1. GOVERNING AGENCIES

Agency: Missouri Department of Health and Senior Services (DHSS)

Role: Administers Medicaid and HCBS Waiver programs, including adult day health services

Agency: Missouri Department of Social Services (DSS)

Role: Oversees Medicaid provider enrollment and service authorization

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight and ensures waiver compliance

2. ADULT DAY HEALTH SERVICE OVERVIEW

Adult Day Health Services provide medical care, therapeutic services, and social activities in a structured setting. Services are designed according to the Individual Service Plan (ISP) or Person-Centered Plan (PCP) and may include:

• Health monitoring and medication administration
• Physical, occupational, and speech therapy
• Assistance with activities of daily living (ADLs)
• Social and recreational activities
• Nutritious meals and snacks
• Caregiver respite and support

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Missouri Secretary of State
• Obtain EIN from the IRS and NPI (Type 2)
• Enroll as a Medicaid provider with the Missouri Department of Social Services
• Obtain an Adult Day Health License from the Missouri Department of Health and Senior Services
• Maintain liability insurance and clinical staff documentation

4. MEDICAID PROVIDER ENROLLMENT PROCESS

Step 1: Pre-Application Contact

• Contact the Missouri Department of Social Services for adult day health provider requirements

Step 2: Application Submission

• Submit business registration, license, liability insurance, and service descriptions

Step 3: License Verification

• Obtain and verify the Adult Day Health License

Step 4: Approval and Medicaid Number Assignment

• Once approved, receive a Medicaid provider number and authorization to deliver services

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business Name Registration
• IRS EIN Letter
• NPI confirmation
• Adult Day Health License
• Liability insurance certificate

Policy & procedure manual including:

• Client intake and health assessment procedures
• Daily schedule of health monitoring and activities
• Safety and infection control protocols
• Documentation of medical care and daily progress
• Staff training and supervision logs

6. STAFFING REQUIREMENTS

Role: Program Director / Health Services Coordinator

Requirements: Experience in healthcare administration or adult care management

Role: Registered Nurse (RN) / Licensed Practical Nurse (LPN)

Requirements:

• Nursing degree and active license
• CPR/First Aid certification
• Background check and TB clearance

Role: Activity Coordinator / Direct Support Worker

Requirements:

• High school diploma or equivalent
• Training in recreational therapy or social work

Training Requirements:

• Infection control and safety procedures
• Client care and ADL assistance
• Documentation and health monitoring
• Communication and social engagement techniques

7. MEDICAID WAIVER SERVICES

Adult Day Health Services in Missouri are available through:

• Aged and Disabled Waiver (ADW)
• Independent Living Waiver
• Medically Fragile Adult Waiver

Approved providers may deliver:

• Health and wellness monitoring
• Therapeutic and rehabilitative activities
• Social interaction and caregiver respite

8. TIMELINE TO LAUNCH

Phase: Business Formation

Timeline: 1–2 weeks

Phase: Medicaid Provider Enrollment

Timeline: 60–90 days

Phase: Staff Hiring and Training

Timeline: 30–45 days

Phase: Facility Licensing and Setup

Timeline: 2–4 weeks

9. CONTACT INFORMATION

Missouri Department of Health and Senior Services (DHSS)

Website: https://health.mo.gov

Missouri Department of Social Services (DSS)

Website: https://mydss.mo.gov

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10. SCOPE OF WORK

• Business registration and licensing assistance
• Medicaid provider enrollment
• Policy & procedure manual for adult day health operations
• Templates for health monitoring logs and activity schedules
• Website, domain, and email setup
• Staff credentialing and training documentation
• Client intake packet and health assessment forms
• Risk management and infection control procedures
• Referral networking with healthcare professionals and community organizations