Kansas adult day care license: KDADS rules, space, fees and the fire marshal track

Kansas licenses adult day care as an “adult care home”

Kansas does not have a separate adult day services act. The adult care home licensure act lists adult day care alongside nursing facilities, assisted living facilities, residential health care facilities, homes plus and boarding care homes as “classifications of adult care homes”, all licensed by the Secretary for Aging and Disability Services ⁠¹. So adult day care uses the same licensing machinery as the residential settings: the KDADS letter of intent, State Fire Marshal approval, a per-bed fee, the KOTA annual report and unannounced surveys ⁠²⁠⁵.

The rules carry over the residential vocabulary too. K.A.R. 26-43 calls the people you serve “residents”, calls the care plan a “negotiated service agreement”, and requires a resident council, even though nobody sleeps there ⁠². This guide says “participants” in plain text but quotes the rules as written.

Running an adult care home without a license is a misdemeanor punishable by a fine of up to $100 or up to six months in county jail ⁠².

Who needs the license

The statute defines adult day care as “any place or facility operating less than 24 hours a day caring for individuals not related within the third degree of relationship to the operator or owner by blood or marriage and who, due to functional impairment, need supervision of or assistance with activities of daily living” ⁠¹. Three points follow from that wording:

• There is no minimum number. The statute sets no floor, so a program serving even a handful of unrelated adults who need daily-living help fits the definition ⁠¹.
• Relatives are carved out only within the third degree of blood or marriage to the owner or operator ⁠¹.
• The trigger is functional impairment. A senior center or social club for adults who do not need supervision of or help with daily living is not described by this definition ⁠¹.

The act excludes some settings from “adult care home” altogether. These include hospitals, physicians’ offices, Medicare-certified hospices serving only hospice patients, and PACE centers approved by CMS that serve only PACE participants ⁠¹.

Neighbouring Kansas licenses a founder might confuse with this one:

• Overnight or 24-hour care for a small group is a home plus: the Revisor’s statute text caps it at 12 residents, and House Bill 2520 (approved April 6, 2026, effective on publication in the statute book) raises the cap to 16 ⁠¹⁠¹². Six or more residents in apartments with 24-hour personal care is an assisted living facility ⁠¹.
• Care in the client’s own home is not adult day care. the Kansas Department of Health and Environment (KDHE) licenses it as a home health agency under K.A.R. 28-51, which covers both skilled services and non-medical supportive care ⁠¹⁴. This site has no Kansas guide for those yet.

Standalone center or a program inside a residence

You can license adult day care as its own facility, or serve day participants inside a residential setting you already operate. The assisted living rules let an ALF serve adult day participants if it has at least 60 square feet of common living, dining and activity space for each resident and each adult day participant ⁠¹³. That matches the 60-square-foot activity standard for a standalone center ⁠². When you list license categories on the application, you select each category and its bed count, and the instructions ask for a total ⁠³.

A standalone center inside a building that houses other services must have “a separate, identifiable space for adult day care activity areas” during its hours of operation. The kitchen and therapy rooms may be shared ⁠².

The person in charge: operator or administrator

Since July 1, 2014, no adult care home may operate unless it is supervised by a registered operator or a licensed adult care home administrator ⁠⁸. The statute names adult day care as one of the settings an operator may oversee ⁠¹.

K.A.R. 26-43-101 requires the person you appoint to ⁠²:

• be at least 21;
• hold a high school diploma or equivalent;
• hold a Kansas adult care home administrator license or have completed the operator training course and passed the test;
• have authority and responsibility for running the facility.

To register as an operator, the statute also requires one of three education paths: a high school diploma plus one year of relevant experience, an associate’s degree in a relevant field, or a bachelor’s degree ⁠⁷. The operator course runs at least 45 clock-hours (a clock-hour is at least 50 minutes of instruction) and covers the statutes and regulations for adult day care. You pass the test with a score of 80% or higher ⁠⁹. As published, registration costs $65, renewal costs $65 with a $35 late fee, and registration expires on April 30 of every other year. Each renewal requires 30 clock-hours of continuing education ⁠⁹.

You also need a written position description for the operator, and it must authorize, in writing, an employee aged 18 or older to act when the operator is absent ⁠². One operator may supervise several separately licensed homes with prior KDADS approval, if all are close enough for daily onsite supervision and their combined capacity does not exceed 60. The limit for a licensed administrator is 120 ⁠².

The building

Adult day care has its own construction rules, K.A.R. 28-39-289 through 28-39-291, in effect since October 8, 1999 ⁠². All new construction, renovation, remodeling or change of building use must meet city, county and state building and fire codes, including the State Fire Marshal’s. New construction must also meet ADA Title III and the 1976 federal food service sanitation manual ⁠².

Site. The site must be served by all-weather roads, be free from noxious smoke or fumes, sit at least 4,000 feet from concentrated livestock operations (including feedlots and shipping and holding pens), be free of flooding for a 100-year period, and have room for drives, parking, sidewalks and an outdoor recreation area ⁠². The livestock setback matters in rural Kansas: confirm it before you sign a lease.

Every exterior entry and exit used by participants needs a means of monitoring for security, and the facility must provide outdoor recreation areas ⁠². If you do laundry on site, you need washers and dryers arranged for one-way flow from soiled to clean, plus a lavatory in or near the laundry area ⁠².

The KDADS and fire marshal track, in order

KDADS publishes one construction guide covering both homes plus and adult day care. Its steps track K.A.R. 26-39-101 ⁠⁴⁠².

1. Send a letter of intent

   It goes to the KDADS Licensure and Certification Specialists and the Licensure, Certification and Enforcement Manager. Include the type of adult care home, the address, a contact person with phone and email, and the legal description of the site ⁠⁴⁠².

2. Site inspection

   A KDADS Physical Environment Specialist contacts you to schedule a site visit. KDADS points you to the Office of the State Fire Marshal (OSFM) for life safety code questions ⁠⁴.

3. Submit a drawing

   For new construction, or conversion of an existing unlicensed building, submit a drawing that identifies the rooms and gives their dimensions as required by K.A.R. 28-39-289 to -291 ⁠²⁠⁴.

4. Plan review meeting

   The specialist schedules the meeting, gives you the new-construction guidelines and the environmental checklist, and reviews time requirements. Any later change to the plans on file must be submitted, and KDADS acknowledges each change in writing ⁠⁴.

5. OSFM plan submission

   Email an 11 x 17 code footprint, sealed, signed and dated by a Kansas-licensed architect or engineer under K.A.R. 22-1-7, with forms C22 and C22A. Send fire alarm and sprinkler plans with calculations too, if code requires those systems. Submissions go to [email protected] (785-296-3401) ⁠³.

6. File the licensure application and policies

   During construction, submit the completed application to the licensing specialists and the required policies to the SCCC Assistant Commissioner ⁠⁴. See the packet below.

7. Finish the building

   The facility must be 100% complete before inspection. OSFM requires 30 days’ notice before occupancy so it can schedule its final inspection ⁠⁴⁠³.

8. Environmental inspection

   Complete your punch list first. The specialist inspects against the checklist and writes the report off-site ⁠⁴.

9. License issued

   KDADS issues the license, with the State Fire Marshal’s approval, once the application is complete, construction is finished, the facility meets the law and the applicant qualifies ⁠². The license names the facility type, capacity and licensee, cannot be transferred, and must be posted ⁠².

KDADS states that supervisory review “can take up to 90 days” once an error-free packet is submitted. The statement sits under the change-of-ownership heading of the adult day care instructions ⁠³. The instructions do not give a processing time for initial applications, so ask the Licensure and Certification Specialists ([email protected]) what to expect before you commit to a lease or opening date.

If the building cannot yet meet every standard, KDADS may issue a provisional license, with fire marshal approval, for up to six months. One more six-month provisional license is at the agency’s discretion ⁠².

What goes in the application packet

The application form is the single Adult Care Home Licensure form used by every classification. Part I identifies the facility, the administrator or operator, the license category and bed count, the building owner, any lessee, sublessee, management firm or other entity, and any industrial revenue bond. Each of those entities completes its own Part II, which traces ownership through any parent entities down to the individuals ⁠³. Business entities must be registered with the Kansas Secretary of State, and the resident agent on the application must match the agent on file there ⁠³.

Lines D and E ask for a resident-fund surety bond and professional liability insurance, but the instructions say “neither is required for Adult Day Care facilities” ⁠³. The required attachments are ⁠³⁠²:

• the warranty deed, plus any signed lease, sublease or management agreement;
• a list of every facility, in any state or country, in which the applicant has or had any share of the operations or real property, with dates acquired and sold;
• resumes of the executives of each entity involved in operating the facility;
• written policies on abuse, neglect and exploitation; admission, transfer and discharge; adult day care; advance medical directives; disaster and emergency preparedness; infection control; resident rights; and respite care, if offered;
• the OSFM submissions described above.

The KDADS adult day care instructions cite home plus regulation numbers (K.A.R. 26-42) for the required policies. The matching adult day care rules are in K.A.R. 26-43: 26-43-101(d) and (f) for rights and abuse, 26-43-104 for disasters, 26-43-200 for admission, 26-43-203 for services and 26-43-207 for infection control ⁠³⁠². Write your policies to the 26-43 text.

Financial showing. K.A.R. 26-39-101(b) asks for a first-month projection of income and expenses, with a balance sheet showing at least one month’s operating expenses in cash or owner’s equity ⁠². K.S.A. 39-927, amended in 2019, lets KDADS require “if applicable” a GAAP budget for the first 12 months, certified by the applicant’s principal officer, with evidence of enough working capital ⁠⁶. The adult day care instructions do not list a budget among the attachments ⁠³. Prepare the 12-month version, which also satisfies the one-month rule.

Staffing, screening and training

K.A.R. 26-43-102 sets no numeric ratio. You must have “a sufficient number of qualified personnel” to deliver each participant’s screening and service agreement. Direct care staff or licensed nursing staff must be “in attendance and responsive at all times”, and a registered nurse must be available to supervise LPNs ⁠². You also need enough staff to move participants who would need help to a secure location in an emergency ⁠².

• Aide training. An unlicensed employee may not give direct, individual care until completing 40 hours of KDADS-approved training supervised by a registered nurse. The facility can run that training on site. Paid nutrition assistants need at least eight hours ⁠². Check the state registry before using anyone in an unlicensed direct-care role ⁠².
• Background checks. K.S.A. 39-970 bars an adult care home from employing people with listed convictions. Some listed convictions stop being disqualifying once five or more years have passed since the sentence or probation was completed ⁠². KDADS moved checks to a new Criminal Record Check system on November 19, 2025. Checks remain name-based, and the system automatically checks the Kansas Nurse Aide Registry for prohibitions ⁠¹⁰.
• Registry checks. Employee files must show that the person has no abuse, neglect or exploitation finding on the Kansas registry or on the registry of any state where they are known to have worked ⁠².
• Orientation and in-service. Topics are principles of adult day care, fire prevention, disaster procedures, accident prevention, resident rights, infection control, and abuse prevention. Add dementia behavior training if you admit people with dementia. Infection control training is repeated at least annually ⁠².

Participants: screening, service agreements and limits

On or before admission, a licensed nurse, a licensed social worker or the operator screens each participant’s functional capacity on the KDADS form. A licensed nurse assesses anyone whose screening shows a need for health care services ⁠². Screening repeats at least every 365 days, after any significant change, and quarterly for anyone a paid nutrition assistant helps to eat ⁠². The screening drives a written negotiated service agreement, signed by everyone involved and reviewed on the same schedule ⁠².

Your admission policy must address four conditions. You may admit or keep participants with them only if the service agreement meets their needs ⁠²:

• incontinence the participant cannot or will not help manage;
• total dependence on another person to exit the building;
• any ongoing condition needing two or more people to physically assist;
• behavioral symptoms beyond what the program can manage.

No one whose condition requires physical restraints may be admitted or kept ⁠².

Dementia programs. You may run a special care section, or make the entire facility special care. That requires written admission criteria, a medical care provider’s written order for each admission, direct care staff present in the section at all times, specific training before staff are assigned, and the least restrictive exit control possible ⁠².

Health services, medications and meals

A licensed nurse provides or coordinates health care services and must be available to give immediate direction to aides for unscheduled needs ⁠². Skilled nursing must follow K.S.A. 39-923, and the provider’s order must be in the participant’s record ⁠².

• Medications. Only licensed nurses and medication aides may give medications the facility manages, and aides may not use the parenteral route. Verbal orders must be signed by the prescriber within seven working days, and standing orders may not include Schedule II or psychopharmacological drugs ⁠². A participant may self-administer after a nurse assessment, repeated annually and after a significant change ⁠². You must offer each participant a medication regimen review by a pharmacist or licensed nurse at least quarterly ⁠².
• Meals. Meals are one of the services you may provide or coordinate. At 11 or more participants, a dietetic services supervisor or licensed dietitian provides scheduled on-site supervision. Below 11, designated staff may plan menus, and menus must be available at least weekly ⁠².
• Services you do not offer. If you will not provide meals, health care, transportation or activities, tell the participant in writing at or before admission ⁠².

Fees

As published in the KDADS compilation of May 31, 2024, K.A.R. 26-39-101(k) sets one formula for the initial license, each annual report and any capacity change ⁠².

A center licensed for 20 participants would pay $100 + (20 × $30) = $700 at application and each year. KDADS does not refund the fee if it denies the application ⁠².

Inspections, reports and renewal

KDADS must make at least one unannounced inspection within 15 months of the previous one, and its statewide average interval may not exceed 12 months ⁠². Keep your most recent survey report and plan of correction where participants and the public can read them, and post contact details for the long-term care ombudsman ⁠².

Ongoing duties under K.A.R. 26-43 ⁠²:

• report every abuse, neglect or exploitation allegation to KDADS within 24 hours and finish the investigation within five working days;
• answer written grievances in writing within 30 days;
• hold a resident council at least quarterly and answer its written concerns within 30 days;
• file semiannual and annual statistical reports electronically within 20 days after each period ends;
• review the emergency plan quarterly and run an evacuation drill at least annually;
• keep participant records at least five years after discharge.

The license stays in effect only while you file the annual report and fee, and it is canceled automatically if you do not ⁠². Renewal is filed on the facility’s home page in KOTA (Kansas Tracking of Adult Care Homes), which also handles change filings, and KDADS emails the administrator before the due date ⁠⁵. Notify KDADS in writing at least 60 days before any change to the information recorded on the license, such as a change of ownership, and within two working days of a change of operator ⁠². For questions, the licensing contact is [email protected] ⁠⁵.

How Kansas adult day centers get paid

The Home and Community Based Services (HCBS) Frail Elderly waiver lists adult day care among its services. To qualify, a participant must be 65, meet the Medicaid nursing facility threshold score, and be financially eligible for Medicaid ⁠¹¹. KDADS directs HCBS providers to the Kansas Medical Assistance Program (KMAP) for enrollment ⁠⁵. The pages checked do not state the waiver’s adult day care rate or the KanCare managed care plan credentialing steps. Ask KDADS or the KanCare plans you want to contract with for the current rate and enrollment steps.

What changed recently and what to watch

• 2026 statute change. House Bill 2520 (2026 Session Laws ch. 50, approved April 6, 2026) amends K.S.A. 39-923 mainly for homes plus. It leaves the adult day care and operator definitions unchanged ⁠¹².
• Background check system. The new KDADS Criminal Record Check system went live on November 19, 2025 ⁠¹⁰.
• Rule text. K.A.R. 26-43 dates from May 29, 2009 ⁠². The rule text here comes from the KDADS compilation published May 31, 2024. Ask KDADS to confirm that no amendment to K.A.R. 26-43 or 28-39-289 to -291 has taken effect since that compilation. K.A.R. 26-43-101 still names the KDHE secretary as the approver of the operator course, a leftover from before KDADS took over adult care home licensing ⁠².

Sources

1. 1
   Kansas Office of Revisor of Statutes, K.S.A. 39-923: Adult care homes, definitions Checked 12 Oct 2026 · Back to text ↑
2. 2
   Kansas Department for Aging and Disability Services, Statutes and Regulations for the Licensure and Operation of Adult Day Care (K.S.A. 39-923 et seq.; K.A.R. 26-39, 26-43, 28-39-289 to 28-39-291) Checked 12 Oct 2026 · Back to text ↑
3. 3
   Kansas Department for Aging and Disability Services, Instructions: Initial / Change of Ownership, Adult Day Care Checked 12 Oct 2026 · Back to text ↑
4. 4
   Kansas Department for Aging and Disability Services, New Construction Information for Home Plus and Adult Day Care Checked 12 Oct 2026 · Back to text ↑
5. 5
   Kansas Department for Aging and Disability Services, Adult Care Home Licensure and Certification Information Checked 12 Oct 2026 · Back to text ↑
6. 6
   Kansas Office of Revisor of Statutes, K.S.A. 39-927: Application for license; contents Checked 12 Oct 2026 · Back to text ↑
7. 7
   Kansas Office of Revisor of Statutes, K.S.A. 39-975: Operator registration; qualifications Checked 12 Oct 2026 · Back to text ↑
8. 8
   Kansas Office of Revisor of Statutes, K.S.A. 39-976: Supervision by registered operator or licensed administrator required Checked 12 Oct 2026 · Back to text ↑
9. 9
   Kansas Department for Aging and Disability Services, Operator regulations (K.A.R. 26-39-500 et seq.) Checked 12 Oct 2026 · Back to text ↑
10. 10
    Kansas Department for Aging and Disability Services, Criminal Record Check Program Checked 12 Oct 2026 · Back to text ↑
11. 11
    Kansas Department for Aging and Disability Services, Frail Elderly (FE) Waiver Checked 12 Oct 2026 · Back to text ↑
12. 12
    Kansas Secretary of State, Session Laws of Kansas 2026, chapter 50 (House Bill 2520) Checked 12 Oct 2026 · Back to text ↑
13. 13
    Kansas Department for Aging and Disability Services, Statutes and Regulations for Assisted Living and Residential Health Care Facilities (K.A.R. 26-41) Checked 12 Oct 2026 · Back to text ↑
14. 14
    Kansas Department of Health and Environment, State Statutes and Regulations (K.A.R. 28-51, Home Health Agency Licensure) Checked 12 Oct 2026 · Back to text ↑

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