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Indicator

Adult Day Services Supply

Adult day services supply nationally fell by 11.5 percent to 54 slots per 10,000 people age 65-plus in 2020–2021, which the 2023 Scorecard applies to state scores and ranks. The COVID-19 pandemic likely played a role in this decrease as adult day centers nationally suspended in-person services; many never reopened, which diminished the available supply. At the state level, just nine states saw an increase in supply by ten percent or more, while 21 saw supply decrease by ten percent or more. California led the nation with 154 adult day slots available per 10,000 adults 65-plus while Arizona and Oregon trailed at just 4 slots per 10,000. 

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154
Best State Performance
54
US Value

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* data not available (including concerns about data quality) or not calculated due to missing data needed for calculation.
† Data not available or not comparable in original source.  AARP estimated values based on additional information (see Appendix B4 for imputation details). 

Methodology

The maximum number of participants, per 10,000 population ages 65+, allowed at any one time at licensed adult day services centers in each state.  

Adult day services capacity refers to the maximum number of participants allowed at an adult day services center location.  The allowable daily capacity is usually determined by law or by fire code, but may also be a program decision.  Adult day capacity data are from two National Study of Long-Term Care Providers (NSLTCP) surveys.  To be eligible for inclusion in these surveys, all adult day services centers identified as adult day care, adult day services, or adult day health services centers and had to: 

  1. Be included in the National Adult Day Services Association database; 
  2. Be licensed or certified by the state to provide adult day services, or accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF); or authorized or otherwise set up to participate in Medicaid (Medicaid state plan, Medicaid waiver, or Medicaid managed care) or part of a Program of All-Inclusive Center for the Elderly (PACE); 
  3. Have one or more average daily attendance of participants based on a typical week; and 
  4. Have one or more participants enrolled at the center at the location at the time of the survey.

Data for current year 2020 and reference year 2016 total licensed adult day services capacity are from the NSLTCP survey.  For several states, data were not available because the estimates did not meet confidentiality or reliability standards for NCHS:

For 2020, no estimates for adult day services centers were presented for the District of Columbia, Montana, New Hampshire, South Dakota, Utah, West Virginia, and Wyoming.  For 2016, no estimates were presented for the District of Columbia, West Virginia, and Wyoming.

For seven states with missing current year estimates, AARP imputed data according to the following procedure:

  • For Montana, New Hampshire, South Dakota, and Utah, the 2020 metric values were estimated to be the same as in 2016.
  • For the District of Columbia, West Virginia, and Wyoming, which did not have 2016 estimates to bring forward, the 2020 metric values were estimated to be equal to average value for the four states with missing 2020 values only (MT, NH, SD, UT).

Because publicly reported adult day services capacity data is rounded to the nearest hundred, the capacity per 10,000 people ages 65 and older was calculated by NCHS and reported rounded to the nearest whole number.  
National Center for Health Statistics (NCHS) (2019, 2022).  Analysis based on data from the 2016 National Survey of Residential Care Facilities and 2020 National Post-acute and Long-term Care Study (unpublished).

US Census Bureau, Annual Estimates of the Resident Population by Single Year of Age and Sex for the United States: April 1, 2020 to July 1, 2021 (Washington, DC: US Census Bureau, 2022), https://www2.census.gov/programs-surveys/popest/datasets/2020-2021/national/asrh/nc-est2021-agesex-res.csv.

US Census Bureau, Annual Estimates of the Resident Population for Selected Age Groups by Sex for the United States: April 1, 2010 to July 1, 2017 (Washington, DC: US Census Bureau, 2018), https://www.census.gov/data/tables/time-series/demo/popest/2010s-state-detail.html.

Population data for 2016 (current year) are from the US Census Bureau Population Estimates, 2017 vintage.  Baseline 2014 population data are from the same source, 2015 vintage.  

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