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Adult Day Services

Adult Day Services

Many vulnerable adults do not need the services of institutional care such as nursing homes, but they still need services that will help them function to their fullest potential. They also need a place that will help them avoid feeling isolated or lonely, and one that will help their caregivers (such as family members) take some time to rest and care for themselves. Adult Day Care (also called “Adult Day Services”) is critical to helping meet these needs. This program is funded through the Social Services Block Grant.

Learn more about: 

Attention Adult Day Services Providers:  Questions and comments regarding adult day services rules can be sent by email to AdultDayServices.DHS@tn.gov

The primary purpose of adult day services is the protection of adults who are participants in adult day services centers.  Minimum requirements are designed to maintain adequate health, safety, and supervision of adults while in adult day services programs.  Licensure rules for adult day services centers may be accessed at the Secretary of State's website. https://publications.tnsosfiles.com/rules/1240/1240-07/1240-07-10.20180524.pdf

Tennessee's adult day services centers are inspected throughout the year to ensure that providers continue to meet licensing requirements.

Adult day services centers are required to post their license.  Agencies are also investigated in response to complaints.

Contact your local child and adult care licensing office to become a licensed adult day services center.

Adult Day Services provides an organized program in a community group setting to promote social, physical and emotional well-being.  These programs offer a variety of activities designed to meet the needs and interests of each older adult who receives care.  Listed below are some tips to help you choose an adult day service center that meets the needs of your family.

TIPS FOR CHOOSING ADULT DAY SERVICES CENTERS

1. Become familiar with rules and laws regarding adult day services in the State of Tennessee.  Adult Day Services Standards

2. Locate a list of adult day care service providers in your area and contact each one to schedule a tour of the facility.  

3. Ask questions of the staff to determine if the facility is a good fit for your loved one and will meet the needs of both of you and your loved one. (Examples of some questions to ask include but are not limited to):

  • What program services and activities are provided?
  • Are nutritious meals and snacks provided?
  • Is assistance provided with feeding, toileting, etc.?
  • Are there accommodations for special needs such as wheelchair or hearing / visual impairment?
  • What is the staff to participant ratio?
  • What are the credentials of the staff?
  • Is this facility licensed and if so by what Department?
  • Does this agency have a history of non-compliance with state regulations or valid complaints of improper care?
  • Is the financial assistance available?
  • What insurance do you accept?
  • What are the fees?
  • Are there additional resources available?

4. Maintain open communication with the adult day services provider to ensure your loved one is receiving care that meets the expectations of the family as well as the needs of the adult participant.

Additional Resources:  National Adult Day Services Association

National Family Caregiver Support Program  

Report Abuse, Neglect and / or Exploitation of an Adult
According to Tennessee Code Annotated Title 71- 6-103(b) "any person having reasonable cause to suspect that an adult has suffered abuse, neglect, or exploitation, shall report or cause reports to be made” reporting such information to the Department.  A report can be made by:

Call Toll Free: 1-888-APS-TENN (1-888-277-8366)  

Report Online: https://reportadultabuse.dhs.tn.gov/

Investigation of Reports of Abuse, Neglect and/or Exploitation of an Adult
The Adult Protective Services Division of the Tennessee Department of Human Services investigates complaints that allege abuse, neglect and/or exploitation of an adult.
To learn more about Adult Protective Services visit: https://www.tn.gov/humanservices/adults/adult-protective-services.html

Report Licensing Violations or Illegal Operations
To report suspected licensing violations or possible illegal adult day services operations, call the Child and Adult Care Complaint Hotline at 1-800-462-8261. You can also e-mail your information to AdultDayServices.DHS@tn.gov

Abuse Registry
The Department of Health Abuse Registry includes the names of persons who have abused, neglected, exploited or misappropriated property of vulnerable persons. Link to Tennessee Department of Health Abuse Registry

Background Checks for Adult Day Services Center Employees

All individuals working in licensed adult care in Tennessee must submit to a criminal history background check through the Tennessee Bureau of Investigation (TBI).

1. Each applicant must complete a Disclosure Form which is retained by the adult day services agency.  Adult Day Care Services Criminal/Juvenile History & State Registry Review Disclosure Form
2. Each applicant must be fingerprinted: Instructions for Fingerprinting
3. Each applicant must retain proof of being fingerprinted by returning the signed receipt to the adult day services agency to be attached to the Disclosure Form.
4. The agency must enter the TCN number on the Disclosure Form. This number is located on the fingerprinting receipt.

Information about obtaining the Originating Agency Identifier, which is required to register for fingerprinting, can be found at: Background Check Terms & Procedures

Find a live scan fingerprinting location and schedule an appointment: Fingerprinting Enrollment Screen

Adult Day Services Centers may receive the results of employee fingerprint background checks which do not result in an exclusion by fax or email. Agencies wishing to receive results in this manner must complete a Transmittal Authorization Form.

Adult Day Services Centers may transfer the background check clearance for employees that have been fingerprinted within the last ninety (90) days to another adult day services center by completing a Criminal Background Check Transfer Form and returning it to the Department. 

How long does it take to get the results of a background check? Normally, the process only takes a few days. If you have not received your results within five days, please contact your Licensing Program Evaluator. Do not send applicants to be reprinted at this point.

When is a reprint necessary? A reprint is required only when the original prints have been rejected. The Department will notify the agency and the applicant in writing if the prints have been rejected. If you receive a letter from the Department notifying you that your original prints have been rejected, you may get a free reprint by following the: Instructions for Scheduling a Reprint

How do I get a duplicate “clear to work” letter? If you need a duplicate “clear to work” letter for a current employee, please email your request to the following address: CC-Criminal-Background-Inquiries.DHS@tn.gov

What offenses exclude a person from an adult day services center?
Criminal offenses for which a person must be excluded from an adult day services center include physical, sexual or emotional abuse or neglect of an adult or child, crimes of violence, any offenses that present a threat to the health, safety or welfare of adults or children, and drug related offenses.  Specific examples of excludable criminal offenses include aggravated assault, arson, child abuse, cruelty to animals, domestic assault, indecent exposure, reckless endangerment, robbery, stalking, vehicular assault, voluntary manslaughter, and weapons offenses.  An expanded list of excludable offenses can be found in the Adult Day Services Standards 1240-07-10-.09.

Reporting Issues or Concerns with the Background Check Process
If you encounter an issue with the background check process, please report the problem by calling the Child and Adult Care Background Check helpline: (615) 253-4170 

Training and resources are powerful tools that enable adult day services providers and family caregivers to increase their knowledge and awareness as they help care for those who need adult day services or other in-home care.

Do you need an Adult Day Services Center License?

Adult day service centers providing care to 5 or more people are required to obtain a license by the Tennessee Department of Human Services (TDHS) and adhere to licensing requirements beginning July 1, 2017.  Adult day services centers currently providing care for 5 to 9 adults without a license should contact the local TDHS child and adult care licensing office to initiate the licensing process.  Find locations here.

Have more questions? Contact a child care licensing office near you

Procedures for Becoming a Licensed Adult Day Services Center

1. Attend and complete an information intake meeting provided by the Department Contact your local DHS licensing office for details and dates.

2. Attend and complete pre-orientation for new Directors  Contact your local DHS licensing office for details and dates.

3. Obtain and read Adult Day Services Licensure Rules

4. Obtain a Federal Employer Identification Number (FEIN) – by calling 1-800-829-4933 or by visiting IRS web site

5. Obtain a Use and Occupancy Permit, Business Permit and any other required permits

6. (DHS) Assign a Program Evaluator (PE).

7. (DHS assigned Program Evaluator) Schedule a site visit to the proposed adult day services facility.  The PE will visually inspect and assess the suitability of the facility for adult day services.

8. Submit a floor plan and photos of the entire facility to include any outdoor space that will be utilized by participants.

9. Submit a completed application and appropriate fee (Non-refundable).  To obtain an application click here. The fee must be in the form of a certified check, business check, government agency check or money order made out to the Treasurer, State of Tennessee.

The Director and / or owner must submit the following items with the application:

  • Proof of Education (copy of diploma or degree)
  • Proof of Experience (a list of previous work history with employer contact information that can be verified)
  • Three non-related references with contact information
  • Documentation of the agency’s business organization

10.  (DHS Program Evaluator) Make requests for the following inspections: State Fire Marshal, local fire department, local health department (Environmentalist). 
Note: The potential licensee is responsible for ensuring the facility is compliant with state fire, local fire, and environmental health requirements.  A written approval must be received prior to the Department issuing a temporary license.

11. Schedule and complete criminal background check (CBC) process.

12. Submit CBC clearance letters for all employees to the Program Evaluator.

13. Upon demonstration of compliance of all laws and regulations governing the adult day service center and if the applicant has satisfactorily met the requirements, the Department shall issue a temporary license for a period of six (6) months.

Procedures for Requesting an Exemption from Licensure
Exception for Limited Respite Care Services