Adult Day Services Centers

Figure 1: Number of COVID-19 cases, hospitalizations, and deaths among adult day services center participants and staff since January 2020 through mid-July 2021

This figure shows the number of presumptive positive or confirmed COVID-19 cases, hospitalizations, and deaths reported by ADSCs from January 2020 through mid-July 2021 grouped by U.S. Census region and metropolitan statistical areas. Data are presented for both participants and staff separately.

• COVID-19 Cases are reported by directors/administrators and include cases that are either presumptive positive or confirmed by testing.
• Participant includes any participant enrolled in the ADSC at any time since January 2020.
• Staff includes direct employees and contractors at the ADSC at any time since January 2020.
• Hospitalizations and Deaths due to COVID-19 are reported by directors/administrators.
• US Census Region is based on the U.S. Census definitions:
  • Northeast
  • Midwest
  • South
  • West
• Metropolitan statistical areas are based on geographic entities delineated by the Office of Management and Budget (OMB):
  • Metropolitan: core urban area of 50,000 or more population
  • Nonmetropolitan: areas with less than 50,000 population

Figure 2: Number of COVID-19 cases since January 2020 through mid-July 2021 among adult day services center participants and staff, by center characteristics

This figure shows the number of presumptive positive or confirmed COVID-19 cases between January 2020 and mid-July 2021 grouped by U.S. Census region and metropolitan statistical areas, according to five key characteristics of ADSCs. Data are presented for both participants and staff separately.

• COVID-19 Cases are reported by directors/administrators and include cases that are either presumptive positive or confirmed by testing.
• Participant includes any participant enrolled at the ADSC at any time since January 2020.
• Staff includes direct employees and contractors at the ADSC at any time since January 2020.
• US Census Region is based on the U.S. Census definitions:
  • Northeast
  • Midwest
  • South
  • West
• Metropolitan statistical areas are based on geographic entities delineated by the Office of Management and Budget (OMB):
  • Metropolitan: core urban area of 50,000 or more population
  • Nonmetropolitan: areas with less than 50,000 population
• ADSC Size: small (1-25 users), medium (26-50 users), and large (51 or more)
• Medicaid certification: whether an ADSC is authorized or set up to participate in Medicaid
• Chain affiliation: whether an ADSC is owned by a person, group, or organization that owns/manages two or more ADSCs, including corporate chains
• Ownership type: whether an ADSC is for profit (private or publicly traded/limited liability company) or nonprofit (including government)
• Any PPE shortage: whether an ADSC experienced a shortage of eye protection, gloves, face masks, isolation gowns, and N95 respirators at any time since January 2020

Figure 3: Percentage of adult day services centers that experienced personal protective equipment shortages since January 2020 through mid-July 2021

This figure shows the percentages of ADSCs that experienced a shortage of personal protective equipment at any time since January 2020 and by four time periods (January 2020 through March 2020, April 2020 through mid-July 2020, July 2020 through September 2020, and October 2020 through mid-July 2021), grouped by U.S. Census region and metropolitan statistical areas.

• Personal Protective Equipment Shortages displays “yes” responses out of three options (yes, no, don’t know) during each time period included:
  • Eye protection, gloves, face masks, and isolation gowns
  • N95 respirators
• US Census Region is based on the U.S. Census definitions:
  • Northeast
  • Midwest
  • South
  • West
• Metropolitan statistical areas are based on geographic entities delineated by the Office of Management and Budget (OMB):
  • Metropolitan: core urban area of 50,000 or more population
  • Nonmetropolitan: areas with less than 50,000 population

Figure 4: Percentage of adult day services centers with selected practices for the prevention, response, or management of COVID-19 infections since January 2020 through mid-July 2021

This figure shows the percentages of ADSCs with infection control practices in their prevention, response, or management of COVID-19 infections between January 2020 and mid-July 2021, grouped by U.S. Census region and metropolitan statistical areas.

• Infection control practices:
  • Screening participants daily for fever or respiratory symptoms
  • Notifying all participants or families of cases in the center within 24 hours
  • Use of telephonics or audio-only calls to assess, diagnose, monitor, or treat participants with presumptive positive or confirmed COVID-19 infection
  • Use of telemedicine or telehealth (ie., audio with video, web videoconference) to assess, diagnose, monitor, or treat participants with presumptive positive or confirmed COVID-19 infection
  • Limiting of hours or temporary closure of this center
• US Census Region is based on the U.S. Census definitions:
  • Northeast
  • Midwest
  • South
  • West
• Metropolitan statistical areas are based on geographic entities delineated by the Office of Management and Budget (OMB):
  • Metropolitan: core urban area of 50,000 or more population
  • Nonmetropolitan: areas with less than 50,000 population

Figure 5: Percent of adult day services centers that imposed in-person restrictions since January 2020 through mid-July 2021

This figure shows the percentages of ADSCs with in-person restrictions on individuals from entering the building, grouped by U.S. Census region and metropolitan statistical areas.

• In-person restrictions included five response options for never, sometimes or often, always, and don’t know for the following types of individuals:
  • Family and relatives
  • Visitors
  • Volunteers
  • Non-essential consultant personnel (e.g. barbers, delivery personnel)
• US Census Region is based on the U.S. Census definitions:
  • Northeast
  • Midwest
  • South
  • West
• Metropolitan statistical areas are based on geographic entities delineated by the Office of Management and Budget (OMB):
  • Metropolitan: core urban area of 50,000 or more population
  • Nonmetropolitan: areas with less than 50,000 population

Technical Notes

• The final data includes survey submissions through mail, web, or CATI survey mode by July 15, 2021. Previous versions of these figures used preliminary data that included survey submissions through mail and web received by March 25, 2021 and excluded later mail and web submissions and all CATI survey mode respondents, which may have introduced response bias and estimates may have changed using final data.
• Other differences between preliminary and final data may be due to differences in the selection of variables used for weighting the data.
• 12.2% of ADSCs reported being temporarily closed and not providing any services to participants at the time of the survey.
• Data are weighted and are nationally representative.
• Cases with missing data are excluded on a variable-by-variable basis.
• Data represent adult day services centers, not individual participants.
• To be eligible to participate in NPALS, an ADSC must be licensed or certified by the state specifically to provide adult day services, or accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF), or authorized or otherwise set up to participate in Medicaid (Medicaid state plan, Medicaid waiver, or Medicaid managed care), or part of a Program of All-Inclusive Care for the Elderly (PACE); have an average daily attendance of one or more participants based on a typical week; and have one or more participants enrolled at the ADSC at the designated location at the time of the survey.
• All estimates shown meet the NCHS Data Presentation Standards for Proportions and meet NCHS confidentiality standards.

Data Source

National Center for Health Statistics’ 2020 National Post-acute and Long-term Care Study adult day services center survey. For more details please visit https://www.cdc.gov/nchs/npals/questionnaires.htm.