DIY Manual Adult Day Care Business Development and Operations Manual - Maryland

Adult Day Care Business Development & Operations Manual – Maryland
By Direct Care Training & Resource Center, Inc.
Launching an Adult Day Care Program in Maryland is one of the fastest-growing opportunities in aging services—but success depends on navigating Maryland’s highly specific licensing, facility, Medicaid, and operational requirements.
This 2026 field-tested manual provides entrepreneurs and operators with a clear, professional roadmap to open or strengthen a compliant Adult Day Care program, whether you plan to offer a medical model, social model, or both.
This manual includes:
✅ Maryland-recognized program types and oversight agencies

Adult Medical Day Care (AMDC) licensed through the Office of Health Care Quality (OHCQ), Maryland Department of Health

Senior Center Plus programs administered through the Maryland Department of Aging

✅ COMAR licensing requirements and step-by-step startup sequence

How to submit the required Letter of Interest

Completing the full AMDC application packet

Preparing for pre-licensure and routine surveys under COMAR 10.12.04

✅ Physical plant, space, and inspection standards Maryland surveyors enforce

Activity space formula: 100 sq ft for first 5 participants / 60 sq ft thereafter

Bathroom rules: 1 toilet + sink per 10 participants, within 30 feet of activity space

Fire Marshal expectations and life safety readiness

✅ Food service and sanitation compliance

Requirements under COMAR 10.15.03

On-site kitchen buildout essentials: hand sinks, 3-compartment wash systems, storage separation, extinguishers, and emergency posting

✅ Transportation requirements and operational safeguards

Door-through-door supervision standards

Driver training topics, rest-stop limits, and incident procedures

Vehicle safety rules surveyors expect documented

✅ Medicaid payer sources, billing structure, and rate planning in Maryland

Medical Day Care reimbursement is typically per diem (not 15-minute units)

Key service codes such as S5102 and S5105

Annual rate updates through Maryland Medical Day Care Transmittals (FY2025 included +3%)

✅ Veterans Affairs contracting opportunities (CCN Region 1 – Optum)

How to explore VA Adult Day Health Care referrals

Community Care Network onboarding basics and authorization requirements

✅ Market feasibility and referral development strategies

Mapping local demand, competition, and waiver case manager referral pipelines

Financial modeling based on realistic Maryland attendance and payer mix

✅ Professional coaching blueprint (first 60–90 days)

Policies aligned to COMAR: infection control, medication services, emergency planning, transportation, incident reporting

Mock survey readiness and corrective action templates to prevent costly delays