Adult Day Care Regulations in Nevada

Who regulates adult day care in Nevada

The Division of Public and Behavioral Health (DPBH), through its Bureau of Health Care Quality and Compliance, licenses adult day centers. State law calls them facilities for the care of adults during the day and classifies them as facilities for the dependent, which need a license under NRS 449.030.

The Division of Health Care Financing and Policy (DHCFP) runs Nevada Medicaid. It enrolls licensed centers as Medicaid providers, authorizes services and pays claims.

Types of adult day programs in Nevada

• Facility for the care of adults during the day: an establishment that provides care during the day, on a temporary or permanent basis, for aged or infirm persons (NRS 449.004). This is the base license for all adult day centers.
• Adult Day Health Care (ADHC): a Nevada Medicaid service for eligible recipients, provided by licensed centers enrolled as Provider Type 39.
• Social Adult Day Care: adult day care under the Medicaid Waiver for the Frail Elderly, provided by licensed centers enrolled as Provider Type 48, specialty 209.

Both Medicaid provider types must hold a DPBH adult day care facility license, so social and health-focused programs need the same state license.

How to get licensed in Nevada

1. Apply to the DPBH Bureau of Health Care Quality and Compliance for a license to operate a facility for the care of adults during the day.
2. If you are building or remodeling, submit building plans first. Under NAC 449.4063, the plans must be approved by the Division, and the Bureau will not approve a facility for licensure until construction is complete and an on-site survey is done.
3. Meet all applicable environmental, health, fire and local building codes. Where state and local requirements differ, the stricter rule applies.
4. To bill Medicaid, enroll with Nevada Medicaid. The Provider Type 39 checklist requires the DPBH license, a Secretary of State business license, tax identification documents, insurance, a Business Associate Addendum and fingerprint background checks for owners, administrators, managing employees and direct-service staff.

Key requirements

Licensing standards are in NAC 449.4061 to 449.4089. Key provisions include:

• Director: at least 21 with a high school diploma or equivalent, plus a similarly qualified acting director for absences (NAC 449.4072).
• Staffing: no fixed ratio. Each facility must have the number and kind of employees its building, client count and services require.
• Supervision: an employee must supervise each client at all times during operating hours, and volunteers meet the same standards as paid staff in similar roles (NAC 449.40723).

Medicaid ADHC centers have added requirements in Medicaid Services Manual Chapter 1800. The version with changes effective January 1, 2024 requires a full-time registered nurse and a full-time program director. A registered nurse, or a supervised licensed practical nurse, must be on site whenever a recipient attends, and at least one employee trained in first aid and CPR must be on site at all times.

Medicaid funding for adult day in Nevada

Nevada Medicaid covers Adult Day Health Care under the 1915(i) HCBS State Plan Option. Recipients must be Medicaid eligible and meet needs-based criteria, and DHCFP Health Care Coordinators prior authorize services. Recipients who live in a residential setting paid per diem for 24-hour care are not eligible.

The Waiver for the Frail Elderly, for people 65 or older who meet a nursing facility level of care, includes adult day care delivered by social adult day care providers.

Billing basics

The Provider Type 39 Billing Guide (updated July 2026) lists two codes for ADHC:

• S5100: adult day care, per 15 minutes, for services authorized and provided for less than 6 hours per day.
• S5102: adult day care, per diem, for services authorized and provided for the maximum of 6 hours per day.

Both codes cannot be billed for the same recipient on the same date. Every ADHC claim needs the prior authorization number that Nevada Medicaid issues to the chosen provider, and claims are submitted monthly. ADHC is not paid for days when the recipient is in a hospital, nursing facility or ICF.

DHCFP's EVV page requires electronic visit verification for personal care, home health and certain personal care type waiver services. It does not mention adult day services.

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

• DPBH: Facility for the Care of Adults During the Day
• NRS Chapter 449
• NAC Chapter 449
• Nevada Medicaid Provider Type 39 Enrollment Checklist
• Nevada Medicaid Social Adult Day Care Enrollment Checklist
• Nevada Medicaid Provider Type 39 Billing Guide

Frequently asked questions

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

Yes. A facility for the care of adults during the day needs a license from the DPBH Bureau of Health Care Quality and Compliance.

Does Nevada Medicaid pay for adult day care?

Yes. Medicaid pays licensed centers for Adult Day Health Care under its 1915(i) state plan option and for social adult day care under the Waiver for the Frail Elderly, with prior authorization.

Who inspects adult day centers in Nevada?

The DPBH Bureau of Health Care Quality and Compliance licenses centers and conducts the on-site survey required before a new facility is approved for licensure.

Is social adult day care regulated in Nevada?

Yes. Social adult day care providers under the Frail Elderly waiver must hold the same DPBH adult day care facility license as other centers.