Kentucky personal services agency certification: opening a non-medical home care agency

What Kentucky means by “personal services”

Kentucky has regulated non-medical home care since 2009, when the General Assembly created the personal services agency certificate in KRS 216.710 to 216.716.⁠¹ The statute gives the operating rule in one sentence: “No personal services agency shall be operated, maintained, or advertised without obtaining a certificate.”⁠¹ Agencies that started after the 2009 grace period must be certified “prior to providing personal services,” and 906 KAR 1:180 repeats that you may not provide personal services before certification.⁠¹⁠³

KRS 216.710(9)(a) defines personal services as four things:⁠²

• helping a client with walking and with activities of daily living as defined in KRS 194A.700;
• facilitating the self-administration of medications that a licensed health-care professional or the client’s designated representative has prepared or directed;
• attendant care, in-home companion, sitter and respite services, and homemaker services when provided together with other personal services;
• services that let the client live safely, comfortably and independently.

The certificate applies to any for-profit or nonprofit person or entity that provides these services through its own employees or agents, through independent contractors, or by referring caregivers when the referrer has an ownership or financial interest in the services.⁠² The referral clause matters if you were planning a registry-style business: a registry that profits from the placements it arranges falls under this law. The regulation’s definition of “employee” also counts contractors and referred workers, so every hiring check described below applies to them as well.⁠³

Kentucky’s term is “certification,” but it does not mean optional or Medicaid-only. It is the state’s permission to operate. Running an agency without it can draw a fine of up to $500 a day, and so can marketing yourself as a personal services agency without one.⁠⁸

Who is outside the law: the three-client rule and other carve-outs

KRS 216.710(9)(b) lists what is not personal services. These exclusions decide whether you need a certificate at all:⁠²

• Family members, and individuals serving no more than three clients concurrently. A self-employed caregiver with three or fewer clients at a time does not need a certificate. The limit counts clients served at the same time, not clients served over a year.
• Cleaning, laundry, personal shopping or transportation, if the business offers no other personal services. A homemaker or companion service on its own is outside the definition. Once you add hands-on help, you need the certificate, because the definition covers homemaker services “provided in conjunction with other personal services.”
• Services provided entirely by volunteers.
• Services that legally require a licensed health-care professional’s order. Those belong to a home health agency.
• Hospitals or other entities that only share caregiver names, make no attempt to manage or coordinate the selection, and give a disclaimer. Free internet caregiver directories are also excluded.
• Health facilities and services defined in KRS 216B.015, and any health-care entity or practitioner already licensed, certified or regulated. Section 2(4) of 906 KAR 1:180 confirms that these providers do not need a separate certificate to offer personal services.⁠³
• Voluntary services an employer or membership organization provides to its own people, when that is not its main business.

Certificate, home health license, or neither

The boundary you are most likely to cross by accident is the one with home health. If any task requires a licensed professional’s order, it is not a personal service.⁠² Providing services “beyond the scope of personal services” is also a ground for revocation.⁠³

If you want to serve people in a day setting rather than in their homes, see the Kentucky adult day health care program license guide. For live-in residential care, see the Kentucky family care home guide or the assisted living community guide.

The medication line your aides cannot cross

Help with medications is the most detailed scope limit in 906 KAR 1:180, and it shapes your training and your intake paperwork. An agency may “facilitate the self-administration of medication” only after the client, or their guardian, health care surrogate or health care attorney-in-fact, has signed a written consent. The consent must name who may prepare or direct the medications and authorize the agency to facilitate.⁠³

The medications must be prepared or directed by the client’s designated representative or by a licensed health-care professional who is not an owner, manager or employee of your agency. You cannot hire a nurse to fill organizers for your own clients under this certificate. Except for ointments, each medication must be preset in a medication organizer or packaged as a single dose, with the client’s name on the container.⁠³

Within those limits, staff may remind the client and watch them take the medication. They may hand it over, and open a unit dose or organizer if the client cannot. They may place the dose in a cup held to the client’s mouth or put it in the client’s hand or mouth, follow the written instructions of the representative or professional, and steady the client’s hand while the client applies an ointment.⁠³ Staff may not:⁠³

• instill eye, ear or nasal drops;
• mix, compound, convert or calculate doses;
• prepare syringes or give any injection;
• give medications by nebulizer or intermittent positive pressure breathing machine;
• give medications through a tube inserted in a body cavity, or give parenteral preparations;
• apply irrigations or debriding agents for skin conditions;
• give rectal, urethral or vaginal preparations.

If you will facilitate medications, your pre-service training must cover these procedures.⁠³

Get your dementia curriculum approved first

One prerequisite happens outside the OIG. Since 2021, KRS 216.713 has required direct-care staff who serve people with symptoms of Alzheimer’s disease or other dementias to complete cabinet-approved training before they provide that care. The statute calls for at least six hours of initial training within the first 60 days of employment and at least three hours every year after that.⁠⁷ Section 7(2) of 906 KAR 1:180 requires your agency to get its curriculum approved under 910 KAR 4:010, issue certificates of completion, and keep records of who completed the training.⁠³

The OIG checklist spells out the practical effect. The approval letter from the Department for Aging and Independent Living’s Office of Dementia Services must “accompany all PSA renewal and initial applications.” Approval is a one-time step unless you change the training.⁠⁵ You can submit a curriculum by mail to the Office of Dementia Services at 275 E Main St. 3 E-E, Frankfort, by hand delivery, or electronically.⁠⁹ Under 910 KAR 4:010, an unaltered standardized curriculum may be used before formal approval if you notify the department that you are using it in its entirety.⁠⁹

Under the statute, the six-hour course must include a passing grade on a post-evaluation, and completion certificates are portable between Kentucky employers.⁠⁷ A worker who has gone 24 months or more without caring for clients with dementia symptoms must repeat the six initial hours within 60 days of resuming that care.⁠³⁠⁷ Advertising dementia care while out of compliance with these rules is prohibited and can be fined up to $500 a day.⁠⁷

Five checks before anyone starts work

Your manager and every worker who will provide direct services must complete all five of these checks before they start in the role:⁠³

1. Criminal record check

   It must be run by the Justice and Public Safety Cabinet or the Administrative Office of the Courts, or by a company that searches those agencies’ records.

2. Nurse aide and home health aide abuse registry

   check, under 906 KAR 1:100. The OIG checklist points to kbn.ky.gov.⁠⁵

3. Caregiver misconduct registry

   check, under 922 KAR 5:120.

4. Substance abuse test

5. Tuberculosis risk assessment

   by a physician, APRN, physician assistant or registered nurse. If the assessment shows increased risk, a skin test or blood assay follows. A positive result requires a medical evaluation and chest x-ray before any direct services.

The risk assessment is repeated every year.⁠³ The OIG checklist asks for the dates of a “two-step Tuberculin Skin Test and TB Education” for each worker. That goes further than the regulation, which requires a skin test or blood assay only after an increased-risk finding, and further than the application form, which asks only for the date of documentation that the worker is free of active tuberculosis.⁠³⁠⁴⁠⁵ The official sources do not say which the OIG applies when it reviews a staff list. Before you buy two-step skin tests for every hire, ask the OIG in writing what it will accept for a worker whose annual risk assessment shows no increased risk.

You may not employ or keep a manager or direct-care worker who:⁠¹⁠³

• has a disqualifying “crime,” meaning a felony conviction or guilty plea related to theft, illegal drugs, abuse, neglect or exploitation of an adult or child, or a sex crime, including out-of-state offenses that would be felonies in Kentucky;⁠²
• is listed on either registry;
• tests positive for an illegal drug;
• cannot produce TB clearance.

Every job application you hand out must state, conspicuously: “For This Type of Employment State Law Requires a Criminal Background Check as Condition of Employment.”⁠¹ Keep employee records for at least five years, with current staff records either on the premises or reachable through a central computer file.⁠³

Assembling the OIG-1180 packet

Neither KRS 216.712 nor 906 KAR 1:180 calls for a pre-application meeting or a local approval. The packet is what the OIG reviews. The application form is OIG-1180, September 2021 edition. It must be typed or printed, and the form warns that an incomplete or illegible application “will be returned without being processed.”⁠⁴ The OIG’s checklist (version 23.5) lists what to include:⁠⁵

1. Fee

   A $500 check or money order payable to the Kentucky State Treasurer. It is nonrefundable.⁠⁴⁠⁵

2. Sections 1 to 5 of the form

   These cover the type of application, identifying information, ownership, manager and alternate manager, and signatures by both the owner or chief executive and the manager.⁠⁴ List office hours day by day, and use the hours of the Kentucky agency itself, not a parent company’s.⁠⁵

3. Secretary of State documents

   Include proof that your company is in good standing. If you operate under a d/b/a, include the Certificate of Assumed Business Name. The checklist says to register both the direct owner’s name and the d/b/a.⁠⁵

4. Manager’s written responsibilities

   The regulation requires a manager responsible for daily operation and a written designee for any absence of three or more consecutive business days.⁠³⁠⁵ 906 KAR 1:180 sets no education or experience minimum for the manager.

5. Dementia curriculum approval letter

   ⁠⁵

6. Training content

   It must cover abuse, neglect and exploitation reporting for adults and children, medication facilitation procedures, and communication techniques.⁠³⁠⁵

7. Competency evaluation method

   Show how you evaluate each worker on each task before they do it without direct supervision. Each evaluation must be dated and signed by the trainer and the worker.⁠³⁠⁵

8. Staff list

   For every manager, alternate manager and direct-care worker active when you apply, list the hire date and the dates of each check, the TB items, the competency evaluation, the training with topics covered, and the dementia training.⁠⁴⁠⁵

9. Service agreement, service plan template and client rights statement

   , each with signature and date lines.⁠⁵

10. Grievance investigation policy

    ⁠⁵

11. Gift and gratuity policy

    KRS 216.712(7) requires it to prohibit soliciting gifts, gratuities or loans from clients and to set the conditions under which any may be accepted.⁠¹⁠⁵

In Section 5 you certify that your agency, and any branches, will limit itself to services allowed under KRS 216.710(9)(a), and that you will serve clients without regard to race, color, religion or national origin.⁠⁴ Mail everything to the Office of Inspector General, Division of Health Care, 275 East Main Street, 5EA, Frankfort, Kentucky 40621.⁠⁴

Provisional certification if you have not hired yet

You may not have a staff list yet. The regulation’s answer is a 90-day provisional certificate. You qualify if you have three or fewer employees when you file and you check the box on Section 1 of the application saying you intend to hire more within 90 days.⁠³⁠⁴ The fee and documents are the same as for initial certification.

At least 14 calendar days before the provisional certificate expires, you must send the full staff information for everyone hired after you applied.⁠³ If you start under a provisional certificate, your first full certification period ends one year from the date of the provisional certificate, not from the later approval.⁠³

How the OIG reviews, and how long it takes

KRS 216.712(4)(a) requires an initial and annual review process “that does not require an on-site visit.”⁠¹ The review is a paper review against the regulation and the statute.⁠³ If something is missing, illegible or needs support, the OIG writes to you, and you have 10 calendar days from the notice to respond.⁠³ The form also warns that the OIG may ask for actual copies of a random sample of employee records, such as criminal record checks.⁠⁴

The OIG must deny an initial application if:⁠³

• someone with a 25 percent or larger ownership interest held a similar stake in a personal services agency or a KRS 216B health facility whose certificate or license was revoked in the three years before you applied;
• the application knowingly contains false information;
• the packet fails to show compliance.

Neither the statute nor the regulation sets a deadline for the OIG to decide, and the OIG’s application page and checklist publish no processing time.⁠⁵⁠⁶ Ask the Division of Health Care how long a complete packet is taking before you set an opening date, and remember that the 10-day response window for missing items runs from the date of the OIG’s notice.

Running the agency: agreements, plans and grievances

906 KAR 1:180 dictates the contents of the paperwork between you and each client.

Service agreement. Every client or representative gets a written agreement with:⁠³

• your charge for each service, and your policy for notifying them of price changes, with at least 30 days’ notice of any increase;
• your office hours, how to reach the manager or designee, and the grievance procedure with a phone number;
• whether you directly employ the caregiver, whether you provide bonded protection, and whether you pay workers’ compensation or other benefits for the caregiver;
• the name of the owner and anyone holding 25 percent or more;
• how to change or end the service plan;
• a client rights statement covering respect for property, the right to change services, the right to file a grievance without reprisal, and freedom from verbal, physical and psychological abuse.

The rule does not require bonding or workers’ compensation, but you must tell clients in writing whether you have them.

Service plan. The manager or designee writes, dates and signs a plan listing the types and schedule of services and the charge per service or per hour, and the client signs it too. Give the client a copy within 10 calendar days of the first service. Record every requested change with the name of the person who asked and the date.⁠³

Grievances. Investigate complaints about services, missed services, price increases made without 30 days’ notice, staff conduct, or rights violations. Document the investigation, tell the person who complained the outcome, and keep the record for five years.⁠³

You must report suspected abuse, neglect or exploitation of an adult, or abuse or neglect of a child, to the cabinet.⁠³ Neither the agency nor any employee may serve as, or apply to be, a client’s guardian, conservator or power of attorney in any of the forms the rule lists.⁠³

Branch offices, out-of-state agencies and changes you must report

A Kentucky-based parent agency’s certificate covers its Kentucky branch offices, and you list them in Section 2C of the application.⁠¹⁠⁴ The branches must be owned and controlled by the parent.⁠³ An out-of-state agency that opens a branch in Kentucky must get a separate certificate for each Kentucky branch.⁠³

Within 30 calendar days after a change of name, a move of the parent office or a branch, the opening of a new branch, or the closing of an office, notify the OIG in writing.⁠³ A change of more than 25 percent of ownership requires a new OIG-1180, the Section 6 documents, a $350 fee and a bill of sale, all within 30 days. The certification then runs one year from the date the OIG approves the change.⁠³

Annual recertification, complaints and revocation

Certificates last one year. File the OIG-1180 with the $350 fee at least 60 calendar days before expiration.⁠³ The form says the Section 6 policies and documents need not be resubmitted at recertification unless they differ from the originals, and the checklist says the dementia approval letter must accompany every renewal.⁠⁴⁠⁵ The regulation still calls for “documentation required by Section 6” with each renewal, and the sources do not say whether that includes a refreshed staff list, so ask the OIG what it expects.⁠³ Missing the recertification filing is itself a ground for revocation.⁠³

Although certification involves no routine inspection, the OIG does go on site for complaints. It investigates:⁠³

• unlicensed operation, and marketing as an agency without a certificate;
• noncompliance with the regulation or the statutes;
• alleged abuse, neglect or misappropriation of client property by staff;
• services that exceed the scope of personal services.

If you deny an OIG representative access, or delay or obstruct the visit, your certificate will be revoked.⁠³ After a substantiated complaint you submit a signed plan of correction within 10 days. If you fail to submit an acceptable plan, your certificate is revoked.⁠³

Other grounds for revocation include failing the background-check and TB rules, knowingly keeping a worker found to have abused a client or misappropriated their property, and keeping a worker convicted of a listed crime.⁠³ The OIG gives at least 30 days’ written notice of a denial, revocation or fine. You can request a KRS Chapter 13B hearing within 30 days, and the action is stayed while the appeal is pending.⁠³ If the agency closes, return the certificate to the OIG.⁠³

Where a certified agency fits in Kentucky Medicaid

Under 907 KAR 7:010, which governs the Home and Community Based (HCB) waiver, version 2, a provider of traditional (non-participant-directed) HCB services must be licensed, certified or approved and be one of these: an adult day health care center, a home health agency, a center for independent living, a public health department, a home-delivered meal provider, or an area agency on aging and independent living.⁠¹⁰ Personal services agencies are not on that list. A personal services agency certificate on its own does not qualify you to bill traditional HCB attendant care.

The regulation does mention personal services agencies in its participant-directed services section, which says a personal services agency must meet 906 KAR 1:180 and follow that section. A participant-directed services provider may not deliver more than 40 hours in a calendar week.⁠¹⁰ The regulation does not spell out how an agency enrolls to take part in participant-directed services, and the OIG pages do not address Medicaid enrollment. Ask the Department for Medicaid Services whether a certified personal services agency can enroll for participant-directed services or other waivers, and under what provider type, before you build revenue projections on it. If Medicaid revenue is central to your plan, compare this route with the home health agency license and adult day health care routes, both of which are on the HCB provider list.⁠¹⁰

Recent changes and what to watch

• 2021: 2021 Ky. Acts ch. 72 amended the definitions in KRS 216.710 and created the dementia training mandate in KRS 216.713, both effective June 29, 2021.⁠²⁠⁷
• February 10, 2022: The amended 906 KAR 1:180 took effect. It added the dementia training section, and the OIG-1180 form moved to the September 2021 edition.⁠³ The OIG checklist dates the dementia training requirement for agencies to May 11, 2022.⁠⁵
• November 24, 2025: 906 KAR 1:180 was recertified without change under Kentucky’s seven-year review. Its next expiration date is November 24, 2032.⁠³

As of 2026-10-12, the legislature’s regulation page shows no pending amendment to 906 KAR 1:180.⁠³ The $500 and $350 fees in the February 10, 2022 text still match the OIG fee page as of that date.⁠³⁠⁶

Sources

1. 1
   Kentucky Legislative Research Commission, KRS 216.712: Certification of personal services agency required; criminal background check; administrative regulations; fees Checked 12 Oct 2026 · Back to text ↑
2. 2
   Kentucky Legislative Research Commission, KRS 216.710: Definitions for KRS 216.710 to 216.714 Checked 12 Oct 2026 · Back to text ↑
3. 3
   Kentucky Legislative Research Commission, 906 KAR 1:180: Operation and services; personal services agencies Checked 12 Oct 2026 · Back to text ↑
4. 4
   Cabinet for Health and Family Services, Office of Inspector General, Application for Certification to Operate a Personal Services Agency, OIG-1180 (September 2021) Checked 12 Oct 2026 · Back to text ↑
5. 5
   Cabinet for Health and Family Services, Office of Inspector General, PSA Initial Application Checklist (v.23.5) Checked 12 Oct 2026 · Back to text ↑
6. 6
   Cabinet for Health and Family Services, Office of Inspector General, Division of Health Care, Applications for Health Care and Long-Term Care Checked 12 Oct 2026 · Back to text ↑
7. 7
   Kentucky Legislative Research Commission, KRS 216.713: Minimum training requirements for direct-care staff serving individuals with Alzheimer's or other dementias Checked 12 Oct 2026 · Back to text ↑
8. 8
   Kentucky Legislative Research Commission, KRS 216.714: Fines for operating without required certification Checked 12 Oct 2026 · Back to text ↑
9. 9
   Kentucky Legislative Research Commission, 910 KAR 4:010: Alzheimer's and dementia services curriculum review and approval Checked 12 Oct 2026 · Back to text ↑
10. 10
    Kentucky Legislative Research Commission, 907 KAR 7:010: Home and community based waiver services version 2 Checked 12 Oct 2026 · Back to text ↑

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