The demand for non-institutionalized care services for adults is increasing, especially given the high cost of care in retirement and assisted living facilities. Many older adults who are not able to afford a continuum of care facility opt for in-home care, but it can be a pricey alternative. For many families, a local adult day care facility may be the perfect choice, providing an opportunity for business-minded individuals to offer services that are high in demand. But before opening your doors, it is important to understand the many facets of running an adult day care business, so do your research and plan thoroughly.

Assess the Local Community's Needs

While nationwide adult day care facilities are in demand, research the need for the service in your local community. Ask questions and interview people who have their pulse on the needs of older adults in your area. For example, you may want to talk to area physicians or a visiting nurse association to see if their patients would benefit from your services. Also, research if there are similar businesses already operating nearby and learn about their specific client demographics and services. You may be able to meet the needs of adults not currently being served and fill a needed gap in client care.

Choose Type of Care to Provide

Many typically think of an adult day care as a place where older adults can interact with others in a safe environment, receive a nutritious meal and receive assistance with some of the activities of daily living. In fact, this level of care may assist a wider variety of clients in addition to the elderly including those with the following conditions:

  • Dementia or Alzheimer's disease
  • Stroke
  • Brain injury
  • Developmental disabilities, yet high functioning 

Providing this type of care will require a specific structure and setup, including training of employees to work with clients dealing with these diagnoses. The type of activities you offer will allow clients to get involved independently and only require support from staff as they participate in the activities.

A second type of adult client who would benefit from day care services are those with developmental disabilities such as Down syndrome, seizure disorders or cerebral palsy. These clients might be more limited in their physical mobility and require more specialized care, including assistance from licensed nursing staff. Some may be non-verbal and most will require assistance with all the activities of daily living including feeding.

Many of these clients may be younger than others in some adult day care centers, but families still value the attention and specialized care their loved ones receive throughout the day while they get a needed break from caregiving and can maintain employment of their own.

Decide on the Scope of Service

Your clients' needs will determine the scope of the services you offer as well as how much money you can invest in going beyond the basics. For example, you'll probably offer meals and nutritional services, day trips, special events, crafts or art therapy sessions. But you might also consider offering rehabilitation services, physical and occupational therapy, podiatric care, hair care in an on-site salon and transportation services. Each of these additional services adds value to your site as a one-stop-shop for older adults' every need, but they will also cost you more to operate.

Set Up Your Business Entity

Solidify your thoughts and develop a formal business plan for every aspect of your business, utilizing advice from the Small Business Administration (SBA). Create a legal business entity in the form of a sole proprietorship, partnership or corporation. A lawyer can help you with the details and make sure you cover all the important details. Some of the other things a business needs to handle before opening include:

  • Acquire an Employer Identification Number (EIN) from the IRS and create a state account for handling employer and income tax
  • Open a business bank account
  • Acquire liability insurance 
  • Locate funding through small business loans or grants

Seek Funding Through Grants

Because of the increasing societal need for care centers, adult day care grants may be available to help you get your business up and running. You will need to research your options, develop a grant proposal and then keep on top of requirements and reporting if you are awarded funds. It may be easier, although more costly, to get a small business loan through the SBA or other lending options.

Locate or Adapt a Facility

Again, the type of services you offer will determine the type of facility you choose for your adult day care business. You might want to keep your business operation on the small side and operate in a home environment, either your own or at a separate site. Or perhaps you have a grand vision for a full-scale operation with multiple rooms including a kitchen, dining area, sitting areas, medical/therapy rooms, a salon and an activity room. Whatever your vision, your budget will need to correspond.

Keep in mind that your facility will need to accommodate individuals with special physical needs, so wherever you locate your business, it will need to be accessible and designed with safety in mind. You may need to install ramps to accommodate wheelchairs, install handrails or specialized seats in the bathrooms and organize the rooms to allow for the free and safe flow of traffic.

Acquire Licensing and Certifications

Regulations concerning licensing will differ depending on the type of facility you open. Research the requirements for your state by contacting the Department of Health and Human Services or the Department of Aging for assistance. Some of the regulations you'll need to consider include the following:

  • General Licensing: legal entity requirements, fees, inspections, sanction resolution

  • Staffing: licensing, staff-patient ratios, ongoing training

  • Program: Intake procedures, continuity of care, documentation
  • Records: Privacy, storage, release of information
  • Safety: Fire procedures, handrails, first aid, heating levels
  • Medicines: Labeling, storage, administration

Hire and Train Qualified Staff

Perhaps one of the most important steps in developing a successful business is the hiring of qualified and compassionate employees. A variety of skills should be represented among your staff so that a range of services can be provided. Employees may include nursing staff, a recreation director, a nutritionist and administrative personnel for the office to handle scheduling, billing and record-keeping.

Set Up Your Management Structure

Depending on the size of your adult day care operation, you may need to set up a hierarchy of responsibilities with supervisory managers. The lead personnel should oversee the rest of the staff within their particular area, taking on the responsibility for hiring, training, oversight and communication of policies and procedures. You may have some of the following managers:

  • Nurse manager for overseeing medical issues and care staff
  • Office manager for billing, accounting, phone calls, scheduling
  • Activities Director for organizing events, transportation and handling daily group activities for clients

Market Your Adult Day Care Business

With the groundwork laid, you will be ready to market your adult day care business to the public. In addition to traditional advertising mediums such as local radio and newspapers, make use of the networks of business people in your area. Become a member of the area Chamber of Commerce, a group that supports networking and referrals. Inform physician's offices of your opening since many of them may have patients who would benefit from your services.

Don't forget to create an engaging website that clearly explains your services, provides rates and highlights your staff. Include photographs of your facility that show the warm and inviting atmosphere. Provide a contact page so prospective clients can ask questions and create a way for you to interact with them about your business.