Adult Day Service

Initial License Requirements – read Title 175 NAC 5-003.01

Stage 1: Submit to the Department a complete application. For facilities which meet the “new construction" definition at 5-002, see additional requirements on the Facility Construction web page.

Stage 2: Pass an onsite inspection & submit a Completion Certificate form completed by a Nebraska-licensed architect or engineer which documents compliance with 175 NAC 5-007.

Please see the Inspections section of this page for initial inspection information.

The application must be printed, completed, signed, and mailed to our office.

• Initial License Application

Renewal License Requirements – read Title 175 NAC 5-003.02​

• Stage 1: Department mails to licensee a notice of expiration & renewal application.
• Stage 2: Licensee returns to the Department the renewal application with correct owner signatures, owner titles, dates, renewal fee, and additional items as required at 175 NAC 5-003.02A.
• Stage 3: Department mails to licensee an updated license card after a complete renewal application is received.

For a Renewal License Application please call (402) 471-4967.

Fees – Title 175 Chapter 5​ Regulations Governing Licensure of Adult Day Service

The licensee must pay fees for licensure and services as set forth below:

• Initial and renewal licensure fees for an ADS are:
  - Programs with license capacity of 4-16 $200
  - Programs with license capacity of 17-50 $250
  - Programs with license capacity of 51 and up $300
• Duplicate license: $10
• Refunds for denied applications:
  - If the Department did not perform an inspection, it must refund the license fee except for an administrative fee of $25.
  - If the Department performed an inspection, the fee is not refunded.

Notifications: An applicant or licensee must notify the Department in writing, by mail, email, or fax.

Additional General Requirements:

Change of premises or ownership – A sale, whether of stock, title, or assets; a change of lease; or discontinuance of operations terminates the license. The licensee must notify the Department in writing 10 days before an adult day service is sold, leased, discontinued, or moved. A license is issued only for the premises and persons named in the application and is not transferable or assignable.

Forms – The following form must be printed, completed, signed, and mailed to our office. A separate form must be completed for each change and/or correction being requested.

Change or Correction Request Form 

The Department inspects the adult day service prior to and following licensure to determine compliance with 175 NAC 5-006 – Standards of Operations, Care and Treatment and 5-007 – Physical Plant Standards. The adult day service may not operate without an active license issued by the Department.

Inspection requirements are at 175 NAC 5-005​​.

Initial Licensure Inspections:

An onsite inspection is scheduled with the applicant after the Department has received a complete initial licensure application as required by 175 NAC 5-003.01A and 5-003.01B, and a written notification from the applicant with the date the applicant will be ready for the inspection. Unless the applicant requests a later date, the Department has 30 working days to conduct this initial onsite inspection after a complete application is received by the Department.

Prior to submitting an initial licensure application or requesting the initial onsite licensure inspection, the applicant should be ready to operate, but not be operating the site. The ADS Administrator and back-up Administrator must be prepared to demonstrate during the Department's onsite inspection how the ADS will comply with the requirements at 175 NAC 5-006 and 5-007. Compliance is demonstrated through the use of ADS-specific organizational charts, job descriptions, policies, procedures, forms, and similar items along with a physical inspection of the ADS prior to the applicant being issued a license by the Department.

Compliance Inspections:

Following initial licensure, the Department may conduct unannounced onsite inspections at any time the Department deems necessary to determine compliance with 175 NAC 5-006.

Inspection Results: See 175 NAC 5-005.05.