Providers' Perspective on Barriers and Solutions to Adult Day Services Provision in Ohio.

BackgroundAdult day services (ADS) are essential home- and community-based supports, yet providers continue to face significant post-COVID operational and engagement challenges. Limited state-level evidence constrains efforts to strengthen ADS capacity.ObjectiveTo identify barriers experienced by ADS providers in Ohio and provider-driven solutions to sustain and strengthen services in the post-COVID environment.MethodsA sequential mixed-methods design integrated pre-survey focus groups (n = 17), a statewide provider survey (n = 28), and post-survey focus groups (n = 11). Descriptive statistics and thematic analysis were used to synthesize findings.ResultsTwo themes emerged: (1) Participants, Family, and Community Engagement, characterized by limited public awareness, caregiver hesitation, and unstable referral pathways; and (2) Operational Challenges and Limited Resources, including financial strain, staffing shortages, transportation barriers, administrative burden, and facility limitations. Providers identified solutions such as statewide education, workforce development, shared transportation models, and regulatory streamlining.