RESIDENTIAL CARE SERVICES PROVIDER IN KENTUCKY

Fatumata Kaba
Jul 25
4 min read

DELIVERING 24/7 SUPPORT IN COMMUNITY-BASED SETTINGS FOR INDIVIDUALS WITH COMPLEX CARE NEEDS

Residential Care Services in Kentucky provide around-the-clock assistance in supervised, home-like settings for individuals who require support with daily living tasks, health monitoring, and community participation. Offered under several Kentucky Medicaid Home and Community-Based Services (HCBS) waivers, residential services aim to promote independence, dignity, and inclusion for participants who cannot live alone or with family caregivers.

1. GOVERNING AGENCIES

Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)

Role: Manages Medicaid reimbursement, provider enrollment, and service integrity

Agency: Kentucky Department for Aging and Independent Living (DAIL)

Role: Oversees compliance with residential care standards under specific waiver programs

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Enforces federal person-centered planning, safety, and quality-of-care regulations

Agency: Managed Care Organizations (MCOs) in Kentucky Medicaid

Role: Authorize residential service plans, credential providers, and ensure billing and documentation compliance

2. SERVICE OVERVIEW

Residential Care Services support participants in provider-operated homes with 24/7 staff supervision and assistance to promote independent living within a structured, community-based environment.

Approved services may include:

ADL assistance (bathing, dressing, toileting, eating, mobility)
Medication administration or reminders (per state policy and staff licensure)
Meal planning and preparation
Housekeeping, laundry, and safety monitoring
Community access and engagement
Behavioral supports and skill development
Supervision and overnight monitoring
Health tracking and appointment support

All services must align with the participant’s Person-Centered Service Plan (PCSP) and be delivered in certified or licensed settings approved under the applicable waiver.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Kentucky Secretary of State
Obtain IRS EIN and Type 2 NPI
Enroll with Medicaid via the Medicaid Partner Portal Application (MPPA)
Obtain KDADS or DAIL licensing or certification for residential settings (based on waiver type)
Maintain property, liability, and workers’ compensation insurance
Pass environmental safety and health inspections
Hire and train staff with background checks, CPR/First Aid certification, and HCBS training
Develop Residential Care Policies & Procedures Manual
Implement HIPAA-compliant documentation and risk management systems

4. KENTUCKY PROVIDER ENROLLMENT PROCESS

Step 1: Facility Licensing and Setup

Secure appropriate licensure or certification from DAIL for a group home or staffed residence
Complete site inspections for fire safety, accessibility, and staffing requirements

Step 2: Medicaid Enrollment via MPPA

Register as a residential care provider for applicable waivers
Complete MCO credentialing and network participation agreements

Step 3: Documentation Submission

Submit business license, staff credentials, site inspection reports, insurance, and policy manual

Step 4: Service Authorization & Launch

Coordinate with case managers and caregivers to complete the ISP
Receive MCO authorization and begin service delivery
Submit claims using approved T-codes or HCPCS codes for residential supports

5. REQUIRED DOCUMENTATION

Kentucky Articles of Incorporation or business license
IRS EIN and NPI confirmation
KDADS/DAIL facility license or certification
Liability, property, and workers’ compensation insurance
Residential Services Policy & Procedure Manual, including:
- Admission/intake forms and ISP implementation procedures
- House rules, emergency plans, and daily log templates
- ADL, behavioral support, and medication administration documentation
- Staffing schedules, training logs, and supervision reports
- Participant rights, HIPAA compliance, and grievance policy
- Critical incident and abuse prevention protocols
- Medicaid billing systems and audit tools

6. STAFFING REQUIREMENTS

Role: Direct Support Professional (DSP) / Residential Aide

Requirements: Experience with developmental disabilities or elderly care; background check; CPR/First Aid; HCBS training

Role: Residential Supervisor / Program Manager

Requirements: Oversee staff and site operations; ensure compliance, documentation, and staff development

Role (if needed): Nurse or Behavior Support Staff

Requirements: Licensed in Kentucky for nursing/clinical tasks as applicable to the participant’s care plan

All staff must complete:

Abuse, neglect, and exploitation training
HIPAA and participant rights training
Fire safety and emergency response
Person-centered care and ISP implementation
Ongoing continuing education

7. MEDICAID PROGRAMS & HCBS WAIVERS

Residential Care Services are available under:

Supports for Community Living (SCL) Waiver
Acquired Brain Injury (ABI and ABI-LTC) Waivers
Model II Waiver (MIIW)
Michelle P. Waiver (for specific planned respite or transitional housing supports)

Service settings must be:

Small, community-integrated homes (not institutional)
Operated under KDADS/DAIL certification standards
Aligned with participants’ autonomy, choice, and privacy rights

8. TIMELINE TO LAUNCH

Phase: Facility Preparation and Licensing

Timeline: 2–3 months

Phase: Medicaid and MCO Enrollment

Timeline: 2–3 months

Phase: Staff Hiring and Training

Timeline: 1–2 months

Phase: ISP Coordination and Program Launch

Timeline: 30–60 days

9. CONTACT INFORMATION

Kentucky Department for Medicaid Services (DMS)

Website: https://chfs.ky.gov/agencies/dms

Medicaid Provider Enrollment (MPPA): https://mppa.ky.gov

Department for Aging and Independent Living (DAIL)

Website: https://chfs.ky.gov/agencies/dail

Kentucky Cabinet for Health and Family Services (CHFS)

Website: https://chfs.ky.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — KENTUCKY RESIDENTIAL CARE PROVIDER

WCG partners with developmental disability providers, community living operators, and supported housing organizations to launch licensed, Medicaid-compliant Residential Care programs in Kentucky.

Scope of Work: