How Adult Day Care Is Licensed: Texas, Missouri, New York City and the NPI Registry
What a Texas DAHS license, a Missouri adult day care license, NYC Aging registration and an NPI each tell you.
There is no single national license for adult day care. Each state decides whether to license, certify or register these programs, which agency does it, and what the rules require. That is why this directory shows different badges in different places. This guide explains the three rosters we use, Texas, Missouri and New York City, and what the federal NPI registry can and cannot tell you about centers elsewhere.
Texas: Day Activity and Health Services (DAHS)
Texas licenses adult day centers through the Health and Human Services Commission under 26 Texas Administrative Code Chapter 559, which implements Chapter 103 of the Texas Human Resources Code. The rule defines a DAHS facility as one that "provides services through a day activity and health services program on a daily or regular basis, but not overnight, to four or more elderly persons or persons with disabilities who are not related to the owner of the facility by blood, marriage, or adoption" (26 TAC §559.3).
HHSC describes DAHS as daytime services, usually Monday through Friday, for adults 18 and older who live in the community: a noon meal and snacks, nursing and personal care, physical rehabilitation, social, educational and recreational activities, and transportation, overseen by a licensed nurse (Texas HHSC: DAHS). HHSC publishes two directories of facilities with an active license, one for traditional DAHS (some also licensed for Individualized Skills and Socialization) and one for ISS-only providers, as well as a closures list.
Individualized Skills and Socialization is the day service for adults with intellectual or developmental disabilities in the HCS, TxHmL and DBMD waivers; ISS providers must hold a DAHS license, and the rules for them are in Subchapter H of Chapter 559 (Texas HHSC: ISS).
Each Texas profile here shows the license number, program type, total licensed capacity, first license date, license expiration date, owner, entity type and administrator as HHSC lists them. A handful of rows carry an expiration date that has already passed; HHSC still lists them as active, and the profile says so rather than guessing why.
Missouri: licensed adult day care programs
Missouri licenses adult day care programs through the Department of Health and Senior Services under 19 CSR 30-90 (19 CSR 30-90). Key points from the rule:
- A licensed program cares for five or more functionally impaired adults for more than two and less than 24 hours a day, outside their own homes.
- The licensed capacity is the number of participants who may be present at any one time.
- A regular license is issued for up to two years. A program that does not yet meet every requirement may receive a provisional license, valid for up to six months and not renewable.
- At least two direct care staff must be present when 2 to 16 participants attend, plus one more for each additional eight participants or part of eight.
- A program with a separate Alzheimer's unit, or that markets itself as providing Alzheimer's or dementia care, must file an Alzheimer's Special Care Services Disclosure describing its philosophy, admission and discharge criteria, care planning, staff training, environment, activities, family involvement, costs and safety measures.
- "Adult day health care" in Missouri means a licensed program that is also certified to provide Medicaid-reimbursed services.
DHSS publishes its adult day care directory as open data. Each Missouri profile here shows the DHSS facility ID, maximum capacity, whether an Alzheimer's unit is listed, days and hours, the director and the licensed provider (Missouri DHSS).
New York City: registered social adult day care
New York City takes a different approach for social adult day care. Under Section 21-204 of the city's Administrative Code, every SADC operating in the city must register with NYC Aging, pay a fee, keep its information current, and follow the New York State Office for the Aging program standards and participant rights and Chapter 2 of Title 69 of the Rules of the City of New York. NYC Aging can investigate complaints and issue notices of violation. Programs must post signs with the SADC Ombuds Office contact and participants' rights. NYC Aging is clear that registration "does not grant a certification or license" and is not a judgment of quality (NYC Aging).
So the New York City badge here says "Registered (NYC Aging)," not "licensed." Each profile shows the NYC Aging program ID, the days and hours the program reports, and whether it receives NYC Aging funding, plus what the program itself reported to NYC Aging: anticipated daily attendance, year established, languages spoken, and whether it says it is ADA compliant and holds a current New York State Office of the Medicaid Inspector General (OMIG) compliance certification. Those last items are self-reported, and the profile labels them that way. Medical adult day health care programs in New York are a separate, state-regulated service and are not on NYC Aging's list.
Everywhere else: the NPI registry
For other states we list organizations whose National Provider Identifier record names "Clinic/Center, Adult Day Care" as their primary specialty (NPPES NPI Registry). An NPI is the federal identifier that health care providers use to bill insurance, including Medicaid. It shows that the organization registered with the federal system and that the number is active. It is not a state license, and the specialty is self-reported. Many NPIs stay active after a center closes or moves, so we leave out records that have not been updated since 2015, and in Texas and Missouri, where the state lists every licensed program, we use the NPI only to add the number to a state-listed center.
If a center you are considering appears here only as "NPI registered," ask it which state license or certification it holds, and look that up with your state's health or aging department before enrolling.
What no license tells you
Every one of these records is a starting point. A license, registration or NPI says a program is known to a government agency; it does not tell you about staff turnover, how participants are treated, or whether the program suits your family member. Visit, ask questions, and read any inspection reports the state makes available. Our checklist guide lists the questions that matter most.
General information only, current as of the date above. The information on Adult Day Care Index is not medical advice and does not replace a doctor, nurse, discharge planner or other qualified professional. Do not use it to make decisions about diagnosis or treatment. If you have a medical emergency, call 911. Rules and programs change; check the official sources linked in this guide.