Operating Status of Adult Day Services Centers in 2022

Operating Status of Adult Day Services Centers in 2022
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by Jessica P. Lendon, Ph.D., Priyanka Singh, M.P.H., Christine Caffrey, Ph.D., Manisha Sengupta, Ph.D., and Zhaohui Lu, M.S.

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Adult day services centers (ADSCs) assist primarily older adults with activities of daily living, medical care, and social or recreational activities in community-based settings. In 2020, some ADSCs were required or chose to temporarily close physical centers and changed how they provided services in response to COVID-19 mitigation efforts. The National Post-acute and Long-term Care Study (NPALS) provided preliminary estimates of ADSC operating statuses in 2020 (1).

This report provides updated NPALS estimates for 2022, comparing centers that were physically open and provided services onsite only with centers that were open or temporarily closed and provided services onsite, at participants’ residences, or virtually. Operating status estimates are compared by U.S. census region, metropolitan statistical area (MSA) status, Medicaid licensure, and number of enrolled participants.

Overall, nearly three-quarters of centers operated onsite only (72.9%), and 27.1% provided services onsite or offsite, or both, in 2022 (Figure 1). Higher percentages of ADSCs in the Northeast (84.6%), Midwest (84.0%), and South (80.8%) were onsite only compared with the West (52.3%) (Figure 1). A higher percentage of centers in non-MSAs were onsite only (84.1%) compared with those in MSAs (71.5%) (Figure 2). More Medicaid-licensed centers were onsite only (78.4%) compared with non-Medicaid-licensed centers (56.1%) (Figure 3). More centers with 1 to 50 enrolled participants were onsite only (81.2%) compared with centers having more than 50 participants (61.7%) (Figure 4).

Data source and methods

Data are from the 2022 NPALS restricted ADSC data files (2), although public-use files are also available (3). NPALS collects national data on ADSCs every 2 years to monitor post-acute and long-term care settings. Results are based on 389 eligible centers and weighted to be nationally representative of about 3,000 centers (4). Statistical differences in operating status by characteristics are based on two-tailed significance tests ( p < 0.05).

Operating status was determined by asking, “Due to the challenges presented by COVID-19, many adult day services centers have altered how they serve their participants. Which of the following best describes the current operating status of this adult day services center? (i) Physical center was open and only served participants onsite; (ii) Physical center was open and served participants onsite and at participants’ places of residence or virtually; (iii) Physical center was temporarily closed but served participants at their places of residence or virtually; (iv) Physical center was temporarily closed and did not serve participants; and (v) Physical center is permanently closed—no longer serving participants.” With 1.7% of ADSCs in the third status of temporarily closed and providing services offsite only, the second and third statuses were combined as “onsite and/or offsite.” Responding ADSCs that chose the fourth (3.6%) and fifth (4.0%) statuses were classified as ineligible and did not complete the survey.

An MSA contains a population of 50,000 people or more, and a non-MSA includes a population of fewer than 50,000 (5). Estimates shown are reliable based on National Center for Health Statistics standards (6) unless noted with an asterisk. More details about NPALS are available online at https://www.cdc.gov/nchs/npals/.

References

  1. Lendon JP, Lu Z. Operating status of adult day services centers due to COVID-19 in 2020 through March 2021. National Center for Health Statistics. 2022.
  2. National Center for Health Statistics. Restricted NPALS data files.
  3. National Center for Health Statistics. National Post-acute and Long-term Care Study 2022 adult day services center public use datasets.
  4. National Center for Health Statistics. 2022 National Post-acute and Long-term Care Study: Survey methodology for adult day services center and residential care community components.
  5. Office of Management and Budget. Revised delineations of metropolitan statistical areas, micropolitan statistical areas, and combined statistical areas, and guidance on uses of the delineations of these areas. OMB Bulletin No. 23-01. 2023.
  6. Parker JD, Talih M, Malec DJ, Beresovsky V, Carroll M, Gonzalez JF Jr, et al. National Center for Health Statistics data presentation standards for proportions. National Center for Health Statistics. Vital Health Stat 2. 2017 Aug(175):1–22.

Suggested citation

Lendon JP, Singh P, Caffrey C, Sengupta M, Lu Z. Operating status of adult day services centers in 2022. NCHS Health E-Stats. 2025 Mar. DOI: https://dx.doi.org/10.15620/cdc/174584.

Figures

Figure 1. Operating status of adult day services centers due to COVID-19, by U.S. census region, 2022

Figure 1 is a stacked bar chart showing the operating status of adult day services centers due to COVID-19 by U.S. census region for 2022.
1Statistically significant difference from centers in the West (p < 0.05).
NOTES: Onsite only refers to adult day services centers (ADSCs) whose physical center was open and served participants only onsite. Onsite or offsite, or both refers to ADSCs whose physical center was open and served participants onsite and at participants’ places of residence or virtually, and ADSCs whose physical center was temporarily closed but served participants at their places of residence or virtually. Regions are based on the four U.S. Census Bureau regions.
SOURCE: National Center for Health Statistics, National Post-acute and Long-term Care Study, 2022.

Figure 2. Operating status of adult day services centers due to COVID-19, by metropolitan statistical area status, 2022

Figure 2 is a stacked bar chart showing the operating status of adult day services centers due to COVID-19 by metropolitan statistical area status for 2022.
* Estimate does not meet National Center for Health Statistics standards of reliability.
1Statistically significant difference from nonmetropolitan centers (p < 0.05).
NOTES: Onsite only refers to adult day services centers (ADSCs) whose physical center was open and served participants only onsite. Onsite or offsite, or both refers to ADSCs whose physical center was open and served participants onsite and at participants’ places of residence or virtually, and ADSCs whose physical center was temporarily closed but served participants at their places of residence or virtually. A metropolitan statistical area contains a population of 50,000 or more, and a nonmetropolitan statistical area includes a population of fewer than 50,000.
SOURCE: National Center for Health Statistics, National Post-acute and Long-term Care Study, 2022.

Figure 3. Operating status of adult day services centers due to COVID-19, by Medicaid licensure, 2022

Figure 3 is a stacked bar chart showing the operating status of adult day services centers due to COVID-19 by Medicaid licensure for 2022.
1Statistically significant difference from centers that are not Medicaid licensed (p < 0.05).
NOTES: Onsite only refers to adult day services centers (ADSCs) whose physical center was open and served participants only onsite. Onsite or offsite, or both refers to ADSCs whose physical center was open and served participants onsite and at participants’ places of residence or virtually, and ADSCs whose physical center was temporarily closed but served participants at their places of residence or virtually.
SOURCE: National Center for Health Statistics, National Post-acute and Long-term Care Study, 2022.

Figure 4. Number of enrolled participants, by operating status of adult day services centers due to COVID-19, 2022

Figure 4 is a stacked bar chart showing the number of enrolled participants by operating status of adult day services centers due to COVID-19 for 2022.
1Statistically significant difference from centers with more than 50 participants (p < 0.05).
NOTES: Onsite only refers to adult day services centers (ADSCs) whose physical center was open and served participants only onsite. Onsite or offsite, or both refers to ADSCs whose physical center was open and served participants onsite and at participants’ places of residence or virtually, and ADSCs whose physical center was temporarily closed but served participants at their places of residence or virtually.
SOURCE: National Center for Health Statistics, National Post-acute and Long-term Care Study, 2022.