Adult Day Care in Michigan

All states: adult day services map

Michigan adult day services at a glance

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

How is adult day care regulated in Michigan?

Michigan does not license adult day programs. Instead, the rules a center must follow depend on who pays for its participants. Centers funded through an Area Agency on Aging follow the state's C-1 Adult Day Services standard, and centers serving MI Choice Medicaid participants follow the Adult Day Health standard in the Medicaid Provider Manual.

Four layers can matter to a Michigan center, each from a different source:

• Licensing (none). A Michigan Department of Education fact sheet states there are no state licensing requirements for Adult Day Services. 2024 Senate Bill 1026, which would have created a license, was referred to committee and never passed. Michigan's adult foster care law (MCL 400.703) does not mention adult day care or care for less than 24 hours.
• Aging network funding (MDHHS ACLS Bureau). The Michigan Department of Health and Human Services Bureau of Aging, Community Living, and Supports sets the C-1 Adult Day Services standard, approved September 20, 2024. Area Agencies on Aging apply it through their contracts with centers paid with Older Americans Act or state aging funds. C-1 defines Adult Day Services as daytime care, for any part of a day but less than 24 hours, for adults with functional or cognitive impairment, including dementia, in a group setting that also gives caregivers a break.
• Medicaid (MDHHS, MI Choice). The MI Choice Waiver pays for Adult Day Health under the MI Choice chapter of the Medicaid Provider Manual (Section 4.1.A, October 1, 2026 version). MI Choice Adult Day Health means four or more hours a day, on a regular schedule, combining health and social services. Regional waiver agencies contract with centers.
• Medicaid (PACE). MDHHS and the federal Centers for Medicare and Medicaid Services run PACE, whose organizations deliver care mainly in their own adult day health centers.

Where the layers differ, the C-1 aging standard is stricter on staffing (1 staff per 5 participants against 1 per 10). MI Choice is stricter on minimum daily hours (four or more) and on director qualifications.

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

No. Michigan has no state license for adult day services of any kind, social or health. To serve participants paid for by an Area Agency on Aging or MI Choice, you need a contract with that funder and must meet its standard, which includes fire, building and health code compliance.

What the contract layers require.

• Aging network (C-1). Each center must show compliance with fire safety standards and the Michigan Food Code (C-1 standard 18).
• MI Choice. Each waiver agency chooses its own providers and must judge a provider capable of the service. Adult Day Health centers must document compliance with Michigan and local barrier-free building codes, fire safety standards and public health codes, and must meet the federal Home and Community-Based Services Settings Rule. Waiver agencies must keep at least two providers for each service.
• Food program. To join the adult part of the federal Child and Adult Care Food Program, a center must meet the state aging adult day standards and hold an agreement with an Area Agency on Aging or a MI Choice waiver agency, according to the MDE fact sheet.

Certificate of need. We did not find a certificate of need requirement or a moratorium for adult day in any layer.

Per-site rules, buying a center and renewals. With no license, there are no state rules on licensing each site, change of ownership or license renewal. Contracts with Area Agencies on Aging and waiver agencies set their own terms, and we did not find a published review frequency in the standards we read. If you buy a center that has these contracts, ask each agency how it handles a new owner.

Local permits. We did not find local permit rules beyond fire, building and health code compliance. Check with your city or county on zoning and occupancy.

The bill that did not pass. SB 1026 was introduced October 2, 2024, with SB 1025 and SB 1027. It would have required a license for facilities caring for cognitively impaired adults, with a $120 application fee and a $100 annual fee. It received no action after being sent to committee, and we did not find a 2025 to 2026 version. None of its terms are law.

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

Michigan has no staffing rule for adult day centers as such. Centers funded through an Area Agency on Aging must have at least 1 staff person for every 5 participants and at least 2 staff on site whenever 2 or more participants are present. MI Choice Adult Day Health requires at least 1 staff person for every 10 participants. A center with no public funding has no state ratio.

• Licensing: no ratio specified, because there is no license.
• Aging network (C-1 standard 11): 1 support staff per 5 participants at all times, and at least 2 staff on the premises whenever 2 or more participants are present.
• Medicaid (MI Choice, Section 4.1.A): at least 1 support staff per 10 participants at all times.

A center that serves both aging network and MI Choice participants should plan around the stricter 1:5 C-1 ratio. Neither current standard sets a separate ratio for participants with dementia, and neither sets nurse or director hours that rise with the number of participants.

Who counts toward the ratio. Under C-1, volunteers count toward staffing minimums only if they are trained to the same level as paid staff. The MI Choice standard does not say.

Director. C-1 requires a director or manager with at least a bachelor's degree or applicable knowledge and experience. MI Choice is stricter: a full-time program director with at least a bachelor's degree in a health or human services field, or a qualified health professional.

Nurses. Under C-1, licensed nurses must oversee medication administration, which they may delegate to trained staff. Nursing itself is optional and is given by an RN, an LPN supervised by an RN, or other staff under RN direction. Under MI Choice, health support services may be provided only under RN supervision.

First aid and CPR. Both layers require a staff person trained in first aid and CPR to be present whenever participants are at the center. C-1 requires that person to be certified, and its staff orientation covers first aid and CPR/AED.

Training. C-1 requires orientation on listed topics, including Adult Protective Services reporting, first aid and CPR/AED, and dementia care, plus in-service training at least twice a year, one of which must focus on dementia care. Training records are required. MI Choice requires basic first aid training plus the manual's general provider training. Neither layer sets a number of training hours.

Background checks and health screening. We did not find background check rules written for adult day centers. The MI Choice criminal history rule is written for staff who go into a participant's home. We also did not find a TB test or vaccination requirement. Ask your Area Agency on Aging or waiver agency what its contract requires.

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

Publicly funded Michigan centers must provide or arrange transportation, personal care, planned activities and meals. MI Choice Adult Day Health must also run at least four hours a day. Neither standard sets square feet per participant or a capacity formula.

Services under C-1 (aging network). Centers must provide or arrange transportation, personal care with activities of daily living, planned person-centered activities, nutrition and referrals for caregivers. Optional services include therapies, medical support, nursing, and dental, foot and eye care. A monthly activity calendar must be posted. C-1 also allows short-term hybrid services, such as phone calls, activity packets, deliveries and monthly check-ins, when a participant cannot attend in person, if the funding agency and the center agree.

Services under MI Choice. Adult Day Health programs must provide or arrange transportation, personal care, nutrition and recreation, for four or more hours a day. Optional services include therapies, medical support, nursing, dental, foot and eye care, health counseling and shopping escort. Meals may not add up to a full regimen of three meals a day.

Meals. Both layers require one hot meal per eight-hour day. C-1 says it must meet one-third of daily nutrition allowances and adds snacks. For participants who stay 8 to 14 hours, both require an additional meal (or snacks under C-1). MI Choice says the two meals together must reach two-thirds of daily allowances.

Space and furnishings.

• C-1 (standard 17) requires a sturdy chair for each participant and staff person, lounge chairs or day beds for rest, storage for belongings (locked on request), an accessible telephone, accessible bathrooms and safe space for arrival and departure. It recommends at least one toilet for every 10 participants.
• MI Choice requires similar furnishings, plus tables for participants who walk and those who do not, and adaptive equipment. It sets no square footage or toilet ratio.

Hours. MI Choice service runs four or more hours a day. We did not find a minimum number of days or hours a center must be open under either layer.

Written policies. C-1 requires written policies on eligibility, preliminary screening, service plans, medication management (including a medication training program approved by an RN, physician or pharmacist), discharge, and medical and other emergencies. Programs that run their own vehicles need safe driving record criteria for drivers. MI Choice requires written medication assistance procedures, approved by a consulting pharmacist, physician or RN, covering consent, checking the regimen, staff training, set-up, secure storage, disposal and charting. Its policies must also fit the manual's general operating standards.

Safety. Both layers require emergency and evacuation procedures posted in each room and practice drills at least every six months, with a record of each drill. C-1 names evacuation and tornado drills.

What rules protect participants in Michigan adult day centers?

Under the aging network C-1 standard, centers screen each person, do a face-to-face assessment before or at admission, write a service plan with the participant, and reassess every six months. MI Choice centers use the waiver agency's assessment and plan instead. Both layers require attendance records and monthly progress notes.

Enrollment (C-1). Centers need written eligibility criteria and a preliminary screen, which may be done by phone or video. A face-to-face comprehensive assessment follows before or at admission. Admission may follow the assessment, a trial visit or a referral. The service plan must be approved by the participant or their representative and reassessed every six months, or sooner if the person's condition changes. Caregiver information is updated each year.

Enrollment (MI Choice). The center must accept the waiver agency's MI Choice assessment and person-centered service plan rather than doing its own. Participants must need regular supervision, need a substitute caregiver, have difficulty with daily activities, be able to leave home with help, and need enrichment to prevent decline.

Discharge. The C-1 discharge policy must include at least one of these reasons: the participant wants to stop, has improved and no longer qualifies, has more caregiver support, has moved permanently to an institution, or the program can no longer serve them. Neither layer sets a discharge notice period.

Participant records. C-1 files are confidential and include:

• Referral details, an emergency contact and a recent photo.
• Screening, assessments and the service plan with dated revisions.
• A record of attendance, monthly progress notes and services provided.
• A medication log with name, dose, time taken, staff initials, refusals and reasons for as-needed doses.

MI Choice files include referral and intake records, the MI Choice assessment and service plan, a list of participant contacts and attendance, at least monthly progress notes, medication notes, services provided and releases of information.

What we did not find. We did not find a required physician order, physical exam or TB screening at enrollment, required contents for an enrollment agreement, a record retention period, or incident reporting timelines in either adult day standard. C-1 orientation does cover Adult Protective Services reporting. Families should ask a center for its written eligibility, discharge and fee policies, and operators should ask their funding agency what it expects.

How does Medicaid pay for adult day in Michigan?

Michigan Medicaid pays for adult day through the MI Choice Waiver, which covers Adult Day Health, and through PACE. MI Choice bills by the day (S5102) or half day (S5101), one unit per day, at rates each regional waiver agency negotiates with the center. MDHHS does not publish a statewide rate.

MI Choice Waiver. MI Choice is a 1915(c) waiver run by MDHHS through regional waiver agencies. It began in 1992 as the Home and Community-Based Services Elderly and Disabled waiver and has covered every county since October 1, 1998. Centers are subcontracted by the waiver agency for their area.

• Billing codes and units: S5102 per day and S5101 per half day, each limited to one unit per day.
• Rates: set in contract negotiation between each waiver agency and the provider. MDHHS has no role in setting them (Medicaid Provider Manual, MI Choice chapter, Section 9.3). Ask each waiver agency you contract with what it pays.
• Service plan: the waiver agency's assessment and person-centered service plan decide what is authorized.

Transportation. Under MI Choice, transportation is part of Adult Day Health when the center offers it. If the center does not, MI Choice can pay for transportation separately.

PACE. MDHHS lists 29 PACE centers in Michigan. PACE serves people 55 and older who meet nursing facility level of care and live in a PACE service area, and a person cannot be in PACE and MI Choice at the same time. PACE organizations deliver social and medical services mainly in an adult day health center, with transportation included. PACE is paid a set amount per enrollee, so adult day is not billed by the unit.

Attendance documentation. MI Choice requires a list of participant contacts and attendance in each participant's file. We did not find an electronic sign-in or attendance tracking requirement for adult day. Waiver agency contracts vary, so ask each agency what attendance records it needs to pay a claim.

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

Yes. Because Michigan has no adult day license, a center that takes only private payment does not need a state license, and the C-1 and MI Choice standards do not apply to it. Check with your city or county about zoning, building, fire and food rules.

What we did not find. We did not find whether offering nursing or medication administration in a private-pay center triggers another kind of license. We also did not find state consumer protection rules for private-pay adult day participants, such as required contract or fee disclosures. Ask MDHHS before adding health services to a private-pay program.

Other funding.

• Older Americans Act and state aging funds. Area Agencies on Aging fund adult day under the C-1 standard, which bills in 1-hour units. Contact your local Area Agency on Aging to ask about a contract.
• Veterans. The U.S. Department of Veterans Affairs offers Adult Day Health Care to enrolled veterans who qualify for community care and meet clinical criteria, at VA medical centers, State Veterans Homes or community organizations. A copay may apply.
• Meals. Centers that meet the aging standards and hold an Area Agency on Aging or MI Choice agreement can join the adult part of the federal Child and Adult Care Food Program, run in Michigan by the Department of Education.

The market. With no license there is no state count of adult day centers. MDHHS lists 29 PACE centers. We did not find a Michigan adult day services association with a website.

What is changing next for adult day in Michigan?

As of our last check on October 21, 2026, we did not find an upcoming change to Michigan's adult day standards or Medicaid adult day payment. Two recent events matter for operators.

• Updated C-1 standard, September 20, 2024. The Commission on Services to the Aging approved an updated C-1 Adult Day Services standard, announced in MDHHS Transmittal Letter #2025-505 (October 10, 2024). It changed the unit of service from 15 minutes to 1 hour and made the Modified Caregiver Strain Index a recommendation instead of a requirement.
• Licensing bill stalled, 2024. SB 1026, with SB 1025 and SB 1027, would have created a state license for adult day-care facilities. It was referred to committee on October 2, 2024 with no further action, and we did not find a newer version. If a licensing bill returns, it would change most of this page.

Michigan adult day sources

• Michigan Department of Education: Adult Day Services Component Fact Sheet (2016)
• MDHHS Transmittal Letter #2025-505 and C-1 Adult Day Services standard (2024)
• Medicaid Provider Manual, MI Choice Waiver chapter (October 1, 2026)
• MDHHS: MI Choice Waiver Program
• MDHHS: Program of All-Inclusive Care for the Elderly (PACE)
• Michigan Legislature: 2024 Senate Bill 1026
• Michigan Legislature: MCL 400.703 (adult foster care definitions)
• U.S. Department of Veterans Affairs: Adult Day Health Care

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
• Adult Day Care Activity Ideas to Keep Clients Engaged
• 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, Illinois, Indiana, Kentucky, Maryland, Massachusetts, 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.