How Kentucky licenses assisted living in Louisville

Who licenses assisted living communities in Louisville, Kentucky?

The Kentucky Cabinet for Health and Family Services' Office of Inspector General (OIG) licenses every assisted living community in Louisville and the rest of the state, under KRS 194A.700 to 194A.729 and the administrative regulation 902 KAR 20:480.

That arrangement is newer than many families realize. Until 2022, Kentucky certified assisted living rather than licensing it. The 2022 General Assembly (2022 Ky. Acts ch. 20, effective July 14, 2022) rewrote the statutes so that, in the words of KRS 194A.710, an assisted living community “shall not operate unless it is licensed.” OIG then adopted 902 KAR 20:480, effective July 25, 2023, which sets the application process, fees, staffing, medication, dietary, records and dementia-care standards.

For a family in Jefferson County this matters in two practical ways. First, the roster to check is OIG's monthly Assisted Living Community Directory, not a marketing list. Second, complaints go to OIG's Division of Health Care, whose Northern Branch serves Louisville and the six surrounding KIPDA counties.

What are the three assisted living license types in Kentucky?

Kentucky issues three assisted living licenses: ALC (a social-model community that helps with daily activities but does not provide basic health services), ALC-BH (adds basic health and health-related services, with no secured dementia unit) and ALC-DC (adds dementia care in a secured dementia care unit).

“Basic health and health-related services” has a precise statutory meaning in KRS 194A.700(8): monitoring and providing for a resident's health needs, storing and controlling medications, administering medications, and arranging therapy a practitioner orders. A social-model ALC may only assist with self-administered medication. One building can hold more than one license — several Louisville campuses carry both an ALC-BH and an ALC-DC license at the same street address — so the roster is organized by license, not by building.

Who can live in a Kentucky assisted living community?

A resident of a Kentucky assisted living community must be ambulatory unless the limitation is temporary, and Kentucky defines ambulatory broadly: able to walk, transfer or move from place to place with or without hands-on help and with or without a walker or wheelchair (KRS 194A.700(2) and 194A.711).

That definition is wider than older Kentucky rules, which drew a line at people who could get around without help. Today a person who uses a wheelchair and needs a staff member's help to transfer can still be an assisted living resident, provided the community can meet those needs. KRS 194A.717(5) requires a written policy for how staff give priority to residents who need hands-on help to evacuate.

Before move-in, the community must have a medical examination on file and must complete a functional needs assessment, which it updates when the resident's condition changes and at least every 12 months. Ask for a copy of both; the law entitles the resident to the assessment and the service plan built from it.

How often does Kentucky inspect assisted living in Louisville?

OIG makes an unannounced on-site licensure review at initial licensure, then 24 months after the previous review, or after 12 months if the last review found a violation that put a resident in imminent danger of death or serious harm (KRS 194A.707(2)).

OIG can also visit at any time to investigate a complaint or when it has reasonable cause to think a community is out of compliance (KRS 194A.707(11)). Because the routine cycle can be two years long, a community's last review may be fairly old. KRS 194A.707(10) requires the cabinet to make findings from the most recent licensure review public, so ask the community for its latest OIG findings and plan of correction, and ask OIG if the community will not share them.

What does an assisted living license cost in Kentucky, and why does it matter to families?

Kentucky's initial and annual assisted living license fee ranges from $500 plus $40 per unit for communities under 25 units to $2,000 plus $40 per unit for communities of 100 units or more (902 KAR 20:480 Section 3).

Families rarely care about a licensing fee for its own sake, but the fee schedule explains why the OIG roster lists a unit count for every license: the unit count sets the fee. That gives you a reliable size number for each community that does not depend on marketing material. On the Louisville-area roster, units range from small single-building communities to campuses with well over a hundred apartments.

Two more rules protect consumers directly. No business may market itself as an assisted living community unless it has applied for or received an OIG license (KRS 194A.707(3)), and a license cannot be sold or transferred with a building (KRS 194A.710(3)); a new owner must apply in its own name.