Kentucky Assisted Living
Kentucky is one of the most affordable states for retirement. The cost of living in Louisville, the state's largest city, is 8.8% below the national average. Kentucky is a largely rural state with a distinctive bluegrass landscape, making it an ideal retirement spot for adults looking for a countryside lifestyle. Residents also benefit from Kentucky's retirement-friendly tax laws, including tax-free Social Security benefits. This guide provides an overview of assisted living costs in Kentucky and the regulations these communities need to follow.
The typical resident population in Kentucky's assisted living communities is 70% female. Overall, 76% of residents are ages 75 and older, with 30% of residents ages 75 to 84 and 46% ages 85 and older.
The Kentucky Department for Aging and Independent Living certifies assisted living communities. It must be noted that no public funding is available for services provided in these communities. Assisted living communities are certified to provide services for five or more adults. The services provided include assistance with activities of daily living (ADLs), instrumental activities of daily living (IADLs), housekeeping, daily social activities, and assistance with the self-administration of medications.
The Division of Health Care within the Kentucky Cabinet for Health Services licenses personal care homes as long-term care facilities. Services in these facilities may be reimbursed from the state general fund. A personal care home provides services that include continuous supervision, basic health and health-related services, personal care services, residential care services, and social and recreational activities.
Adult foster care provides 24-hour supervision and personal care services in a residential environment for no more than three individuals who are unable to care for themselves due to an illness or disability.
The resident agreement for an ALF is a lease agreement between the community and the resident or their representative. The agreement includes the general services provided by the community and its fee structure, specific care services provided and their fees, policies for payment, non-payment, refunds and cancellations, discharge policies and procedures, terms for occupancy, grievance policies, and the rules of conduct of the staff.
Assisted living communities are not permitted to provide health care services.
In order to be admitted or retained in an ALF, a resident must be ambulatory or mobile non-ambulatory unless it is due to a temporary health condition. If a health condition prevents the resident from being mobile, they must not be a danger to themself or others.
Personal care homes are not permitted to admit or retain residents unable to manage their ADLs or residents whose care is not provided by the home.
Assisted living communities provide assistance with ADLs, including bathing, dressing, grooming and hygiene, toileting, transferring, and eating. The community also assists with housekeeping, shopping, laundry, transportation, and self-medication. The community also offers social activities based on resident preferences.
The community must complete an assessment of each resident prior to entering into a lease agreement. This assessment must be repeated annually. This assessment is used to develop a service plan for the resident.
Residents of ALFs can arrange for additional services not provided by the community with an outside agent, professional provider, or an individual designated by the resident.
A personal care home provides basic health and health-related services to its residents. These services include supervision and monitoring of residents to make certain that their health care needs are met. The home supervises the self-administration of medications and arranges for therapeutic services ordered by a physician and unavailable in the facility. Other services provided by the home include personal care, housekeeping, and laundry services.
All personal care home residents must have a medical evaluation within 14 days before or upon admission.
ALFs provide their residents with three meals and at least one snack per day.
Personal care homes are required to provide three meals per day and snacks. Therapeutic diets may be provided. If these meals are provided, they must be provided with consultation from a qualified dietitian or nutritionist.
Assisted living communities must have a designated manager responsible for the facility's daily operations. There are no set staffing ratios, but there must be adequate staffing in both numbers and qualifications to meet the needs of its residents 24 hours per day for both scheduled and unscheduled needs. There must be one staff member who is awake at all times.
Personal care homes must have an administrator responsible for the home's operations. There are no set staff ratio requirements, but the staff must provide for the needs of its residents. One attendant must be awake and on-duty on every floor of the facility at all times.
All staff in assisted living communities must receive an orientation within the first 90 days of employment. Annual training is required on subjects that are appropriate to each employee's responsibilities. It includes residents' rights, community policies, first-aid for adults, CPR, recognizing adult abuse and neglect, recognizing signs of dementia, community emergency procedures, and assistance with ADLs and IADLs.
Employees in personal care homes must receive training in their respective job responsibilities. Their training must include the services the home will provide; procedures for reporting abuse, neglect, or exploitation; methods for helping residents maximize their ADL abilities; procedures for maintaining a clean, healthful environment; an overview of the aging process; emotional problems with illness; and the use of medication.
The majority of assisted living housing units are single-occupancy, but dual-occupancy units are available. These units are for married couples or residents of the same sex who wish to share a unit. Each unit must have at least one unfurnished room with a lockable door, a private bathroom with a tub or shower, a window to the outside, and a telephone jack. If the community has more than 20 units, each unit must have an individual thermostat.
A maximum of four residents can share a room in personal care homes. No more than one-third of the rooms in a facility can have more than two beds. For facilities that have central bathing areas, there must be a bathroom and shower/baths for each sex on each floor. One toilet is required for every eight residents, a sink for every 16 residents, and a shower/bathtub for every 12 residents.
There are several requirements that each assisted living community must provide for its residents. The facility must offer both general observations and health supervision to assist in identifying each resident's health condition and ability to function. The facility must assist residents with all ADLs and medication services and assess the need for medication attention or nursing services.
In Kentucky, ALFs must provide care and services in the resident’s care plan. This can include coordinating medical care and appointments. Communities may also deliver health services, with 55% of communities providing skilled nursing. Many have health care specialists and on-site services, with 55% of communities offering dental care. In addition, 49% of ALFs have hospice services.
Mental health issues are a growing consideration for communities, and services to address these concerns are becoming more common. In Kentucky, 73% of communities conduct depression screenings and 54% offer mental health counseling. Social work programs are also found in 49% of ALFs. Social workers can provide counseling, conduct assessments, and help ensure residents can access all necessary resources.
Some assisted living residents live with various medical conditions. In Kentucky, 32% have Alzheimer's disease or another form of dementia. In addition, 41% have high blood pressure, 32% have heart disease, 29% have depression, and 16% have diabetes.
The Kentucky Cabinet for Health and Family Services - Division of Behavioral Health manages the state's funded mental health treatment programs. The Adult Mental Health and Recovery Services Branch provides services through 14 regional centers to support adults with severe mental health problems. It also operates phone lines to provide emergency care to people experiencing a mental health crisis.
You can also access support through Kentucky 2-1-1. This 24-hour hotline directs residents to the correct services and information to help them manage their condition. The Kentucky branch of the National Alliance on Mental Illness (NAMI) provides advocacy services for adults living with mental illness and their families.
ALFs are permitted to assist in the self-administration of medications but are not permitted to administer medications to their residents. Assistance includes reminding residents to take medications, reading label instructions to the resident, confirming that the medication has been taken by the resident, opening the packaging but not removing or handling the medication, storing the medication, and communicating with the physician and pharmacy for prescriptions.
A primary service of assisted living that benefits residents is receiving help with activities of daily living (ADLs). These are fundamental tasks that a person must do regularly to sustain life and general health, including toileting, bathing or showering, dressing, transferring (getting in and out of bed or a chair), ambulating (walking), and eating. Signs that a person may benefit from living in assisted living include increased isolation, loss of mobility, noticeable weight loss or gain, and/or neglect of household chores.
Residents in Kentucky’s assisted living facilities often receive help with their ADLs. In Kentucky, 10% of residents need help eating. Other commonly used services include bed transfer (20%), toileting (27%), and walking (46%). Caregivers in ALFs help 35% of residents dress, and 52% need help bathing.
The average cost of assisted living care in Kentucky is $3,448. This cost is $1,052 lower than the monthly national average of $4,500 per month. The cost of living in Kentucky is lower than the national average by 6.9%, with health care costs less than the national average by 18.4% and housing costs less than the national average by 20.1%.
The level of care a person requires impacts the cost of care, as does where you live. The cost of assisted living ranges from a low of $3,088 in the Owensboro area to a high of $4,568 per month in the Lexington area of Kentucky.
If you live close to one of Kentucky’s borders, you may find assisted living in a neighboring state is an affordable option; however, because the average cost is higher in all of Kentucky’s bordering states, you may have to search. While the average monthly cost of assisted living in Kentucky is $3,448, costs in bordering states range from an average in Tennessee of $4,105 and West Virginia of $4,160 on the lower end up to Ohio at $4,635 and Virginia at $5,250 on the high end.
The KY Office of the Inspector General has oversight of the licensing and regulatory compliance of all long-term care settings in the state. The Kentucky Long-Term Care Ombudsman advocates for people living in residential care communities and assists with complaint resolution. Volunteer ombudsmen also regularly visit assisted living communities and other long-term care settings to monitor care quality and living conditions.
All assisted living communities throughout the state must comply with the standards detailed in Title 910 of the Kentucky Revised Statutes. Individual living units must meet minimum quality and accessibility standards and adhere to life safety codes. Communities must undergo an annual certification review and inform the Department for Aging and Independent Living of any significant changes in the type and scale of the services offered.
The department requires all staff members working in assisted living communities to undergo a criminal record check within seven days of starting work and every other year throughout their employment. Communities can lose their certification if they knowingly employ a person with a criminal conviction for certain offenses.
The term "elder law" is often associated with estate planning, trusts, and help to obtain benefits through Medicare or Medicaid. Unfortunately, the field has grown to include cases involving elder abuse, elder neglect, and exploitation. Skilled attorneys can help older adults affected by these issues.
Kentucky Legal Aid provides free advice and representation to qualifying adults. Its legal team can support you with problems relating to Medicare, Medicaid, or SSI claims. You can find a list of Kentucky elder law legal aid and pro bono attorneys on the Justia website.
The typical resident population in Kentucky's assisted living communities is 70% female. Overall, 76% of residents are ages 75 and older, with 30% of residents ages 75 to 84 and 46% ages 85 and older.
Assisted Living Facility (ALF) Definitions
The Kentucky Department for Aging and Independent Living certifies assisted living communities. It must be noted that no public funding is available for services provided in these communities. Assisted living communities are certified to provide services for five or more adults. The services provided include assistance with activities of daily living (ADLs), instrumental activities of daily living (IADLs), housekeeping, daily social activities, and assistance with the self-administration of medications.
The Division of Health Care within the Kentucky Cabinet for Health Services licenses personal care homes as long-term care facilities. Services in these facilities may be reimbursed from the state general fund. A personal care home provides services that include continuous supervision, basic health and health-related services, personal care services, residential care services, and social and recreational activities.
Adult foster care provides 24-hour supervision and personal care services in a residential environment for no more than three individuals who are unable to care for themselves due to an illness or disability.
Resident Agreements and Disclosures
The resident agreement for an ALF is a lease agreement between the community and the resident or their representative. The agreement includes the general services provided by the community and its fee structure, specific care services provided and their fees, policies for payment, non-payment, refunds and cancellations, discharge policies and procedures, terms for occupancy, grievance policies, and the rules of conduct of the staff.
Assisted living communities are not permitted to provide health care services.
Assisted Living Admission and Retention
In order to be admitted or retained in an ALF, a resident must be ambulatory or mobile non-ambulatory unless it is due to a temporary health condition. If a health condition prevents the resident from being mobile, they must not be a danger to themself or others.
Personal care homes are not permitted to admit or retain residents unable to manage their ADLs or residents whose care is not provided by the home.
Assisted Living Services and Service Planning
Assisted living communities provide assistance with ADLs, including bathing, dressing, grooming and hygiene, toileting, transferring, and eating. The community also assists with housekeeping, shopping, laundry, transportation, and self-medication. The community also offers social activities based on resident preferences.
The community must complete an assessment of each resident prior to entering into a lease agreement. This assessment must be repeated annually. This assessment is used to develop a service plan for the resident.
Residents of ALFs can arrange for additional services not provided by the community with an outside agent, professional provider, or an individual designated by the resident.
A personal care home provides basic health and health-related services to its residents. These services include supervision and monitoring of residents to make certain that their health care needs are met. The home supervises the self-administration of medications and arranges for therapeutic services ordered by a physician and unavailable in the facility. Other services provided by the home include personal care, housekeeping, and laundry services.
All personal care home residents must have a medical evaluation within 14 days before or upon admission.
Assisted Living Food and Dietary Provisions
ALFs provide their residents with three meals and at least one snack per day.
Personal care homes are required to provide three meals per day and snacks. Therapeutic diets may be provided. If these meals are provided, they must be provided with consultation from a qualified dietitian or nutritionist.
Assisted Living Staffing Requirements
Assisted living communities must have a designated manager responsible for the facility's daily operations. There are no set staffing ratios, but there must be adequate staffing in both numbers and qualifications to meet the needs of its residents 24 hours per day for both scheduled and unscheduled needs. There must be one staff member who is awake at all times.
Personal care homes must have an administrator responsible for the home's operations. There are no set staff ratio requirements, but the staff must provide for the needs of its residents. One attendant must be awake and on-duty on every floor of the facility at all times.
Assisted Living Staff Training Requirements
All staff in assisted living communities must receive an orientation within the first 90 days of employment. Annual training is required on subjects that are appropriate to each employee's responsibilities. It includes residents' rights, community policies, first-aid for adults, CPR, recognizing adult abuse and neglect, recognizing signs of dementia, community emergency procedures, and assistance with ADLs and IADLs.
Employees in personal care homes must receive training in their respective job responsibilities. Their training must include the services the home will provide; procedures for reporting abuse, neglect, or exploitation; methods for helping residents maximize their ADL abilities; procedures for maintaining a clean, healthful environment; an overview of the aging process; emotional problems with illness; and the use of medication.
Assisted Living Housing Requirements
The majority of assisted living housing units are single-occupancy, but dual-occupancy units are available. These units are for married couples or residents of the same sex who wish to share a unit. Each unit must have at least one unfurnished room with a lockable door, a private bathroom with a tub or shower, a window to the outside, and a telephone jack. If the community has more than 20 units, each unit must have an individual thermostat.
A maximum of four residents can share a room in personal care homes. No more than one-third of the rooms in a facility can have more than two beds. For facilities that have central bathing areas, there must be a bathroom and shower/baths for each sex on each floor. One toilet is required for every eight residents, a sink for every 16 residents, and a shower/bathtub for every 12 residents.
What Is Included With Assisted Living Care In Kentucky?
There are several requirements that each assisted living community must provide for its residents. The facility must offer both general observations and health supervision to assist in identifying each resident's health condition and ability to function. The facility must assist residents with all ADLs and medication services and assess the need for medication attention or nursing services.
Health Care Services
In Kentucky, ALFs must provide care and services in the resident’s care plan. This can include coordinating medical care and appointments. Communities may also deliver health services, with 55% of communities providing skilled nursing. Many have health care specialists and on-site services, with 55% of communities offering dental care. In addition, 49% of ALFs have hospice services.
Mental health issues are a growing consideration for communities, and services to address these concerns are becoming more common. In Kentucky, 73% of communities conduct depression screenings and 54% offer mental health counseling. Social work programs are also found in 49% of ALFs. Social workers can provide counseling, conduct assessments, and help ensure residents can access all necessary resources.
Some assisted living residents live with various medical conditions. In Kentucky, 32% have Alzheimer's disease or another form of dementia. In addition, 41% have high blood pressure, 32% have heart disease, 29% have depression, and 16% have diabetes.
Mental Health Resources
The Kentucky Cabinet for Health and Family Services - Division of Behavioral Health manages the state's funded mental health treatment programs. The Adult Mental Health and Recovery Services Branch provides services through 14 regional centers to support adults with severe mental health problems. It also operates phone lines to provide emergency care to people experiencing a mental health crisis.
You can also access support through Kentucky 2-1-1. This 24-hour hotline directs residents to the correct services and information to help them manage their condition. The Kentucky branch of the National Alliance on Mental Illness (NAMI) provides advocacy services for adults living with mental illness and their families.
Medication Provisions
ALFs are permitted to assist in the self-administration of medications but are not permitted to administer medications to their residents. Assistance includes reminding residents to take medications, reading label instructions to the resident, confirming that the medication has been taken by the resident, opening the packaging but not removing or handling the medication, storing the medication, and communicating with the physician and pharmacy for prescriptions.
Activities of Daily Living (ADLs) Assistance Services
A primary service of assisted living that benefits residents is receiving help with activities of daily living (ADLs). These are fundamental tasks that a person must do regularly to sustain life and general health, including toileting, bathing or showering, dressing, transferring (getting in and out of bed or a chair), ambulating (walking), and eating. Signs that a person may benefit from living in assisted living include increased isolation, loss of mobility, noticeable weight loss or gain, and/or neglect of household chores.
Residents in Kentucky’s assisted living facilities often receive help with their ADLs. In Kentucky, 10% of residents need help eating. Other commonly used services include bed transfer (20%), toileting (27%), and walking (46%). Caregivers in ALFs help 35% of residents dress, and 52% need help bathing.
Cost Of Assisted Living Care In Kentucky
The average cost of assisted living care in Kentucky is $3,448. This cost is $1,052 lower than the monthly national average of $4,500 per month. The cost of living in Kentucky is lower than the national average by 6.9%, with health care costs less than the national average by 18.4% and housing costs less than the national average by 20.1%.
The level of care a person requires impacts the cost of care, as does where you live. The cost of assisted living ranges from a low of $3,088 in the Owensboro area to a high of $4,568 per month in the Lexington area of Kentucky.
How Costs Compare In Nearby States
If you live close to one of Kentucky’s borders, you may find assisted living in a neighboring state is an affordable option; however, because the average cost is higher in all of Kentucky’s bordering states, you may have to search. While the average monthly cost of assisted living in Kentucky is $3,448, costs in bordering states range from an average in Tennessee of $4,105 and West Virginia of $4,160 on the lower end up to Ohio at $4,635 and Virginia at $5,250 on the high end.
Kentucky Assisted Living Oversight
The KY Office of the Inspector General has oversight of the licensing and regulatory compliance of all long-term care settings in the state. The Kentucky Long-Term Care Ombudsman advocates for people living in residential care communities and assists with complaint resolution. Volunteer ombudsmen also regularly visit assisted living communities and other long-term care settings to monitor care quality and living conditions.
Quality and Safety of Assisted Living Communities in Kentucky
All assisted living communities throughout the state must comply with the standards detailed in Title 910 of the Kentucky Revised Statutes. Individual living units must meet minimum quality and accessibility standards and adhere to life safety codes. Communities must undergo an annual certification review and inform the Department for Aging and Independent Living of any significant changes in the type and scale of the services offered.
The department requires all staff members working in assisted living communities to undergo a criminal record check within seven days of starting work and every other year throughout their employment. Communities can lose their certification if they knowingly employ a person with a criminal conviction for certain offenses.
Legal Resources
The term "elder law" is often associated with estate planning, trusts, and help to obtain benefits through Medicare or Medicaid. Unfortunately, the field has grown to include cases involving elder abuse, elder neglect, and exploitation. Skilled attorneys can help older adults affected by these issues.
Kentucky Legal Aid provides free advice and representation to qualifying adults. Its legal team can support you with problems relating to Medicare, Medicaid, or SSI claims. You can find a list of Kentucky elder law legal aid and pro bono attorneys on the Justia website.
