National Health Statistics Reports

Number 124  April 30, 2019

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Service Provision, Hospitalizations, and 

Chronic Conditions in Adult Day Services Centers: 

Findings From the 2016 National Study of 

Long-Term Care Providers

by Christine Caffrey, Ph.D., and Jessica Penn Lendon, Ph.D.

Abstract

Introduction—This report presents the most recent nationally representative 

percentages of adult day services centers (ADSCs) with hospitalizations and 

chronic conditions by service provision. Service provision may further one or two 

of the primary goals of adult day services: to reduce the risk of hospitalizations and 

readmissions, and manage chronic conditions among their participants.

Methods—Estimates are from the 2016 Adult Day Services Center survey in the 

biennial National Study of Long-Term Care Providers conducted by the National 

Center for Health Statistics. Service provision was measured using scales that included 

five types of services: mental health, social work, therapeutic (physical, speech, or 

occupational), dietary and nutritional, and skilled nursing. Provision methods included 

by employees only or a mix of employees, arrangement, or referrals; by arrangement 

or referrals; and not provided. The percentage of ADSCs with hospitalizations was 

measured by having at least one participant discharged from an overnight hospital 

stay in the past 90 days. The number of chronic conditions included the four most 

prevalent types of chronic conditions reported by ADSCs (Alzheimer disease and 

other dementias, diabetes, depression, and heart disease). Analyses included univariate 

and bivariate statistics showing the percentages of ADSCs with hospitalizations and 

chronic conditions by service provision.

Results—Although a little more than one-half of ADSCs (52.6%) provided all five 

services, approximately one-tenth of ADSCs provided none of the five services. About 

64.0% of ADSCs had hospitalizations among participants. Almost 7 in 10 ADSCs 

(69.2%) reported the prevalence of all 4 conditions in their center. Approximately 

three-fourths (74.3%) of ADSCs that provided all five services had hospitalizations 

among participants compared with almost one-third of ADSCs (31.5%) that provided 

none of the services. Almost 83.0% of ADSCs that provided all five services had all 

four conditions in their center, compared with approximately one-third (31.5%) of 

ADSCs that provided none of the five services.

Keywords: home- and community-based services • long-term services and supports

Introduction

In 2016, 286,300 participants were 

enrolled in 4,600 adult day services 

centers (ADSCs) nationwide in the 

United States (1). ADSCs are a growing 

home- and community-based sector 

of long-term care with a primary goal 

of helping individuals with chronic 

conditions and disabilities remain living 

in the community and preventing or 

delaying institutionalization (2).

As part of their goal to prevent 

or delay institutionalization, ADSCs 

offer a variety of services, including 

mental health; social work; physical, 

occupational, or speech therapy; dietary 

and nutritional; and skilled nursing. 

They typically provide these services 

in a variety of ways including by center 

employees, by arrangement with outside 

providers or contractors, or by referrals 

to outside providers. Some ADSCs may 

provide and coordinate services with a 

mix of all three methods of provision. By 

providing a variety of services through 

mixed methods of provision, ADSCs 

may better meet the diverse needs of 

their participants, and prevent them from 

having to obtain services elsewhere. 

However, not all ADSCs offer all (or any) 

services (1). Service provision supports 

long-term care users with chronic 

NCHS reports can be downloaded from: https://www.cdc.gov/nchs/products/index.htm.
Page 2 National Health Statistics Reports  Number 124  April 30, 2019

conditions and disabilities, and those 

who have had hospitalizations, and has 

been found to reduce the likelihood of 

readmissions (3). 

Hospitalizations among older 

adults are a strong predictor of future 

institutionalization or nursing home 

admission, and are associated with health 

and disability declines, lower quality of 

life, and greater health care costs (4–6). 

The increased risks associated with 

hospitalizations are of particular concern 

to ADSCs, and reducing hospitalizations 

and readmissions is a main goal for 

ADSCs. A recent study found that home 

health patients who also participated in an 

ADSC had lower rates of hospitalizations 

(7). In 2016, 4% of ADSC participants 

had at least one hospitalization in a 

90-day period (8).

Often ADSCs have participants 

with diverse health needs, including 

common chronic conditions, such as 

Alzheimer disease and other dementias, 

depression, diabetes, and heart disease. 

In 2016, 38% of ADSC participants were 

diagnosed with Alzheimer disease and 

other dementias, 30% with diabetes, 28% 

with depression, and 27% with heart 

disease (8). These chronic conditions 

have been found to be associated with 

hospitalizations and readmissions in 

long-term care settings (4,9,10). Having a 

participant case mix with several different 

chronic conditions may increase the need 

to provide a wider variety of services 

and to have staff with knowledge about a 

number of conditions. 

Despite ADSCs’ primary goals 

of reducing hospitalizations and 

readmissions and managing chronic 

conditions among participants, national 

estimates on the relationship between 

service provision and hospitalizations 

and chronic conditions are limited. This 

report fills this gap by presenting 2016 

national estimates of the percentages of 

hospitalizations in the past 90 days and 

the number of chronic conditions among 

ADSCs, by service provision.

Methods

Data source

Data in this report are from the 

2016 Adult Day Services Center survey, 

which is a component of the biennial 

National Study of Long-Term Care 

Providers (NSLTCP), conducted by the 

National Center for Health Statistics 

(NCHS). The 2016 NSLTCP used a 

census of ADSCs in the National Adult 

Day Services Association’s (NADSA) 

database. To be eligible for the 2016 

survey, an ADSC must (a) have been 

included in the NADSA database and 

in operation as of November 2015; 

(b) 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, or 

part of a Program of All-Inclusive Care 

for the Elderly (PACE); (c) have an 

average daily attendance of one or more 

participants based on a typical week; and 

(d) have one or more participants enrolled 

at the center at the designated location at 

the time of the survey.

Respondents to the survey are 

ADSC administrators, directors, or 

otherwise knowledgeable ADSC staff. 

The survey was administered by mail, 

web, and Computer-Assisted Telephone 

Interviewing (CATI) follow up for 

nonrespondents. The 2016 NSLTCP had 

a response rate of 61.8%. For additional 

information about NSLTCP and ADSC 

survey methodology and variable 

construction, see the 2016 NSLTCP 

survey documentation (11,12). The 2016 

NSLTCP data are accessible via restricted 

use only. Information on how to access 

the data are available from: https://www.

cdc.gov/nchs/nsltcp/nsltcp_rdc.htm.

Measures

For service provision, respondents 

were asked to mark which of the 

services they provided and how they 

provided them, referred to in this 

report as provision method. Services 

included mental health, social work, 

therapeutic (including physical, speech, 

or occupational services), dietary and 

nutritional, and skilled nursing. The 

provision methods described in the 

survey included the following:

● provides by paid center employees 

(employee provision);

● arranges to be provided by outside 

service providers (arrangement);

● refers participants or family to 

outside service providers (referral); 

and

● does not provide by any of these 

methods (no provision).

This report describes services in 

terms of number of services provided and 

how they were provided.

A six-category service provision 

scale was initially constructed using the 

five services to measure the number of 

services provided, ranging from zero 

(does not provide any of the five services) 

to five (provides all of the five services). 

In addition, a category for provision of 

one to four services is shown.

Another provision scale was 

constructed to measure how services 

were provided with the following four 

mutually exclusive categories: 

1. all five services provided by 

employees;

2. all five services provided by 

arrangement or referrals;

3. none of five services provided; and

4. the remaining adult day services 

centers. 

The “provided by employees” 

category includes services that are 

provided by employees only or by a 

mix of employees, arrangement, or 

referrals. This report focuses on provision 

of all five services because it was the 

most efficient way of collapsing the 

information, and in doing this, ADSCs 

that provide the most services can 

be described. The remaining ADSCs 

category includes those providing one to 

four of the services by any combination 

of employees, arrangement, referrals, and 

no provision.

Hospitalizations were measured 

using an item that asked ADSCs 

how many of their currently enrolled 

participants were discharged from 

an overnight hospital stay in the 

past 90 days. Trips to the hospital 

emergency department that did 

not result in an overnight hospital 

stay were excluded. The number of 

90-day hospitalizations across ADSCs 

ranged from 0 to 93 participants 

with the following distribution: 

35.8% had 0 hospitalizations; 
National Health Statistics Reports  Number 124  April 30, 2019 Page 3

19.3% had 1 hospitalization; 

14.8% had 2 hospitalizations; 8.9% 

had 3 hospitalizations; 4.8% had 

4 hospitalizations; 5.8% had 5 

hospitalizations; and 10.6% had 6 or 

more hospitalizations. A binary variable 

was constructed measuring whether or 

not the center had at least one participant 

with a hospitalization. 

The number of chronic conditions 

in ADSCs was measured using an 

aggregated item that asked how many 

currently enrolled participants of the 

ADSC had been diagnosed with any 

of the following conditions: Alzheimer 

disease or other dementias, diabetes, 

depression, and heart disease. This 

center-level measure ranged from zero if 

a center indicated it had no participants 

with any of the four conditions to four if 

a center reported having all four chronic 

conditions represented across one or 

more participants. Across all ADSCs, 

2.0% had zero conditions; 5.2% had one 

condition; 7.7% had two conditions; 

15.4% had three conditions; and 69.2% 

had all four conditions. This measure 

was collapsed into two categories for this 

report: zero to three conditions and all 

four conditions because there were too 

few ADSCs in the zero, one, two, and 

three conditions for individual analyses. 

Constructing it this way allowed for the 

scaling of ADSCs from least to most 

number of chronic conditions in a center, 

indicating centers with more complex 

needs among their participant case mix.

Analyses

Overall national estimates on service 

provision, hospitalizations, and number 

of chronic conditions are reported first as 

context. Then, the percentage of ADSCs 

with hospitalizations by service provision 

is presented. Finally, the number of 

chronic conditions by service provision is 

reported.

Analyses took into account the 

complex survey design of the 2016 

NSLTCP. Weights were used to 

adjust for unknown eligibility status 

of nonresponding ADSCs and for 

nonresponse bias. Results are nationally 

representative. See the 2016 NSLTCP 

documentation for details about the 

weighting methods (11). Cases with 

missing data were excluded from the 

analyses on a variable-by-variable basis, 

ranging from 8.9% for hospitalizations 

to 14.1% for diagnoses of heart disease. 

Data analyses were performed using 

the following statistical packages: SAS, 

version 9.3 (SAS Institute, Cary, N.C.)

(13); SAS-callable SUDAAN, version 

11.0.0 (RTI International, Research 

Triangle, N.C.) (14); and Stata/SE, 

version 14 (StataCorp, College Station, 

T.X.) (15). Statements of differences 

among subgroups are based on two-tailed 

chi-squared and t tests with significance 

at the p < 0.05 level. If a chi-squared test 

was statistically significant, a post hoc t

test procedure was used to make pairwise 

comparisons among subgroups. A 

weighted least-squares regression method 

was used to test the significance of linear 

trends. Statistically significant differences 

and trends are indicated in the figures and 

discussed in the “Results” section.

Results

Overall national estimates

Table 1 shows the percentage 

of ADSCs by service provision, 

the percentage of ADSCs with 

hospitalizations in the past 90 days, and 

the percentage of ADSCs by number of 

chronic conditions.

● More than one-half of ADSCs 

(52.6%) provided all five services 

(Table 1). 

● About 37.0% of ADSCs provided 

one to four of the five services, with 

11.2% providing four of the five 

services, 9.2% providing three of the 

five services, 10.5% providing two of 

the five services, and 6.4% providing 

one of the five services. 

● Approximately one-tenth of ADSCs 

(10.2%) provided none of the five 

services. 

● Nearly one-tenth (8.4%) of ADSCs 

provided all of the five services with 

employees and 10.3% provided all of 

the five services by arrangement or 

referral.

● More than two-thirds of 

ADSCs (64.2%) had at least 

one hospitalization among their 

participants.

● Overall, 30.8% of ADSCs reported 

zero to three of the conditions in 

their center and 69.2% reported all 

four conditions.

Figure 1. Percentage of adult day services centers with hospitalizations in the past 90 days, 

by service provision: United States, 2016

 

 

 

 

 

 

 

 

 

 
Page 4 National Health Statistics Reports  Number 124  April 30, 2019

Hospitalizations by service 

provision

Table 2 shows the percentage 

of ADSCs with hospitalizations by 

service provision. Figure 1 highlights 

these findings for the service provision 

methods. 

● Almost three-fourths of ADSCs that

provided all five services (74.3%)

reported at least one hospitalization

in the past 90 days.

● Almost one-third (31.5%) of ADSCs

that provided none of the five

services had hospitalizations.

● Among ADSCs that provided all

five services with employees, 81.7%

had hospitalizations compared with

59.4% of ADSCs that provided all

five services by arrangement or

referral.

Number of chronic 

conditions by service 

provision

Table 3 shows the percentage of 

chronic conditions among ADSCs by 

number of chronic conditions and service 

provision. Figure 2 highlights findings for 

the service provision methods. 

● Across ADSCs that provided all five

services, 17.5% had zero to three

of the four chronic conditions in

their center and 82.5% had all four

conditions.

● In ADSCs that provided none of

the five services, 70.6% had zero to

three of the four chronic conditions

in their center and 29.4% had all four

conditions.

● Among ADSCs that provided all

five services with employees, 3.8%

had zero to three of the four chronic

conditions in their center and 96.2%

had all four conditions.

● In ADSCs that provided all five

services by arrangement or referral,

36.3% had zero to three of the four

chronic conditions in their center and

63.7% had all four conditions.

Conclusion

In summary, the majority of ADSCs 

(52.6%) provided all five services, and 

approximately 90.0% provided at least 

one service, showing a high level of 

service provision. However, about 10.0% 

of ADSCs provided none of these five 

services. A majority (64.2%) had at least 

one participant with a hospitalization 

in the past 90 days. Almost 70.0% of 

ADSCs reported having all four chronic 

conditions (Alzheimer disease or other 

dementias, diabetes, depression, and 

heart disease) in their center, indicating 

that the majority of centers have a 

diverse set of health needs to meet. 

The percentage of hospitalizations was 

greatest (74.3%) for ADSCs providing 

all five services, especially in ADSCs 

providing all five services directly by 

employees (81.7%). Hospitalizations 

were lower among ADSCs that provided 

none of the five services (31.5%). As 

with hospitalizations, the percentage 

of all four conditions in an ADSC was 

highest in ADSCs that provided all five 

services (82.5%), particularly when all 

five services were provided by employees 

(96.2%), whereas this was lowest among 

ADSCs that provided none of the five 

services (29.4%).

The strength of this analysis includes 

the focus on the relationships among 

service provision, hospitalizations, 

and chronic conditions among a 

nationally representative sample of 

ADSCs. Despite these strengths, 

there were some limitations. The 

measurement of hospitalizations 

may be underrepresenting the actual 

percentage because of the timing of data 

collection, and the 90-day time period 

in the question. For example, an ADSC 

may have a current participant who has 

been hospitalized but has not yet been 

discharged and therefore not counted in 

the hospitalizations measure. Between 

9% and 14% of ADSCs were excluded 

from the study because of missing data. 

In analyses comparing the included with 

the excluded, the two groups differed 

significantly for hospitalizations, all five 

services, and prevalence of diabetes. This 

could result in bias in the results. The 

2016 NSLTCP survey has aggregated 

participant characteristics, and so it is 

impossible to assess co-morbidity (one or 

more conditions) at the participant level. 

Finally, due to the cross-sectional nature 

of the survey, causality cannot be inferred 

from the findings. 

This report demonstrates that ADSCs 

with greater levels of participant needs, 

as indicated by increased hospitalizations 

and the number of chronic conditions, are 

more likely to provide a greater number 

of services in general and these services Figure 2. Percentage of adult day services centers, by number of chronic conditions and 

service provision: United States, 2016 

 

 

 

 

 

 

 

 

 
National Health Statistics Reports

 Number 124 April 30, 2019 Page 5

are more often provided by employees 

and not solely by arrangement or referral. 

The level of participant needs, as 

indicated by hospitalizations, and chronic 

conditions among participants, were 

lower in ADSCs that provided select 

services by arrangement or referrals and 

in ADSCs that did not provide select 

services.

References

1. Harris-Kojetin L, Sengupta M, Lendon JP, 

Rome V, Valverde R, Caffrey C. Longterm care providers and services users in 

the United States, 2015–2016. National 

Center for Health Statistics. Vital Health 

Stat 3(43). 2019.

2. Kelly R, Puurveen G, Gill R. The effect of 

adult day services on delay to institutional 

placement. J Appl Gerontol 35(8):814–35. 

2016.

3. Caffrey C, Harris-Kojetin L, Rome V, 

Schwartz L. Relationships between 

residential care community characteristics 

and overnight hospital stays and 

readmissions: Results from the National 

Study of Long-Term Care Providers. 

Seniors Hous Care J 26(1):38–49. 2018.

4. Becker M, Boaz T, Andel R, DeMuth A. 

Predictors of avoidable hospitalizations 

among assisted living residents. J Am 

Med Dir Assoc 13(4):355–9. 2012.

5. Friedman SM, Mendelson DA, 

Bingham KW, McCann RM. Hazards 

of hospitalization: Residence prior 

to admission predicts outcomes. 

Gerontologist 48(4):537–41. 2008.

6. Pfuntner A, Wier LM, Elixhauser 

A. Overview of hospital stays in the 

United States, 2011. HCUP Statistical 

Brief #166. Rockville, MD: Agency for 

Healthcare Research and Quality. 2013. 

Available from: http://www.hcup-us.ahrq.

gov/reports/statbriefs/sb166.pdf.

7. Kelly R. The effect of adult day 

program attendance on emergency room 

registrations, hospital admissions, and 

days in hospital: A propensity-matching 

study. Gerontologist 57(3):552–62. 2017.

8. Lendon J, Rome V. Variation in 

operating characteristics of adult day 

services centers, by center ownership: 

United States, 2016. NCHS Data Brief, no 

296. Hyattsville, MD: National Center for 

Health Statistics. 2018. Available from: 

https://www.cdc.gov/nchs/data/databriefs/

db296.pdf.

9. Hedrick SC, Guihan M, Chapko MK, 

Sullivan J, Zhou XH, Manheim LM, et 

al. Assisted living pilot program: Health 

outcomes. J Aging Health 21(1):190–207. 

2009.

10. Wheaton AG, Ford ES, Cunningham TJ, 

Croft JB. Chronic obstructive pulmonary 

disease, hospital visits, and comorbidities: 

National Survey of Residential Care 

Facilities, 2010. J Aging Health 

27(3):480–99. 2015.

11. National Center for Health Statistics. 

2016 National Study of Long-Term 

Care Providers: Survey methodology 

for the Adult Day Services Center and 

Residential Care Community components. 

Hyattsville, MD: National Center for 

Health Statistics. 2017. Available from: 

https://www.cdc.gov/nchs/data/nsltcp/

NSLTCP_2016_survey_methodology_

documentation.pdf.

12. National Center for Health Statistics. 

2016 National Study of Long-Term 

Care Providers (NSLTCP) Adult Day 

Services Center Survey restricted data 

file: Data description and usage (readme). 

Hyattsville, MD: National Center for 

Health Statistics. 2017. Available from: 

https://www.cdc.gov/nchs/data/nsltcp/

NSLTCP_2016_ADSC_Readme_RDC.

pdf.

13. SAS Institute. SAS Statistical Software 

(Release 9.3) [computer software]. 2011.

14. RTI International. SAS-callable SUDAAN 

Statistical Software (Release 11) 

[computer software]. 2012.

15. StataCorp. Stata Statistical Software 

(Release 14) [computer software]. 2013.
Page 6 National Health Statistics Reports  Number 124  April 30, 2019

Table 1. Service provision, hospitalizations in the past 90 days, and number of chronic conditions in adult day services centers: 

United States, 2016

Service provision scale Percent Standard error

Number of services

Provides all five.................................................. 52.6 0.6

Provides one to four .............................................. 37.3 0.6

Provides four of five............................................. 11.2 0.4

Provides three of five............................................ 9.2 0.4

Provides two of five ............................................. 10.5 0.4

Provides one of five............................................. 6.4 0.3

None of five provided ............................................. 10.2 0.4

How service is provided

All five provided by employees ...................................... 8.4 0.4

All five provided by arrangement or referral ............................ 10.3 0.4

None of five provided ............................................. 10.2 0.4

Remaining adult day services centers ................................ 71.2 0.6

Hospitalizations in past 90 days

Yes ........................................................... 64.2 0.6

No............................................................ 35.8 0.6

Number of chronic conditions 

Zero to three .................................................... 30.8 0.5

All four ........................................................ 69.2 0.5

NOTES: Percentages are rounded to the nearest tenth; estimates may not add up to totals because of rounding. The four conditions include Alzheimer disease and other dementias, heart disease, 

diabetes, and depression. The five services provided include mental health, social work, therapeutic, dietary and nutritional, and skilled nursing. Provides all five services category includes provided 

by employees, arrangement, or referrals. Provided by employees category includes providing by employees only and providing by a mix of employees, arrangement, or referrals. Remaining adult day 

services centers category includes those providing one to four services by a mix of employees, arrangement, referrals, and no provision.

SOURCE: NCHS, National Study of Long-Term Care Providers, 2016.
National Health Statistics Reports  Number 124  April 30, 2019 Page 7

Table 2. Percentage of adult day services centers with hospitalizations in the past 90 days, by service provision: United States, 2016

Service provision scale

Hospitalizations in past 90 days (percent)

Yes No Standard error

Number of services

Provides all five.................................................. 74.3 25.7 0.7

Provides one to four .............................................. 59.6 40.4 1.0

Provides four of five............................................. 64.0 36.0 1.8

Provides three of five............................................ 59.1 40.9 2.0

Provides two of five ............................................. 59.8 40.2 2.0

Provides one of five............................................. 52.3 47.7 2.6

None of five provided ............................................. 31.5 68.5 2.0

How service is provided

All five provided by employees ...................................... 81.7 18.4 1.9

All five provided by arrangement or referral ............................ 59.4 40.6 1.9

None of five provided ............................................. 31.5 68.5 2.0

Remaining adult day services centers ................................ 67.9 32.1 0.7

NOTES: The five services include mental health, social work, therapeutic, dietary and nutritional, and skilled nursing. Provides all five services category include providing by employees, arrangement, 

or referrals. Provided by employees category includes providing by employees only and providing by a mix of employees, arrangement, or referrals. Remaining adult day services centers category 

includes those providing one to four services by a mix of employees, arrangement, referrals, and no provision.

SOURCE: NCHS, National Study of Long-Term Care Providers, 2016.
Page 8 National Health Statistics Reports  Number 124  April 30, 2019

Table 3. Percentage of adult day services centers, by number of chronic conditions and service provision: United States, 2016

Service provision scale

Number of chronic conditions (percent)

Zero to three All four Standard error

Number of services

Provides all five.................................................. 17.5 82.5 2.0

Provides one to four .............................................. 40.4 59.7 1.1

Provides four of five............................................. 33.2 66.8 2.7

Provides three of five............................................ 38.4 61.6 2.1

Provides two of five ............................................. 44.4 55.6 2.1

Provides one of five............................................. 50.0 50.0 1.8

None of five provided ............................................. 70.6 29.4 0.7

How service is provided

All five provided by employees ...................................... 3.8 96.2 0.9

All five provided by arrangement or referral ............................ 36.3 63.7 2.0

None of five provided ............................................. 70.6 29.4 2.0

Remaining adult day services centers ................................ 28.2 71.8 0.7

NOTES: The four conditions include Alzheimer disease and other dementias, heart disease, diabetes, and depression. The five services include mental health, social work, therapeutic, dietary and 

nutritional, and skilled nursing. Provides all five services category includes providing by employees, arrangement, or referrals. Provided by employees category includes providing by employees only 

and providing by a mix of employees, arrangement, or referrals. Remaining adult day services centers category includes those providing one to four services by a mix of employees, arrangement, 

referrals, and no provision.

SOURCE: NCHS, National Study of Long-Term Care Providers, 2016.
National Health Statistics Reports  Number 124  April 30, 2019

For more NCHS NHSRs, visit: 

https://www.cdc.gov/nchs/products/nhsr.htm.

For e-mail updates on NCHS publication releases, subscribe online at: https://www.cdc.gov/nchs/govdelivery.htm.

For questions or general information about NCHS: Tel: 1–800–CDC–INFO (1–800–232–4636) • TTY: 1–888–232–6348 

Internet: https://www.cdc.gov/nchs • Online request form: https://www.cdc.gov/info

DHHS Publication No. 2019–1250 • CS303367

FIRST CLASS MAIL

POSTAGE & FEES PAID

CDC/NCHS

PERMIT NO. G-284

U.S. DEPARTMENT OF

HEALTH & HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road, Room 4551, MS P08

Hyattsville, MD 20782–2064

OFFICIAL BUSINESS 

PENALTY FOR PRIVATE USE, $300

Suggested citation

Caffrey C, Lendon JP. Service provision, 

hospitalizations, and chronic conditions in adult 

day services centers: Findings from the 2016 

National Study of Long-Term Care Providers. 

National Health Statistics Reports; no 124. 

Hyattsville, MD: National Center for Health 

Statistics. 2019.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health Statistics

Jennifer H. Madans, Ph.D., Acting Director

Amy M. Branum, Ph.D., Acting Associate 

Director for Science

Division of Health Care Statistics

Denys T. Lau, Ph.D., Director 

Alexander Strashny, Ph.D., Associate Director

for Science