Adult Day Care Illinois

All states: adult day services map

Illinois adult day services at a glance

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

How is adult day care regulated in Illinois?

Illinois has one adult day model, called Adult Day Service (ADS). We did not find a state license for adult day centers. Instead, the Illinois Department on Aging (IDoA) certifies and contracts with centers that serve participants in its Community Care Program and other Medicaid waivers, and its rules are the main standard for how those centers operate.

Illinois does not separate adult day care from adult day health care. Adult Day Service combines social activities with health-related services such as health monitoring, intermittent nursing and help with medications (89 Ill. Adm. Code 240.230). The Department of Human Services uses the name Adult Day Care in some of its programs, but the provider standards are the same.

The rules come from several agencies, all tied to public funding:

• Medicaid and the Community Care Program (IDoA). The Community Care Program rules, 89 Ill. Adm. Code 240, Subpart O, set the provider standards for staffing, space, services and records. IDoA runs the Persons Who Are Elderly waiver for the state Medicaid agency, the Department of Healthcare and Family Services (HFS).
• Home Services Program (DHS Division of Rehabilitation Services). Adult day providers serving the Persons with Disabilities, Brain Injury and HIV/AIDS waivers must meet all of the IDoA rules plus some added requirements in 89 Ill. Adm. Code 686.100.
• Developmental disabilities waiver (DHS Division of Developmental Disabilities). Adult day providers in the Adults with Developmental Disabilities waiver must hold an IDoA adult day contract and follow the same staffing ratios and qualifications.
• Other funding. Area Agencies on Aging may fund adult day with federal Older Americans Act money. We did not find separate adult day standards for that funding.

Where the layers overlap, the IDoA rules are the stricter layer on the staffing ratio, nurse time and yearly training hours. The DHS Home Services Program adds a full-time program director and an Affirmative Action Plan on top of them. IDoA notes that some centers focus on people with Alzheimer's disease and related disorders, but we did not find a separate dementia license or certification.

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

We did not find a state license for adult day centers in Illinois. To serve Community Care Program or other Medicaid waiver participants, a center must be certified by the Department on Aging, sign a provider agreement and enroll in Medicaid. Certification lasts up to three years, and a new provider may start with provisional certification.

How certification works. Any willing and qualified agency may apply through IDoA's open certification process (89 Ill. Adm. Code 240.1600):

• Submit the required documentation. If IDoA asks for more information, you have 30 days to respond, and the request closes after 60 days.
• Pass an on-site review. Adult day applicants need one unless IDoA did a performance review in the prior 12 months.
• Have your management staff, at least the Program Administrator, complete IDoA adult day management training before the contract is awarded (240.1550).
• Enroll in Medicaid through the HFS IMPACT system. You cannot become an active Community Care Program provider until IDoA notifies HFS (IDoA Provider Procurement).

What applicants must show. Under 240.1505, an adult day applicant needs two years of direct social services programming experience, disclosure of any past sanctions, written policies, insurance, audited financial statements or a bank-approved business plan, assets to cover 90 days of operating expenses (no more than 30 days of it from a line of credit), and at least five independent references. Provisional certification may be granted for up to two years.

Building and safety codes. Certified centers must meet the Illinois Plumbing Code, Accessibility Code, State Fire Marshal rules, the NFPA 101 Life Safety Code (2018 edition, chapters 16 and 17), the Food Service Sanitation Code, the ADA, and local building, fire, health and safety codes, with required inspections documented. The site must also meet federal home and community-based settings rules, so a site inside an inpatient facility, on or next to a public institution, or one that isolates participants is not presumed to qualify.

Fees. We did not find a certification or application fee in the rules. Ask IDoA.

Certificate of need. We did not find a certificate of need requirement or a moratorium on new adult day centers.

More than one site. A satellite site needs a written request for IDoA authorization, a proposal, notice of the start date and an on-site review (240.1565). The rule does not say whether each site holds its own certification.

Buying a center. Provider agreements cannot be assigned. A merger, consolidation or asset sale must be reported to IDoA immediately, and failing to report it means termination. The new owner must be certified and sign a new agreement (240.1607). Changes in agency or contact information must be reported within seven days.

Renewal and reviews. Certification lasts no more than three years, provider agreements generally run three years, and providers are recertified at least every three years. The DHS Division of Rehabilitation Services also reviews Home Services Program adult day providers at enrollment, every two years and at IMPACT revalidation.

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

Certified Illinois centers must have at least 2 staff on site whenever any participant attends, with more staff as attendance grows, ending at about 1 staff per 7 participants. A nurse must be on duty at least half of each day, and the program director full time. No separate ratio is set for participants with dementia.

The ratio. Under 89 Ill. Adm. Code 240.1555, the minimum number of full-time or full-time equivalent staff on site while participants are present is:

• 2 staff for 1 to 12 participants
• 3 staff for 13 to 20
• 4 staff for 21 to 28
• 5 staff for 29 to 35
• 6 staff for 36 to 45
• 1 more staff member for each additional 7 participants

By layer:

• IDoA (Community Care Program and Medicaid): the tiers above.
• DHS Developmental Disabilities waiver: the same ratios and qualifications.
• DHS Home Services Program: providers must meet the IDoA rules, so the same tiers apply.
• Older Americans Act funding: we did not find a staffing standard.

Who counts toward the ratio. Qualified staff, trained volunteers and substitutes can count, but only if they spend at least half their time in on-site direct service or supervision, are actively involved with participants and are immediately available in the activity area (except at drop-off and pick-up). Staff must be assigned only to the adult day program.

Key staff. Under 240.1560:

• The Program Coordinator/Director (or a qualified substitute) must be on duty full time when participants attend.
• The Program Nurse, an RN or an LPN supervised by an RN who meets with the LPN at least monthly, must be on duty at least half of a full-time work period each day participants attend. A nurse who also serves as administrator or director must work full time.
• At least one nutrition staff person must meet the Food Service Sanitation Code, and a licensed nutrition consultant or dietitian, paid or in-kind, must approve menus. A social service worker is optional.

The DHS Home Services Program also requires a full-time program director, the equivalent of a full-time program coordinator/director, a nurse on duty at least part of every standard business day, and nutrition staff. The IDoA nurse rule (half of each day) is the stricter one.

Qualifications. The Program Administrator and the Program Coordinator/Director need a bachelor's degree in a health or human services field or RN licensure (the administrator may instead be a licensed Health Services Administrator). Two years of supervisory experience serving older adults can replace each year of education, up to four years. Program assistants need a high school diploma or GED, or two years of documented experience with older adults.

Training. New employees complete at least 26 hours of pre-service training in their first week, including 2 hours on dementia. CNAs, nurses, degree holders and staff with equivalent recent training may be exempt, but the dementia hours cannot be waived. All employees complete at least 14 hours of in-service training a year, including 2 hours on dementia (DHS sets 12 hours per fiscal year for its providers, so the IDoA 14 hours is stricter). At least two staff must hold CPR and first aid training, and one of them must be on site whenever participants are present.

Background checks. Staff and regularly scheduled volunteers with participant contact need a criminal background check under the Health Care Worker Background Check Act, an Adult Protective Services Registry check, and checks of the federal HHS and state HFS Inspector General exclusion lists (240.1520).

Health screening. Employees with direct contact get influenza education every year, and vaccination records are due each January 31. We did not find a staff TB test or physical exam requirement. Ask IDoA whether one applies.

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

A certified Illinois center must provide an assessment and care plan, activities, help with daily living, health-related services, a midday meal, transportation and emergency care. It needs at least 40 square feet of activity space per participant. Therapies, skilled nursing, shopping and escort services are optional and are not paid in the IDoA rate.

Required services. Under 240.230, every center provides:

• An assessment and person-centered plan of care.
• Activities whenever the center is open, with a monthly activity calendar posted.
• Help with activities of daily living.
• Health-related services: health monitoring, intermittent nursing, and medication administration or supervision.
• A midday meal.
• Transportation, with at least one accessible vehicle.
• Emergency care and critical event reporting.

Hours. The Persons Who Are Elderly waiver describes the service as 4 or more hours a day, though fewer hours are allowed, on a regular schedule of one or more days a week. We did not find minimum opening days or hours for the center itself in the rules. Providers must hold monthly Advisory Council meetings with participants to plan activities.

Meals. The midday meal must provide at least one-third of the Dietary Reference Intakes, plus snacks and any special diet a physician orders. A registered dietitian approves menus, which are planned at least four weeks ahead and posted in advance (240.1550).

Transportation. Vehicles carrying participants need a working two-way communication device and written emergency procedures. Drivers need CPR and first aid training and the right driver's license.

Space and building. Under 240.1550:

• At least 40 square feet of activity area per participant. Multi-use space is pro-rated, and exits, offices, storage, bathrooms, meal preparation kitchens, equipment space and gyms used only for active sports do not count.
• At least one accessible bathroom for up to 12 participants, and at least two (one accessible) for 13 or more.
• At least one quiet rest area with a recliner, cot or bed, and a dining area big enough for the daily census.
• Room temperatures of 70 to 85 degrees, hot water of 100 to 119 degrees checked weekly, exit alert devices, and a landline that can call 911.

We did not find a capacity formula beyond the 40 square foot rule, or separate space rules for dementia care.

Written policies. Providers must set and follow written policies in 23 areas listed in 240.1510, including confidentiality, delivering services under the plan of care, staff development and personnel, keeping records that support billed units, quality improvement (reviewed at least once a year), infection control, complaints, an all-hazards disaster plan, supervision of staff and volunteers, mandated reporting, a ban on seclusion and restraint unless it is in the plan of care with trained staff, marketing standards, and influenza education. Adult day centers also need written procedures for medication storage and administration, food receiving and storage, and safe transportation. DHS Home Services Program providers also need an Affirmative Action Plan approved by their governing body.

Safety. Centers post an emergency evacuation plan and route diagrams in corridors and common areas and hold fire drills every quarter, with the dates on file.

What rules protect participants in Illinois adult day centers?

In the Community Care Program, a participant is referred by a local Care Coordination Unit after a needs assessment. The center's team writes an adult day plan by the fourth week of service and reviews it at least once a year. Critical events must be reported to IDoA within seven days, and records supporting billing are kept at least six years.

Who can enroll. Community Care Program participants must be 60 or older, show a risk of nursing facility placement on the Determination of Need assessment, have non-exempt assets of $17,500 or less, and apply for Medicaid if eligible (IDoA Community Care Program). Providers must serve every participant the Care Coordination Unit refers unless the person does not meet the center's admission criteria or the person's condition calls for discharge under the center's own discharge criteria. A center that cannot take all referrals may ask for a written service cap. Younger adults with disabilities can be served through the DHS waivers.

Care plan. An adult day team, made up of the participant or representative, the Program Coordinator/Director and the Program Nurse, writes an ADS Addendum to the person-centered plan no later than the fourth week of service. It is reassessed as needed and at least once a year (240.230).

Medications. For participants who cannot take their own medications, administration must be backed by a physician order or the plan of care, given by appropriately licensed staff and recorded in the case record.

Communication. Providers must respond to participant requests within 15 calendar days and tell the Care Coordination Unit and caregivers about changes in a participant's health or functioning.

Records. Each participant record includes an emergency contact and a recent photograph. Records that support billed units must be kept at least six years after the year they were created or last took effect, and provider records at least six years after the provider agreement ends (240.1520). DHS Home Services Program providers keep records at least 5 years or until state and federal audits are complete, so the IDoA six years is the stricter rule.

Attendance. Participants or their representatives sign Hours of Service Calendars, on paper or electronically, to acknowledge the hours they received. IDoA compares those calendars to billed hours for a sample of participants during its quality reviews.

Incidents. Critical incidents, complaints and status change requests are entered in IDoA's automated system, with an initial report due within seven days of the event or of learning about it. Abuse, neglect and exploitation fall under mandated reporting to Adult Protective Services.

What we did not find. We did not find a required physical exam or TB screening at enrollment, required contents for an enrollment agreement, or set discharge reasons and notice periods for adult day. Each center sets its own discharge criteria. Families should ask the center for its written admission, discharge and fee policies.

How does Medicaid pay for adult day in Illinois?

Illinois Medicaid pays for adult day by the hour. In the Community Care Program the rate is $16.84 per hour (S5100) plus $12.44 per one-way ride (T2003), effective January 1, 2026. The Adults with Developmental Disabilities waiver pays $21.82 an hour with transportation included.

Persons Who Are Elderly waiver (Community Care Program). IDoA runs this waiver for HFS, and the same services are offered with state-only funds to people who are not Medicaid eligible. Billing works like this (IDoA current rates, 240.230):

• Unit: one hour, meaning 60 consecutive minutes of active programming, not counting transportation time. Hours are billed in quarter-unit increments.
• Rates: $16.84 per hour (S5100) and $12.44 per documented one-way trip (T2003), at most two trips a day, effective January 1, 2026.
• Claims: providers submit an electronic Vendor Request for Payment listing units per participant by the 15th of the following month. The billing system rejects units beyond the participant's authorization and duplicate billing.

Home Services Program waivers (DHS Division of Rehabilitation Services). The Persons with Disabilities waiver, for people under 60 when they apply, pays $16.84 an hour with transportation billed separately at $12.44. Adult Day Care is also a listed service in the Brain Injury and HIV/AIDS waivers, and DHS caps its adult day payment at the IDoA-approved rate (686.140). Home Services Program providers bill monthly and include a progress report for each customer. We did not confirm the billing codes for these waivers, so ask DHS.

Adults with Developmental Disabilities waiver (DHS Division of Developmental Disabilities). Providers must hold an IDoA adult day contract. The rate is $21.82 an hour, and transportation is included rather than billed separately. DHS describes the service as for people 60 and older, generally at least four hours a day; younger adults may qualify if their planning team finds day habilitation or employment inappropriate because they are medically fragile.

HealthChoice Illinois (managed care). For members of a HealthChoice Illinois health plan, the plan's care coordinator coordinates waiver services, including adult day. We did not find published billing terms for adult day under these plans, so ask each plan you work with.

PACE. HFS offers PACE in five regions: West Chicago, South Chicago, Southern Cook County, Peoria and East St. Louis. PACE centers include day health functions, and PACE is paid a set amount per enrollee, so adult day is not billed by the unit (HFS PACE).

Attendance documentation. To support each claim, participants or representatives sign Hours of Service Calendars, and IDoA compares calendar hours to billed hours for a sample of participants at least once in each three-year contract cycle. The waiver applies electronic visit verification to in-home personal care, not to adult day, and we did not find a requirement for electronic sign-in and sign-out at adult day centers.

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

We did not find an Illinois license or rule that covers a center serving only private-pay participants. The IDoA adult day standards apply to centers certified for the Community Care Program and Medicaid waivers. Because we could not search Illinois statutes directly, confirm with the Department on Aging before you open a private-pay-only center.

What we did not find. We did not find state limits on what an uncertified center may do (such as personal care, nursing or medication help), or state consumer protections for private-pay participants such as contract or fee disclosure rules. Your city or county may still have building, fire, health and zoning requirements, so check with them before you sign a lease.

Other funding.

• State Community Care Program funds. IDoA serves people who are not Medicaid eligible with state-only funds, under the same Community Care Program services, including adult day. A center needs IDoA certification to take these participants.
• Older Americans Act. Title III Part B grants to Illinois's 13 Area Agencies on Aging list adult day care among the services they may fund (CSFA 402-03-0027). Your local Area Agency on Aging can tell you what it funds in your region.
• Veterans. The U.S. Department of Veterans Affairs offers Adult Day Health Care to enrolled veterans who meet clinical criteria, at VA medical centers, State Veterans Homes or community organizations.
• Food program. Centers may take part in the federal Child and Adult Care Food Program and must reapply every year.

The market. We did not find a published, dated count of certified adult day centers in Illinois. IDoA has a provider search tool on its website. We also did not find a website for a state adult day association.

What is changing next for adult day in Illinois?

The waiver adult day rate is proposed to rise from $16.84 to $17.84 an hour, and transportation from $12.44 to $13.44 a trip. The proposed waiver amendments set the change for January 1, 2027, or whenever the federal Centers for Medicare and Medicaid Services (CMS) approves them, so the timing is not final.

• Elderly and Persons with Disabilities waivers. HFS has posted proposed amendments to both waivers that would raise the adult day rate to $17.84 an hour and the transportation rate to $13.44 per one-way trip, tied to Public Act 104-0470 (Persons Who Are Elderly waiver amendment). Until CMS approves them, the current rates apply.
• Adults with Developmental Disabilities waiver. A proposed amendment would raise the adult day rate from $21.82 to $23.22 an hour, also on January 1, 2027 or upon CMS approval (DD waiver amendment).
• Community Care Program rate study. On October 7, 2025, IDoA contracted for a calendar year 2026 rate study of all Community Care Program services, including adult day and adult day transportation. No result or effect on rates has been published.

Illinois adult day sources

• Illinois Department on Aging: Adult Day Service
• Illinois Department on Aging: Community Care Program current rates
• 89 Ill. Adm. Code 240.230: Adult Day Service definition and units
• 89 Ill. Adm. Code 240.1505: provider certification requirements
• 89 Ill. Adm. Code 240.1550: adult day building, meal and service standards
• 89 Ill. Adm. Code 240.1555: adult day staffing and training
• 89 Ill. Adm. Code 240.1560: adult day staff positions and qualifications
• 89 Ill. Adm. Code 686.100: Home Services Program adult day care providers
• HFS: Persons Who Are Elderly waiver, proposed amendment effective January 1, 2027
• HFS: Adults with Developmental Disabilities waiver, proposed amendment effective January 1, 2027

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: 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 with no state adult day license

Alabama, Alaska, Colorado, Connecticut, District of Columbia, Idaho, 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.