Adult Day Care Maine

All states: adult day services map

Maine adult day services at a glance

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

How is adult day care regulated in Maine?

Maine licenses all adult day programs through the Department of Health and Human Services (DHHS), Division of Licensing and Certification (DLC). A program is licensed as a Social Adult Day Services Program, an Adult Day Health Services Program, or both. MaineCare, the state Medicaid program, pays only for day health services at a licensed site, and a separate state funded program helps some people who do not qualify for MaineCare.

Four sets of rules can apply to a Maine program, and each comes from a different source:

• Licensing (DHHS DLC). The Regulations Governing the Licensing and Functioning of Adult Day Services Programs, 10-144 CMR Chapter 117, adopted under the Adult Day Care Program law, 22 M.R.S. sections 8601 to 8606. Chapter 117 was last amended January 4, 2006, and DLC still links it as the current rule. It covers the license, staffing, space, services, records and participant rights for every program, whatever the payer.
• Medicaid (DHHS Office of MaineCare Services). MaineCare Benefits Manual Chapter II, Section 26, Day Health Services, with rates in Chapter III, Section 26. It sets who qualifies, how many hours a week, the plan of care and the records needed to bill.
• State funding (DHHS Office of Aging and Disability Services, OADS). OADS Policy Manual Section 61 (10-149 CMR Chapter 5) pays licensed providers for adults who are not eligible for MaineCare long term care and cannot afford to pay.
• Veterans' programs (state law). Since October 1, 2011, 22 M.R.S. sections 9001 to 9004 require a separate DHHS license for veterans' adult day health care programs. We did not find a DLC rule that carries out this law.

Social vs health programs. The two license types differ by how much care they give (Chapter 117, Section 9). A social program provides supervision, activities, help with activities of daily living (ADLs, such as eating, bathing and toileting) and morning and afternoon refreshments. A health program adds health monitoring, nursing by an RN or LPN, at least one meal and medication administration, based on each person's needs. A provider can hold both licenses at one site if it keeps separate records for each.

Night Program. Either type of program may add a separately approved Night Program, with awake staff between 5 PM and 7 AM, for people with dementia. No program may serve a person for 24 hours in a row.

Where the layers overlap, the licensing rules are the stricter layer for how a program operates. MaineCare adds its own medical eligibility, plan of care, weekly hour limits and billing records for the members it pays for.

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

Yes. Maine law says no one may run an adult day care program for 3 or more unrelated adults age 19 or older without a DHHS license, and the rule requires the license before the program opens. This applies to social and health programs alike, whether participants pay privately or through MaineCare. A new program starts with a provisional license and must pass a State Fire Marshal inspection first.

Who is covered. State law defines an adult day care program as care, activities and protection for any part of a day for 3 or more unrelated adults age 19 or older (22 M.R.S. sections 8601 and 8603). Chapter 117 requires a license for a program of more than two consumers and defines a program as running at least two hours a day. Programs run by licensed residential facilities and licensed day activity programs fall outside the law's definition.

How to apply. DLC's Assisted Housing Program licenses adult day programs along with assisted living and residential care. New, renewal and change applications are filed through its online application. Under Chapter 117, Sections 1 and 2, the application includes:

• Refund, complaint resolution, medication administration, confidentiality and admissions policies.
• Proof of liability and property insurance, plus vehicle insurance if you will transport participants.
• Scaled floor plans showing at least 50 square feet of activity space per participant.
• A letter showing the site meets local codes, and a posted emergency plan.
• A Basic Safety Test of the well water with each application, if the site uses a private well.

Fire safety. No license may be issued or reissued until the site passes a State Fire Marshal inspection (22 M.R.S. section 8605). The Life Safety Code standard depends on how many people attend a session: family day care rules up to 6 adults, group day care rules for 7 to 12, and child day care rules above that.

Fees. Chapter 117 sets a non-refundable application fee by licensed capacity: $10 for up to 10 participants, $20 for 11 to 20, $30 for 21 to 30, $40 for 31 to 40 and $50 for 41 or more, with a like fee at each annual renewal. DLC says the current fees are shown on its online application form. We did not confirm that those match the 2006 rule amounts, so check the form.

Certificate of need. We did not find a certificate of need, moratorium or cap on new adult day programs in Chapter 117 or the adult day law.

One license per site. The license names the program, administrator, program type, maximum capacity, owner and address. It cannot be transferred to another location or another person.

Buying a center. A new owner must apply for and receive its own license, and pay the fee, before running the program. The rule sets no advance notice period for a change of ownership, so contact DLC early in any purchase.

Changes after licensing. Raising capacity, changing the program or adding a Night Program needs prior written approval. A change of administrator must be reported within 72 hours, with a new application within 60 days. A program that plans to close must notify DLC within 30 days of the projected closing date.

Renewal and inspections. A new program gets a provisional license of 3 to 12 months (never more than 24 months in a row). A full license runs one year, and the renewal application is due at least 30 days before it expires. DLC may visit without notice, but the rule sets no fixed inspection schedule.

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

Maine licensing rules require at least 1 staff member for every 6 participants whenever participants are present, in both social and health programs. Programs with 3 to 6 participants also need a second person on call for emergencies. MaineCare sets no ratio of its own, so the 1:6 licensing ratio is the one to staff to. We did not find a separate ratio for participants with dementia.

The ratio is in 10-144 CMR Chapter 117, Section 5.

• Licensing (DHHS DLC): 1:6 at all times, plus 1 more staff person for each 6 participants above 60. DLC may require more staff based on participants' needs.
• Medicaid (MaineCare Section 26): no ratio specified. Section 26 lists who may deliver day health services (see below).
• State funding (OADS Section 61): no ratio specified. Section 61 will not pay for services by a personal care assistant with certain criminal convictions or registry findings.

Who counts toward the ratio. Volunteers count only when they meet the same standards and job qualifications as paid staff and have set duties. No one under 18 counts, except someone 16 or older who is enrolled in a health related course of study. A program located inside a nursing facility or assisted living must schedule separate adult day staff hours.

Administrator. The administrator must be at least 21 and have management and supervisory experience in a social or health service setting. An administrator who is on site less than half of operating hours must name someone to be responsible for the site. The rule says other staff should preferably have at least one year of training or experience in social or health care services.

Nurses and professionals. Adult Day Health Services Programs must provide nursing by an RN or LPN as participants need it, but the licensing rule sets no nurse hours. For MaineCare, Section 26.07-1 says day health services are delivered by qualified professionals (RN, LPN, social worker, occupational therapist, physical therapist or speech language pathologist), who may be employees or consultants, and by CNAs and aides supervised by one of those professionals. This is a list of who may provide the service, not a required staff roster.

Training. All new staff and volunteers need an orientation. Each year, full time staff and qualified volunteers working 21 or more hours a week need at least 12 hours of training, and part time staff and volunteers working 20 hours or less need 6 hours. Topics include participant rights, emergencies, choking, nutrition, first aid and cognitive impairment.

Medications. Unlicensed staff who give medications must complete Department-approved training and an 8 hour refresher every two years (Chapter 117, Section 5.12). The only injections unlicensed staff may give are bee sting kits and insulin, after RN training. Someone qualified to give medications must be on site whenever a participant has an as-needed (PRN) medication they cannot take on their own.

Background checks. Programs must run a comprehensive background check on staff with direct access to participants and follow the state's employment limits for disqualifying offenses (22 M.R.S. section 8606). The licensing rule also bars hiring anyone convicted of abuse, neglect, exploitation or misappropriation in a health care setting.

Health screening. We did not find a staff TB test or vaccination requirement. The rule only bars staff who have a dangerous communicable disease. Ask DLC whether it expects more.

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

Every licensed Maine program provides supervision, varied activities and help with daily living, and social programs must serve a morning and afternoon refreshment. Adult day health programs also provide health monitoring, RN or LPN nursing, at least one meal and medication administration. Programs need at least 50 square feet of activity space per participant. Transportation is optional.

Social programs. Under Chapter 117, Section 9.3, a Social Adult Day Services Program provides supervision; social, leisure, physical, therapeutic or educational activities; help with ADLs; and a morning and afternoon refreshment. Meals and medication administration are optional.

Health programs. Under Section 9.4, an Adult Day Health Services Program adds, based on each person's needs, health monitoring, nursing services by an RN or LPN, at least one meal meeting one third of the daily dietary allowance, and medication administration. MaineCare day health services may also include rehabilitation, health promotion, exercise groups and counseling, with noon meals and snacks included in the service.

Activities. Therapeutic activity is the focus of every program. Activities must be varied, voluntary and suited to adults, and include quiet and stimulating activities, fitness, creative expression, memory stimulation and community outings.

Meals. Food served must meet one third of daily nutritional needs, with menus planned a week ahead and posted.

Transportation. The licensing rules do not require programs to provide transportation, but a program that does must carry vehicle insurance.

Space and capacity. Under Chapter 117, Sections 2 and 6:

• At least 50 square feet of total program activity space per participant, shown on scaled floor plans. Programs inside a licensed nursing facility or assisted living need their own separate space that meets this standard.
• The license states the maximum number of participants, which may not be exceeded.
• Two exits remote from each other, heat to at least 70 degrees, adequate light and ventilation, comfortable nonfolding chairs, tables and recliners, a telephone participants can use without paying, and access for people with disabilities.

We did not find a rule on the number of restrooms per participant or a required separate rest area or dementia space.

Hours. A program must run at least two hours a day to meet the rule's definition, and a Night Program runs between 5 PM and 7 AM. We did not find any other minimum hours in the licensing rule. Providers paid through the state funded OADS Section 61 program must be open at least two days a week.

Written policies. Chapter 117 requires written policies on refunds, complaint resolution, medication administration, confidentiality and admissions (all filed with the application), plus a posted emergency plan, a fire safety plan approved by fire authorities, personnel policies (job descriptions, orientation, training and evaluation), steps to prevent further harm during abuse investigations, service plan development, and participant rights.

Safety and postings. Programs run fire drills at irregular times at least monthly and record evacuation times, and tell participants about emergency procedures at admission and at least twice a year. DLC and the Fire Marshal must be told right away after any unplanned evacuation. The license, the latest state survey results with the plan of correction, and information on advocacy and legal services must be posted where the public can see them.

What rules protect participants in Maine adult day centers?

Maine rules require a written assessment started by the first day of attendance and finished within 30 days, and a service plan within 7 days after that, reviewed at least every 6 months. A participant can be discharged only for safety or health risks, nonpayment or program closure, usually with at least two weeks' written notice. Records are kept at least 5 years after a participant leaves.

Assessment and service plan. Under Chapter 117, Section 8:

• A comprehensive written assessment is begun by the first day of attendance, completed within 30 days, reviewed at least every 6 months and fully redone every 12 months. A Department assessment done within 6 weeks before admission may be used.
• A service plan is developed with the participant within 7 days of completing the assessment and reviewed at least every 6 months, with monthly progress notes.
• Medications, diets and treatments given at the program need signed orders from a practitioner.

MaineCare members. MaineCare adds its own steps (Section 26). The Department or its assessing agent must assess the member on the Medical Eligibility Determination (MED) form, for a classification period of up to 12 months. A written plan of care, developed with an RN (or an LPN supervised by an RN), is needed before services start and is reviewed at least every 6 months.

Contracts and fees. When there is a contract, the participant gets a signed original. It must list the services included and may not hold anyone but the participant responsible for charges. Programs must make rates available on request, explain what the rate covers and any other charges, give 30 days' written notice of rate or service changes, and refund overpayments within 30 days.

Discharge. A participant may be discharged only if the safety or health of participants is endangered, for nonpayment after reasonable notice, or if the program closes. At least two weeks' written notice is required unless others' safety is at risk (Chapter 117, Sections 7.2.12 and 7.2.13).

Complaints. Programs must review complaints within 48 hours and give the person who complained written findings within 10 days.

Attendance and records. Each participant's file lists the dates and hours of attendance and includes incident or accident reports. Participant records are kept at least 5 years after the person leaves, even if the program closes. Personnel records and monthly staff schedules are kept at least 2 years.

Abuse reporting. Suspected abuse, neglect or exploitation of an incapacitated adult must be reported right away to DLC, the Office of Elder Services and Adult Protective Services, and the program must investigate internally when staff are involved (Chapter 117, Section 4).

What we did not find. We did not find a required physical exam or physician order to enroll (other than orders for medications, diets and treatments), TB screening of participants, or a deadline for reporting other incidents such as falls to DLC. Ask DLC what it expects.

How does Medicaid pay for adult day in Maine?

MaineCare pays for adult day health through MaineCare Benefits Manual Section 26, Day Health Services, a state plan benefit run by the DHHS Office of MaineCare Services. Programs bill code S5100 with modifier HC. The rate was set at $5.18 per unit on January 1, 2023 and has since been raised by cost of living adjustments. MaineCare does not pay for social adult day.

Who qualifies. Members must meet Section 26 medical eligibility, assessed by the Department or its agent on the MED form. Weekly limits depend on level of care (Sections 26.04 and 26.05):

• Level I: up to 16 hours a week.
• Level II: up to 24 hours a week.
• Level III (nursing facility level of care): up to 40 hours a week.

Billing code and rate.

• Code: S5100 HC.
• Rate history: The official Secretary of State copy of Chapter III, Section 26 still shows $3.45 per 15 minutes from July 1, 2019, which is out of date. DHHS raised the rate to $3.99 on July 1, 2022 and to $5.18 on January 1, 2023 after a rate study (MaineCare state plan).
• Later increases: a 1.95% cost of living adjustment on July 1, 2025 and a 1.0% adjustment on January 1, 2026.
• Therapy: individual physical, occupational and speech therapy may be billed separately under their own MaineCare sections.

Transportation. Section 26 does not address transportation, and we did not find whether MaineCare pays for trips to and from adult day separately. Ask the Office of MaineCare Services.

Waiver programs. The current Section 19 Elderly and Adults with Disabilities waiver rule and its federal fact sheet do not list adult day health as a waiver service, so Section 26 is the MaineCare route for adult day. We did not find a PACE program in Maine.

Attendance documentation. The licensing rules require programs to record the dates and hours each participant attends. For MaineCare, each member record must have a summary note for every date of service billed (the service, date, provider, signature and any unusual event) and monthly progress notes signed by the licensed professional overseeing the plan of care (Section 26.07-5). The plan of care may not exceed the weekly hours the Department authorized. Section 26 does not require an electronic sign-in or sign-out system.

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

Yes, a program can be fully private pay, but it still needs a DHHS license if it serves more than two unrelated adults. Maine law bars accepting payment for adult day services for more than two unrelated people without a license, whoever pays. Programs serving two or fewer unrelated adults fall outside licensing.

Protections for private-pay participants. Licensed programs must share rates on request, explain what the rate covers, give 30 days' written notice of rate or service changes, refund overpayments within 30 days and give participants a signed copy of any contract (Chapter 117, Section 4). We did not find a rule that bars treating people differently by how they pay, or any limits on what a program serving two or fewer adults may do.

State funded adult day (OADS Section 61). The Office of Aging and Disability Services pays licensed providers an hourly allowance for adults who are not eligible for MaineCare long term care (10-149 CMR Chapter 5, Section 61). This is the main public route for social adult day. Participants must:

• Be 18 or older and live in Maine.
• Have assets of no more than $50,000 (individual) or $75,000 (couple).
• Not be eligible for MaineCare long term care programs, and meet MED functional criteria.
• Pay 20% of the cost, unless that is waived for households at or below 200% of the federal poverty level with assets of $15,000 or less.

Section 61 covers help with ADLs, snacks and a meal, activities, and limited transportation (mileage over 10 miles one way for plan of care trips, and rides to and from the program only as a last resort). Providers bill OADS on an approved form, up to 30 hours a week per person, and must be open at least two days a week. We did not find the current hourly allowance, so ask OADS what it pays and whether funding is available.

Older Americans Act. Programs that use Older Americans Act Title III funds may not require a payment from participants but may ask for a donation.

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, and a copay may apply. Maine law also sets reimbursement for licensed veterans' adult day health care programs at 65% of the MaineCare nursing facility rate (22 M.R.S. section 9002).

The market. OADS says adult day services may be funded through MaineCare and other state and federal programs, and it publishes an adult day provider contact list. We did not find a published count of licensed programs; DLC (207-287-3707) can tell you. We did not find a Maine adult day services association.

What is changing next for adult day in Maine?

As of our last check on October 21, 2026, we did not find an upcoming change to Maine's adult day licensing rules or MaineCare Section 26. The recent changes are rate increases that are already in effect.

• 1.0% rate increase, January 1, 2026. MaineCare raised Section 26 Day Health rates by a 1.0% cost of living adjustment under P.L. 2025, chapter 388, Part GGG (MaineCare bulletin).
• 1.95% rate increase, July 1, 2025. MaineCare put in place a 1.95% cost of living adjustment for Section 26, first scheduled for January 1, 2025 (MaineCare bulletin).
• Proposed Section 19 waiver amendment. DHHS proposed changes to the Elderly and Adults with Disabilities waiver covering direct care worker training, service caps and grievances, with comments closed March 29, 2026. No effective date has been published, and the proposal does not mention adult day (DHHS notice).

The licensing rule, Chapter 117, has not been amended since January 4, 2006. If DLC proposes new rules, this page will be updated.

Maine adult day sources

• 10-144 CMR Chapter 117: Regulations Governing the Licensing and Functioning of Adult Day Services Programs
• 22 M.R.S. chapter 1679: Adult Day Care Programs
• Maine DHHS Division of Licensing and Certification: Assisted Housing (adult day programs)
• MaineCare Benefits Manual Chapter II, Section 26: Day Health Services
• MaineCare Benefits Manual Chapter III, Section 26: Day Health Services reimbursement
• MaineCare state plan
• MaineCare bulletin: cost of living adjustments effective January 1, 2026
• OADS Policy Manual Section 61: Adult Day Services (state funded)
• Maine DHHS Office of Aging and Disability Services: Adult Day Services
• 22 M.R.S. chapter 1689: Veterans' Adult Day Health Care Programs

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, Georgia, Hawaii, Iowa, Kansas, 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.