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Kansas - Assisted Living Facility — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

The Kansas Department for Aging and Disability Services (KDADS), through its Survey, Certification and Credentialing Commission (SCCC), licenses Assisted Living Facilities under K.S.A. 39-923 to provide housing, personal care, and supervised nursing care. Facilities seeking Medicaid reimbursement must enroll in the Kansas Medical Assistance Program (KMAP) and subsequently secure network contracts with the three KanCare managed care organizations (MCOs) that administer the state's 1115 demonstration waiver.

Before KDADS accepts a formal licensure application, prospective operators must submit a formal Letter of Intent to the department and secure a Kansas-licensed Adult Care Home Administrator. Medicaid reimbursement is entirely dependent on securing active contracts with Aetna Better Health of Kansas, Sunflower Health Plan, and UnitedHealthcare Community Plan, as KanCare operates under a mandatory managed care model for long-term services and supports.

1. Service Definition and Scope

In Kansas, an Assisted Living Facility (ALF) is defined under K.S.A. 39-923 as a setting caring for six or more individuals who may need personal care or supervised nursing care to compensate for activities of daily living limitations. The service combines housing, personalized supportive services, and health care designed to respond to the individual needs of residents requiring assistance.

Medicaid covers ALF services primarily through the KanCare Frail Elderly (FE) and Physical Disability (PD) waivers. Room and board costs are explicitly excluded from Medicaid reimbursement and must be negotiated directly with the resident using their personal needs allowance and private income.

2. Regulatory and Oversight Agencies

KDADS is the primary regulatory body for adult care homes in Kansas, handling both state licensure and federal certification activities. The Survey, Certification and Credentialing Commission (SCCC) within KDADS conducts initial and annual inspections.

Medicaid enrollment is managed through the Kansas Medical Assistance Program (KMAP), while actual service authorization and payment are overseen by the KanCare MCOs.

3. Gatekeeping Prerequisites: Who Can Even Apply

Kansas does not require a Certificate of Need (CON) for Assisted Living Facilities. However, K.A.R. 26-39-101 mandates that applicants submit a Letter of Intent to KDADS prior to initiating the formal application process.

Facilities must also employ a Kansas-licensed Adult Care Home Administrator before operations can commence. Medicaid participation requires the facility to be fully licensed first; there is no concurrent licensure and Medicaid enrollment track.

4. Licensure and Certification Requirements

The licensure process is managed through the Kansas Tracking of Adult Care Homes (KOTA) web application. Applicants must submit architectural plans for review and approval before beginning construction or major renovations.

Initial licensure requires passing a comprehensive on-site survey by KDADS SCCC to verify compliance with K.A.R. 28-39-144 through 28-39-174. Licenses must be renewed annually.

5. Medicaid Provider Enrollment

Once licensed by KDADS, facilities must enroll as atypical providers in the KMAP system. Enrollment requires submitting a Provider Agreement, W-9, and proof of KDADS licensure.

Because Kansas operates under KanCare, KMAP enrollment is only the first step. Providers must subsequently complete credentialing and contracting with Aetna, Sunflower, and UnitedHealthcare to receive patient referrals and payments.

6. Staffing, Training and Background Checks

Kansas requires ALFs to have a licensed Adult Care Home Administrator and a licensed nurse available to conduct resident assessments. Direct care staff must complete state-approved training.

All employees must undergo criminal background checks through the Kansas Bureau of Investigation (KBI) and be screened against the KDADS Nurse Aide Registry and Adult Abuse, Neglect, and Exploitation Registry.

7. Documentation, Policies and Records

ALFs must maintain comprehensive policies covering admission and discharge criteria, medication management, infection control, and resident rights. Facilities serving residents with special needs (e.g., dementia) must explicitly outline these services in their admission criteria.

Resident records must include a physician's order for admission, a negotiated service agreement, and regular health assessments conducted by a licensed nurse.

8. Billing, Rates and Claims

Medicaid billing for ALF services is processed through the KanCare MCOs, not directly to the state. Providers must submit claims using the specific procedure codes outlined in the KMAP HCBS Provider Manual.

Room and board cannot be billed to Medicaid. Providers must collect the room and board portion directly from the resident, allowing the resident to retain their state-mandated Personal Needs Allowance (PNA).

9. Approval Sequence and Timeline

The approval process begins with the Letter of Intent to KDADS, followed by architectural plan review and local zoning approval. Once the physical plant is ready, the formal KOTA application is submitted.

After passing the KDADS initial survey and receiving the license, the provider applies to KMAP. The final and often longest phase is MCO credentialing, which can take 90 to 120 days post-KMAP enrollment.

10. Common Denials and Survey Findings

Licensure applications are frequently delayed due to incomplete architectural plans or failure to secure local zoning and fire marshal approvals prior to KDADS review.

During initial and annual surveys, common citations include inadequate documentation of resident health assessments, medication administration errors, and failure to properly execute negotiated service agreements.

11. Key Contacts and Resources

Providers should utilize the KDADS website for licensure regulations, KOTA system access, and architectural review guidelines. The KMAP portal provides all necessary Medicaid enrollment forms and provider manuals.

For MCO contracting, providers must contact the network management departments of Aetna, Sunflower, and UnitedHealthcare directly.

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