Adult day care is growing fast, but most centers describe themselves the same way: "safe, social, meals, and activities." That's not differentiation - that's table stakes. This article breaks down the real differences between program types (including the often-overlooked I/DD day programs), explores what actually sets top-performing centers apart, and shares practical strategies for operators who want to stand out with families, referral sources, and payers. Along the way, we'll share how technology - including solutions from Ankota - can help operators focus less on paperwork and more on the people they serve.
If you search "adult day care" online, you'll mostly find articles written for families trying to understand the basics. That's fine as far as it goes, but it misses the operator's perspective entirely. Before you can differentiate your center, you need to understand the landscape you're operating in - and where your center fits.
Most people think "adult day care" and picture a program for older adults - and they're not wrong. The majority of adult day centers serve people who are typically in their late 70s and above (the average participant is closer to 78, not 65, despite what many articles imply). These programs generally fall into two categories.
Social model programs focus on companionship, recreational activities, meals, and supervision. They serve people who are generally independent but benefit from structured engagement and a safe daytime environment. Staff help with some activities of daily living (ADLs), but the primary value proposition is socialization and caregiver respite.
Adult Day Health Care (ADHC) programs layer medical and therapeutic services on top of the social model. Nursing care, physical and occupational therapy, medication management, and health monitoring are standard. ADHC programs require state licensing - and this licensing matters enormously for reimbursement.
Here's a nuance that most articles get wrong: it's not universally true that only ADHC programs are reimbursable. The distinction matters most for Medicare, which is the federal program primarily for people over 65 or with qualifying disabilities - Medicare generally won't cover social-only day care. But Medicaid - which is the federal-state program that's more socioeconomically based - is a different story. Many states reimburse social day care programs through Medicaid waiver programs, particularly Home and Community-Based Services (HCBS) waivers. And it's worth noting that disability services are mostly reimbursed by Medicaid regardless of socioeconomic conditions.
Understanding which waivers your state offers and what they cover is foundational to your business model - and to how you differentiate.
Specialized memory care programs deserve their own mention. Centers serving individuals with Alzheimer's disease and other forms of dementia need specialized training, secure environments, and programming designed specifically for cognitive decline. This is one of the fastest-growing and most differentiated segments in adult day care, and the centers that do it well are very intentional about designing every aspect of the day around the needs of this population.
The key takeaway for older adult programs: not all older people are alike. A person with early-stage memory loss has very different needs than someone recovering from a stroke or someone who is physically healthy but socially isolated. The best centers recognize this and create programming where each participant feels at home - not warehoused.
Here's where most articles about adult day care fall short: they completely ignore programs for adults with intellectual and developmental disabilities (I/DD).
I/DD day programs - sometimes called Day Habilitation or "DayHab" - serve a fundamentally different population with fundamentally different goals. While a program for older adults is primarily about ADLs, safety, and socialization, an I/DD program is about helping participants lead their best lives. That's a much broader and more ambitious mission.
I/DD day programs focus on skill-building, community integration, and person-centered goal achievement. A participant might be working on cooking skills, learning to navigate public transportation, building social confidence, or developing vocational capabilities. Every person is different in terms of ability, and the goals need to be deeply person-centered - but the underlying philosophy is always growth and independence, not maintenance.
These programs are also harder to operate. The documentation requirements are intensive - staff need to record detailed notes about how each participant was supported during each activity and what progress was made toward individual goals. A direct support professional (DSP) caring for four or five participants might need to write thousands of words of documentation per day, pulling time away from the actual hands-on support that participants need.
This documentation dilemma is one of the biggest operational challenges in DayHab, and it's one that smart software solutions are beginning to solve. For a deeper dive into how, read our article on how DayHab programs can solve the documentation dilemma.
I/DD day programs operate under different regulatory frameworks and are funded primarily through Medicaid HCBS waivers. The HCBS Settings Rule, in particular, emphasizes community integration as a fundamental requirement - meaning that the old model of keeping participants inside a building all day is increasingly at odds with regulatory expectations.
One thing the top-ranking articles on this topic get right - even if unintentionally - is that your programming is your differentiation. The Aspen Senior Day Center article, for example, reads like a brochure, but buried in the self-promotion is a genuine insight: their specialized Cognasium program for memory care is a real differentiator that gives families a reason to choose them over a generic alternative.
Here's the problem: if the only way a prospective family learns about your unique programming is by scheduling a tour, you're not going to scale. Most families start their search online, and if your website looks like every other center's website - stock photos, vague language about "enriching activities," and a phone number - you're invisible.
The centers that grow are the ones that make their differentiation visible. That means publishing your activity calendars. It means having a family-facing app where caregivers can see what their loved one did today. It means showcasing real programming on your website, not just listing services in bullet points.
Technology plays a direct role here. Centers using modern software platforms can publish schedules, share activity updates with families in real-time, and give prospective families a window into what daily life actually looks like at your center. That transparency is a competitive advantage that most centers haven't yet tapped.
So how do you actually stand apart? Here are the strategies that matter most for operators.
The most common mistake in adult day care is trying to be everything to everyone. A center that serves people with advanced dementia, socially isolated older adults, and young adults with I/DD - all with the same programming and the same staff - isn't differentiated. It's diluted.
The best centers pick a lane and go deep. That doesn't mean you can't serve multiple populations, but it means each population gets intentional programming, appropriately trained staff, and a daily experience designed specifically for them. If your center has both an older adult program and an I/DD program, those should feel like different experiences with different rhythms, goals, and approaches.
Every operator knows that staffing is the top challenge across all care and service industries today. But adult day programs have a structural advantage that often goes unrecognized: ratios.
In home care, you need one caregiver for each client. In adult day, you typically need one staff member for every six or seven participants. That ratio advantage means adult day centers can offer more predictable schedules, a team-based work environment, and less isolation than home care - all things that matter enormously to direct care workers.
Smart operators use this to their advantage in recruiting. Centers that position themselves as a better place to work than home care can attract talent that might otherwise leave the care industry entirely. And centers that use their day program as a training ground for home care staff get an even bigger advantage - new caregivers build confidence and skills in a team setting before being sent into homes alone.
For more on how home care agencies are thinking about adult day as a strategic complement, see our article on why home care agencies should add adult day care.
Emerging staffing models - including shared staffing across home care and day programs, career ladders for DSPs, and technology-assisted workflows that reduce administrative burden - are beginning to reshape how the best operators think about workforce. We'll cover emerging models in depth in a future article (stay tuned).
This is where the industry has its biggest opportunity gap. Most adult day centers measure success by census - how many people showed up today. The best ones measure what actually happened while they were there.
What does outcome measurement look like in practice? It depends on your population:
For older adult programs, it might mean tracking changes in cognitive function, monitoring health indicators over time, documenting reductions in emergency room visits or hospitalizations, or measuring improvements in social engagement and mood.
For I/DD programs, outcomes are even more central to the mission. Person-centered goals are the foundation, and progress toward those goals - cooking a meal independently, successfully navigating a community outing, maintaining a conversation with a peer - is what demonstrates the program's value.
For all programs, caregiver burden reduction is a powerful outcome to track. If you can show a referring physician or social worker that your program measurably reduces caregiver stress and delays institutionalization, you become indispensable in their referral network.
Centers that can demonstrate outcomes have a significant advantage in payer negotiations, referral relationships, and - increasingly - in responding to audits and compliance reviews. AI-powered tools are beginning to make outcome tracking more practical, with automated service summaries and progress documentation that don't require staff to spend hours on paperwork.
For many families, choosing an adult day center is one of the hardest decisions they'll ever make. They're entrusting their loved one - their parent, their spouse, their adult child - to someone else's care. The centers that earn and keep that trust are the ones that keep families connected.
This means a family-facing app or portal where caregivers can see daily activities, view photos, read care notes, and stay informed without having to call and ask. It means proactive communication - not just when there's a problem. It means caregiver support groups and education that acknowledge the emotional weight of what families are going through.
When families feel connected, they stay. When they feel in the dark, they start looking for alternatives.
Here's a cautionary reality that every adult day operator should be aware of: all care programs funded by Medicaid and Medicare are under increasing scrutiny for fraud, waste, and abuse. Recent high-profile cases - while primarily involving children's day care programs - have focused regulatory attention on all day service models.
The home care industry went through this transition already. Concerns about billing accuracy and service verification led to Electronic Visit Verification (EVV) requirements through the 21st Century Cures Act. Agencies that were ahead of the curve adapted smoothly. Those that weren't scrambled.
Adult day services may be earlier on that same compliance curve, but the direction is clear. Centers that invest now in auditable documentation, electronic attendance tracking, and care plan alignment will be better positioned when - not if - requirements tighten.
For a deeper look at what home care's compliance journey means for adult day, read Why Adult Day Services Should Learn from Home Care Before They Have To.
Technology in adult day care shouldn't mean a TV in the corner or a sign-in sheet on a clipboard. The right technology platform touches every aspect of differentiation we've discussed:
The centers that treat technology as a strategic asset - not just an operational necessity - will be the ones that pull ahead.
If you're an adult day operator looking to grow, learn, and connect with peers, the National Adult Day Services Association (NADSA) is an essential resource. NADSA is the leading voice for the adult day services industry, offering education, advocacy, networking, and national conference opportunities. Their Executive Director, Tia Sauceda, joined us on the Home Care Heroes and Day Service Stars podcast to discuss the future of the industry - it's a conversation worth listening to.
At Ankota, we build software for adult day care centers, I/DD day programs, and home care agencies. Our platform handles attendance, scheduling, billing, documentation, family communication, and compliance - so your team can focus on what matters most: the people you serve.
Whether you're running a social day program, an ADHC center, or an I/DD DayHab, we'd love to show you how the right software makes differentiation easier. Contact us to learn more.
AI doesn't do the caring. It clears the path for it.
Ankota's mission is to enable the Heroes who keep older and disabled people living at home to focus on care because we take care of the tech. If you need software for home care, EVV, I/DD Services, Self-Direction FMS, Adult Day Care centers, or Caregiver Recruiting, please Contact Ankota. If you're ready to accept that the homecare agencies of the future will deliver care with a combination of people and tech, visit www.kota.care.