Adult Day Care Utah

All states: adult day services map

Utah adult day services at a glance

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

How is adult day care regulated in Utah?

Utah has one license for adult day care, issued by the Office of Licensing in the Utah Department of Health and Human Services (DHHS) Division of Licensing and Background Checks. There is no separate adult day health care license. Medicaid pays for the same licensed service through two waivers: the Aging Waiver calls it Adult Day Health, and the New Choices Waiver calls it Adult Day Care.

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

• Licensing (DHHS Office of Licensing). Utah Code Title 26B, Chapter 2, Part 1 treats adult day care as a "human services program" that needs a license (Utah Code 26B-2-101). The adult day rule, Utah Admin. Code R501-13, sets staffing ratios, space, activities and meals. It adds to R501-1, the general rule for all human services programs, and overrides it where the two conflict. The licensing procedures are in R380-600. These rules apply to every center, whatever the payer.
• Medicaid (DHHS). The DHHS Office of Long Term Services and Supports is the state Medicaid agency for two 1915(c) waivers that include adult day. A 1915(c) waiver is a Medicaid program that pays for home and community services for people who would otherwise need nursing facility care. The Waiver for Individuals Age 65 or Older (the Aging Waiver) is operated by the Division of Aging and Adult Services through local Area Agencies on Aging. The New Choices Waiver is run by the Office of Long Term Services and Supports. Only these two of Utah's 1915(c) waivers list adult day (Medicaid.gov Utah waiver list).
• Other funding. The Division of Aging and Adult Services and local Area Agencies on Aging run the Home and Community Based Alternatives Program (R510-400), which uses state, federal and local funds. It is not Medicaid, and we did not confirm whether it pays for adult day.

Utah law defines adult day care as nonresidential care and supervision for three or more adults, for at least 4 but less than 24 hours a day, that meets the needs of functionally impaired adults through health, social, recreational and related support services in a protective setting. Because that one definition covers both health and social services, there is no separate medical model license. We did not find a dementia-specific adult day license or certification.

Where the layers overlap, licensing sets all of the operating standards. Medicaid adds its own service definitions and provider enrollment. For the Aging Waiver, the Division of Aging and Adult Services also checks each provider's qualifications every year.

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

Yes, if your program will care for 3 or more functionally impaired adults for at least 4 but less than 24 hours a day. The DHHS Office of Licensing licenses these programs whether clients pay privately, through Medicaid or some other way. Until your license is approved, you may not accept fees, sign service agreements or serve clients.

What the application includes. Under Utah Admin. Code R380-600-3, an application must include:

• The completed application form and the fees for each license category.
• A background check for each covered person, such as owners, the director, employees and volunteers with unsupervised access to clients or their records.
• The program's required written policies.
• Contact details for the owners and the director.
• Proof that the program meets fire and business license rules, or is exempt from them.

You must also follow local zoning, fire, safety, sanitation and building codes, hold a fire clearance and food handler permits (or exemptions), and settle any disputed local clearance before the license is issued (R501-1-6). An application that is not completed within six months must be started over. We could not open the Division of Licensing and Background Checks website, so we did not find a published step-by-step guide. Contact the Office of Licensing to start.

Fees. We did not find license fee amounts we could verify. The Division of Licensing and Background Checks publishes a fee schedule, but we could not open it, so ask the Office of Licensing for current fees.

Certificate of need. We did not find a certificate of need requirement or a moratorium for adult day care in Utah Code Title 26B, Chapter 2, Part 1 or in R501-13.

One license per site. Each license applies to one site, and a program needs a separate license for each location. The current license must be posted where the public can see it (Utah Code 26B-2-105).

Buying a center. Utah licenses cannot be assigned or transferred. Under R380-600-4, a transfer of 50 percent or more of ownership, a move, a change in the population served or an added license category needs a new license application and fees at least 30 days before the change, and no new clients may be served until the new license is issued. Smaller ownership changes, capacity or space changes, name changes and a new responsible decision maker need a program change application 30 days ahead.

Renewal and inspections. A license expires one year after it is issued, at the end of that month. A licensee that has held a license for at least 24 months with no violations may get a two-year renewal. Renewal requests and fees are due at least 30 days before the license expires. A late renewal is allowed within 30 days after expiration with a late fee, and after that a new application is required. The Office of Licensing may make announced and unannounced inspections (R380-600-7). We did not find a fixed inspection schedule for adult day care.

Who does not need this license. Adult day care run inside a Type 1 or Type 2 assisted living facility does not need a separate adult day license. Also excluded are health care facilities licensed under Part 2 (such as nursing facilities), federal facilities and Department of Corrections programs. A program serving fewer than 3 adults, or for less than 4 hours a day, falls outside the definition of adult day care.

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

Utah's licensing rule scales staff with attendance: one staff person in direct supervision plus a second immediately available for 8 or fewer clients, two staff for 9 to 16 clients, and one staff per 8 clients once 16 or more attend. When half or more of the clients have Alzheimer's disease or a related dementia, the ratio is one staff to six clients. Medicaid does not set its own ratio, so the licensing ratios are the ones to staff to.

The ratios are in Utah Admin. Code R501-13-4.

• Licensing (DHHS Office of Licensing): 8 or fewer clients, 1 staff in direct supervision at all times with a second qualified staff person immediately available; 9 to 16 clients, 2 staff in direct supervision at all times; 16 or more clients, 1 staff per 8 clients; 1 staff per 6 clients in any program where half or more of the clients have a medical diagnosis of Alzheimer's disease or a related dementia.
• Medicaid (Aging Waiver and New Choices Waiver): no ratio specified. The Aging Waiver relies on R501-13 licensure. We could not open the New Choices Waiver document, so we did not review its adult day standards.
• Other funding: we did not find staffing standards for adult day from any other funding source.

Who counts toward the ratio. Administrative and maintenance staff do not count once 9 or more clients are present. Staff trainees must be supervised at all times while they are with clients.

Staffing beyond the ratio. Under the general rule (R501-1-15), a center must add staff above the usual ratio when needed to manage behaviors and individual supervision needs. A manager or qualified designee must be immediately available while the program operates, and at least one staff member certified in CPR and first aid must be available whenever clients are present, unless a licensed health care professional is there.

Director. The director must be a licensed nurse, licensed social worker, licensed psychologist, licensed or certified recreational or physical therapist, or another licensed professional with experience serving functionally impaired adults. A person with verifiable training may also direct the program if they consult on an ongoing basis with a professional who holds those credentials. The director needs 10 hours of related training each year.

Direct care staff. Direct care staff must be at least 18 and show they can work with functionally impaired adults. They receive 8 hours of program-specific orientation when they start and 10 hours of work-related training each year.

Nurses. We did not find a nurse or RN staffing requirement in the adult day rule.

Training. All staff complete pre-service training before working unsupervised and within 30 days of hire (R501-1-16). Topics include program policies, emergency preparedness, CPR and first aid, client rights, supervision and ratios, abuse and neglect reporting, and the code of conduct. Annual training on listed topics follows.

Background checks. Direct care staff need an approved background clearance from the DHHS Office of Background Processing before working unsupervised. Owners, directors, employees, caregivers and volunteers with unsupervised access to clients or their records are covered. Utah Code 26B-2-120 governs background checks for people with direct access to vulnerable adults.

Health screening. We did not find a staff TB test or vaccination requirement for adult day programs. The general rule requires TB screening only for programs serving clients with substance use disorders. Ask the Office of Licensing whether anything else applies.

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

Every licensed Utah center must plan and post daily activities, give each client access to four of eight activity areas each day, and serve meals or snacks no more than three hours apart. Centers need at least 50 square feet of program space per client and at least one bathroom reserved for clients. Transportation is not required by licensing.

Activities. Under R501-13-3, each center prepares daily activity plans for individual and group needs, such as community living skills, recreation, nutrition, personal hygiene and social skills, keeps them on file, and posts and follows a daily schedule. Each client must be able to use four of these eight activity areas every day: general, sedentary, specialized, rest, self-care, outdoor, kitchen and nutrition, or reality orientation. The licensing rule does not list required nursing, personal care or therapy services.

Meals. Meals and snacks must follow the Child and Adult Care Food Program, with no more than three hours between servings and enough food for second helpings (R501-13-5).

Hours. By definition, adult day care runs at least 4 but less than 24 hours a day. We did not find a minimum number of days per week. For Aging Waiver clients, Adult Day Health is generally provided 4 or more hours a day on a regular schedule, one or more days a week or as the care plan says.

Space and capacity. Under R501-13-5:

• At least 50 square feet of indoor floor space per client, set aside for the program during operating hours. Hallways, kitchens, offices, storage and bathrooms do not count.
• At least one bathroom reserved for clients during operating hours, with privacy, toilet paper, towels or a dryer, soap and ventilation.
• An indoor temperature of at least 70 degrees Fahrenheit, outdoor recreation space on or off site, a site that meets local accessibility codes, and protection from hazards such as burns, falls and drowning.

Capacity counts every staff member and client on the premises and cannot go over limits set by local authorities. The Office of Licensing may use square footage to set a program's capacity. We did not find a restroom-to-client ratio or a separate dementia space requirement.

Transportation. Licensing does not require transportation. If a program uses vehicles, they must be licensed and registered.

Written policies. The general rule (R501-1-4 and R501-1-6) requires written policies, including:

• Abuse, discrimination and harassment, with prevention and reporting steps, submitted to the Office of Licensing before the program starts.
• Safe practices for client health and safety, the population served, the building, supervision and mixing populations.
• Public information on services, eligibility and exclusion criteria, discharge reasons, each cost and fee, and the refund policy.
• A complaint process, staff and client grievance procedures, and a quality improvement plan.
• An emergency preparedness, response and recovery plan, and an infectious disease prevention plan.
• Record retention (7 years), and medication management overseen by a medical professional if the program manages or gives medications.

Any change to a policy the Office of Licensing approved must be approved before it takes effect. We did not find a set policy review schedule, but staff must be trained on program policies every year. We did not find a governing board or advisory committee requirement.

Safety and postings. Fire drills must be held and documented at least every quarter, a phone that can call 911 must be on site, and medications and hazardous chemicals not in use must be locked (R501-1-8). Centers post abuse reporting laws, a civil rights notice, an ADA notice, the license, any notice of agency action and the department code of conduct poster, and keep proof of financial viability and insurance available on request.

What rules protect participants in Utah adult day centers?

Before admission, a Utah center must complete an intake screening, keep a physician-signed health assessment on file, and have the client or guardian sign a fee agreement and consent. Centers keep daily attendance records and keep client records for seven years. Critical incidents go to the Office of Licensing within one business day, and abuse allegations go to Adult Protective Services within 24 hours.

Enrollment. The director must keep a current health assessment signed by a physician on site for each client (R501-13-2). Under R501-1-12, the intake screening verifies eligibility, checks exclusion criteria, describes the person's needs and includes a suicide risk screening.

Enrollment paperwork. The client or guardian signs and gets copies of:

• The eligibility decision.
• A fee agreement showing costs and who pays.
• A consent covering program rules and expectations, services, Medicaid and insurance billing, client rights and licensing contact information.

Care plans. We did not find a center-level care plan timeline in the licensing rules, though each client record must include a service plan. For Aging Waiver clients, the waiver case manager develops a care plan within 30 calendar days after the full assessment and renews it each year in the same month. That is the waiver's plan, not the center's.

Discharge. Centers must publish the behaviors and issues that would lead to discharge or exclusion. A discharge plan states the reason for discharge or transfer, an aftercare plan, a summary of services and a progress evaluation. We did not find a required discharge notice period.

Attendance and records. The director keeps daily attendance records on site at all times. Each client record includes contact and emergency information, medications and conditions, intake and discharge documents, the service plan, dated and signed progress notes, a summary of attendance and absences, grievances, incident reports and signed consents (R501-1-11). Records are kept for seven years, and staff and client files must stay available for seven years even if the program closes.

Incidents. Critical incidents, such as a missing client, a serious injury, a medical emergency beyond first aid, an abuse allegation, suspected Medicaid fraud or a death related to an adverse event, must be reported to the Office of Licensing within one business day. Allegations of abuse, neglect or exploitation go to Adult Protective Services and law enforcement within 24 hours, and the guardian must be told within 24 hours (R380-600-7). For Aging Waiver clients, the Division of Aging and Adult Services also reports critical incidents to the Medicaid agency.

What we did not find. We did not find TB screening for adult day clients, a center-level care plan review schedule or a discharge notice period. Families should ask the center for its published eligibility, discharge and fee policies.

How does Medicaid pay for adult day in Utah?

Utah Medicaid pays for adult day through two waivers: the Aging Waiver, which calls the service Adult Day Health, and the New Choices Waiver, which calls it Adult Day Care. Both pay per day under code S5102. The Aging Waiver rate sheet effective July 1, 2026 lists $75.00 per day, and transportation is billed separately.

Aging Waiver (Waiver for Individuals Age 65 or Older). DHHS is the Medicaid agency, and the Division of Aging and Adult Services runs the waiver through local Area Agencies on Aging. It serves people 65 and older who meet nursing facility level of care and Medicaid financial rules, and it has a waiting list (Aging Waiver fact sheet). Adult Day Health providers can be centers licensed under R501-13, nursing facilities or assisted living facilities, and the Division of Aging and Adult Services checks their qualifications every year.

• Billing code and unit: S5102 with the U3 modifier, per day.
• Rate: $75.00 per day, the maximum allowable rate on the Aging Waiver Codes and Rates sheet effective July 1, 2026.
• Transportation: not included in the adult day rate. Non-medical transportation is billed separately under T2003 at $16.00 per one-way trip on the same sheet.
• Limits: Adult Day Health and long-term care facility respite cannot be billed on the same day.

New Choices Waiver. The New Choices Waiver serves adults 18 and older who meet nursing facility level of care and are moving out of a nursing facility, assisted living facility or other licensed medical institution. CMS approved the current waiver for July 1, 2025 through June 30, 2030 (Medicaid.gov).

• Billing code and unit: S5102 with the U8 modifier, per day.
• Rate: $37.66 per day, the maximum allowable base rate on the New Choices rate sheet effective July 1, 2023. We did not find a newer sheet, so this rate may have changed.
• Transportation: billed separately under non-medical transportation codes T2003 (one-way trip) and S0215 (per mile).

Attendance documentation. Licensing requires daily attendance records on site and a summary of attendance and absences in each client record. We did not find an electronic sign-in or attendance verification requirement for adult day in either waiver, and we did not review the Medicaid provider manual's documentation rules for adult day claims. Ask DHHS Medicaid or the waiver program what records it expects behind each daily claim.

PACE. We did not find a PACE (Program of All-Inclusive Care for the Elderly) organization operating in Utah.

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

Yes, a center can be fully private pay, but it still needs a DHHS Office of Licensing license if it serves 3 or more adults for 4 to under 24 hours a day. Utah's licensing rules apply whoever pays. There is no unlicensed adult day category; a program is outside the license only if it is too small, too short or one of the listed exclusions.

What falls outside the license. Under Utah Code 26B-2 and R501-13-1, the exclusions are:

• Programs serving fewer than 3 adults, or for less than 4 hours a day.
• Adult day care inside a Type 1 or Type 2 assisted living facility.
• Health care facilities licensed under Part 2, such as nursing facilities.
• Federal facilities and Department of Corrections programs.

Protections for private-pay clients. Every client signs a fee agreement showing costs and who pays. Each program must publish every cost and fee, its refund policy, its complaint process and its eligibility and discharge criteria (R501-1-6). We did not find a rule against discrimination by payment source.

Other funding. The Home and Community Based Alternatives Program is funded by state and federal money plus local funds, fees and contributions, and each Area Agency on Aging must use 75 percent of its program funding for people 60 or older (R510-400). We did not confirm whether it, Older Americans Act funds or a Utah VA medical center pays for adult day. Your local Area Agency on Aging can tell you what is available in your area.

The market. We did not find a state-published count of licensed adult day programs in Utah, and we did not find a Utah adult day association.

What is changing next for adult day in Utah?

Utah has proposed waiver amendments that would raise Adult Day Health rates by 65.2 percent in both the Aging Waiver and the New Choices Waiver once CMS approves them. No effective date has been published. A change to the background check law for staff who work with vulnerable adults also takes effect January 1, 2027.

• Proposed 65.2 percent rate increase (not final). Utah's May 2026 waiver amendments, funded by SB288, propose the increase for Adult Day Health in both waivers. The state says the changes need approval before they take effect (DHHS HCBS waiver amendment summary). We did not find whether CMS has approved them, or whether the $75.00 Aging Waiver rate on the July 1, 2026 sheet already includes the increase.
• Background check law, January 1, 2027. Utah Code 26B-2-120, which covers background checks for people with direct access to vulnerable adults, was amended in the 2026 General Session with an effective date of January 1, 2027. We did not review the specific changes, so ask the Office of Background Processing how they affect your staff.
• Aging Waiver rate sheet, July 1, 2026. The current Aging Waiver codes and rates sheet, effective July 1, 2026, lists Adult Day Health (S5102) at $75.00 per day.

Utah adult day sources

• Utah Admin. Code R501-13: Adult Day Care
• Utah Admin. Code R501-13-4: staffing
• Utah Code 26B-2-101: definitions (adult day care)
• Utah Code Title 26B, Chapter 2: licensing of human services programs
• Utah Admin. Code R380-600-3: license application and renewal
• Utah Admin. Code R380-600-4: changes of ownership and program changes
• Utah Medicaid: Aging Waiver renewal State Implementation Plan (January 2025)
• Utah Medicaid: Aging Waiver Codes and Rates, effective July 1, 2026
• Utah Medicaid: New Choices Waiver rate sheet, effective July 1, 2023
• Utah DHHS: HCBS waiver amendments executive summary (2026)

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: 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 that license or certify every adult day center

California, Delaware, Florida, Georgia, Hawaii, Iowa, Kansas, Maine, Missouri, Montana, Nebraska, Nevada, New Mexico, North Carolina, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, 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.