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Adult Day Health Care

Generated from the gc-benefits catalog. It lists what the owner record states. It is not an eligibility decision; confirm current rules with the program.

Adult day health care gives the person cared for medically supervised health care services in a non-residential group day setting. It helps them stay in the community.

  • Owner record: ny/adult-day-health-care
  • Jurisdiction code: NY
  • Frame: care_recipient
  • Review by: 2026-11-11
  • Authority: 10-nycrr-425

Offering 1: adult_day_health_care

Health care services and activities in a non-residential group setting for people with functional impairments, to maintain their health status and enable them to remain in the community.

  • Availability (owner codes): {"checked": null, "intake": "unknown", "type": "unknown"}
  • Amounts (as stated by the owner): [{"period": "weekly", "value": "generally one to five days", "what": "days of service offered per week"}, {"period": "per session", "value": "five hours", "what": "minimum operating time of each approved program session, not including transportation, with at least one meal"}, {"period": "n/a", "value": "Medicaid, private payment, and some health insurers", "what": "who pays: available through"}, {"period": "per individual visit", "value": "may be fewer than five hours or longer than five hours depending on the assessed needs of the registrant", "what": "individual visit duration"}]

Conditions:

  • All of these:
  • Fact rule: recipient.nursing_facility_level_of_care is true
  • Stated condition, not checked automatically: "who is not a resident of a residential health care facility"
  • Stated condition, not checked automatically: "is functionally impaired and not homebound"
  • Stated condition, not checked automatically: "requires supervision, monitoring, preventive, diagnostic, therapeutic, rehabilitative services or palliative care but does not require continuous 24-hour-a-day inpatient care and services"
  • Stated condition, not checked automatically: "whose assessed social and health care needs can satisfactorily be met in whole or in part by the delivery of appropriate services in the community setting"
  • Stated condition, not checked automatically: "who has been accepted by an adult day health care program based on an authorized practitioner's order or a referral from a managed care plan and a comprehensive assessment conducted by the adult day health care program or by the managed care plan"

Access route 1.1

  • Where: NY
  • How: Seek help from community organizations, health care providers, or hospital discharge planners to find a program. Admission is based on an authorized practitioner's order or a referral from a managed care plan and a comprehensive assessment.
  • Url: https://www.health.ny.gov/health_care/medicaid/program/longterm/addc.htm
  • Phone: null

Owner confirmations

  • /caregiving_effect: sha256:ac804e8128b6d5b83aa5ba0d53a60f0cfa1f1514090da8df9153fd76e22ff73f
  • /offerings/0/access/0: sha256:ed7f5a1155c982d08cd15a11ece678f37a77522c4fe1bf05b36c1134b478040f
  • /offerings/0/rules/all/0: sha256:0f4845e81464d3059cbb5f142b1adbcb11e76123cef755d69cb8d849812697fa

Evidence

  • /name: "Adult Day Health Care" (source, capture d435a2cd42779b8ca8c114c792eea0484a212fca2764bd4ced01d1f95fb04ccf)
  • /caregiving_effect: "Medically-supervised services for individuals with physical or mental impairment" (source, capture d435a2cd42779b8ca8c114c792eea0484a212fca2764bd4ced01d1f95fb04ccf)
  • /caregiving_effect: "to maintain their health status and enable them to remain in the community" (source, capture d55b1297811b6fb2a19cbe0182bba05aec8f33181a0caa433945726160fa1305)
  • /offerings/0/summary: "the health care services and activities provided in a non-residential group setting to a group of registrants with functional impairments to maintain their health status and enable them to remain in the community" (source, capture d55b1297811b6fb2a19cbe0182bba05aec8f33181a0caa433945726160fa1305)
  • /offerings/0/rules: "All patients are required to be eligible for nursing home placement and have a physician's order for the day services." (source, capture d435a2cd42779b8ca8c114c792eea0484a212fca2764bd4ced01d1f95fb04ccf)
  • /offerings/0/rules: "who is not a resident of a residential health care facility, is functionally impaired and not homebound, and requires supervision, monitoring, preventive, diagnostic, therapeutic, rehabilitative services or palliative care but does not require continuous 24-hour-a-day inpatient care and services" (source, capture d55b1297811b6fb2a19cbe0182bba05aec8f33181a0caa433945726160fa1305)
  • /offerings/0/rules: "whose assessed social and health care needs can satisfactorily be met in whole or in part by the delivery of appropriate services in the community setting" (source, capture d55b1297811b6fb2a19cbe0182bba05aec8f33181a0caa433945726160fa1305)
  • /offerings/0/rules: "(3) who has been accepted by an adult day health care program based on an authorized practitioner's order or a referral from a managed care plan and a comprehensive assessment conducted by the adult day health care program or by the managed care plan." (source, capture d55b1297811b6fb2a19cbe0182bba05aec8f33181a0caa433945726160fa1305)
  • /offerings/0/access/0/how: "the patient or the patient's family may seek the help of community organizations, health care providers, or hospital discharge planners" (source, capture d435a2cd42779b8ca8c114c792eea0484a212fca2764bd4ced01d1f95fb04ccf)
  • /offerings/0/access/0/how: "have a physician's order for the day services" (source, capture d435a2cd42779b8ca8c114c792eea0484a212fca2764bd4ced01d1f95fb04ccf)
  • /offerings/0/access/0/how: "(3) who has been accepted by an adult day health care program based on an authorized practitioner's order or a referral from a managed care plan and a comprehensive assessment conducted by the adult day health care program or by the managed care plan." (source, capture d55b1297811b6fb2a19cbe0182bba05aec8f33181a0caa433945726160fa1305)
  • /offerings/0/amounts: "Generally, services are offered from one to five days per week, with some services available on weekends." (source, capture d435a2cd42779b8ca8c114c792eea0484a212fca2764bd4ced01d1f95fb04ccf)
  • /offerings/0/amounts: "This program is available through Medicaid, private payment, and some health insurers." (source, capture d435a2cd42779b8ca8c114c792eea0484a212fca2764bd4ced01d1f95fb04ccf)
  • /offerings/0/amounts: "Each approved adult day health care session must operate for a minimum of five hours duration, not including time spent in transportation, and must provide, at a minimum, nutritional services in the form of at least one meal and necessary supplemental nourishment in the form of snacks and hydration of choice, and activities at planned and at registrant desired times(s)." (source, capture d55b1297811b6fb2a19cbe0182bba05aec8f33181a0caa433945726160fa1305)
  • /offerings/0/amounts: "A registrant's individual visit may be fewer than five hours or longer than five hours depending on the assessed needs of the registrant." (source, capture d55b1297811b6fb2a19cbe0182bba05aec8f33181a0caa433945726160fa1305)