Resources
Adult day care attendance & Medicaid compliance, explained plainly
Straight answers to the questions adult day center owners and administrators actually search for — attendance documentation, sign-in sheets, EVV, and what a Medicaid audit looks like. Every claim here is dated and sourced. None of it is legal advice, and it isn't a substitute for checking with your own state Medicaid agency or managed care plan.
Start with the question you have
Four guides, each answering one specific question in the first few sentences, before the detail.
What attendance documentation does Medicaid require for adult day care?
There is no single national rule — but a consistent pattern across state policy and enforcement. Here is what auditors actually ask for.
Are paper sign-in sheets enough for Medicaid adult day care billing?
Sometimes, in principle. A February 2026 New York audit shows what happens when they aren't, in practice.
Does EVV apply to adult day care?
No — congregate and center-based services are explicitly outside federal EVV scope. Here is what that actually means for your center.
What happens during an adult day care Medicaid audit?
Who conducts these audits, how a sample turns into an extrapolated finding, and what a recent state audit actually found.
Why we publish this
We build attendance-evidence software for adult day centers, so we spend a lot of time reading state Medicaid policy, audit findings, and enforcement actions. This section is that research, written for owners and administrators instead of for us. Where a rule varies by state or hasn't been confirmed publicly, we say so — we would rather leave a question open than guess at an answer that could cost a center money.
Every day you bill, provable
Face-verified check-in, digital signatures, and timestamped records that assemble themselves into an audit packet.