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Budgeting
In general, new adult day centers should not plan to reach profitability for the first 9-24
months. Craig Kittelson, CFO of Augustana Care, has developed an Excel budgeting tool (see
document 04-003.16) that can provide guidance in the budget development process. If you are
interested in obtaining a copy, please contact Roni Falck at LeadingAge Minnesota at
651.529.2399 or rfalck@leadingagemn.org.
Days open
Estimated daily census
Projected rates for varying payment sources
Other revenue sources (i.e. Federal Food Program, personal cares, transportation,
contributions)
Wages and fringe benefits (i.e. accrued vacation, health insurance, dental insurance,
workers compensation, FICA, retirement plans)
Consultant fees (if applicable)
Expenses related to administration, property, dietary, housekeeping and maintenance,
consultants and utilities
Licensure fees
It is important to consider a number of factors when determining your funding and payment
sources. Public funding is available through Medicaid waivers and Veterans Benefits. Medicare
does not cover Adult Day Services. Some long term care insurance policies also provide
coverage for Adult Day Services. As you work with potential clients, it is helpful to understand
all of the payment options that are available.
Private Pay
Providers establish a daily fee, which includes meals, activities, outings, supplies, etc. Many
providers offer additional services, including baths and therapies, for an additional fee. It is
helpful to consider the market rate for services in your area. The 2016 Genworth Cost of Care
Survey found the average daily rate for Adult Day Services in Minnesota was $57. Providers
who accept Medicaid waivers may not charge less for private pay clients than for clients who
receive waiver funding.
Medicaid Waivers and Provider Enrollment
Medicaid waivers provide funding for home and community based services for individuals who
are eligible for Medical Assistance (MA) and require the level of care provided in a nursing
EW defines adult day services as a program operating less than 24 hours per day that
provides an individualized and coordinated set of services (including health services,
social services, and nutritional services) directed to maintaining or improving a
recipients capabilities for self-care, including:
Supervision
Care assistance
Training
Activities based on the recipients needs and directed toward the achievement of
specific outcomes identified in the community support plan
Disability Waivers
In order to be covered as a waivered service under the disability waivers, you must:
People that retain their MA eligibility and assessed to have needs and ADLs are eligible for state
plan PCA services or Community First Services and Supports. They may not use ECS.
Residence
To receive ECS, one must live in their own home or apartment ECS cannot be provided in
congregate settings that may include:
Adult day centers receive payments for serving nutritious meals to adults who are 60 or older,
or who are physically or mentally impaired to the extent that limits their independence and
ability to carry out activities of daily living.
CACFP reimbursements help lower the cost of serving meals at centers that provide adult day
services to meet the needs of functionally impaired adults.