Kentucky assisted living community rules: what you must document about each resident

Who these rules cover

Kentucky law defines an assisted living community as "a licensed facility that provides sleeping accommodations and assisted living services" for five or more unrelated adults.⁴ Residents are adults who have signed a lease with the community.

Until recently these communities were certified under 910 KAR 1:240. That regulation is now marked repealed, and licensing sits with the Office of Inspector General under 902 KAR 20:480, effective July 25, 2023.¹ The regulation uses three license types:

If you are still working from 910 KAR 1:240 materials, update them. Several requirements changed with the move to licensure.

The functional needs assessment

Kentucky's assessment is called a functional needs assessment, and the state publishes the form (Form OIG 20:480-A, July 2023 edition, incorporated by reference).¹ The statute says what it covers and when:

Upon move-in, a copy of a functional needs assessment pertaining to the resident's ability to perform activities of daily living and instrumental activities of daily living and any other topics the assisted living community determines to be necessary;KRS 194A.705(6)(a)

The regulation sets the update schedule. The community completes the assessment upon move-in and then:

As needed with updated information if there is a change in the resident's condition, but no later than once every twelve (12) months.902 KAR 20:480 Section 7(1)(c)

The person giving the assessment needs a bachelor's degree in health or human services or a related field, an associate's degree plus a year of relevant experience, or a high school diploma plus two years of experience with older adults or assessments. The assessment is used to confirm the resident meets eligibility criteria, can at least minimally direct or take part in their own ADL and IADL help, and does not need 24-hour nursing supervision.¹ A medical examination is also required before admission.

Notice the phrase "any other topics the assisted living community determines to be necessary." The state's focus is function, but it leaves room for you to add more.

The service plan

The statute defines a service plan simply:

"Service plan" means the written plan agreement between the resident and the licensee about services that will be provided to the resident;KRS 194A.700(24)

After move-in, the resident gets a copy of the updated functional needs assessment together with "the service plan designed to meet identified needs."² The regulation adds one explicit preference requirement:

Information about the resident's eating and dining preferences shall be included in the resident's service plan based on the resident's preferences.902 KAR 20:480 Section 9(5)(b)

The same subsection says nothing in the regulation takes precedence over "the resident's right to make decisions regarding his or her eating and dining." Residents may also do some IADLs on their own, as documented in the service plan, but cannot be forced to.¹

Activities and social programming

Every Kentucky assisted living community must give residents access to a short list of services under the lease. One of them is activities:

Scheduled daily social activities that address the general preferences of residents;KRS 194A.705(1)(c)

"General preferences of residents" is a group standard, not an individual plan. It asks whether your calendar fits the people who live with you. In practice the only way to know is to ask residents what they enjoy and keep track of the answers.

Assisted living communities with dementia care

This is where Kentucky's rules turn personal. KRS 194A.7052, adopted in 2022, requires each ALC-DC to provide person-centered, nonpharmacological practices, social activities on or off site, and more. The regulation requires each ALC-DC to evaluate every resident on its secured dementia unit for engagement in activities and to develop an individualized activity plan.¹ The statute spells out the evaluation:

Each resident shall be evaluated for engagement in activities. The evaluation shall address: (a) Past and current interests; (b) Current abilities and skills; (c) Emotional and social needs and patterns;KRS 194A.7052(2)

The evaluation also covers physical abilities, adaptations needed to take part, and activities that can serve as behavioral interventions. Then "an individualized activity plan shall be developed for each resident based on his or her activity evaluation. The plan shall reflect the resident's activity preferences and needs."³

Daily options can include occupation or chore-related tasks, spontaneous activities "for enjoyment or to help defuse a behavior," one-to-one time with staff, and spiritual, creative, sensory, physical and outdoor activities. The community must also offer support services to family and others with significant relationships at least every six months.³

"Past and current interests" and "emotional and social needs and patterns" together describe most of a life history. The rule does not use that phrase, but a good activity evaluation will read like one.

A community that claims to provide special care for Alzheimer's disease or other brain disorders must also keep a written manual describing its dementia program and make it available on request.⁵

What surveyors tend to look for

Based only on what the text asks communities to document, expect a review of:

• A functional needs assessment on the state form, done upon move-in by a qualified staff person, with a copy given to the resident.
• Updates after a change in condition and at least every 12 months.
• A written service plan, including eating and dining preferences.
• A daily activity schedule that plausibly reflects residents' general preferences.
• In an ALC-DC: an activity evaluation for each resident on the secured unit covering past and current interests and social patterns, and an individualized activity plan that follows from it.
• Records of family support services offered at least every six months.

How to gather preferences and life history well

• Start in the first two weeks. The assessment is due at move-in, but interests come out over conversations. Book a follow-up talk once the resident has unpacked.
• Ask open questions. "Tell me about the job you liked best." "What did Sunday dinner look like?" "What do you do when you can't sleep?" These feed both the dining preferences and the activity plan.
• Bring in family. For residents with dementia, relatives often supply the "past interests" the resident can no longer name: the church choir, the fishing spot, the bowling league.
• Write down comfort and what to avoid. Kentucky's dementia statute expects activities that help defuse behavior. Knowing what soothes someone, and what topics upset them, is the raw material.
• Revisit at each update. Use the 12-month reassessment to ask what has changed in what the person enjoys.

How Porchlight can help

Porchlight helps you gather and keep the interests, routines and life-story material behind Kentucky's activity requirements, in the resident's own words. A resident taps one large button on a tablet, a life question is read aloud and shown in large type, they talk, and the answer is recorded and transcribed. There are 800+ human-written questions organized by life chapter; any can be skipped and nothing is scored. Staff can record profile facts, including topics to avoid. Family get a private page to listen, leave voice replies and add their own questions and photos. Staff get a "Know Your Resident" briefing with conversation starters, story highlights, a printable life-story biography and a weekly Monday email digest. The assessment, the service plan and compliance remain your community's responsibility.

Frequently asked questions

Who licenses assisted living in Kentucky now?

The Cabinet for Health and Family Services, Office of Inspector General, licenses assisted living communities under KRS 194A.700 to 194A.729 and 902 KAR 20:480. The older certification rule, 910 KAR 1:240, has been repealed.

When is the Kentucky functional needs assessment due?

Upon move-in, with a copy to the resident. It is updated as needed when the resident's condition changes, but no later than once every 12 months, and the updated copy goes to the resident with the service plan.

Does Kentucky require assisted living to record resident preferences?

In specific places. Communities must offer scheduled daily social activities that address the general preferences of residents, and the service plan must include the resident's eating and dining preferences. In a community with dementia care, each resident on a secured dementia unit gets an individualized activity plan that reflects the resident's activity preferences and needs.

Does Kentucky require a life history for memory care residents?

Not by that name. But KRS 194A.7052 requires each resident in a community with dementia care to be evaluated for engagement in activities, and the evaluation must address past and current interests and emotional and social needs and patterns. That is most of a life history.

What is an ALC-DC in Kentucky?

An assisted living community with dementia care: a community that advertises or promotes specialized care for people with Alzheimer's disease or other dementia. A community with a secured dementia care unit must be licensed this way.