The adult day services plan of care in Minnesota runs on three deadlines from Minn. R. 9555.9700: an intake screening before admission with the outcome communicated within five working days, a needs assessment and preliminary service plan within 30 days of admission, and a written plan of care within 90 days that is reviewed and revised quarterly. Every plan must be dated and placed in the participant's record.
Those deadlines matter twice. A licensor checks them under ch. 245A, and a waiver auditor checks them because Department of Human Services (DHS) billing guidance requires a needs assessment and current plan of care for every adult day participant, alongside the daily attendance record.
This guide covers each step in order, then billing, discharge and transfer records, and the deficiencies reviewers find most often. For the service itself, see What are adult day services in Minnesota?.
The Rule 9555.9700 timeline
| Step | Deadline | What it produces | Rule |
|---|---|---|---|
| Intake screening | Before admission; outcome within five working days after screening begins | Determination of how or whether the center can serve the person | 9555.9700, subp. 1 |
| Application and medical report | At admission; medical report dated within three months before or 30 days after admission | Emergency contacts, physician, medical history, diet and medication needs | 9555.9660, subp. 1, items A and B |
| Needs assessment and preliminary service plan | Within 30 days of admission | Psychosocial, functional, and physical status; attendance days, transportation, nutrition, caregiver role, immediate services | 9555.9700, subp. 2 |
| Individual plan of care | Within 90 days of admission | Dated plan with measurable objectives, responsible staff, duration, and review provisions | 9555.9700, subp. 3 |
| Review and revision | Quarterly | Dated update to objectives and services | 9555.9700, subp. 3, item E |
| Progress notes | At least monthly | Participation reports and progress notes | 9555.9660, subp. 1, item E |
| Physical examination update | Annually | Updated medical report | 9555.9660, subp. 1, item B(1) |
| Discharge summary | At discharge | Summary in the participant record | 9555.9660, subp. 1, item L |
Intake screening and admission criteria
Rule 9555.9700, subp. 1 requires the center to screen every prospective participant before admission. The screening determines how or whether the center can serve the individual, based on the center's licensure, its policies and services, and the individual's needs and condition. If possible it includes an interview with the participant and the caregiver. The center must notify the individual of the outcome no more than five working days after the screening process begins. There is no statewide list of admission criteria beyond that; each center's policies define whom it can serve, and a licensor checks screenings against them.
Two admission documents from Rule 9555.9660 feed the plan. The application (item A), signed by the participant or caregiver, records identifying information, date of admission, living arrangement, referral source, two emergency contacts, and the participant's physician. The medical report (item B) must be dated within three months before or 30 calendar days after admission and signed by a physician, or by a physician assistant or registered nurse and cosigned by a physician. It covers the physical examination, medical history, dietary restrictions and medication regimen, a release for structured exercise, and freedom from communicable disease.
For centers licensed under group E-3 occupancy, item K adds a signed admission statement on whether the participant is capable of self-preservation under emergency conditions, plus a fire drill within six months. That designation drives the staffing ratio in the staffing ratios and training guide.
The 30-day needs assessment and preliminary service plan
Subpart 2 says the center must begin "immediately after admission" and finish within 30 days. The needs assessment (item A) draws on observation and other sources, expressly including any assessment under Minn. Stat. § 256B.0911, which today means the lead agency's MnCHOICES assessment. It must address:
- Psychosocial status, such as awareness level, personal care needs, and need for privacy or socialization.
- Functional status, such as endurance and capability for ambulation, transfer, and managing activities of daily living.
- Physical status, determined by observation, the intake interview, and the physician's medical report.
The preliminary service plan (item B) is based on that assessment and coordinated with the participant's other service plans. It must state the scheduled days of attendance, transportation arrangements, nutritional needs and any dietary restrictions, the caregiver's role in carrying out the plan, and the services and activities the participant takes part in immediately on admission.
The 90-day plan of care and what it must contain
Subpart 3 requires a written plan of care within 90 days of admission, developed by center staff together with the participant, the participant's caregiver, and other agencies and individual service providers. The plan must be dated and must include:
| Element | Rule 9555.9700, subp. 3 | What a reviewer expects to see |
|---|---|---|
| Updated preliminary plan and additional services | Item A | Current attendance days, transportation, nutrition and diet, caregiver role, plus any service added since admission (bath, medication assistance, exercise) |
| Objectives | Item B | Short and long-term objectives stated in concrete, measurable, time-specific outcomes, not "maintain socialization" |
| Responsible staff | Item C | The staff members responsible for implementing the plan, by name or position |
| Duration | Item D | The anticipated duration of the plan as written |
| Review provisions | Item E | How and when the quarterly review and revision will happen |
Health and medication needs and emergency information are not listed in subpart 3, but the same record must hold them under Rule 9555.9660 (medical report, medication notes under item F, emergency contacts) and Rule 9555.9720, subp. 3, which requires each participant's caregiver, backup contact, and physician phone numbers to be readily available at the center and in center vehicles.
Compliance note: "measurable and time-specific" is the element most plans fail. "Participant will walk with the exercise group" cannot be reviewed quarterly; "Participant will complete the 15-minute morning walk on three attendance days a week by December 31" can.
Quarterly review and the annual medical update
Item E requires provisions for quarterly review and quarterly revision of the plan of care. Rule 9555 does not use the phrase "annual reassessment"; the annual item in the record is the physical examination update under Rule 9555.9660, subp. 1, item B(1). Progress notes must be recorded at least monthly (item E of the same subpart), and those notes are what the quarterly review draws on.
A workable cycle: a monthly progress note against each objective; a dated, signed quarterly review that revises objectives, attendance days, transportation, diet, and the self-preservation designation; an annual medical report update; and a new plan whenever the anticipated duration in item D expires. Family adult day services follow Minn. Stat. § 245A.143 instead, under which the service plan is revised when needs change or annually, whichever is sooner.
Participant and family involvement
The rule's language is "developed by the center staff together with the participant, the participant's caregiver, and other agencies and individual service providers." Involvement means participation in setting objectives, not a signature line. Rule 9555.9710, subp. 7 requires social services staff to interview the participant and caregiver at admission and keep a family and social history, the natural start of that conversation.
Two record items support involvement: the center's participant rights statement, signed by the participant or caregiver (Rule 9555.9660, subp. 1, item H), and written notice that the participant, guardian, or caregiver may contest the accuracy and completeness of the record (subp. 3). Both belong in the admission packet next to the plan.
How the plan of care supports billing
DHS's billing guidance for waiver and Alternative Care services requires an adult day provider to keep a needs assessment and current plan of care for each person, under Rule 9555.9700 for centers or § 245A.143, subd. 4 to 7 for family adult day services, together with daily attendance records showing the date and the pickup and drop-off times in hours and minutes. The plan and the attendance log are the two documents behind every claim:
- S5102 (daily, six or more hours). The attendance record proves the hours; the plan's attendance days show the day was scheduled.
- S5100 (15-minute units). Same evidence, with units counted from arrival and departure times.
- T2003 UC (waiver transportation, per one-way trip). The plan's transportation arrangements show the participant was expected to ride; the vehicle log shows the trip.
The service agreement should match the plan's attendance days. If the plan says three days a week and the claims show five, either the plan is stale or the claims are wrong, and a pre-payment reviewer will ask which. The billing and attendance records guide covers the codes, the attendance fields, and the monthly reconciliation that catches the mismatch.
Discharge and transfer records
Rule 9555.9660, subp. 1, item L requires a discharge summary in the record if the participant is discharged. The rule does not prescribe its contents, so center policy should; the discharge date, the reason, status against the plan objectives, medications and diet at discharge, and the participant's destination give the next provider and the case manager what they need.
Transfers use the same record. Item C holds reports received from other agencies involved in the participant's care, so a transfer packet should include the current plan, the latest quarterly review, the medical report, and any incident reports under Rule 9555.9720, subp. 4. Family adult day services must state a discharge policy in the service plan under § 245A.143.
Common plan of care deficiencies
The recurring findings are mostly timing and specificity problems:
- No dated intake screening, or no record of the outcome within five working days.
- Needs assessment or preliminary plan completed after day 30, or undated.
- Plan of care completed after day 90, or a preliminary plan still standing in a year later.
- Objectives that are not measurable or time-specific.
- No named responsible staff, or staff who no longer work at the center.
- Quarterly reviews missing, undated, or more than three months apart.
- Attendance days in the plan that do not match the service agreement or the claims.
- Medical report outside its window, or no annual physical update.
- Self-preservation designation never documented or never revisited after a decline.
- No discharge summary for participants who left.
Sampling your own records against this list is the fastest self-audit; the DHS audit preparation checklist explains how to pull and score a sample.
How Trustora helps
Trustora's adult day module builds the participant record around the Rule 9555.9700 timeline. The intake screening, application, and medical report open the file; the 30-day preliminary service plan and the 90-day plan of care have due dates calculated from the admission date, with alerts before each one and before every quarterly review. Objectives are entered with a measurable target and a date, responsible staff are selected from the active staff list, and each quarterly review is dated and signed in place.
The plan's attendance days and transportation arrangements flow into the schedule and the daily attendance record, so the pre-claim gate can compare each S5102, S5100, or T2003 UC line against the plan and the service agreement before the claim goes out. The one-click DHS audit binder assembles the screening, plans, reviews, progress notes, attendance, and discharge summary for any participant and date range. See the platform overview.