Spotify 
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iHeartRadio Every publicly funded service industry follows a familiar pattern over time.
It begins as relationship-driven and trust-based. Documentation requirements exist, but they're designed for smaller scale and human review. Oversight focuses more on intent than instrumentation. Most providers know their regulators, and regulators assume good faith because, historically, that assumption has been reasonable.
Then the industry grows.
Participation expands. Funding increases. New operators enter the market. Programs scale faster than the administrative and compliance systems meant to support them. Processes that once worked through paper logs, spreadsheets, or loosely connected tools begin to strain.
Eventually, something gives.
Sometimes the issue is fraud. Sometimes it's inconsistent documentation. Sometimes it's simply an inability to clearly demonstrate that services were delivered as authorized, when they were authorized, and in the manner they were intended. The trigger varies, but the response is consistent: increased scrutiny, more audits, and tighter compliance requirements.
Adult day services may be approaching such a moment. Recent high-profile cases involving day care fraud—while involving children's programs, not adult services—have focused regulatory attention on all day service models. The question isn't whether adult day centers have similar issues. The question is whether they have systems that can demonstrate they don't.
This pattern is not political. It's structural.
Regulation Is Almost Always Reactive
Oversight rarely tightens because an industry is functioning perfectly. It tightens when visibility breaks down at scale.
This is true across publicly funded systems, including healthcare, financial services, and transportation. Regulation typically follows a moment where trust alone is no longer sufficient and evidence becomes necessary.
Home care agencies experienced this transition directly. Concerns about billing accuracy and service verification did not begin as a technology conversation. They began with a practical question: How do you reliably prove that services were delivered as authorized across thousands of providers and millions of visits?
Electronic Visit Verification, or EVV, emerged as a scalable answer to that question. Over time, it became a regulatory requirement through the 21st Century Cures Act. Whether agencies viewed EVV as helpful or burdensome ultimately didn't matter. Once codified, it became part of doing business.
Why Now Matters
State budget pressures and federal Medicaid oversight—which funds half of all Medicaid expenditures—are increasing scrutiny of publicly funded programs across the board. When auditors look for efficiency opportunities, they often start with programs that lack robust verification systems. Not because fraud is assumed, but because verification is harder to demonstrate quickly.
Adult day services, funded increasingly through Medicaid waiver programs and other government-subsidized models, represent a natural point of focus as oversight intensifies.
EVV Wasn't About Software—It Was About Proof
It's easy to think of EVV as a software mandate imposed on home care agencies. In reality, technology was simply the tool used to solve a much older problem: verification.
Regulators needed a way to confirm:
- That services occurred
- When and where they occurred
- That they aligned with authorized care plans
Technology provided consistency, auditability, and scale. But the underlying issue was not innovation. It was accountability.
That distinction matters for other service models, including adult day services.
What EVV Required of Home Care:
- Location confirmation
- Service alignment with care plans
- Audit-ready documentation
- Real-time service verification
Question for adult day centers: Which of these would be difficult for your program to produce today?
(Visit our Adult Day Care Services Reference Guide)
Adult Day Services Are Earlier on the Same Curve
Adult day services occupy a different point on this same compliance trajectory.
The sector continues to grow, supported in many states by public funding through Medicaid waiver programs and other government-subsidized models. Documentation requirements exist, but many programs still rely on attendance logs, manual service records, or systems that were never designed for large-scale oversight or audit readiness.
That doesn't mean adult day services are doing anything wrong. It means the industry still has something rare: choice.
Choice in how service delivery, attendance tracking, and documentation evolve before external mandates define them.
Compliance Does Not Have to Mean Bureaucracy
One of the unintended consequences of reactive regulation is operational friction. When compliance rules are introduced quickly, they often prioritize audit defensibility over day-to-day usability. Staff workflows become more complex. Administrative burden increases. Organizations spend time adapting to
requirements they had little role in shaping.
There is an alternative.
When documentation and verification are treated as part of service delivery, rather than an after-the-fact obligation, compliance becomes less visible. Well-designed systems support staff instead of slowing them down. Verification happens naturally as services are delivered.
The goal is not surveillance. The goal is consistency.
Consistent systems tend to attract very little regulatory attention. For most providers, that outcome is ideal.
The Strategic Advantage of Preparing Early
Adult day centers that invest early in clear, auditable documentation practices often see benefits that go beyond compliance:
- Fewer surprises during audits or funding reviews
- Less disruption when state or federal requirements change
- Easier staff training and onboarding
- Cleaner reporting for families, payers, and oversight bodies
- Greater credibility when participating in policy discussions
Most importantly, early preparation preserves control. Providers shape their workflows intentionally instead of adapting them under pressure.
Looking Ahead Without Alarm
This perspective is not a warning and it is not a prediction. It's an observation informed by adjacent industries that have already navigated similar transitions.
Adult day services deliver critical community-based care. The question is not whether that work deserves trust. It's whether trust can be supported by systems that scale alongside the industry itself.
Organizations that recognize these patterns early tend to adapt on their own terms. Those that wait often find the decisions have already been made for them.
Start by asking one question: If your state requested proof of attendance, service delivery, and care plan alignment for the past 90 days, how long would it take your team to produce that documentation? If the answer is more than a few hours, you have an opportunity—while it's still optional.
Ready to Future-Proof Your Documentation?
Ankota's adult day services software was built by people who've been through compliance transitions before. Our platform handles attendance tracking, service documentation, and care plan alignment automatically—so verification happens as part of your daily workflow, not as an afterthought.
Whether you're preparing for tighter oversight or simply want systems that make your team's job easier, we can help you get there on your own terms.
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.
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