Maine adult day services program license: Chapter 117, the 1:6 ratio and the fire marshal sign-off

Who needs a Maine adult day license, and who does not

Maine has licensed adult day programs since July 1, 1988: no person may run an “adult day care program” without a license from the Department of Health and Human Services ⁠³, and the program is one of the services listed in the state’s general licensing law ⁠⁷. The statute defines the program as care, activities and protection given on a regular basis, in a private home or any other building, for pay, for any part of a day, to 3 or more adults aged 19 or older who are not blood relatives and who come for the purpose of attending the program ⁠².

The rule, 10-144 C.M.R. Chapter 117, adds detail. It covers a program that runs “for at least two (2) hours a day” for more than two adults, up to seven days a week, and it bars anyone from accepting payment for adult day services for more than two unrelated people without a license ⁠¹. In practice:

• Two participants who are not relatives, or relatives of any number, do not trigger a license.
• Three or more unrelated adults aged 19+, for pay, do.
• The age line is 19, not 18. A “consumer” in Ch. 117 is someone at least 19 who is not a blood relative of the provider ⁠¹.

The statute says “any part of a day”; Ch. 117 adds the two-hour minimum. Neither source says how DLC treats a paid group program that runs under two hours a day. If your program would meet for less than two hours, ask Assisted Housing at (207) 287-9300 for a written answer before you accept payment from three or more unrelated adults.

Three nearby setups get confused with this license:

• A program inside an assisted living or residential care facility. The statute excludes “any program for adults provided by a licensed residential facility” ⁠², but Maine’s assisted housing rules, effective September 18, 2025, say that once an adult day program in an assisted living program or residential care facility serves three or more non-residents, it must meet Chapter 117 ⁠¹¹⁠¹². Activities for your own residents stay under the facility license; opening the doors to outside attendees brings in Ch. 117. See the Maine assisted living facility guide and the Maine residential care facility guide.
• Day activity programs that DHHS licenses under other rules are also outside the definition ⁠².
• In-home help. Sending aides to people’s homes is a personal care agency or home health license, not adult day. See the Maine personal care agency guide and the home health license overview.

Choose your program type first: Social, Adult Day Health, or both

Your license states which program you run, the maximum number of participants, and whether you are approved for a Night Program ⁠¹. Decide this before you design the space and hire staff, because the services the rule requires differ.

Sources: Ch. 117 ⁠¹.

A few rules shape a night program. A participant can attend up to seven times a week, but day and night attendance together are capped at seven dates in any seven-day period, and no program may give anyone 24 consecutive hours of service ⁠¹. The record must show the hours each person was awake and asleep ⁠¹. If you plan to add a night program or switch from social to health later, you need prior written approval from DLC ⁠¹.

The choice also decides your payer mix. MaineCare’s Day Health Services benefit (Section 26) pays for services that include nursing and health monitoring, so an Adult Day Health license is the one built for that benefit (see the payment section below).

The site: space, local sign-off and the fire marshal

Most of the work before you file is about the building. Chapter 117 requires the initial application to include ⁠¹:

• Floor plans drawn to scale showing at least 50 square feet of program space per participant. Inside a licensed nursing facility or assisted living program, the adult day space must be distinct.
• A letter from your municipal official confirming the site complies with local laws and codes for this type of program. Programs located in already-licensed facilities are exempt from this letter.
• A lease, if you rent, showing which party maintains the property, available to DLC on request.
• A written emergency plan posted at the site, and a first aid kit staff know how to use.

The fire inspection is a hard gate. The statute bars DHHS from issuing a license until it receives a written statement from the Commissioner of Public Safety, signed by a designated fire inspector, that the program meets the Life Safety Code ⁠⁵, and Ch. 117 repeats that no license is issued or reissued until the State Fire Marshal’s Office has passed the site and sent DLC a signed report ⁠¹. Which Life Safety Code section applies depends on how many adults attend per session ⁠⁵:

Source: 22 M.R.S. §8605 ⁠⁵. The statute’s wording leaves exactly 13 per session unassigned: subsection B stops at 12 and subsection C starts above 13. Neither the statute nor Ch. 117 says which section applies at 13, so if you plan to serve 13 adults per session, ask the Office of State Fire Marshal in writing which one it will apply before you sign a lease.

Ch. 117 also sets building standards that inspectors look at ⁠¹:

• heat that can hold at least 70°F throughout program space
• screened windows and doors used for ventilation
• at least two exits remote from each other and kept clear
• non-folding chairs and tables, plus rocking and reclining chairs
• accessibility for people with disabilities in every area participants use
• a telephone that is not a pay phone, with free local calls
• a fire safety plan approved by local or state fire authorities and posted in the program area

If the site is on a private well, DLC requires a Basic Safety Test of the water before you file an initial or renewal application, with the results sent in with the application ⁠⁹. Ch. 117 also requires an annual test of a private water supply with a satisfactory result ⁠¹.

The administrator and the 1:6 staffing table

Every licensee appoints a program administrator who is at least 21 ⁠¹. Ch. 117 does not require a degree or a professional license. It asks for management and supervisory experience in a social or health service setting, or comparable technical or human service training or experience ⁠¹. If the administrator is on site for less than half the program’s hours, they must name someone to run the site during the rest ⁠¹.

DLC judges both the applicant and the administrator. You consent to a review of professional licensing board records, criminal history, child protective records and adult protective records. DLC also weighs experience in health care or social services, past compliance, and ability to manage the program’s money and staff ⁠¹.

The ratio is one staff member to six participants at all times when participants are present, and a program with three to six participants must also keep a second staff person on call for emergencies ⁠¹. Ch. 117 publishes the steps:

Source: Ch. 117 ⁠¹. DLC may require more staff based on participants’ needs ⁠¹.

Other staffing rules ⁠¹:

• Volunteers count toward the ratio only if they meet the same standards as paid staff and have assigned duties.
• Nobody under 18 counts toward staffing, unless they are at least 16 and enrolled in a health-related course of study, with proof in the file.
• A program in a licensed nursing or assisted living facility must schedule staff with hours assigned only to the adult day program.
• The rule prefers staff with at least one year of training or experience in social or health care services.
• A dated monthly staff schedule, with each employee’s name, title and hours, must be kept where staff can use it and held on file for two years.

Background checks, training and medication staff

The statute requires a comprehensive background check for direct access personnel, as that term is defined in 22 M.R.S. §1717, and applies the disqualifying-offense restrictions of 22 M.R.S. §1812-G ⁠⁶. Ch. 117 separately bars hiring anyone convicted of abusing, neglecting, mistreating or exploiting people, or misappropriating funds, in a health care or related setting ⁠¹. Every employee and volunteer signs a confidentiality agreement ⁠¹.

Training under Ch. 117 ⁠¹:

• Orientation for every new employee and volunteer, covering program policies, participant rights, emergency procedures and fire safety, the job description, confidentiality, communication skills, needs of the population served, elder abuse reporting, Standard Precautions and the licensing rules.
• Annual training of 6 hours for part-time staff and volunteers working 20 hours a week or less, and 12 hours for full-time staff and volunteers working 21 hours or more. Topics must include rights, emergency preparedness, workplace safety, body mechanics, choking prevention, nutrition and food safety, first aid, behavioral interventions and cognitive impairment.

Medication rules apply if you give medications at all ⁠¹:

• Unlicensed staff who give medications must complete Department-approved training and an eight-hour refresher every two years.
• Unlicensed staff may not give injections, except bee sting kits and insulin, and only after RN training documented in their file. For diabetes, the RN training covers diet, oral medications, insulin mixing and storage.
• Someone qualified to give medications must be on site whenever a participant has an “as needed” (PRN) prescription they do not take themselves.
• Medications stay in pharmacy-labeled containers and are kept locked when staff give them.

All staff must know the Adult Protective Services Act, and suspected abuse, neglect or exploitation of an incapacitated adult must be reported right away to DLC and Adult Protective Services ⁠¹.

Filing the application, step by step

Applications for adult day, assisted living and residential care facilities all go through the same online portal ⁠⁹. The portal’s main menu offers options to apply for a license, renew one, check an application’s status and change an application ⁠¹⁰. DLC’s page lists Adult Day Programs among the programs the Assisted Housing unit licenses ⁠⁹. Assisted Housing can be reached at (207) 287-9300 ⁠¹⁰.

1. Pick the program type and capacity

   Your licensed capacity sets the fee bracket and the staffing you must show, and the license will state the maximum number of participants ⁠¹.

2. Secure the site and municipal letter

   Get the local code compliance letter and, if you rent, a lease that assigns maintenance ⁠¹.

3. Prepare scaled floor plans

   showing 50 square feet per participant ⁠¹.

4. Write the five required policies

   These are refund, complaint resolution, medication administration, confidentiality, and admissions (who the program can appropriately serve) ⁠¹. You also need a posted emergency plan and a fire safety plan approved by fire authorities ⁠¹.

5. Get insurance certificates

   Proof of liability and property damage insurance goes in with the application, plus vehicle liability insurance if you will transport participants ⁠¹.

6. Test the well

   if the site is on one ⁠⁹.

7. File online with the fee

   DLC must tell you within two weeks whether the application is complete. An incomplete application left untouched for 60 days is void ⁠¹.

8. Pass inspections

   DLC reviews the site and the State Fire Marshal inspects. If the site is ready and the state has not completed its inspections more than 90 days after you were told the application was complete, Ch. 117 says a provisional license will be issued by default ⁠¹.

9. Open only after the license is issued

   Operating before then can bring sanctions ⁠¹. Post the license where the public can see it ⁠¹.

If you want relief from a rule that statute does not require, submit a written waiver request before the license is issued or renewed. DLC publishes a waiver request application ⁠⁹. A waiver cannot harm participants’ health or safety, and it ends with the license term ⁠¹.

Fees

Ch. 117 §2.3.4 says the non-refundable application fee is “as determined by the Department,” then sets these minimums by licensed capacity ⁠¹. The statute allows “reasonable” fees that differ by number of participants or license type ⁠⁴.

Renewal costs “a like fee” each year ⁠¹. The rule calls these amounts minimums set by the Department, and the online portal’s fee screen is only visible once an application is started, so confirm the exact amount charged at filing with Assisted Housing at (207) 287-9300 ⁠¹⁰. The statute separately requires DHHS to establish and pay reasonable fees to the Department of Public Safety or the municipal official for each fire safety inspection ⁠⁵; neither the statute nor Ch. 117 says whether that cost is passed on to applicants or what it is, so ask Assisted Housing.

Provisional license, inspections and renewal

A first license is provisional. Ch. 117 sets the term at three to 12 months, for an applicant who meets every rule except those that can only be met once participants are enrolled ⁠¹⁠⁸. If you served no one during the first 12 months, DLC may reissue it for up to another 12 months ⁠¹. No provisional license can run past 24 consecutive months ⁠¹. After that comes a full license for one year ⁠¹. The statute lets DHHS issue adult day licenses for one or two years ⁠⁸. Ch. 117 still says renewals run one year, and that is how the rule reads as of October 12, 2026 ⁠¹.

• Renewal: file the renewal application and fee at least 30 days before expiration ⁠¹. A fire marshal sign-off is needed again before reissue ⁠¹.
• Inspections: DLC may enter at any time, make unannounced visits and talk with participants privately ⁠¹.
• Deficiencies: after an inspection you get a statement of deficiencies and have 10 working days to return a signed plan of correction ⁠¹. Survey results and the plan must be posted where participants, families and the public can read them ⁠¹.
• Conditional license: if you fall out of compliance, DLC can issue a conditional license of up to 12 months listing the corrections due ⁠¹.
• Changes: increasing capacity, changing program type, or altering spaces participants use all need written approval before you act ⁠¹. A new administrator must be reported within 72 hours, and a new application naming them filed within 60 days ⁠¹.
• Sale or closure: licenses do not transfer. A buyer must get its own license and pay the fee before operating ⁠¹. If you close, notify DLC within 30 days of the projected closing date and surrender the license ⁠¹.

A program accredited by a national body that DHHS approves may be found in compliance with comparable state rules if it submits written evidence such as the accreditation approval, reports and findings; DHHS can still review compliance after a complaint ⁠⁷.

Day-to-day obligations that inspectors check

These rules shape your intake paperwork and daily routine, so build them into your forms before opening ⁠¹:

• Assessment starts no later than a person’s first day and must be finished within 30 days. Review it at least every six months and do a full reassessment every 12 months. An assessment done by a Department assessor within six weeks before admission can be used.
• Service plan within seven days of the assessment, reviewed at least every six months, with progress notes at least monthly.
• Fire drills at least monthly, at irregular times, logged on Department-approved forms. DLC posts an evacuation drill log ⁠⁹. Any unplanned evacuation must be reported to DLC at 1-800-383-2441 and to the State Fire Marshal right after everyone is out.
• Meals: if you serve food, it must meet one-third of daily nutrition needs. Menus are planned a week ahead and kept three months.
• Complaints are reviewed within 48 hours, with written findings to the complainant within 10 days.
• Money: refund overpayments within 30 days and give 30 days’ written notice of rate changes.
• Discharge needs at least two weeks’ written notice unless other participants’ health or safety is at risk.
• Restraints: participants have the right to be free of physical restraints and psychoactive drugs used as punishment or for staff convenience.

How Maine adult day programs get paid

MaineCare covers adult day health through Chapter II, Section 26, “Day Health Services,” and Ch. 117 lists both Section 26 and Section 19 as references ⁠¹⁠¹³. Under Section 26 ⁠¹³:

• Services take place at a licensed site and can include health monitoring, help with daily living, nursing, rehabilitation, exercise groups and counseling. A noon meal and snacks are part of the service.
• Members qualify through the Department’s Medical Eligibility Determination (MED) assessment. Hours are capped by level: up to 16 hours a week at Level I, 24 at Level II and 40 at Level III. Level III uses the nursing facility medical criteria.
• A written plan of care must exist before services start, and an RN or LPN must help write the first one.
• Residents of private non-medical institutions cannot be billed under Section 26.
• Members of the Home and Community Benefits for the Elderly and Adults with Disabilities program are billed under that program’s rule instead.
• Payment is the lower of your charge or the Chapter III allowance. Since July 1, 2019, the wage portion of the rate has received an annual cost-of-living increase, which continues until DHHS finishes and implements a rate study.

Section 26 describes services led by nurses and health monitoring, so it lines up with the Adult Day Health program type rather than a Social-only license. Enrolling as a MaineCare provider is a separate process from the DLC license.

What has changed and what to watch

• The rule is old. Ch. 117 was last amended January 4, 2006. The version DLC linked as of October 12, 2026 is a July 16, 2025 Word conversion and accessibility check, with no change to the text ⁠¹⁠¹⁴. It still names the “Community Services Programs” unit and lists fees of $10 to $50. Expect a rewrite at some point, but no proposed replacement appeared on DLC’s rules page as of October 12, 2026 ⁠¹⁴.
• Assisted housing rewrite, September 2025. The new Ch. 113 Parts A and B, effective September 18, 2025, kept the rule that adult day programs serving three or more non-residents inside assisted living or residential care facilities must follow Ch. 117 ⁠¹¹⁠¹². Facility operators adding a day program should plan for distinct space and staff hours ⁠¹.
• Two-year terms. The statute now allows one- or two-year adult day licenses at DHHS’s discretion ⁠⁸, while Ch. 117 still says one year ⁠¹.

If you are weighing a residential model alongside a day program, compare the residential care facility and assisted living facility licenses, which the same DLC Assisted Housing program issues through the same portal ⁠⁹.

Sources

1. 1
   Maine Department of Health and Human Services (via Maine Secretary of State), 10-144 C.M.R. Ch. 117, Regulations Governing the Licensing and Functioning of Adult Day Services Programs (July 2025 Word version) Checked 12 Oct 2026 · Back to text ↑
2. 2
   Maine Legislature, Office of the Revisor of Statutes, 22 M.R.S. §8601: Definition (adult day care program) Checked 12 Oct 2026 · Back to text ↑
3. 3
   Maine Legislature, Office of the Revisor of Statutes, 22 M.R.S. §8603: License Checked 12 Oct 2026 · Back to text ↑
4. 4
   Maine Legislature, Office of the Revisor of Statutes, 22 M.R.S. §8604: Fee for license Checked 12 Oct 2026 · Back to text ↑
5. 5
   Maine Legislature, Office of the Revisor of Statutes, 22 M.R.S. §8605: Fire safety Checked 12 Oct 2026 · Back to text ↑
6. 6
   Maine Legislature, Office of the Revisor of Statutes, 22 M.R.S. §8606: Prohibited employment based on disqualifying offenses Checked 12 Oct 2026 · Back to text ↑
7. 7
   Maine Legislature, Office of the Revisor of Statutes, 22 M.R.S. §7801: License or approval required Checked 12 Oct 2026 · Back to text ↑
8. 8
   Maine Legislature, Office of the Revisor of Statutes, 22 M.R.S. §7802: Issuance of license or approval Checked 12 Oct 2026 · Back to text ↑
9. 9
   Maine DHHS, Division of Licensing and Certification, Assisted Housing Checked 12 Oct 2026 · Back to text ↑
10. 10
    State of Maine Regulatory Licensing & Permitting, Residential Care Facility / Assisted Living Facility / Adult Day Program Online Application Checked 12 Oct 2026 · Back to text ↑
11. 11
    Maine Department of Health and Human Services, 10-144 C.M.R. Ch. 113 Part B, Residential Care Facilities (effective September 18, 2025) Checked 12 Oct 2026 · Back to text ↑
12. 12
    Maine Department of Health and Human Services, 10-144 C.M.R. Ch. 113 Part A, Assisted Living Facilities (effective September 18, 2025) Checked 12 Oct 2026 · Back to text ↑
13. 13
    Maine DHHS, Office of MaineCare Services (via Maine Secretary of State), MaineCare Benefits Manual, Chapter II, Section 26: Day Health Services Checked 12 Oct 2026 · Back to text ↑
14. 14
    Maine DHHS, Division of Licensing and Certification, Rules & Regulations Checked 12 Oct 2026 · Back to text ↑

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