All states: adult day services map
In short: All adult day centers are licensed by the Health Care Authority at 1 direct care staff per 5 participants; Medicaid pays adult day health per 15 minutes.
| License or certification | Yes. A Health Care Authority license for any facility serving 3 or more adults for under 24 hours a day, any payer. |
|---|---|
| Who licenses or certifies | New Mexico Health Care Authority (HCA), Division of Health Improvement, under 8.370.20 NMAC |
| Adult day care vs adult day health | One license (center, or home for 3 to 5 people). Adult day health is the Medicaid service name, delivered by a licensed center. |
| Strictest staffing ratio | 1 full-time-equivalent direct care staff per 5 participants (HCA licensing), at all times including meals |
| Dementia ratio | No ratio specified. HCA may require higher ratios for people with special needs. |
| Medicaid programs | Turquoise Care Agency-Based Community Benefit (adult day health); PACE (InnovAge New Mexico PACE) |
| Medicaid billing unit | 15 minutes (S5100), $2.96 per unit recommended minimum from July 1, 2026. PACE is paid per member, not per unit. |
| Licensed centers | Not confirmed. We did not find a published count. |
Last verified against state sources: 2026-10-21.
New Mexico has one adult day license, issued by the New Mexico Health Care Authority (HCA). It comes in two settings: an adult day care center in a commercial building, and an adult day care home in a private residence serving 3 to 5 adults. There is no separate adult day health care license. Medicaid pays for a service it calls adult day health, and that service must be delivered by a licensed adult day care center.
Important: Adult day licensing moved from the Department of Health (old rule 7.13.2 NMAC) to the Health Care Authority under 8.370.20 NMAC on July 1, 2024. Older guides, and even the Medicaid policy manual for adult day health, still refer to the Department of Health and the old rule. Use 8.370.20 NMAC and HCA for licensing questions.
Three layers of rules can apply to a New Mexico center, and each comes from a different agency:
Licensing also allows new or innovative adult day programs for 3 or more adults with special needs that do not fit the center or home types. HCA may approve these at its sole discretion, with variances, after reviewing a proposal with need data. Every licensed facility must be able to remind participants about medications and appointments, provide meals and monitor activities, and serve people who can walk or move in a wheelchair with minimal help.
Where the layers overlap, Medicaid is the stricter layer for centers that bill it. It accepts only a full permanent license and adds a care plan, a quarterly team meeting and time-based documentation on top of the licensing rules.
Yes. Any public or private facility that provides care, services and supervision to 3 or more non-resident adults for less than 24 hours a day must be licensed by HCA under 8.370.20 NMAC, whoever pays. The license fee is $300, and licenses are renewed every year after an on-site survey.
What goes in the application. Under 8.370.20.9 NMAC, the initial application must be typed or printed, signed, dated and notarized, and include:
Adult day care homes do not need floor plans or building, fire and Environment Department approvals. A facility that supervises self-administration of medication or keeps medications safe for participants also needs a custodial drug permit from the Board of Pharmacy.
Fees. The fee is $300 per license under 8.370.3 NMAC. HCA proposed changes to this fee rule in 2026, and we could not confirm whether they were adopted, so check the current amount with HCA.
Survey and first license. HCA schedules an initial survey once the application is complete and issues a license when the facility complies. A temporary license may be issued for up to 120 days, and no more than two temporary licenses can be issued in a row.
Certificate of need. We did not find a certificate of need or a moratorium for adult day care in 8.370.20 NMAC or 8.370.3 NMAC. Confirm with HCA before you sign a lease.
One license per site. We did not find a clause that says one license per site, but the license is tied to a location and becomes void if the facility moves (8.370.20.14 NMAC). A program inside a multi-use building must be self-contained, with its own staff and its own area.
Buying a center. Licenses cannot be transferred to another person or location. A license is void on a change of ownership, location or licensee, or when the facility stops operating, and the new operator must file an initial application at least 30 days before the change. A change of director, facility name or capacity needs an amended license within 10 working days, and a capacity change needs an on-site visit first.
Renewal and inspections. The renewal application, notarized and with the fee, is due at least 30 days before the license expires and is followed by an on-site survey. If you do not file before expiration, the facility must stop operating and apply again as a new facility. HCA surveys each facility at least once a year and may also make unannounced visits.
If you plan to bill Medicaid. The center needs a full permanent adult day care license with no gaps (temporary or provisional licenses are not accepted), must comply with Titles II and III of the Americans with Disabilities Act, must be located in New Mexico, and must enroll as a Medicaid provider and contract with the Turquoise Care health plans.
New Mexico licensing rules require one full-time-equivalent direct care staff position for every 5 participants in an adult day care center, kept at all times including meal times. Participants may never be left unattended. Medicaid does not set its own ratio, so the 1:5 licensing ratio is the one to staff to. There is no fixed ratio for dementia, but HCA may require more staff for people with special needs.
Minimum staff on site. Staff must be physically present with participants at all times, and at least one staff member on duty at all times must hold current first aid and CPR certification.
Who counts toward the ratio. Staff counted in the ratio must be 18 or older and assigned to direct care. People hired only for clerical, cooking or maintenance work do not count. Volunteers are treated as staff and must meet the same rules, and part-time and substitute staff counted in the ratio must meet the same requirements.
Director. Each center needs a full-time program director with at least a bachelor's degree in geriatrics or a health-related field that includes care of the elderly, or who is a registered nurse, plus two years of experience serving elderly or disabled adults. An adult day care home operator needs a high school diploma or equivalent and two years of full-time experience.
Nurses and social workers. We did not find a nurse or social worker requirement in the licensing rules or the Medicaid manual section for adult day health. Private duty nursing and skilled therapies given in the center must be done by licensed nurses and therapists and are billed separately.
Training. Every staff member completes an orientation before starting work, covering services, first aid and signs of abuse, fire and evacuation, the licensing rules, the needs of elderly and disabled people, participant rights and sanitation (8.370.20.58 NMAC). Center staff, including the director, need at least 40 documented training hours a year, 20 of them on the physical, emotional, intellectual and social needs of adults. Adult day care home staff need 24 hours a year. Before working unsupervised, all employees and volunteers must also be trained on incident policies for abuse, neglect and exploitation, with a refresher at least every 12 months (8.370.9 NMAC).
Background checks. Adult day care centers are care providers under the Caregivers Criminal History Screening Act and must get fingerprint-based state and national criminal history screening for caregivers (8.370.5 NMAC). Centers must also check the Employee Abuse Registry before hiring or contracting and keep proof in the personnel file. The licensing rules bar anyone convicted of a felony or a misdemeanor involving moral turpitude from working in the facility, and references and work history must be checked before hire.
Health screening. Each staff member or volunteer who works more than 8 hours a week with participants needs a certificate from a physician or health facility stating they are free of transmissible tuberculosis. We did not find a vaccination requirement.
Every licensed New Mexico facility provides supervision, medication and appointment reminders, a meal and snacks, and activities that follow each person's plan of care. Centers may operate only between 6 a.m. and 9 p.m. and need 40 square feet of activity space per participant plus an outdoor activity area. Transportation is optional, but rules apply if you offer it.
Activities. Activities must follow individual plans of care and balance social, intellectual, cultural, emotional and physical activities. A monthly activity calendar goes to participants and families, and daily activities are posted (8.370.20.62 and .63 NMAC).
Meals. A meal that meets at least one-third of daily nutritional needs is served at standard mealtimes, with mid-morning and mid-afternoon snacks, and no participant goes more than three hours without a meal or snack offered. Therapeutic diets are provided when prescribed, a registered dietitian must be consulted, menus may not repeat within a week, and the weekly menu is posted.
Hours. Licensing limits operation to between 6 a.m. and 9 p.m. It sets no minimum number of days or hours. For Medicaid members, adult day health is generally provided two or more hours a day on a regular schedule, one or more days a week.
Transportation. A facility that transports participants is responsible for them from pick-up to drop-off. Vehicles need seatbelts, a fire extinguisher and a first aid kit, and riders must be offered a rest stop at least every 30 minutes (8.370.20.78 NMAC).
Space and capacity.
Medicaid services. Adult day health provides structured therapeutic, social and rehabilitative services under the member's care plan. Services may include coordinating transportation, personal care, supervising self-administered medication, activities that build skills and independence, intergenerational and community involvement, and access to community resources. Activities are included in the rate.
Written policies. Under 8.370.20.27 and .28 NMAC and 8.370.9 NMAC, every facility needs written policies and procedures on:
Policies may be adopted from other sources. We did not find a required schedule for reviewing them. Facilities must also hold fire drills at least monthly at different times of day and keep records, and must post the license, emergency numbers by each phone, a fire evacuation plan (centers) and the notifiable disease list.
Each New Mexico participant must have a complete record and a signed enrollment agreement listing services and costs at admission, and the facility keeps a daily attendance record. Abuse, neglect and exploitation are reported to Adult Protective Services right away and to HCA within 24 hours. Medicaid adds a written adult day health plan and a team review at least every quarter.
Who can enroll. Licensed facilities serve adults who can walk or who can move in a wheelchair with minimal help. An adult with a severe diagnosed mental or physical handicap may be admitted on the written recommendation of a licensed physician or therapist. People who are ill or have a notifiable disease may not attend, and they need written physician approval to return after a notifiable disease.
Participant record and enrollment agreement. Under 8.370.20.25 NMAC, the record is complete at admission, including for drop-ins, and contains personal and emergency information, physician contact, consent for emergency transport and treatment, allergies and medications. It also includes a signed enrollment agreement that lists the services and their costs and acknowledges the facility's policies.
Care plan. Licensing ties activities to individual plans of care but sets no assessment or care plan timeline. For Medicaid members, the health plan's comprehensive needs assessment (done at least once a year) must find a need for Community Benefit services. The center writes an adult day health plan with goals and measurable objectives that becomes part of the health plan's care plan, and an interdisciplinary team meets at least quarterly.
Discharge. Facilities must have written admission and disenrollment policies, but we did not find set discharge reasons or a notice period in 8.370.20 NMAC. Families should ask the center for its written disenrollment policy.
Attendance and records. Participant records include daily attendance. Facilities also keep a daily staff attendance record and weekly staff schedules for six months. Licensing requires participant records to be kept at least six months after disenrollment. Medicaid providers must keep medical and business records for at least six years from the payment date (8.302.1.17 NMAC), so the Medicaid rule is the one to follow if you bill Medicaid.
Incidents. Facilities report to HCA incidents such as a lost or missing participant, sexual or physical abuse, accidents or injuries needing medical care, disasters causing structural damage, and notifiable diseases. Under 8.370.9 NMAC, abuse, neglect and exploitation are reported immediately to Adult Protective Services, and these and other reportable incidents go to HCA within 24 hours (the next business day on weekends and holidays). The facility must finish its own investigation and report within five days. The HCA Division of Health Improvement complaint and incident line is 1-800-752-8649.
What we did not find. We did not find a required physical exam or TB screening for participants at enrollment, or set discharge reasons and notice periods. Ask HCA what it expects.
New Mexico Medicaid pays for adult day health through the Turquoise Care Agency-Based Community Benefit, for members who meet nursing facility level of care. Centers bill the member's Turquoise Care health plan under code S5100 in 15-minute units. HCA's recommended minimum rate from July 1, 2026 is $2.96 per unit (about $11.84 an hour), and each health plan negotiates its own rate. PACE also covers adult day center care for eligible people in its service area.
Turquoise Care adult day health. HCA's Medical Assistance Division runs Turquoise Care through contracted managed care organizations. Adult day health is part of the Agency-Based Community Benefit under 8.308.12 NMAC and Section 8.5 of the Turquoise Care policy manual.
The S5100 code also appears in the self-directed rate range as Customized Community Supports, which is a different service. Do not use that range for adult day health.
Transportation. The manual lists coordination of transportation as part of adult day health, but we did not find whether trips to the center can be billed separately. Ask HCA or the health plan.
PACE. HCA's PACE program, run by InnovAge New Mexico PACE, serves people 55 and older who live in a PACE service area and are eligible for nursing home care. PACE receives a monthly payment per enrollee, so adult day center care is not billed by the unit.
Attendance documentation. Licensing requires a daily attendance record for each participant and does not require an electronic system. For Medicaid, services billed in time units must be documented in enough detail to show the actual time spent and the services provided (8.302.1.17 NMAC), so record arrival and departure times. We did not find a state sign-in form or required attendance system for adult day.
Yes, a center can be fully private pay, but it still needs an HCA license if it serves 3 or more adults for less than 24 hours a day. The licensing rule applies to public and private facilities with no exception for payer, and HCA surveyors may investigate facilities that operate without a license. We did not find any rule that allows an unlicensed program for 3 or more adults.
Protections for private-pay participants. Every participant, whoever pays, must have a signed enrollment agreement that states the services to be provided and their costs (8.370.20.25 NMAC). We did not find a rule barring discrimination by payment source for adult day.
Reporting an unlicensed program. Concerns can go to the HCA Division of Health Improvement complaint and incident line at 1-800-752-8649.
Other funding. The Aging and Long-Term Services Department lists adult day care among the Older Americans Act Title III supportive services offered through the Aging Network, which includes the Area Agencies on Aging and their providers. We did not find ALTSD adult day standards or rates, so ask your Area Agency on Aging what it funds in your region. We also did not find a Department of Veterans Affairs adult day health care program on the VA New Mexico health care pages, so veterans should ask their VA care team.
The market. We did not find a state-published count of licensed adult day centers and homes, or a statewide adult day association. HCA licensing is the best source for a current list.
As of our last check on October 21, 2026, we did not find a confirmed upcoming change to New Mexico's adult day rules or Medicaid adult day payment. HCA has proposed changes to two licensing rules that apply to adult day, but we could not confirm whether they were adopted. Two recent changes are already in effect.
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Questions about New Mexico adult day rules are best put to the state. Start with 8.370.20 NMAC, Requirements for Adult Day Care Facilities. The state lists this contact: HCA Division of Health Improvement complaint and incident hotline 1-800-752-8649 (as published in 8.370.9 NMAC).
California, Delaware, Florida, Georgia, Hawaii, Iowa, Kansas, Maine, Missouri, Montana, Nebraska, Nevada, North Carolina, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Wyoming. See every state on the adult day services map.
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.
