Adult Day Care Regulations in Mississippi

Who regulates adult day care in Mississippi

We found no Mississippi license for adult day centers. The Mississippi State Department of Health (MSDH) health facilities licensure rules have 23 chapters, and none of them covers adult day care.

The main oversight comes from the Mississippi Division of Medicaid (DOM), which administers and operates the Elderly and Disabled (E&D) Waiver. Adult day care providers must meet the E&D Waiver enrollment standards in Title 23, Part 208, Chapter 1 of the Mississippi Administrative Code, and DOM inspects the facility as part of enrollment.

Types of adult day programs in Mississippi

The program type defined in state rules is Adult Day Care (ADC) under the E&D Waiver. Rule 208-1.6 describes ADC as community-based programs that provide health, social and related supportive services in a protective setting during daytime and early evening hours.

The service includes personal care and supervision, limited health care including medications, at least one meal and two snacks a day, and round trip transportation to the center and center-sponsored activities. We found no separate state definition of social adult day care.

Opening an adult day center in Mississippi

Because we found no state adult day license, the requirements below are the E&D Waiver provider enrollment steps in Rule 208-1.3 (amended June 1, 2025). They apply to centers that want to serve Medicaid participants.

1. Be an established business that has provided the service for at least one year, with a physical Mississippi office that is not in a personal residence.
2. Gather an NPI, Secretary of State business registration, tax ID confirmation and proof of financial solvency, including a business line of credit covering three months of operations.
3. Attend DOM's mandatory orientation and score at least 85 on the orientation exam.
4. Submit a proposal package to DOM's Office of Long-Term Care. DOM approves the counties you will serve and inspects the facility.
5. If you prepare food on site, get an MSDH kitchen permit, and have vehicles inspected by a certified mechanic before you apply.
6. Sign a Medicaid provider agreement within six months of your approved proposal letter.

Key requirements

• Staffing: at least two staff, including one paid employee, whenever attendees are present, and a staff to attendee ratio of 1:6, or 1:4 for programs serving many severely impaired attendees.
• Key roles: an administrator, a program director if the administrator is not on site full time, a licensed nurse on site at least eight hours a week, an activities coordinator and a program assistant.
• Space: at least 60 square feet of program space per attendee, ADA-compliant exits and locked storage for toxic substances.
• Hours: centers must be open and providing services at least nine continuous hours a day, Monday through Friday, 8 a.m. to 5 p.m., except state and federal holidays (Rule 208-1.6, as amended June 1, 2025).
• Transportation: no participant may ride for longer than 60 minutes per trip.
• Background checks: fingerprint-based national checks before employment and every two years, plus registry checks before employment and monthly.

Medicaid funding for adult day in Mississippi

Medicaid pays for ADC through the E&D Waiver, which covers home and community-based services as an alternative to nursing facility care (Rule 208-1.1). DOM administers and operates the waiver, and waiver services must be delivered in home and community-based settings that meet federal rules.

Payment for all waiver services is made through DOM's approved Medicaid Management Information System (MMIS). Claims must match the services authorized in the participant's Plan of Services and Supports (Rule 208-1.10).

Billing basics

• ADC is billed in 15-minute increments for the time from the participant's arrival to departure, not counting transportation (Rule 208-1.6).
• Each day is its own line item, span billing is not allowed, and DOM pays the lesser of the daily maximum or the billed units.
• Bill ADC no sooner than the first day of the month after services were provided, and keep service records for at least five years (Rule 208-1.10).
• The rule requires electronic visit verification (EVV) for personal care and in-home respite claims. ADC is not on that list.
• We could not confirm the ADC procedure code or claim format from an official fee schedule.

Other ways centers are paid

Enrolled veterans who meet VA eligibility and clinical criteria can get Adult Day Health Care through the VA, which may be provided at VA medical centers, State Veterans Homes or community organizations.

Official resources

• Mississippi Division of Medicaid
• Miss. Admin. Code Title 23, Part 208, Chapter 1: Elderly and Disabled Waiver
• Rule 208-1.3: Provider Enrollment
• Rule 208-1.6: Covered Services
• MSDH Health Facilities Licensure and Certification Rules
• Mississippi Association of Adult Day Services
• VA Adult Day Health Care

Frequently asked questions

Do I need a license to open an adult day center in Mississippi?

We found no state adult day license, and MSDH's facility licensure rules do not include adult day care. To serve Medicaid participants, you must complete DOM's E&D Waiver provider enrollment, including a facility inspection.

Does Mississippi Medicaid pay for adult day care?

Yes. Adult Day Care is a covered service in the Elderly and Disabled Waiver, paid through DOM's claims system in 15-minute units up to a daily maximum.

Is social adult day care regulated in Mississippi?

We found no Mississippi rule that licenses social adult day programs. The standards we found apply to Adult Day Care providers enrolled in the E&D Waiver.

Who inspects adult day centers in Mississippi?

DOM inspects adult day care facilities when they enroll as E&D Waiver providers. MSDH issues the kitchen permit for centers that prepare food on site.