Personal care homes and family care homes, explained

What is a personal care home in Kentucky?

A Kentucky personal care home is an OIG-licensed residential health facility, regulated under 902 KAR 20:036, that provides room, meals, supervision and help with daily activities to residents who are ambulatory or mobile nonambulatory, with at least one staff member awake and on site at all times.

“Mobile nonambulatory” means someone who cannot walk unaided but can get around with a walker, crutches or wheelchair, can leave the building on their own in an emergency, and can transfer from bed to chair independently or with minimal help. A person who cannot do those things is not eligible for a personal care home. Unlike assisted living, a personal care home is a licensed health facility under KRS Chapter 216B, and OIG has posted personal care home inspection findings in its GenSearch database since 2024.

In the Louisville area, personal care licenses show up in two places on OIG's rosters: freestanding personal care homes, and personal care beds licensed inside larger long-term-care campuses such as continuing-care communities.

What is a family care home in Kentucky?

A Kentucky family care home is a small OIG-licensed home, regulated under 902 KAR 20:041, where the licensee provides 24-hour supervision and personal care to no more than three residents who are not related to the licensee.

Residents must be ambulatory or mobile nonambulatory and able to manage most daily activities themselves; medical or skilled nursing care is outside what a family care home provides. Most of the Louisville-area family care homes on OIG's current directory are in Jefferson County neighborhoods west and south of downtown, and many list a bed count of zero with a license status of “Pending Renewal”, which is exactly why the roster is worth checking before you rely on one.

Can a personal care home become an assisted living community in Kentucky?

Yes. Under KRS 194A.704, a personal care home that meets the apartment-style living-unit standards in KRS 194A.703 converts its license to an assisted living community license with basic health care (ALC-BH) or with dementia care (ALC-DC), applying at least 60 days before its personal care home renewal date (902 KAR 20:480 Section 2).

The conversion rule is why some Louisville buildings that families remember as personal care homes now appear on the assisted living roster. Unlicensed staff who give oral or topical medications in a converted apartment-style personal care home had to meet Kentucky's medication aide training standard within six months of June 29, 2023 (KRS 194A.705(2)(d)).

Why does the license type matter for paying for care in Kentucky?

It matters because Kentucky's State Supplementation Program, a state cash supplement for people on or eligible for SSI, pays toward care only in licensed personal care homes and family care homes, or for a hired caretaker, and never in an assisted living community (921 KAR 2:015).

The regulation's base standards of need are $1,409 a month for a personal care home resident and $965 for a family care home resident, raised by each Social Security cost-of-living adjustment since 2021. The home must accept the standard, minus a personal needs allowance the resident keeps ($60 in a personal care home, $40 in a family care home), as payment in full. For a low-income Louisville resident who cannot live alone, that can make a personal care home the only residential setting that is affordable without Medicaid nursing-home eligibility. See our State Supplementation guide for how to apply.