Resources · Documentation
What attendance documentation does Medicaid require for adult day care?
Short answer
Medicaid doesn't set one national attendance-documentation standard for adult day care — your state Medicaid agency or managed care plan does. But across the state policies and audit findings we've reviewed, the pattern holds: proof of presence per member per date — a name, a date, and start and end times — kept in a form that can't be quietly changed after the visit.
The elements auditors consistently ask for
State policy language differs, but requests we've reviewed converge on the same handful of elements, per member, per date.
Proof of presence
A record that the member was actually there that day — a check-in and a check-out, not an assumption based on enrollment.
Date and exact times
The calendar date plus the start and end time of the visit, not just a day marked present.
A signature or confirmation
Some form of attributable confirmation that the visit happened — a signature, an identity check, or both.
The method it was captured with
A record of how and where the entry was made, so it can be evaluated on its own, not just taken on faith.
The clearest example we've found
What New York requires today
New York is the one state we've found that has put this requirement into explicit written policy for adult day. Under MLTC Policy 25.05, effective September 8, 2025, managed long-term care (MLTC) plans must collect and review social adult day care (SADC) sign-in and sign-out records — member name, date, and start and end times — verify that the records line up with actual occupancy, and retain them for audit.
If you operate in New York and bill through an MLTC plan, that policy is the most direct written requirement available today — worth reading in full rather than taking secondhand.
Why this isn't hypothetical
What happens when this documentation is missing
On February 19, 2026, the New York State Comptroller released an audit of the state's SADC program identifying $285 million in improper payments. Within that audit, $672,147 was disallowed at three facilities specifically because they lacked proper sign-in sheets. The same audit found one Flushing center had billed for 530 participants in a single day against a 323-person capacity, and it recommended uniform recordkeeping standards statewide.
The honest caveat
Requirements are set state by state — verify with your program
Outside of New York's written policy, we haven't found a single national rule that names the exact fields, retention period, or format your state or plan requires. That doesn't mean no requirement exists where you operate — it means the specifics are set locally, and the only reliable source for them is your own state Medicaid agency or managed care plan. Ask directly, and ask again if a policy changes.
This page is general information, not legal advice, and is not a substitute for your own state Medicaid agency's or managed care plan's current requirements. Documentation, audit, and retention rules vary by state and by program — verify specifics with your own Medicaid agency or plan before relying on them.
Documentation requirements — frequently asked
No. Medicaid is state-administered, and attendance-documentation requirements for adult day programs are set by each state Medicaid agency or, for members in managed long-term care, by the managed care plan. New York is the clearest example we've found of a state making that requirement explicit in policy.
Under NY MLTC Policy 25.05, effective September 8, 2025, managed long-term care plans must collect and review social adult day care sign-in/sign-out records — member name, date, and start and end times — verify occupancy against enrollment, and retain the records for audit.
It can, depending on your state and plan — but a February 2026 New York State Comptroller audit disallowed $672,147 in claims at three social adult day centers specifically because their sign-in sheets weren't adequate. We cover that audit in detail in a separate guide.
We don't have a confirmed, sourced retention period to give you here, and we'd rather say that plainly than guess. Retention requirements vary by state and by payer — ask your state Medicaid agency or managed care plan for the exact schedule that applies to you.
No single tool can promise that. What AdultDayGenie captures — a timestamped check-in and check-out, a signature or face-match confirmation, and a member name and date on every event — lines up with the elements every state policy and audit finding we've reviewed asks for. Confirm the specifics with your own program.
See what a complete attendance record looks like
Timestamp, method, signature, and a member name and date on every event — captured the moment it happens.