Small adult day care center

Families paying privately, plus state Medicaid programs, the VA and long-term care insurance policies where your center qualifies.

A daily or hourly rate per participant, paid privately or reimbursed by programs. Extras such as transport or meals may be billed separately, depending on your state's rules.

• Patience and warmth with older or disabled adults
• Organizing staff, schedules and activities
• Handling paperwork and record keeping
• Talking with families and care professionals

• State licensing or certification, which varies a lot and may take months to complete
• Staffing ratios, staff training, background checks and first aid or CPR requirements
• Building rules: zoning, fire safety, accessibility (ADA) and health department checks for meals
• General liability and professional liability insurance, plus workers' compensation once you hire
• Check whether Medicaid or other programs need separate approval before you can bill them
• Cash flow, since reimbursements can be slow and early months may have few participants

Estimates suggest startup costs of typically around $30,000 to $150,000, depending on the rented space, how you fit it out, staffing before opening, insurance and licensing costs. Early months may have few participants, so allow for that.

Monthly revenue is typically around $8,000 to $40,000, depending on how many participants attend, your fees and whether programs such as Medicaid, the VA or long-term care insurance pay for some of them. Reimbursements can be slow.

Check your state's licensing or certification, which varies a lot and may take months. Also check staffing ratios, training and background checks, zoning, fire safety, ADA accessibility, health department rules for meals, and whether Medicaid needs separate approval.