What New York’s 2026 Social Adult Day Care Audit Means for Attendance and Documentation

For a New York Social Adult Day Care (SADC) that contracts with a Managed Long Term Care (MLTC) Partial Capitation or Medicaid Advantage Plus (MAP) plan, the current MLTC oversight requirements for attendance records are set out in New York Department of Health Policy 25.05, and they are separate from a 2026 oversight audit. MLTC Policy 25.05 tells those plans, during initial and later site evaluations, to collect and review attendance (sign-in/out) records that indicate, at minimum, the member's name, the date, and start and end times, and to verify that service-delivery records are maintained and available for surveillance and audit. Separately, the Office of the State Comptroller (OSC) issued Medicaid Program – Oversight of Social Adult Day Care Programs (2023-S-21) on February 6, 2026. That audit found sampled sign-in logs at three SADCs did not support 7,964 of 92,969 encounter claims (about 9%), totaling $672,147, during January 2019 through October 2024.

ElderSuite serves adult day care centers nationwide. This resource is New York-specific.

What the OSC audit is

OSC's objective was to determine whether the Department of Health (DOH) provided adequate oversight of Medicaid MLTC plans to ensure SADC program services met program standards. The audit covered January 2019 through October 2024. OSC addressed the report to DOH. The findings describe that review period. They are not themselves the current DOH rulebook.

From January 2019 through October 2024, OSC reports that MLTC plans made $2.4 billion in payments for SADC services. SADC has been a covered MLTC service since March 2014. SADCs must comply with New York Codes, Rules and Regulations (NYCRR), Title 9, Section 6654.20, which establishes minimum standards for SADC program administration and operation.

Read the OSC audit page and the full audit report (PDF).

The attendance and sign-in finding

OSC visited three SADCs and identified $1.3 million in improper payments for services lacking supporting documentation. On attendance, OSC wrote that all three SADCs used member sign-in logs to document the delivery of services. OSC also found that each SADC had a different sign-in procedure for its members. OSC requested member sign-in logs to support a judgmental sample of 92,969 encounter claims submitted by those three SADCs. The review found 7,964 of 92,969 encounter claims (about 9%) totaling $672,147 were not supported by a sign-in log.

OSC also stated that NYCRR required SADC services to be documented, but that during the review period neither the rules nor DOH specified what was considered sufficient documentation to support billing for SADC services. OSC wrote that DOH did not have a policy describing what documentation is required to support billing for SADC services, and that sign-in logs were not included in the SADC Site Evaluation Tool.

Those statements are OSC findings about January 2019 through October 2024. They are not a current DOH attendance form.

The audit also found assessment and service-plan documentation problems

The same OSC documentation review covered assessments and Person-Centered Service Plans. From a judgmental sample of 15 members' assessments and Person-Centered Service Plans at two of the three SADCs visited, OSC found non-compliant files for 14 of the 15 members, totaling $625,360 in payments.

OSC's examples of non-compliance included payments for claims that occurred before a member had the required initial assessment, and missing and unsigned Person-Centered Service Plans. OSC wrote that those plans are meant to ensure the member participated in developing the plan for their services. The $625,360 figure is OSC's associated payment amount for that sampled documentation finding.

Those statements are OSC findings about January 2019 through October 2024. They are not a new SADC assessment form and they do not themselves establish a current Department of Health documentation rule. For the Health Assessment & Service Plan record ElderSuite maintains, see Health Assessment & Service Plan - Form 3050. How nursing records sit together is covered in Adult Day Care Nursing Documentation. Neither is a New York SADC Person-Centered Service Plan.

Current DOH guidance is Policy 25.05

Policy 25.05 is current DOH guidance for how MLTC Partial Capitation and MAP plans oversee contracted SADCs. The official title is Managed Long Term Care (MLTC) Policy 25.05: Enhanced MLTC Plan Oversight of Contracted Social Adult Day Cares (SADCs). Date of Issuance is September 8, 2025. Effective Date is September 8, 2025. The policy states that it does not apply to Program of All-Inclusive Care for the Elderly (PACE) plans.

The OSC audit reports findings and recommendations; it is not itself a regulation or DOH policy establishing a new SADC attendance form or documentation standard. For the attendance and documentation packet plans are told to collect now, use Policy 25.05 and New York Social Adult Day Care Documentation and National Provider Identifier (NPI) Requirements: MLTC Policy 25.05.

What Policy 25.05 currently requires for attendance and service-delivery records

The audience on the policy page is the plan. During initial and all subsequent SADC site evaluations, Policy 25.05 tells plans to:

The SADC may redact protected health information (PHI) and personally identifiable information (PII) for members not enrolled with the MLTC plan conducting the evaluation.

The Department's MLTC Policy 25.05 Frequently Asked Questions (February 17, 2026) address those records. On records of service delivery, the FAQ quotes Title 9 NYCRR 6654.20 (d)(2)(iii) - Records: the program shall maintain on file administrative and financial records; participant personal records, including identifying, emergency, and medical information including physician name, diagnosis, and medications; and services records, including the individual assessment, the service plan, and documentation of the delivery of services. The FAQ states that MLTC plans are required to obtain copies of service delivery records for all of that plan's members attending the SADC. On Person-Centered Service Plan documentation, the FAQ states that the MLTC plan must obtain and review person centered service plans (PCSPs) for all members that include at minimum all fields within the SADC PCSP Template issued by the Department, in conjunction with NYSOFA, and confirm the initial PCSP was created within 30-days of enrollment and subsequent PCSPs were conducted at least annually thereafter.

A SADC that serves those members is the source of the attendance and service-delivery records the plan is told to collect and copy.

Occupancy in the audit versus occupancy in Policy 25.05

OSC also reported occupancy findings for the review period. OSC reviewed Certificates of Occupancy and related documentation for two SADCs and found that MLTC plans were not always ensuring SADCs meet requirements. One SADC operating on three floors had, according to its Certificate of Occupancy, a combined maximum capacity of 323 people. OSC identified 386 service dates where members exceeded that capacity. On September 28, 2022, according to encounter claims data, that SADC served 530 members (totaling $47,255 in payments) — 207 over its maximum allowed capacity.

Those occupancy figures are OSC findings about the audit period. They are not Policy 25.05.

Separately, Policy 25.05 currently tells plans to verify a current COO for the correct SADC ownership and physical location before network enrollment and annually afterward, observe occupancy during the site visit, and use attendance (sign-in/out) records that show the member's name, date, and start and end times to check occupancy against that COO.

Arrival and departure times, and supporting files

Policy 25.05's attendance minimum is the member's name, the date, and start and end times. Service-delivery records are to be maintained and available for surveillance and audit.

In ElderSuite, arrival and departure times are recorded in Attendance & Transportation Records for the applicable service date and these records can document the member's attendance times. How to Record Attendance and Transportation Times in ElderSuite covers entering those times.

Client Documents may store signed and supporting PDF files with the client they belong to. If a center separately maintains signed attendance sheets or other supporting PDFs, Client Documents can keep those files with the appropriate client record.

Those attendance times and supporting files are part of the client documentation ElderSuite maintains.

Primary sources

Confirm the current text on the official OSC and DOH pages.