Adult Day Emerges As New Potential Service Line For Home Care Providers

Now that the public health emergency (PHE) has ended, one segment of the senior care space that had a particularly difficult time throughout the pandemic could make a serious comeback.

That is adult day services.

“Adult day definitely struggled during the pandemic in a lot of ways that other care models didn’t,” Brendan Flinn, a senior policy advisor at the AARP Public Policy Institute, told Home Health Care News. “But adult day remains a really important part of the care ecosystem for older adults and for family caregivers. Those that survived are going to continue to survive and I think it’s a really important and interesting time in the space. There’s a lot of potential that remains.”


Though specific services vary across providers, adult day centers give seniors access to community-based social and health services. This can include recreational activities, meals, medical services, therapeutic activities, personal care and more.

There are now more than 7,500 adult day centers across the U.S., according to the National Adult Day Services Association (NADSA).

However, at least two-thirds of states had some sort of temporary restrictions on adult day centers during the pandemic.


One of the biggest challenges adult day faced during those years was the inability to collect federal funds in the same way home health, hospice and home care providers did.

Adult day is generally paid for by private pay, Veterans Affairs (VA), or Medicaid.

As home care providers’ billing rates rise, a smaller portion of the population can pay for services. Those stuck in between – individuals who cannot afford to pay for private-pay services, but don’t qualify for Medicaid – are left behind.

Arosa CEO Ari Medoff told HHCN last month that his company was considering wading into adult day due to that dynamic.

The home care provider Senior Helpers has also had adult day communities for years.

Adult day services are a much more affordable option for families. According to research done by Genworth, the monthly median cost for adult day care in the U.S. in 2021 was $1,690. That’s significantly lower than a home health aide ($5,148) and an assisted living facility ($4,500).

“I think adult day is another great way of being able to reach older adults and family caregivers in the community,” Flinn said. “When home care or home health isn’t necessarily the best option, it still provides a good, quality level of care. As opposed to needing to move into a nursing home or an assisted living facility, they can move towards this model of care where members really need that support throughout the day.”

Adult day can also be an additive service to a senior care provider’s portfolio, one that helps form a fuller continuum.

“Home health care providers that see the need to offer a continuum of care will benefit from providing more services to their clients,” Kara Harvey, CEO and executive director of Elder-Well Adult Day Program, told HHCN. “This seamless transition benefits the seniors, allowing them to receive consistent care from familiar faces, promoting continuity and trust in the caregiving process.”

Elder-Well is a Massachusetts-based non-medical adult day care provider.

Despite some of the industry-wide struggles during the pandemic, Harvey said her company’s survival and continued growth can be attributed to a combination of adaptability, innovation and commitment.

“Operating during the pandemic was difficult, but the innovations and adapted offerings have found a permanent place in our program,” she said. “We still practice a version of the enhanced safety measures developed, we continue to offer virtual engagement and Elder-Well now offers a home care service extension. This consistency helped maintain a sense of familiarity and comfort for our participants and employees, contributing to the program’s overall success.”

In addition to Arosa, other home care providers have told HHCN they are considering the adult day model.

Even if they’re not, some are at least up for partnering with established adult day communities.

“Home care providers understand that caregiving for seniors can be physically and emotionally demanding, so by investing in adult day care centers, they can offer respite services for family caregivers,” Harvey said. “Andm in most cases, adult day care centers can be more cost-effective than full-time home care services. By utilizing these centers during the day, seniors can receive professional daytime care and attention at a more affordable rate.”

Future collaboration with home care agencies could create “a seamless continuum of care” down the line, she added.

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