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.