What is the difference between in-home care and assisted living in Louisville?
In-home care brings a caregiver to the house: non-medical help from an OIG-licensed personal services agency, or clinical visits from a licensed home health agency; assisted living moves the person into a licensed community where housing, meals, activities and round-the-clock staff presence are bundled.
Kentucky licenses personal services agencies separately from home health agencies, and Medicare pays only for the latter. OIG's roster lists over a hundred personal services agencies based in the seven Louisville-area counties and eight home health agency licenses, all in Jefferson County.
Which is cheaper in Kentucky, home care or assisted living?
At Kentucky's 2025 medians, home care at about $32.50 an hour costs less than assisted living at about $5,290 a month until a parent needs roughly 37 to 38 hours of paid help a week; above that, assisted living is usually cheaper, before counting the household costs that continue at home.
The full table is on our crossover page. For Medicaid-eligible adults who meet nursing-facility level of care, the HCB waiver can pay for attendant care and adult day health at home, subject to a waiting list.
When does in-home care stop working for a Louisville family?
In-home care usually stops working when overnight supervision becomes necessary, when falls or wandering make solo time unsafe, or when the family caregiver can no longer cover the gaps between paid shifts.
A useful test is a bad-weather week: if the plan collapses when one aide calls out and a daughter in La Grange cannot drive in, it is fragile. Adult day health a few days a week often extends a home plan.
How do I check a Louisville home care agency's license?
Look the agency up on OIG's Personal Services Agency Directory (non-medical) or the Miscellaneous Directory's home health listings (clinical); both give the license number and expiration date, and our directory reproduces them with filters by city and county.
Ask any agency about minimum shift lengths, background checks, how it covers call-outs and whether the same caregiver will come each visit.
At a glance
| In-home care in Kentucky is | Assisted living in Kentucky is | |
|---|---|---|
| License | Personal services agency or home health agency | ALC, ALC-BH or ALC-DC community |
| Billing | Hourly (about $32.50 median, 2025) | Monthly (about $5,290 median, 2025) |
| Overnight | Paid by the hour, if staffed at all | One awake staff member on site at all times |
| Medicaid | HCB waiver may pay for some services | No Kentucky waiver pays |
Sources include KRS Chapter 194A, 902 KAR 20:480, Kentucky CHFS and DMS pages, CareScout and VA rate tables as cited above; see our editorial standards.
