ADC Enrollment Packet
Thank you for your interest in the Missouri Medicaid ADULT DAY CARE (ADC) Program. The Adult Day Care Waiver provides adult day care to active MO HealthNet participants ages 18 to 63 who meet nursing facility level of care. Adult day care services under the Aged and Disabled Waiver provides adult day care to active MO HealthNet participants aged 63 and over. Adult day care service provides continuous care and supervision of disabled adults in a licensed adult day care setting. Services include, but are not limited to, assistance with activities of daily living, planned group activities, food services, client observation, skilled nursing services as specified in the individual’s plan of care, and transportation. Planned group activities include socialization, recreation and cultural activities that stimulate the individual and help the participant maintain optimal functioning. Meals which are provided as part of the adult day care service do not constitute a “full nutritional regimen” (3 meals a day). The provider must arrange or provide transportation to and from the adult day care facility at no cost to the participant.
A provider of Adult Day Care must be enrolled with the Missouri Department of Social Services (DSS), Missouri Medicaid Audit and Compliance Unit (MMAC), Provider Contracts. An investigation of the provider’s professional background will be conducted pursuant to 13 CSR 70-3.020. Each adult day care providing services to Missouri Medicaid participants must enroll separately.
All required documents listed must be included. Please read carefully.
Mandatory enrollment requirements for ADULT DAY CARE (ADC) Services:
- Provider Questionnaire Form
- Missouri Medicaid Enrollment Application for Adult Day Care Services
- Signed Participation Agreement for Adult Day Care Services.
- Business Organizational Structure Form (BOS) and all documents as indicated by the section of the form completed.
- A copy of the Federal Employer Identification Number (FEIN) notification from the Internal Revenue Service.
- A copy of the ADC license issued by the Department of Health and Senior Services, Division of Regulation and Licensure. If the ADC is not currently licensed, an Application for License is available on DHSS’ web site.
- Direct Deposit Application with documents indicated by the form.
Upon receipt of the above listed documents and required attachments, your application will be reviewed. You will be notified via email if additional information is needed or the application is finalized.
Please send the completed enrollment packet to:
MMAC Provider Contracts
205 Jefferson Street, Second Floor
P.O. Box 6500
Jefferson City, MO 65102-6500
Fax # (573) 751-5065
If you have questions or need assistance completing the enrollment forms, please contact Provider Contracts via email at email@example.com.
For more information on adult day care licensing and regulation through the Department of Health and Senior Services, please review 19 CSR 30-90.010 and 19 CSR 30-90.020. If not currently licensed, the application for an ADC license can be found at http://www.health.mo.gov/seniors/nursinghomes/adultdaycare.php.