Learn More About Adult Day Services

The primary purpose of adult day services is the protection of adults who are participants in adult day services centers.  Minimum requirements are designed to maintain adequate health, safety, and supervision of adults while in adult day services programs.  Licensure rules for adult day services centers may be accessed at the Secretary of State's website. https://publications.tnsosfiles.com/rules/1240/1240-07/1240-07-10.20230123.pdf

Tennessee's adult day services centers are inspected throughout the year to ensure that providers continue to meet licensing requirements.

Adult day services centers are required to post their license. Agencies are also investigated in response to complaints.

  1. Prospective providers will contact the Pre-Licensure Unit at ChildCarePrelicensure.DHS@tn.gov to attend the informational orientation meeting provided by the department.
  2. A Program Specialist will send an email to instruct the prospective provider with the steps of becoming licensed and with instruction on how to start creating an account in the provider portal. 
  3. Prospective Providers will create an account in the Elicensing System and will register for Orientation.  The Prospective Provider will complete the Pre-application Training.  Information will be provided by the Program Specialist at the time of registration.
  4. Prospective Providers will attend Orientation/Intake Session and will be verified in the system as having attended the session.  The Prospective Provider can complete the Pre-application screen.
  5. After completing Orientation/Intake, The Prospective Provider will reach out to ChildCarePrelicensure.DHS@tn.gov  to inform the department of being ready to move forward in the process.
  6. Once the Program Specialist confirms that the Prospective Provider has a location, the Prospective Provider will complete the application information in the Elicensing system.
  7. The Program Specialist will conduct a measuring visit/walk-through of the location slated for the agency.  The Program Specialist will measure for capacity and look for any obvious hazards or safety issues.  The Program Specialist will request State Fire inspection and/or Local Fire Inspection, Environmental Inspection, and Choose Safe Places review.  The Program Specialist will also instruct the Prospective Provider to secure a clearance letter from Codes and Zoning and will guide/work with the Prospective Provider if any Special Use and Occupancy permits are required. 
  8. After all inspections and clearance letters have been received, the Program Specialist will request the fee and will provide options and specifics on how to submit payment. 
  9. The Program Specialist will conduct the first walk-through visit.
  10. The Program Specialist, a Licensing Consultant (LC) and Field Supervisor (FS) will conduct the second    walk-through visit. 
  11. A recommendation for a Temporary License will be submitted by the Program Specialist and approved by a Program Manager if the agency is compliant with all rules and requirements set forth by the department and all required documents and trainings have been completed and recorded. 
    • The agency will be granted a Temporary License for a period of 6 months. 

Procedures for Requesting an Exemption from Licensure
Exception for Limited Respite Care Services 

The Director and / or owner must submit the following items with the application:

  • Proof of Education (copy of diploma or degree)
  • Proof of Experience (a list of previous work history with employer contact information that can be verified)
  • Three non-related references with contact information
  • Documentation of the agency’s business organization

10.  (DHS Licensing Consultant ) Make requests for the following inspections: State Fire Marshal, local fire department, local health department (Environmentalist). 
Note: The potential licensee is responsible for ensuring the facility is compliant with state fire, local fire, and environmental health requirements.  A written approval must be received prior to the Department issuing a temporary license.

11. Schedule and complete criminal background check (CBC) process.

12. Submit CBC clearance letters for all employees to the Licensing Consultant.

13. Upon demonstration of compliance of all laws and regulations governing the adult day service center and if the applicant has satisfactorily met the requirements, the Department shall issue a temporary license for a period of six (6) months.

Procedures for Requesting an Exemption from Licensure
Exception for Limited Respite Care Services

Adult Day Services provides an organized program in a community group setting to promote social, physical and emotional well-being.  These programs offer a variety of activities designed to meet the needs and interests of each older adult who receives care.  Listed below are some tips to help you choose an adult day service center that meets the needs of your family.


1. Become familiar with rules and laws regarding adult day services in the State of Tennessee.  Adult Day Services Standards

2. Locate a list of adult day care service providers in your area and contact each one to schedule a tour of the facility.  

3. Ask questions of the staff to determine if the facility is a good fit for your loved one and will meet the needs of both of you and your loved one. (Examples of some questions to ask include but are not limited to):

  • What program services and activities are provided?
  • Are nutritious meals and snacks provided?
  • Is assistance provided with feeding, toileting, etc.?
  • Are there accommodations for special needs such as wheelchair or hearing / visual impairment?
  • What is the staff to participant ratio?
  • What are the credentials of the staff?
  • Is this facility licensed and if so by what Department?
  • Does this agency have a history of non-compliance with state regulations or valid complaints of improper care?
  • Is the financial assistance available?
  • What insurance do you accept?
  • What are the fees?
  • Are there additional resources available?

4. Maintain open communication with the adult day services provider to ensure your loved one is receiving care that meets the expectations of the family as well as the needs of the adult participant.

Additional Resources:  National Adult Day Services AssociationNational Family Caregiver Support Program  

Abuse Registry: The Department of Health Abuse Registry includes the names of persons who have abused, neglected, exploited or misappropriated property of vulnerable persons. Link to Tennessee Department of Health Abuse Registry

Training and resources are powerful tools that enable adult day services providers and family caregivers to increase their knowledge and awareness as they help care for those who need adult day services or other in-home care.

 Resources for Adult Day Services Providers and Family Caregivers: 

  1. Administration for Community Living (ACL)
  2. AgeWell Middle Tennessee | Telephone: (615) 353-4235
  3. Alzheimer’s Tennessee | Telephone: 1-888-326-9888
  4. American Psychological Association
  5. Council On Aging of Middle Tennessee | Telephone: (615) 353-4235
  6. Fifty Forward | Telephone: 615-743-3400
  7. Greater Nashville Regional Council
  8. Mental Health America of the Mid-South
  9. National Adult Protective Services Organization
  10. Tennessee Association of Adult Day Services
  11. Tennessee Commission on Aging and Disability | Telephone: 1-866-836-6678
  12. Tennessee Disability Coalition | Brain Links | Telephone: (615) 383-9442
  13. Tennessee Division of TennCare
  14. Tennessee Justice Center | Telephone: (615) 255-0331
  15. Tennessee Respite Coalition (TRC)
  16. U.S. Department of Health & Human Services
  17. American Association of Retired Persons Website