Kansas assisted living facility license: KDADS rules, fees and steps

Assisted living, residential health care or home plus?

Kansas law defines an assisted living facility as any place caring for six or more people who are not related to the administrator, operator or owner within the third degree of relationship. The residents, by choice or because of functional impairment, may need personal care and supervised nursing care. The facility must include apartments and provide or coordinate personal care or supervised nursing care that is available 24 hours a day, seven days a week ⁠¹. Skilled nursing is not banned. The statute says skilled services are generally intermittent or limited-term, or regular only if limited in scope ⁠¹.

What counts as an “apartment” decides your classification. An apartment is a private unit with a toilet room with bathing facilities, a kitchen, sleeping, living and storage space, and a lockable door. An “individual living unit” has everything except the kitchen ⁠².

Scroll the table sideways to see every column.

Sources: ⁠¹⁠²

Some places are not adult care homes. These include state- and federally operated institutions (except those run by the Kansas office of veterans services), hospitals, hotels, Medicare-certified hospices serving only hospice patients, and PACE centers serving only PACE participants ⁠¹.

If you plan to bring in day participants, you do not need a separate license. An assisted living facility may serve adult day care participants who meet its admission criteria. It must have written policies and at least 60 square feet of common living, dining and activity space for every resident plus every day participant ⁠². A stand-alone day program is its own classification; see adult day care licenses.

Operator or licensed administrator

Kansas lets smaller assisted living facilities be run by a registered operator instead of a licensed nursing home administrator. The operator can oversee an assisted living or residential health care facility with fewer than 61 residents ⁠¹. K.S.A. 39-976 says no adult care home may operate without a registered operator or a licensed adult care home administrator in charge ⁠⁹. The KDADS instructions put it directly: assisted living and residential health care facilities with more than 60 residents require a licensed adult care home administrator ⁠⁴.

Under K.A.R. 26-41-101(b), whoever you appoint must ⁠²:

• be at least 21;
• have a high school diploma or equivalent;
• hold a Kansas adult care home administrator license, or have completed the operator training course and passed the approved test;
• have authority and responsibility for running the facility and meeting licensing rules.

The operator registration statute adds an education floor. You need a high school diploma plus one year of relevant experience, a relevant associate’s degree, or any bachelor’s degree. You also need the approved course on principles of assisted living, a passing exam score, an application and the fee ⁠⁸.

Operator registration costs $65 for a full two-year period, which runs May 1 to April 30. If you register partway through a period, the fee is prorated, down to $32 for a registration issued in April. Renewal is $65, plus $35 if postmarked after April 30 but before May 31 (as published on 2026-10-12) ⁠¹⁰. Online renewal for operators opens March 15 ⁠¹⁴.

The statute requires a course on principles of assisted living and an exam, both approved by the KDADS secretary ⁠⁸. KDADS’s published sources do not name the course provider or give its hours or cost, and K.A.R. 26-41-101 still refers to a course approved by the KDHE secretary, a holdover from before KDADS took over ⁠². Ask KDADS Licensing ([email protected]) which course and exam it approves before you enroll ⁠³.

Plan ahead if you will open more than one home. With KDADS’s prior authorization, one person may supervise several separately licensed homes. The homes must be close enough for daily onsite supervision. Combined capacity is capped at 120 residents for a licensed administrator and 60 for an operator, with no more than four homes plus ⁠². You must tell KDADS within two working days when your administrator or operator changes ⁠². A mid-year change of administrator costs $15 ⁠².

Site and building standards

K.A.R. 28-39-254 sets requirements that rule out some sites before you design anything. The facility must be ⁠²:

• served by all-weather roads;
• free from noxious smoke or fumes;
• at least 4,000 feet from concentrated livestock operations, including feedlots and shipping and holding pens;
• free of flooding for a 100-year period;
• large enough for the building, drives, parking, sidewalks and an outdoor recreation area. In high-density urban areas, KDADS may accept a terrace or roof garden as the recreation area.

New construction must meet Title III of the Americans with Disabilities Act and all city, county and state building and fire codes, including the State Fire Marshal’s ⁠².

Each assisted living apartment must have ⁠²:

• a sleeping area with a window that opens;
• storage with a door, a shelf and a hanging rod;
• a kitchen area with a sink, a refrigerator, a stove or microwave, and storage for utensils and supplies, with a way to disconnect the stove if a resident’s safety requires it;
• a toilet room with a toilet, a lavatory and a tub or shower;
• a lockable door, master-keyed from the corridor side;
• at least 200 square feet of living space, not counting the toilet room, closets, built-ins, alcoves and vestibules.

A residential health care facility needs at least 100 square feet per individual living unit, or 80 square feet per resident when two residents share ⁠².

Other requirements:

• ground-level entrances accessible to people with disabilities;
• a way to monitor every exterior entry and exit for security;
• common social and recreation areas;
• an accessible public restroom on each floor;
• a public telephone in a private area ⁠².

An assisted living facility attached to a nursing facility may share common areas. It still needs at least one living or recreation area mainly for its own residents ⁠².

The KDADS construction track, in order

For new construction or for converting an unlicensed building, the K.A.R. 26-39-101 rules and the KDADS new-construction sheet set this order ⁠²⁠⁶:

1. Letter of intent

   Send it to KDADS licensure staff. Include the type of adult care home, the site address or legal description, and a contact person with phone and email ⁠²⁠⁶.

2. Site approval

   Ask for site approval at least 30 days before construction begins. Give the site’s dimensions and boundaries and name the utilities that serve it: water, sewer, electricity and gas. A KDADS physical environment specialist (PES) schedules a site inspection ⁠²⁠⁶.

3. Plan review meeting

   Your architect sends plans to the PES. You, the architect and facility staff then meet with KDADS to review them against K.A.R. 28-39-254 to -256. KDADS gives you its construction guidelines and its environmental checklist ⁠⁶.

4. Final plans

   The architect submits sealed, signed final plans with a letter certifying compliance. KDADS sends a letter acknowledging receipt. That letter does not approve the plans; compliance is the architect’s responsibility. Construction cannot begin until you have the acknowledgement letter ⁠²⁠⁶.

5. State Fire Marshal review

   The Office of the State Fire Marshal (OSFM) needs an 11 x 17 code footprint under K.A.R. 22-1-7, sealed by a Kansas-licensed architect or engineer, submitted with forms C22 and C22A. If code requires them, it also needs fire alarm plans (NFPA 72) and sprinkler plans with hydraulic calculations (NFPA 13). Email PDFs to [email protected] ⁠⁴.

6. Apply by the halfway point

   For a new facility, the licensure application must be with KDADS by 50% completion. Give KDADS and OSFM 30 days’ notice before you reach 50% ⁠²⁠⁶.

7. Policies six weeks out

   Send your policies and procedures to the KDADS Assistant Commissioner at least six weeks before the final inspection ⁠⁶.

8. Final inspections

   Give KDADS 30 days’ notice of the completion date. OSFM needs 30 days’ notice before occupancy so it can schedule its final inspection. The building must be 100% complete, with punch lists finished, before the KDADS environmental inspection ⁠⁴⁠⁶.

Additions and renovations to a licensed facility also need architect-sealed plans and the 30-day notices ⁠².

What goes into the licensure packet

The application form (Parts I and II) asks for:

• the legal entity and its federal tax ID;
• the administrator or operator;
• licensed capacity by category;
• professional liability insurance;
• the building owner, any lessee, sublessee or management firm, and any other operating entities;
• whether an industrial revenue bond financed the building ⁠⁴⁠⁵.

Each entity listed must complete and sign its own Part II. You must trace ownership through every layer until the individual owners are named. Business entities must be registered with the Kansas Secretary of State, and the resident agent on the application must match their records ⁠⁴.

KDADS’s instruction sheet requires these attachments ⁠⁴:

• the recorded, stamped warranty deed for the property;
• signed lease, sublease or management agreements;
• a 12-month projected budget prepared under generally accepted accounting principles (GAAP) and certified by the applicant’s principal officer, with evidence of enough working capital to run to that budget (cash on deposit, a line of credit, equity or a mix). This is required by K.S.A. 39-927 as amended in 2019 ⁠⁷;
• a list of every facility, in any state or country, in which the applicant has or had any ownership share in the operations or the real estate. For each one, give its compliance history, any disciplinary action, any license denial or revocation, and any lawsuits about operations or resident and staff safety ⁠⁴⁠⁷;
• résumés of the executives of each entity involved in operating the home;
• a certificate of professional liability insurance. Assisted living and residential health care facilities are required to carry it ⁠⁴;
• policies and procedures on abuse, neglect and exploitation (using the K.S.A. 39-1401 definitions); admission, transfer and discharge; advance directives; disaster and emergency preparedness; infection control; and resident rights. Add adult day care, respite care and special care policies if you will offer those services ⁠⁴.

The older regulation, K.A.R. 26-39-101(b), still describes a one-month projected statement and a balance sheet showing one month’s operating expenses in cash or equity ⁠². The statute and the KDADS instructions ask for the 12-month budget, so prepare that.

Kansas also limits ownership structure. No more than three different persons may be licensed to operate any one adult care home ⁠².

Mail the application and fee to KDADS, Survey, Certification and Credentialing Commission, 503 S. Kansas Ave., Topeka, KS 66603 ⁠⁵. KDADS says that once a complete, error-free packet arrives, supervisory review can take up to 90 days ⁠⁴. Licensing questions go to [email protected] ⁠³.

A license is issued only when ⁠¹⁠²:

• the application is complete;
• construction is finished;
• the facility meets the law;
• the State Fire Marshal approves;
• KDADS finds the applicant fit and qualified.

Fees as published by KDADS

Sources: ⁠²⁠⁵⁠¹⁰

The application fee is not refunded if KDADS denies the license ⁠². Make checks payable to the Kansas Department for Aging and Disability Services ⁠⁵. If KDADS directs a local health department to do the inspection, 40% of the fee goes to that department ⁠².

Staffing, training and background checks

K.A.R. 26-41 sets no numeric staffing ratio for assisted living. K.A.R. 26-41-102 requires enough qualified staff to deliver each resident’s functional capacity screening, health care service plan and negotiated service agreement. Direct care staff or licensed nurses must be awake and responsive at all times. A registered nurse must be available to supervise licensed practical nurses ⁠². The statute also requires a qualified person to be with residents at all times ⁠².

Training requirements:

• 40 hours of training first. Unlicensed employees may not give direct, individual care until they finish 40 hours of approved training in basic resident care, supervised by a registered nurse (K.S.A. 39-936(c)) ⁠².
• Registry check. Before using an unlicensed direct care worker, you must check the state registry ⁠². Staff files must show the Kansas nurse aide registry check, and a check of the registry in every other state where the person worked as a certified nurse aide ⁠².
• Orientation and in-service topics. These must cover principles of assisted living, fire prevention, disaster procedures, accident prevention, resident rights, infection control, and abuse, neglect and exploitation. If you admit residents with dementia, add training on dementia-related behaviors ⁠².
• Special care sections. Staff need training on the residents’ specific needs before assignment, and direct care staff must be present in the section at all times ⁠².

K.S.A. 39-970 bars you from knowingly running a home where someone works who has a conviction for a listed crime, such as murder, voluntary manslaughter or assisting suicide. Some other felonies are allowed once five years have passed since the sentence was completed ⁠². KDADS ran these criminal record checks through a new system that went live November 19, 2025. Checks remain name-based. For a new applicant entered through the “Request Existing Individual” option, the system checks the Kansas Nurse Aide Registry automatically, and prohibition letters are posted on the employee list instead of emailed ⁠¹¹.

Admission limits, service agreements and medications

K.A.R. 26-41-200 lists conditions that bar admission or retention unless the resident’s negotiated service agreement includes services that meet the need ⁠²:

• incontinence the resident cannot or will not help manage;
• total dependence on another person to get out of the building;
• any ongoing condition requiring two or more people to physically assist;
• ongoing skilled nursing needed 24 hours a day;
• behavior that exceeds manageability.

Anyone whose condition requires physical restraints may not be admitted or kept ⁠².

The care cycle works like this ⁠²:

• Screening. On or before admission, a licensed nurse, a licensed social worker or the administrator or operator completes the KDADS functional capacity screening form. It is repeated at least every 365 days and after any significant change.
• Agreement. The screening feeds a signed negotiated service agreement, developed at admission and reviewed at least every 365 days.
• Nurse involvement. When health care services are needed, a licensed nurse writes the health care service plan and is named as responsible for it.

Facility-managed medications may be given only by licensed nurses or medication aides, and medication aides may not use the parenteral (injection) route. A licensed pharmacist must do a medication regimen review at least quarterly for every resident whose medications you manage. Residents who manage their own medications must be offered the same review ⁠². Menus are planned by a dietetic services supervisor or licensed dietitian. In facilities with fewer than 11 residents, designated staff may plan them ⁠².

Other operating rules in K.A.R. 26-41 ⁠²:

• Emergency plan. It must cover fire, flood, severe weather, tornado, explosion, gas leaks, loss of power or water, and missing residents.
• Emergency agreements. You need written agreements for fresh water, an evacuation site and resident transportation.
• Drills and reviews. Review the plan with staff and residents quarterly, and run at least one evacuation drill a year.
• Resident council. It must meet at least quarterly. Written concerns from the council and residents’ written grievances get a written response within 30 days.
• Abuse reports. Report abuse, neglect or exploitation allegations to KDADS within 24 hours and finish your investigation within five working days.
• Discharge notice. Residents get 30 days’ written notice of an involuntary transfer or discharge, except in emergencies.

Getting paid: private pay and the Frail Elderly waiver

Kansas Medicaid (KanCare) reaches assisted living through a waiver. KDADS’s Home and Community Based Services Frail Elderly (FE) waiver serves people who are 65 or older, meet the Medicaid nursing facility threshold score and are financially eligible for Medicaid ⁠¹³. KDADS’s FE page lists a question on whether the waiver pays for an individual who lives in an assisted living facility, residential health care facility, home plus or boarding care home, but the answer was not readable when checked on 2026-10-12 ⁠¹³. Ask KDADS what the FE waiver covers in assisted living, and whether room and board is excluded, before you build a business plan around waiver residents. On July 6, 2026, KDADS put a waitlist on the FE waiver for new applicants, citing demand above the available slots, so a prospective resident may not be able to get waiver funding right away ⁠¹⁶. Waiver providers enroll through the Kansas Medical Assistance Program (KMAP) ⁠³. Before admission, every resident must receive a statement of services and daily or monthly charges. Residents are liable only for charges disclosed in the signed admission agreement ⁠².

After licensure: annual report, inspections and changes

Under K.S.A. 39-928, a Kansas license stays in effect as long as you file the annual report and pay the annual fee, and it is automatically canceled if you do not ⁠². You file both online in the Kansas Tracking of Adult Care Homes (KOTA) web application, and KDADS emails the administrator before the due date ⁠³. You must also submit annual and semiannual statistical reports electronically within 20 days after each period ends ⁠².

KDADS must make at least one unannounced inspection within 15 months of the previous one, and its statewide average interval may not exceed 12 months ⁠². If you are not fully compliant, KDADS may issue a provisional license for up to six months, plus one more six-month extension at its discretion. A buyer does not get extra time on a provisional license ⁠². The license is issued only for the named premises and persons. It cannot be transferred and must be posted ⁠².

For changes:

• Change of ownership. Notify KDADS in writing at least 60 days ahead. The buyer files a new application packet ⁠²⁠⁴.
• Capacity changes. These take effect on the first day of the month after KDADS approves them ⁠².
• Renovations. Converting rooms used for other purposes back into apartments needs KDADS’s prior approval ⁠².

For state fiscal year 2025, the Legislature required assisted living facilities to report every involuntary transfer or discharge to KDADS. A facility that does not file within 60 days of the discharge, or of the resolution of a formal complaint, is subject to a civil penalty ⁠¹². KDADS’s page does not say whether the requirement continues in later years, so ask the agency.

What changed in 2024 to 2026

• Home plus cap rises to 16. House Bill 2520 (2026 Session Laws, chapter 50), approved April 6, 2026, raises the home plus limit from 12 to 16 residents. It takes effect on publication in the statute book ⁠¹. The assisted living definition in the same bill keeps the six-resident threshold and the apartment requirement. Homes already licensed can renew in the appropriate category at their next annual renewal ⁠¹. When checked on 2026-10-12, the Revisor of Statutes’ online copy of K.S.A. 39-923 still showed the 12-resident cap ⁠¹⁵. The bill says it takes effect on publication in the statute book and gives no calendar date, so confirm with KDADS whether the 16-resident cap is already in force before you plan around it.
• Continuing care retirement communities. As of July 1, 2024, HB 2784 created a statutory definition of a continuing care retirement community (CCRC) and moved CCRC registration from the Kansas Insurance Department to KDADS ⁠¹². This matters if your assisted living building is part of a CCRC campus.
• Background checks. The new KDADS criminal record check system replaced the old process on November 19, 2025 ⁠¹¹.

Sources

1. 1
   Kansas Secretary of State, Session Laws of Kansas 2026, chapter 50 (House Bill 2520), amending K.S.A. 39-923 Checked 12 Oct 2026 · Back to text ↑
2. 2
   Kansas Department for Aging and Disability Services, Statutes and Regulations for the Licensure and Operation of Assisted Living/Residential Health Care Facilities (K.S.A. 39-923 et seq.; K.A.R. 26-39, 26-41, 28-39-254 to -256) Checked 12 Oct 2026 · Back to text ↑
3. 3
   Kansas Department for Aging and Disability Services, Adult Care Home Licensure and Certification Information Checked 12 Oct 2026 · Back to text ↑
4. 4
   Kansas Department for Aging and Disability Services, Instructions: Initial / Change of Ownership, Assisted Living and Residential Health Care Checked 12 Oct 2026 · Back to text ↑
5. 5
   Kansas Department for Aging and Disability Services, Application: Initial / Change of Ownership, Adult Care Home Licensure Checked 12 Oct 2026 · Back to text ↑
6. 6
   Kansas Department for Aging and Disability Services, New Construction / Remodel Information for ALF/RHCF Facilities Checked 12 Oct 2026 · Back to text ↑
7. 7
   Kansas Office of Revisor of Statutes, K.S.A. 39-927 (Application for license; contents) Checked 12 Oct 2026 · Back to text ↑
8. 8
   Kansas Office of Revisor of Statutes, K.S.A. 39-975 (Operator registration; qualifications) Checked 12 Oct 2026 · Back to text ↑
9. 9
   Kansas Office of Revisor of Statutes, K.S.A. 39-976 (Operator registration or administrator license required) Checked 12 Oct 2026 · Back to text ↑
10. 10
    Kansas Department for Aging and Disability Services, Fees: Kansas Registered Adult Care Home Operators Checked 12 Oct 2026 · Back to text ↑
11. 11
    Kansas Department for Aging and Disability Services, Criminal Record Check Program Checked 12 Oct 2026 · Back to text ↑
12. 12
    Kansas Department for Aging and Disability Services, Legislative Policy Updates Checked 12 Oct 2026 · Back to text ↑
13. 13
    Kansas Department for Aging and Disability Services, Frail Elderly (FE) waiver Checked 12 Oct 2026 · Back to text ↑
14. 14
    Kansas Department for Aging and Disability Services, Health Occupations Credentialing, Licensure Checked 12 Oct 2026 · Back to text ↑
15. 15
    Kansas Office of Revisor of Statutes, K.S.A. 39-923 (Definitions), online statute text Checked 12 Oct 2026 · Back to text ↑
16. 16
    Kansas Department for Aging and Disability Services, KDADS to Implement Waitlist for Frail Elderly HCBS Waiver Effective July 6, 2026 Checked 12 Oct 2026 · Back to text ↑

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