Adult Day Care Regulations in Kentucky

Who regulates adult day care in Kentucky

The Cabinet for Health and Family Services (CHFS) Office of Inspector General, Division of Health Care, licenses and surveys adult day health care programs under 902 KAR 20:066. That regulation was most recently certified effective February 17, 2026. In-state programs also need a certificate of need from the OIG Division of Certificate of Need.

The Department for Medicaid Services (DMS) enrolls adult day health care centers as Medicaid providers and runs the waivers that pay for adult day health care.

Types of adult day programs in Kentucky

• Adult day health care program: licensed by OIG under 902 KAR 20:066. A program that provides nursing services, meaning medication or treatment by an RN or an LPN supervised by an RN, must be licensed to provide those services.
• Adult day health care (ADHC) waiver service: health-related services on a regular schedule for Medicaid waiver participants, delivered by an ADHC center licensed under 902 KAR 20:066.
• Social model adult day care: the Department for Aging and Independent Living formerly certified social model programs under 910 KAR 1:160. The Legislative Research Commission now lists that rule and the adult day care center certification rule (910 KAR 1:230) as inactive. Confirm current requirements with OIG before opening a social program.

How to get licensed in Kentucky

The steps below come from OIG's supplemental documentation checklist (December 2025), the regulation and the DMS adult day health care provider summary.

1. Obtain a certificate of need from the Division of Certificate of Need.
2. Apply to OIG for an adult day health care license, indicating whether you will provide nursing services.
3. Submit the certificate of need, a fire marshal report, a staff list, a description of services, emergency first aid and transport procedures, an abuse and neglect reporting procedure, medication storage and pharmacy arrangements, and CPR and tuberculosis test records.
4. OIG's preliminary review leads to a provisional license. Full policies and procedures are reviewed later during an onsite survey.
5. To bill Medicaid, enroll as provider type 43 through the KY Medicaid Partner Portal. DMS's provider type summary (revised February 2023) says it will not assign a provider number to an in-state facility until a survey or license has been received.

Key requirements

• Administrator: at least two years of college, or equivalent training with two years of clinical experience, plus a degree or health-related license; a licensed nursing home administrator also qualifies.
• Staff health and safety: direct care staff need current CPR certification from the American Heart Association or American Red Cross, and every employee needs a tuberculosis test by the first week of work and annually after.
• Nursing: nursing services must be delivered by an RN or an LPN supervised by an RN.
• Staffing and space: 902 KAR 20:066 sets no numeric staff ratio or space per participant. It requires a sufficient number of qualified staff and adequate space, and a program that provides nursing services must have a treatment room of at least 120 square feet.
• Care planning: each patient is evaluated on admission and has a care plan.
• Waiver ADHC centers: under 907 KAR 7:010, an RN or LPN must be present, at least one meal a day must be served during posted hours, and participants sign in and out.

Medicaid funding for adult day in Kentucky

Kentucky Medicaid pays for adult day health care through 1915(c) waivers. The main one is the Home and Community Based (HCB) waiver, which serves people 65 and older and people with physical disabilities who meet nursing facility level of care. The HCB waiver has a waiting list.

Under 907 KAR 7:015, amended effective July 30, 2025, HCB waiver ADHC is paid in 15-minute units and limited to 200 units per calendar week per participant. The Michelle P. waiver also covers ADHC, limited to 40 hours per calendar week alone or combined with certain other services, and DMS lists ADHC under the ABI Long Term Care waiver as well.

Billing basics

Waiver services are paid fee-for-service. DMS directs HCB waiver claims to Gainwell Technologies on a CMS-1500, and claims must be received within 12 months of the date of service. Case managers approve most waiver services through the participant's service plan.

The DMS 1915(c) services summary (rates effective January 1, 2025) lists adult day health care under procedure code S5100 per 15-minute unit for the HCB, Michelle P. and ABI Long Term Care waivers, with modifier U1 for HCB Level II.

Electronic visit verification (EVV) does not appear to apply to adult day health care. The DMS list of EVV services (updated August 2023) covers in-home services and notes that EVV is not required for respite provided in congregate settings such as an adult day health care center.

Other ways centers are paid

Enrolled veterans who meet VA eligibility and clinical criteria can get Adult Day Health Care through the VA, which may be provided at VA medical centers, State Veterans Homes or community organizations.

Official resources

• 902 KAR 20:066: Adult Day Health Care Programs
• OIG Supplemental Documentation for Adult Day Health Applicants
• DMS Adult Day Health Care Provider Summary
• Home and Community Based Waiver
• 907 KAR 7:010: HCB Waiver Services
• 907 KAR 1:835: Michelle P. Waiver
• DMS EVV Affected Services

Frequently asked questions

Do I need a license to open an adult day center in Kentucky?

Adult day health care programs need an OIG license under 902 KAR 20:066, and in-state programs need a certificate of need first. The state's former social adult day certification rules are listed as inactive, so confirm current requirements with OIG.

Does Kentucky Medicaid pay for adult day care?

Yes. Medicaid pays licensed adult day health care centers through 1915(c) waivers, mainly the HCB waiver, plus the Michelle P. and ABI Long Term Care waivers, billed in 15-minute units.

Who inspects adult day centers in Kentucky?

The CHFS Office of Inspector General surveys adult day health care programs, including an onsite survey after the provisional license.

Is adult day care in Kentucky subject to EVV?

DMS's EVV affected-services list (updated August 2023) applies EVV to in-home waiver services and does not include adult day health care. Confirm with DMS before assuming an exemption.