Adult Day Care Center: Opening a Medicaid Certified Adult Day Care Center

Please review Wis. Stat. § 49.45(47)(b) and Wis. Admin. Code § 105.14 prior to completing an application. You must complete an application using the DHS DQA Provider Portal.

DQA is launching the DHS DQA Provider Portal, a new system for licensure, background checks, plan reviews, and other provider applications for ADCCs. Certification applications will not be accepted electronically or postmarked as of November 22, 2025, as we transition to the new system. We will accept applications starting December 15, 2025. Applications must be submitted using the DHS DQA Provider Portal. To prepare for this transition and for more information, visit our DHS DQA Provider Portal webpage.

As part of the application process, you must submit:

• An application fee of $127.
• A clearly labeled floor plan showing all measurements, and clearly labeled areas that qualify as participant square footage under Wis. Admin. Code § 105.14(8)(a)2, which requires 50 sq. ft. per participant, not including passageways, bathrooms, lockers, office, storage areas, staff room, furnace rooms, and parts of rooms occupied by stationary equipment. Keep this square footage in mind as you determine your ADCC's maximum participant capacity.
• Fire inspection report.
• Background checks for all owners, operators, or licensees, and any non-client residents will also be completed through the DHS DQA Provider Portal. To learn more about background check requirements, please see our Background Checks Program webpage.
• Complete Model Balance Sheet, F-62674A showing 60 days operating funding. Upload the Model Balance Sheet to the DHS DQA Provider Portal as part of the Fit and Qualified application.
• A financial reference showing that your ADCC has access to at least the amount of money needed on your Model Balance Sheet, which could be any 1 or more of the following:
  • Letter of reference from the ADCC's financial institution.
  • Bank statement.
  • Evidence of stock ownership.
  • Verification of outside employment or other income.
• Your IRS Tax ID letter.
• Organizational documents depending on your ADCC structure:
  • Corporations: Provide a copy of articles of incorporation.
  • Limited liability companies (LLCs): Provide a copy of articles of organization and operation agreement.
  • Limited liability partnerships (LLPs): Provide a copy of the partnership agreement.
• Proof of transportation insurance, if the ADCC provides transportation.
• Well water test results, if applicable.
• Program evaluation plan.
• Program description. This is a document that would be provided to potential participants and members of the general public, and needs to include:
  • Operator name.
  • Program director name.
  • Participant capacity. This capacity needs to reflect the qualifying square footage under Wis. Admin. Code § 105.14(8)(a)2, as discussed above.
  • Program goals and description.
  • Hours.
  • Limits.
  • Fee schedule.
  • Procedure for informing of changes.
  • Procedures for incident reporting.
  • Participant group and explanation, if more than one.
  • Grievance procedure.
  • Criteria for involuntary discharge.
• Participant rights document, to be provided to potential and current participants. This is often included in an ADCC's program description.

Once the application materials are accepted, a surveyor from the Acute Care Compliance Section (ACCS) will work with you to schedule and complete an announced initial visit. It is the provider's responsibility to know and understand the regulations governing adult day care centers. Additionally, the operator is responsible for the information contained in the DQA numbered memos. You may also sign-up to receive email notifications of new DQA memos, DQA Quarterly Updates, and additional health care policy-related information.

A review of your physical space is integral to the ADCC certification process. Therefore, re-application and re-survey of an ADCC's new location is required when a move occurs. Some elements of the initial application process are not required, as you are already an established ADCC in good standing.

You must complete an application for a relocation using the DHS DQA Provider Portal. DQA is launching the DHS DQA Provider Portal, a new system for licensure, background checks, plan reviews, and other provider applications for ADCCs. Certification applications will not be accepted electronically or postmarked as of November 22, 2025, as we transition to the new system. We will accept applications starting December 15, 2025. Applications must be submitted using the DHS DQA Provider Portal. To prepare for this transition and for more information, visit our DHS DQA Provider Portal webpage.

You must contact DQA through the DHS DQA Provider Portal if your existing ADCC is undergoing a:

• Change of ownership (CHOW) - The Medicaid contract of the previous owners terminates upon a CHOW and the new owners must submit a new application.
• Relocation - Your new location will be subject to review by our survey team to assure continued compliance with state regulations and the federal Home and Community Based Services (HCBS) standards before the relocation is approved.
• Remodel - Depending on the specifics of the remodel, your changes will be subject to review by our survey team to assure continued compliance with state regulations and the federal Home and Community Based Services (HCBS) standards before the remodel can be approved and your participant capacity can be changed.
• Any other change in capacity, such as including or excluding space used within an existing building.
• Program Director or Operator change.
• Contact information change.
• Change in participant groups served.
• Change in hours or days of operation.
• Agency closure.