Kentucky family care home license: three residents, a $42 fee and no certificate of need

What a family care home is under Kentucky law

Kentucky’s family care home is the smallest licensed residential care setting in the state. Under 902 KAR 20:041 it provides 24-hour supervision and personal care, in residential accommodations, to adults who because of “impaired capacity for self care” choose or need a protective environment but do not have an illness, injury or disability that calls for constant medical care or skilled nursing.⁠¹ The rule defines impaired capacity as a mental or physical limitation that requires supervision, assistance, or the use of prescription medicines to normalize daily living.⁠¹

The defining limit is in Section 3(6): the home may have no more than three residents who are not related to the operator within the third degree of consanguinity.⁠¹ The application form, Form OIG 007, asks you to tick a licensed capacity of “TWO” or “THREE” and to list every person who lives in the home with their age and relationship to you (family member, patient or other).⁠⁴ Residents must be at least 18.⁠¹

The license is issued by the Cabinet for Health and Family Services, Office of Inspector General (OIG), through its Division of Health Care, which licenses health facilities under KRS Chapter 216B and runs four regional offices.⁠¹⁷ The rule text still names the “Division for Licensing and Regulation” and the “Cabinet for Health Services”, older names for the same functions.⁠¹

Operating a health facility without a license is a violation of KRS 216B.105,⁠⁶ and a willful violation carries a fine of $500 to $10,000 for each violation under KRS 216B.990(1), as in effect since July 15, 2024.⁠⁷

When you need a different license

Founders usually come to this license from one of three directions, and Kentucky draws the lines sharply.

• Four or more unrelated residents. A personal care home (PCH) is defined without a resident minimum, as an establishment in a permanent building with resident beds that gives supervision, personal care and residential care services,⁠¹⁸ but OIG issues a provisional PCH license only after certificate of need approval and then approval of plans and specifications under 902 KAR 20:031.⁠¹⁵ The OIG applications page states that long-term care facilities need a certificate of need before licensure, “with the exception of family care homes.”⁠³
• Five or more unrelated adults in assisted living. An assisted living community is defined in KRS 194A.700(5) as a licensed facility serving five or more adults not related within the third degree to the owner or manager.⁠¹⁴ KRS 216B.020(1) exempts “assisted living residences” and “family care homes” from certificate of need review.⁠⁵ See the Kentucky assisted living community guide.
• Room and board only. A boarding home accommodates three or more unrelated adults for room and board on a 24-hour basis, and a “boarder” is someone who does not need supervision or help with medication, daily living activities or a supervised plan of care. A licensed facility is outside that definition.⁠¹³ If your residents need supervision and personal care, the boarding home route is not available.

Exactly four unrelated residents fall between the family care home cap of three and the assisted living minimum of five. The statutes and rules reviewed set no separate license for that size, so a personal care home, with its certificate of need requirement, is the licensed route; ask the Division of Health Care to confirm before you plan around four residents.

If you plan to send caregivers into clients’ own homes rather than house residents, that is a personal services agency or a home health agency, which Kentucky certifies or licenses separately; daytime care is an adult day health care program, also a separate license.

Who can be the operator

902 KAR 20:041 sets a short list of personal qualifications, and they are about the person, not a credential:⁠¹

• Age and literacy. The licensee must be “a mature literate adult, at least eighteen (18) years of age,” with knowledge and understanding of adults who need supervision and personal care.
• Around-the-clock responsibility. The licensee is directly responsible for the home’s 24-hour daily operation. For a temporary absence you may delegate to “another similarly qualified individual,” whose name must be in writing and given to the OIG inspector.
• Annual training. You must attend at least one family care home operator training program a year “if offered or approved by” the Cabinet.⁠¹ The OIG applications page and Division of Health Care page list no such program, so ask your regional office whether one is offered or approved this year.⁠³⁠¹⁷

Form OIG 007 also asks for the operator’s years of education, whether the people operating the home work outside it and for how many hours, and whether you have been convicted of violating any law in the past five years.⁠⁴

OIG must deny an initial license, or revoke an existing one, if the applicant has been convicted of a crime bearing on suitability to run a family care home, unless the crime was more than five years ago and the applicant shows sufficient rehabilitation.⁠¹ The same result follows if you failed to see that a person in your care got nutrition, medication or treatment consistent with acceptable professional practice; took part in or condoned an illegal act involving a person in your care; or had a facility or service license suspended or revoked in the three years before applying.⁠¹

Separately, OIG returns an application, with the fee, if anyone holding a significant financial interest had, within the previous seven years, a significant financial interest in a Cabinet-licensed facility whose license was denied, suspended, revoked or given up after an investigation that put residents at risk of death or serious harm, or if the application contains false information.⁠²

Registry and criminal checks for you and anyone you hire

Kentucky statutes treat family care homes as long-term care facilities, which pulls in several rules written for larger homes:

• Nurse aide abuse registry. KRS 216.532 bars long-term care facilities, as defined in KRS 216.510 (which lists family-care homes), from being operated by or employing anyone listed on the nurse aide abuse registry.⁠⁸⁠⁹ 902 KAR 20:041 repeats the duty.⁠¹
• Felony bar for direct care staff. KRS 216.789 applies to long-term care facilities as defined in KRS 216.535(1), which also lists family care homes.⁠¹⁰ Such a facility may not knowingly employ a person in a direct care position who has been convicted of a felony related to theft, illegal drugs, abuse, neglect or exploitation of an adult, or a sexual crime, and must request conviction information from the Justice and Public Safety Cabinet for applicants.⁠¹¹
• Fingerprint checks. Kentucky’s fingerprint-based National Background Check Program (KARES) under 906 KAR 1:190 applies to private long-term care employers that “participate voluntarily.”⁠¹⁹

An employee who contracts an infectious disease may not work until it can no longer be transmitted.⁠¹ You must report every case of adult abuse, neglect or exploitation under KRS 209.030.⁠¹

The house

Section 5 of 902 KAR 20:041 is the building standard, and it is written for an ordinary dwelling rather than an institution. No certificate of need applies to this license type.⁠³⁠⁵

Source: 902 KAR 20:041.⁠¹

The toilet ratio counts everyone residing in the home, so your household plus residents must stay within six per toilet and lavatory.⁠¹ Each resident gets a bureau or cupboard, personal toiletries not shared with others, and access to living rooms, kitchen, dining and recreation areas for entertainment and visits.⁠¹

The rule requires compliance with state and local law on location, zoning, plumbing and sanitation, but neither the rule nor Form OIG 007 calls for a zoning letter or fire inspection.⁠¹⁠⁴ The applications page tells applicants to contact OIG before applying to learn whether certificate of need or fire marshal approval applies to their facility type, so ask your regional office whether a local sign-off is expected for your address.⁠³

Who you can admit and keep

The resident profile is narrow. A resident must be ambulatory (walks without help) or mobile nonambulatory: unable to walk unassisted but able to move about and self-exit using a walker, crutches or wheelchair, and capable of independent bed-to-chair transfer.⁠¹ Residents must manage most activities of daily living.⁠¹

Before admission you need evidence of a physician’s physical examination within the previous three months, or, for someone coming from another health facility, a discharge summary or transfer form with medical history, exam and diagnosis.⁠¹ You may not knowingly admit someone with a communicable disease reportable to the health department, except a noninfectious tuberculosis patient under continuing medical supervision.⁠¹ And a resident may not need a degree of care “exceeding the skill of the operator to provide.”⁠¹ You must have arrangements in place with other health agencies and facilities for residents who later need a different level of care.⁠¹

Residents have the long-term care resident rights in KRS 216.510 to 216.525, which the rule makes a licensing condition.⁠¹⁠⁸

Medication, meals and records

Medication. The home supervises self-administration, monitors storage and arranges therapy and physician services.⁠¹ Self-administration of a prescription drug requires the attending physician’s written instruction, and no medication may be given without a written order from a physician or other practitioner within their scope.⁠¹ Medications are kept in a locked cabinet, and each prescription medication given is recorded with date, time and dose and signed.⁠¹ If a drug must be given by a licensed person, you arrange for one.⁠¹

Meals. At least three meals a day, with no more than 15 hours between the evening meal and breakfast; a written, rotating menu; a written record of food served, including snacks; therapeutic diets only when medically prescribed; refrigerators below 45°F with a thermometer in each refrigerator and freezer.⁠¹

Records. For each resident, keep on the premises, typed or in ink: name, sex, marital status, birthdate, religion and clergy (with consent), physician and dentist, next of kin or responsible party, admission and discharge dates, physician visits and assessments, and the amount charged per week or month.⁠¹ Post hospital, ambulance, fire department and physician numbers by the telephone in large print, and keep a written procedure for getting emergency services.⁠¹

Incidents. Write up any accident, any incident affecting a resident’s health, welfare or safety, and any death; send the original to OIG within seven days and keep a copy.⁠¹

Applying to the Office of Inspector General

1. Get the house and household ready first

   Form OIG 007 states that a completed application “should not be submitted … until the facility is ready for an inspection.”⁠⁴

2. Complete Form OIG 007

   (January 2017 edition), marking “Provisional Licensure,” your capacity (two or three), the household roster and the operator questions.⁠²⁠⁴ The form is on the OIG applications page.⁠³

3. Include the $42 fee

   An incomplete application or missing fee may be returned.⁠³⁠⁴

4. OIG reviews the file

   for ownership, personnel, operating policies and services.⁠²

5. Prelicensure home visits

   902 KAR 20:041 requires a visit by an OIG licensing representative and a visit and prelicensure assessment by a representative of the “Department for Social Services,” a name the rule has not updated.⁠¹ The rule does not say which Cabinet department now performs that assessment; ask your regional OIG office who will contact you and when.

6. Provisional license

   If the application is complete and no deficiencies are found, OIG issues a provisional license and you may begin serving residents.⁠² Notify OIG within three business days after you start, or in writing if you have not started within ten business days.⁠²

7. Unannounced inspection within three months

   OIG then decides to license or deny. A denial means you stop providing services immediately; an approval is backdated to the provisional license date.⁠²

Post the license in a public area of the home.⁠² A license is not transferable and is tied to one location.⁠⁶

Fees as published on 2026-10-12

902 KAR 20:008 was last certified effective September 3, 2025, and the OIG applications page listed the same $42 fee on 2026-10-12.⁠²⁠³ With a $42 fee, the $25 floor is the late penalty that applies.⁠²

Inspections, violations and renewal

All inspections of long-term care facilities are unannounced, and outside complaint visits a family care home must be inspected 7 to 15 months after the previous inspection.⁠¹² OIG notifies you of any violation in writing; you then have ten days to submit a signed plan of correction stating the correction date, the fix, and how you will prevent a repeat.⁠²

The license expires one year from its effective date and is renewed by validation letter once you submit a completed application, pay the fee, have no pending adverse action and answer the Cabinet’s information requests.⁠² File written notice within 30 days of a change of ownership, which Kentucky defines as acquisition of more than 25 percent of the facility or the owning entity’s equity or voting rights.⁠² Denials and revocations become final 30 days after notice unless you request a hearing in writing.⁠²

State supplementation: the payer for many residents

Kentucky’s state supplementation program under 921 KAR 2:015 pays an optional supplement for adults who are aged, blind or have a disability, need a full-time living arrangement and lack income to meet the standard. Living in a licensed family care home, at age 18 or older, is one qualifying arrangement.⁠¹⁶ Applicants who may qualify for SSI must apply for it.⁠¹⁶

The standard of need for a family care home resident is $965 plus every Social Security cost-of-living adjustment since 2021, to the extent funds are available (921 KAR 2:015, amended effective July 30, 2024).⁠¹⁶ The family care home must accept that standard, minus a $40 personal needs allowance the resident keeps, as full payment for the cost of care.⁠¹⁶ A personal care home’s standard is $1,409 with a $60 allowance.⁠¹⁶ The rule does not state the adjusted dollar figure, so ask the Department for Community Based Services what standard applies to a resident today.

If you receive a resident’s supplementation check because there is no guardian or other payee, the rule sets reporting duties, and a home that relinquishes its license must return later checks to the Kentucky State Treasurer.⁠¹⁶

How old the rule is

The substantive text of 902 KAR 20:041 dates from an amendment effective March 17, 1999. The regulation history shows certifications effective April 30, 2019 and February 17, 2026.⁠¹ The certificate of need exemption in KRS 216B.020(1) was last amended effective June 27, 2025, and still names family care homes.⁠⁵ Expect agency names and addresses in the rule to be out of date; use the OIG applications page and the Division of Health Care regional contact list for routing.⁠³⁠¹⁷

Sources

1. 1
   Kentucky Legislative Research Commission, 902 KAR 20:041, Operation and services; family care homes Checked 12 Oct 2026 · Back to text ↑
2. 2
   Kentucky Legislative Research Commission, 902 KAR 20:008, License procedures and fee schedule Checked 12 Oct 2026 · Back to text ↑
3. 3
   Cabinet for Health and Family Services, Office of Inspector General, Applications for Health Care and Long-Term Care Checked 12 Oct 2026 · Back to text ↑
4. 4
   Cabinet for Health and Family Services, Office of Inspector General, Form OIG 007, Application for License to Operate a Family Care Home (January 2017) Checked 12 Oct 2026 · Back to text ↑
5. 5
   Kentucky Legislative Research Commission, KRS 216B.020, Certificate of need exemptions Checked 12 Oct 2026 · Back to text ↑
6. 6
   Kentucky Legislative Research Commission, KRS 216B.105, License procedure Checked 12 Oct 2026 · Back to text ↑
7. 7
   Kentucky Legislative Research Commission, KRS 216B.990, Penalties Checked 12 Oct 2026 · Back to text ↑
8. 8
   Kentucky Legislative Research Commission, KRS 216.510, Definitions for resident rights statutes Checked 12 Oct 2026 · Back to text ↑
9. 9
   Kentucky Legislative Research Commission, KRS 216.532, Nurse aide abuse registry prohibition Checked 12 Oct 2026 · Back to text ↑
10. 10
    Kentucky Legislative Research Commission, KRS 216.535, Definitions for KRS 216.537 to 216.590 Checked 12 Oct 2026 · Back to text ↑
11. 11
    Kentucky Legislative Research Commission, KRS 216.789, Prohibition against employing certain felons at long-term care facilities Checked 12 Oct 2026 · Back to text ↑
12. 12
    Kentucky Legislative Research Commission, KRS 216.530, Inspections of long-term care facilities Checked 12 Oct 2026 · Back to text ↑
13. 13
    Kentucky Legislative Research Commission, KRS 216B.300, Definitions (boarding homes) Checked 12 Oct 2026 · Back to text ↑
14. 14
    Kentucky Legislative Research Commission, KRS 194A.700, Definitions (assisted living communities) Checked 12 Oct 2026 · Back to text ↑
15. 15
    Kentucky Legislative Research Commission, 902 KAR 20:036, Operation and services; personal care homes Checked 12 Oct 2026 · Back to text ↑
16. 16
    Kentucky Legislative Research Commission, 921 KAR 2:015, Supplemental programs for persons who are aged, blind, or have a disability Checked 12 Oct 2026 · Back to text ↑
17. 17
    Cabinet for Health and Family Services, Office of Inspector General, Division of Health Care Checked 12 Oct 2026 · Back to text ↑
18. 18
    Kentucky Legislative Research Commission, KRS 216.597, Definitions (personal care homes) Checked 12 Oct 2026 · Back to text ↑
19. 19
    Kentucky Legislative Research Commission, 906 KAR 1:190, Kentucky National Background Check Program Checked 12 Oct 2026 · Back to text ↑

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