How to Start an Adult Day Care

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If you’ve ever cared for a loved one with a physical or mental health condition, you know how demanding the job can be. For families with adult family members who need continuous care or supervision, caregiving can alter their lives and be emotionally draining. That’s where adult day cares come in. These businesses are gaining in popularity, and by opening a day care of your own, you can help to relieve families of their caregiving duties while also improving adult clients’ quality of life. It’s a rewarding business venture to explore and, with the increased need for senior care, it could be a profitable venture, too. 

Business Overview

Adult day cares serve multiple purposes, and with the increasing senior population in the United States, these businesses are growing in popularity. Day care centers provide adults with a safe place to go during the day. These centers may offer a variety of services, but generally a day’s activities will include some sort of exercise, a chance for participants to interact socially, and mental interaction, too. Centers may assist adults with personal care as needed, and they may provide meals or snacks tailored to each attendee’s dietary needs. Transportation can be a challenge for adults, so many day cares offer transportation services, too. 

Adult day cares may also specialize in a certain field. Some have a health basis, focusing on therapeutic services. Others may specialize in providing care to adults with specific conditions, like those who are deaf or hard of hearing, or those who have Alzheimer’s or dementia.

Day cares provide their participants with many benefits, and they can help to combat some of the isolation and loneliness that adults may feel when living at home. At the same time, day cares give their attendees’ caregivers a much-needed break, helping to transfer some of the caregiving burdens off of family members during the day. 

Industry Summary

According to IBIS World, from 2014 through 2019, the adult day care industry experienced 5.3 percent annual growth. During that time, the number of businesses grew to 16,407 and industry employment increased to 211,600. The industry was expected to bring in $9 billion in total revenue in 2019 alone. 

This growth is driven by a number of factors. The aging population means more adult care services are needed. Many adults are unable to afford the expensive cost of nursing homes and assisted living centers, driving them to seek out alternative options like day care. Additionally, since per capita disposable income increased from 2014 through 2019, adults and caregivers who couldn’t have previously afforded day care may now have the income available to make this a possibility. 

Industry Trends

Multiple trends are shaping the adult day care industry. According to Home Health Care News, as more seniors wish to remain in their homes as they age, there’s an increased demand for these day care services. The number of day care businesses has increased, but the industry is still largely fragmented. 

Traditionally, adult day care facilities were largely non-profit operations, but that is now shifting more toward the for-profit model; you’ll find both models in operation today. Because there isn’t an official federal definition of what adult day care consists of, different states regulate this industry differently. Some states have no licensure, while others have licensure and certification requirements. Some states also require a day care have a certain number of caretakers to every day care participant; 1:6 and 1:8 ratios are common requirements. 

Target Market

An adult day care’s market will depend on its specialization and business model. Day cares that provide general supportive care for adults may market to caretakers of adults with physical or mental conditions that prohibit them from being left at home alone. If a day care specializes in a certain area, like providing specialized services to adults with Alzheimer’s, the business’ target market will be more specific. 

While family members acting as caretakers are generally the primary target market for day cares, a business may also market to doctors, nurses, social services, and other professionals who might refer families back to the day care. 

Skills, experience, and education useful in running an adult day care

Starting and running an adult day care doesn’t require a business degree, but certain skills and experiences can increase the chances of a business being a success. 

Caregiving experience. Experience in caring for adults with mental or physical conditions is highly valuable in this industry. A day care owner who has this caregiving experience will have a better understanding of the challenges and nuances that come with this type of business. 

Medical knowledge. A day care owner doesn’t necessarily need a medical degree, but experience working in or knowledge of the medical industry will be helpful. 

Management experience. Experience in hiring, training, and managing staff is important in this industry, since any day care will need multiple employees. 

Interpersonal skills. Strong customer service and interpersonal skills are a must, and they’ll allow a business owner to establish relationships with both clients and their families. 

Attention to detail. Small details can make big differences in this industry when it comes to caregiving, scheduling, monitoring clients’ health, and more. A business owner needs to be focused on details to be successful. 

Marketing skills. While adult day cares are growing in popularity, many people are still unaware that they exist and need to be informed of their benefits. Marketing will be an ongoing activity, so a business owner will need to be involved in marketing efforts. 

Costs to Start an Adult Day Care

The cost to start an adult day care will vary widely, and it will partially depend on whether the day care offers social services or if it takes a medical healthcare focus. Startup costs for a smaller day care designed to provide social interaction and general care can start at $50,000 or more. A day care with a medical focus can cost $75,000 or more to start, mainly because of the cost of required medical equipment. 

Common startup costs for an adult day care include: 

  • Furniture
  • Medical equipment
  • Remodeling expenses
  • Supplies like food
  • Signage

Steps to Starting an Adult Day Care

Step 1. Write your Business Plan

After coming up with the idea, the next step in starting your business should be to write a business plan.  Not only will a bank require you to have a business plan, but multiple studies have shown that a business plan helps increase the odds of starting a successful business.

How to write a business plan
Free sample business plans

Step 2. Form a Business Entity

A business entity refers to how a business is legally organized to operate. There are four primary business entities to choose from which include the sole proprietorship, partnership, corporation and LLC.  Each type of entity has its own pros and cons such as liability exposure, costs and administrative requirements.

Related: Comparison of Business Entities

Step 3. Select your Location

Adult day cares need very specific types of spaces, and finding or modifying an appropriate space can take both time and money. Handicap accessibility, multiple bathrooms, and the presence of a kitchen space are all necessary. A large space with these amenities can cost more than traditional retail space, and the building’s location will also affect its rental cost. 

Related: Choosing a business location

Step 4. Apply for Business Licenses and Permits

In some states, adult day care businesses are required to hold specific licensing or certification. Check with your state’s Department of Human Services to learn about the specific requirements in your state. 

In addition, there are general business registrations at the local, state and federal level that a adult day care might need such as an Employer Identification Number, and Occupancy Permit among others.

Related: Common business licenses, permits and registrations by state

Step 5. Find Financing 

Coming up with a good business idea and having the skills to run it are one thing, but getting the funding to start an adult day care is another.  Funding to start an adult day care can be difficult as a lot of start-up expenses go towards to remodeling and working capital for wages, which don’t have collateral value.  In order to get a loan, the borrower(s) will need to have good credit and be able invest 15-25% of their money towards the total start-up costs.

Related: Finding the money to start a business  

Step 6. Get your Marketing Plan in Place

Marketing is an essential ongoing expense for an adult day care. Marketing activities may consist of paid online and print advertising, direct mail marketing, establishing and maintaining a social media presence, and even advertising on the radio or on television. Marketing costs will depend on the type and volume of the activity performed. 

Related: Low-cost ideas to market a new business

Step 7. Get Insurance

Day cares need several types of insurance to be fully covered: 

  • General liability insurance protects the business if a client or their family members are ever injured while on the business’ property. This insurance can cover costs like legal fees. 
  • Commercial property insurance protects the day care against the loss of property and supplies after an event, like a fire. 
  • Commercial auto insurance covers the expenses, like legal fees and medical bills, that can result if a company-owned vehicle is ever in an accident. 
  • Worker’s compensation insurance helps to cover potential expenses like medical bills or lost wages if a staff member is ever hurt while at work. 

Insurance policy costs are affected by factors like the day care’s location, the value of the building and the equipment inside, and even the number of employees on staff. Because of these variables, policy costs can differ. To get an accurate idea of what insurance may cost, request quotes from multiple providers. When comparing the quotes, pay attention to factors like coverage limits and exclusions, premiums, and deductibles.  

Step 8. Hiring Employees

Any adult day care will need multiple employees. According to Indeed, expect to pay these average hourly rates for standard adult day care staff positions 

  • Licensed Vocational Nurse: $19.16
  • Registered Nurse: $31.47
  • Nursing Assistant: $15.43
  • Social Worker: $21.60
  • Activity Aide: $9.81
  • Truck Driver: $14.59
  • Caregiver: $10.98

In addition to employee salaries, a day care also needs to budget for expenses like worker’s comp insurance, paid time off, and health insurance contributions. 

Related: Hiring your first employee

Amazon has several books that go into detail on starting and running a adult day care:

How much can you potentially make owning an adult day care? 

A day care’s income will depend on many factors, including the number of clients, the day care’s rates, and even the particular services that it offers. For instance, day cares with health specializations can charge higher rates than similar businesses that don’t offer the same health care focus. According to Genworth Financial’s most recent Cost of Care Survey, adult day health care costs an average of $72 per day. Most days range between 8 and 10 hours of care. 

Things to consider before starting an adult day care

There’s still a lot of confusion and lack of awareness around adult day care availability and benefits, so business owners need to be prepared to not only market the business, but to also educate local medical service providers and clients at the same time. While adult day cares are gaining in popularity, they’re still somewhat limited in their availability. While this means that businesses will need to work harder to establish themselves, it also works as an advantage. A new adult day care could be the first in the area, establishing itself as a reputable, quality facility before others develop in the area. 


Aging Life Care Association
American Health Care Association
National Adult Day Services Association