By Louisville Senior Advisor Care Team · October 15, 2026
A social-model Kentucky ALC cannot give injections. In an ALC-BH or ALC-DC, a certified medication aide can give preloaded injectable insulin under an available LPN, RN or APRN (KRS 194A.705(2)(c)). Residents who give their own insulin can live in any license type.
Why does insulin come up so often?
Diabetes is common in older adults, and insulin is the medication that most often exposes the difference between Kentucky's assisted living licenses. A parent who has given their own insulin for years may start needing help as eyesight, dexterity or memory change, and the community they live in may or may not be allowed to provide it.
What can a social-model ALC do?
Every Kentucky assisted living community may assist with self-administration of medication, which KRS 194A.700(4) defines narrowly: reminding, observing, handing the resident their medication, opening a pre-set organizer, steadying a hand. The same subsection specifically excludes preparing syringes and administering medication by injection. So in a social-model ALC, staff can remind a resident to take insulin and observe, but cannot inject it.
| Task | ALC | ALC-BH / ALC-DC |
|---|---|---|
| Remind and observe the resident self-injecting | Yes | Yes |
| Give preloaded injectable insulin | No | Yes, by a certified medication aide under an available nurse |
| Draw up insulin from a vial into a syringe | No | Nurse scope; ask the community |
| Check blood sugar and adjust per orders | No (resident does it) | Under the community's health-services policies |
What changes in an ALC-BH or ALC-DC?
These licenses add basic health and health-related services, including administering medications. KRS 194A.705(2)(c) allows a certified medication aide, or unlicensed staff who completed a Kentucky Board of Nursing-approved medication aide program, to give oral or topical medication or preloaded injectable insulin under the authority of an available LPN, RN or APRN. 902 KAR 20:480 also requires these communities to have a nurse readily available whenever unlicensed staff perform delegated nursing tasks.
The key word is preloaded. Pens and prefilled devices fit the statute; drawing insulin from a vial and calculating doses are nursing tasks.
What should Louisville families do?
List exactly how your parent takes insulin now: pen or vial, fixed dose or sliding scale, how many times a day, and who checks blood sugar. Ask the physician whether a pen is appropriate if a vial is used now. Then filter our assisted living roster by license type. On OIG's October 2026 directory, the seven Louisville-area counties have 27 ALC-BH and 28 ALC-DC licenses, so there are real choices.
If your parent prefers a smaller social-model ALC, ask whether its policy allows an outside home health nurse to give injections. Kentucky lets residents arrange outside health services when the community's written policy permits.
What happens after a hospital stay?
Medication lists change at discharge, sometimes adding insulin for the first time. 902 KAR 20:480 adds medication-reconciliation duties for communities that manage medications; ask who reconciles the discharge list and when. A social-model ALC receiving a resident who now needs injections may have to issue a move-out notice, which Kentucky requires in writing with help finding a new place.
Does memory care change the answer?
An ALC-DC holds the same basic health and health-related service authority as an ALC-BH, plus its secured dementia unit, so a resident with dementia and diabetes can receive preloaded insulin there from a certified medication aide under an available nurse. Dementia adds its own complications, such as refusing injections or eating unpredictably, and Kentucky requires flexible meal times on secured units. Ask how the community coordinates blood sugar checks with irregular eating.
What about nursing homes and personal care homes?
Licensed nursing staff in a nursing facility can administer any prescribed insulin regimen, which is one reason residents with complex sliding-scale orders often end up in nursing care. Personal care homes are a different license under 902 KAR 20:036, with their own medication rules and delegation provisions; ask the specific home what it can do, and confirm its license on OIG's roster.
Whatever the setting, the most useful single document is a current, reconciled medication list signed by the prescriber. Bring it to every tour.
What should we ask on the tour about diabetes care?
Ask who gives insulin on the overnight shift and on weekends, which nurse is available when an aide is giving it, how low blood sugar is recognized and handled, how the community stocks snacks and glucose tabs, and how it communicates with the prescribing doctor. Ask too how many current residents receive insulin from staff, which tells you whether the routine is well practiced or rare.
Frequently asked questions
Can assisted living staff give insulin in Kentucky?
In an ALC-BH or ALC-DC, a certified medication aide can give preloaded injectable insulin under an available LPN, RN or APRN. In a social-model ALC, staff cannot inject.
Can my parent give their own insulin in any Kentucky assisted living?
Yes, if they can do it safely; staff in any license type may remind and observe.
What is a certified medication aide?
A staff member who completed a Kentucky Board of Nursing-approved medication aide training and competency program.
How do I find ALC-BH communities near Louisville?
Use the license-type filter on our assisted living roster, built from OIG's monthly directory.
