How to start a home care agency in Kentucky

Kentucky requires a Certificate to operate a Personal Services Agency from Kentucky Cabinet for Health and Family Services, Office of Inspector General (OIG) to operate a home care agency. Fee: $500. Processing time: OIG may issue a 90-day provisional certificate while the application is reviewed; with a provisional certificate, the first certification period runs one year from the provisional date.

License required

Yes

License

Certificate to operate a Personal Services Agency

Issuing agency

Kentucky Cabinet for Health and Family Services, Office of Inspector General (OIG)

Fee

$500

Fee details

$500 initial application fee, payable to the Kentucky State Treasurer. A change in ownership interest of more than 25% must be reported within 30 days with a $350 fee.

Renewal

Every year · $350 annual recertification fee; the recertification application is due at least 60 days before the certificate expires.

Processing time

OIG may issue a 90-day provisional certificate while the application is reviewed; with a provisional certificate, the first certification period runs one year from the provisional date.

Insurance and bonds

No insurance or bond amount is required; the agency must tell clients in writing whether it provides bonded protection and whether it pays workers' compensation.

Regulation

KRS 216.710 to 216.716; 906 KAR 1:180

1. Submit form OIG-1180 (Application for Certification to Operate a Personal Services Agency) with required documentation and the $500 fee
2. Optionally operate under a 90-day provisional certificate; send employee information for new hires at least 14 days before it expires
3. Screen the manager and every direct care worker before they start: criminal record check, nurse aide/home health aide abuse registry, caregiver misconduct registry, drug test, TB risk assessment
4. Train workers before they serve clients
5. Recertify every year at least 60 days before expiration with the $350 fee

Staffing

• A manager responsible for daily operations, who designates a backup in writing for absences of 3+ business days
• Pre-hire criminal record check, abuse registry check, caregiver misconduct registry check, drug test and TB risk assessment for the manager and direct care staff; annual TB risk assessment
• No hiring of anyone with disqualifying convictions under KRS 216.710(3), registry listings, or a positive drug test

Training

• Before serving clients: training on reporting abuse, neglect and exploitation; on helping with self-administered medication (if offered); and on communication tailored to each client
• Staff serving clients with Alzheimer's disease or other dementia: at least 6 hours of initial dementia training (before serving such clients) and 3 hours annually, using a cabinet-approved curriculum
• Agency evaluates each worker's competency on each personal-service task before the worker performs it unsupervised

Program

Kentucky Medicaid (Department for Medicaid Services)

Enrollment portal

Kentucky Medicaid Partner Portal Application (MPPA)

Fiscal agent

Gainwell Technologies (fiscal agent for KY Medicaid claim processing, KYHealth-Net)

Application fee

Kentucky's MAP-811 checklist tells providers subject to the fee to attach a check payable to the Kentucky State Treasurer; DMS's provider-type summaries say which types owe it. Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.

Fingerprinting

Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.

Site visit

Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.

Revalidation

Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.

Full Kentucky Medicaid enrollment guide →

CON program

Yes

Program

Certificate of Need

Agency

Kentucky Cabinet for Health and Family Services, Office of Inspector General

Services covered

• hospitals
• ambulatory surgical centers
• home health agencies
• hospice (including residential hospice by a non-hospice entity)
• nursing facilities, personal care homes, ICF and ICF/IID
• chemical dependency treatment programs
• psychiatric residential treatment facilities (Level I and II)
• PET, MRI, megavoltage radiation and cardiac catheterization
• open heart surgery and organ transplant programs
• special care neonatal beds
• prescribed pediatric extended care facilities
• ground ambulance providers (unless exempt)
• nonsubstantive review: adult day health, private duty nursing agencies, PACE, hospital-owned off-campus freestanding EDs, industrial ambulance, certain acute bed transfers

Kentucky certificate of need details →

Model

hybrid

State vendor

Therap (state-sponsored system); DMS also names Netsmart as its EVV contractor

Services in scope

• personal care
• home health
• 1915(c) waiver in-home services

Alternate EVV allowed

Yes

Program

https://www.chfs.ky.gov/agencies/dms/dca/Pages/evv.aspx

Kentucky EVV requirements →

State minimum wage

$7.25 an hour

Effective

2009-07-24

Scheduled increases

No scheduled change found in the official sources reviewed.

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Personal care / in-home supportive care organizations — active organization NPIs (NPPES)

400 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

1,264,449 (as of Jun 1, 2026)

All Kentucky Home care Medicaid rates, ranked →

• Acquired Brain Injury Waiver (1915(c))
• Acquired Brain Injury – Long Term Care Waiver (1915(c))
• Community Health for Improved Lives and Development (CHILD) Waiver (1915(c))
• Home and Community Based Waiver (1915(c))
• Model Waiver II (1915(c))
• Michelle P. Waiver (1915(c))
• Supports for Community Living Waiver (1915(c))

Kentucky waivers and waiting lists →