Nursing Homes in Kentucky
Nursing homes provide a wide range of services, including both medical and personal care. This involves skilled nursing, rehabilitation, help to get in and out of bed, bathing, grooming, getting dressed and meals. Nursing home care is also referred to as custodial care. These facilities are ideal for seniors who require continuous medical supervision but don’t require hospitalization. For many, nursing home care is the only option because these individuals can’t live safely on their own.
Kentucky’s seniors make up around 17% of the total population, and currently around 20,349 of these older adults live in the 280 facilities that are located throughout the state. There are other options for long-term care, but nursing homes provide the most comprehensive services. Nursing homes also tend to be the most expensive of all long-term care services.
This guide covers the laws and regulations each nursing home must adhere to. It also covers public benefit programs that can help seniors and their families pay for services.
Popular Cities in Kentucky
Cost of Kentucky Nursing Homes
The average cost of nursing homes in Kentucky is $208 per day. This is higher than the national average which is $228 per day.
Can You Use Medicaid to Pay for Nursing Home Care in Kentucky?
In Kentucky, Medicaid pays for the cost of a nursing home for seniors who meet specific financial criteria. Kentucky Medicaid helps low-income seniors and families receive the health coverage they need. While the program covers medical care directly, help with personal care needs is covered by Kentucky’s Home and Community-Based Services waiver. As of December 2022, the program has enrolled approximately 1,613,644 individuals. This total enrollment includes both adult and children’s coverage.
Eligibility for Medicaid in Kentucky
To be eligible for Kentucky state Medicaid, seniors must meet the financial requirements and other qualifying criteria. A single applicant must have an income of no more than $2,742 per month with total assets of no more than $2,000. In a two-person home, both individuals must have an income of $2,742 per month. The applicant can have assets totaling up to $2,000. The nonapplicant can have assets of up to $148,620, which allows for home ownership. In a two-person household, both applicants must have incomes less than $2,742 per month with assets of no more than $4,000.
| Income Limits* | Asset Limits | |
|---|---|---|
| Single Person | $2,742 per month | $2,000 |
| Two-Person HouseholdOnly One Person Applying | $2,742 per month for applicant | $2,000 per applicant$148,620 for nonapplicant |
In addition to asset and income limits, seniors also have additional eligibility qualifications:
- 65 years of age or older
- Require nursing home-level care
- Resident of Kentucky
- U.S. Citizen or qualifying alien
Applying for Medicaid in Kentucky
Individuals may apply for Medicaid benefits by contacting the toll-free number at (855) 459-6328 or by submitting an application through the Kentucky Health Benefit Exchange website. Individuals may also apply through the Kynect website or by applying in person at any local Cabinet for Health and Family Services office.
What Information You Will Need
Before applying for state Medicaid, seniors should gather the appropriate supporting documentation. This includes:
- Photo identification
- Proof of citizenship or legal status
- Copies of income, including awards letters from retirement, Social Security and veterans' benefits
- Bank statements from the past three years
- Health and Life insurance numbers
- Proof of property ownership
- Details of current bills or liabilities
Additional Medicaid Support & Resources in Kentucky
Help is provided to Kentucky seniors applying for Medicaid benefits through several public agencies. These agencies offer coverage information and details of eligibility.
| Contact | Service | |
|---|---|---|
| Benefits.gov | (866) 762-2237 | Benefits.gov is a federal site that details public benefits programs for each state. The site includes a list of qualifications for each program and information on how to contact the plan administrators. |
| Northern Kentucky Council on Aging | (859) 283-1885 | The Northern Kentucky Council on Aging provides information and recommendations on the varying public benefit programs in Northern Kentucky. Counselors provide unbiased insurance counseling and help seniors determine how much insurance they need and whether they need additional prescription or private insurance. |
| Kynect Benefits | (855) 306-8959 | The Kynect Benefit site connects older adults in Kentucky with state benefit programs. Individuals applying for Medicaid can receive insurance counseling and details about what Medicaid covers and how to apply for assistance. |
Can You Use Medicare to Pay for Nursing Home Care in Kentucky?
Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it's most valuable for those who are recovering from an injury, illness, or surgery.
Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.
What Does Medicare Cover?
Medicare covers a number of specific services, including:
- Meals
- A semiprivate room
- Medications
- Skilled nursing
- Physical therapy
- Occupational therapy
- Speech therapy
- Audiologist care
- Medical supplies
- Medical social services
- Nutritional counseling
- Ambulance transportation
What Isn't Covered by Medicare?
Medicare does not cover long-term custodial care that addresses seniors' day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.
For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.
Medicare Support & Resources in Kentucky
There are several organizations in Kentucky that can help seniors to explore their Medicare options and compare the different plans. These programs help explain the basics and provide additional details about coverage amounts, the application process and eligibility.
| Contact | Service | |
|---|---|---|
| Medicare.gov | (800) 633-4227 | Medicare.gov is the official federal site for Medicare. Seniors can chat with an agent 24/7, learn about basic plans and get local contact information. Individuals can also get help with billing and complaints and receive information about supplemental insurance plans. |
| Kentucky State Health Insurance Assistance Plan (SHIP) | (855) 306-8959 | SHIP delivers information and counseling about state and federal insurance plans and helps seniors determine how much coverage they need to pay for long-term care services. The service is provided by trained counselors who provide unbiased information about health care, including Medicare. |
| Kentucky Legal Aid | (866) 452-9243 | Kentucky Legal Aid provides a variety of services to low-income seniors throughout the state. The agency offers benefits counseling, including help with Medicaid appeals and fraud detection. It also provides answers to the most common questions regarding Medicare, Medicaid and supplemental health insurance. |
Other Financial Assistance Options for Nursing Home Care in Kentucky
While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.
| How to Apply | How It Works | |
|---|---|---|
| Aid and Attendance | Learn more and apply online at va.gov. | Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for skilled nursing care. |
| Reverse Mortgages | Learn more about your options and how to apply at ftc.gov. | If you own a home, you may be able to use a reverse mortgage to help pay for nursing care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. This type of funding can be especially useful for married couples when only one partner needs nursing care, as the other residents of the home may continue living there. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan. |
| Long-Term Care (LTC) Insurance | Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov. | Seniors who already have long-term care insurance may be covered for skilled nursing care. Most policies cover at least a portion of the cost of nursing home care, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not be eligible to sign up for a LTC insurance policy. |
Nursing Home Laws and Regulations in Kentucky
| Licensing Requirements | Nursing homes are licensed, monitored and certified by the Commonwealth of Kentucky Division of Health Care. There are four regional branches that serve different areas of the state. Surprise annual inspections are performed by the Cabinet for Health and Family Services. |
| Staffing Requirements | All nursing homes are required to have a charge nurse on staff for each shift. The charge nurse can be any fully licensed nurse. There must be enough additional staff members for each shift to adequately address the needs of the residents. |
| Staff Training Requirements | RNs and LPNs must meet the requirements to maintain their licenses. Nurses’ aides must complete at least 75 hours of training with 16 hours of clinical experience. |
| Admission Restrictions | Nursing home care in South Carolina is only available for individuals who require constant medical care outside of inpatient hospital care. The facility must be able to meet the needs of the individual. |
| Care Planning Requirements | Each resident must have a comprehensive care plan on file that details the level of care that’s required. Nursing homes should also receive a medical evaluation within 5 days of admission or a complete medical file within 48 hours. |
| Dietary and Nutritional Services Requirements | Nursing homes must employ a culinary director who’s responsible for the dietary needs of each resident, which includes three meals and snacks per day. The director must work at least 35 hours per day. |
| Specialized Rehabilitative Services | All nursing homes must provide rehabilitation services, including occupational, speech and physical therapy either on-site or through an off-site medical clinic. For off-site services, the nursing home must provide transportation. |
| Medication and Pharmaceutical Services | A full-time pharmacist or RN must be on-site to supply and administer medications to residents. The medication plans for each individual must be reviewed each month to ensure proper dosage. Nursing homes can either hire a full-time pharmacist or contract the services externally. |
| Activities Requirements | A calendar of recreational and social activities must be provided for residents of nursing homes. Activities must also be planned for those who are bedridden and unable to leave their rooms. |
| Infection Control Requirements | All communities must adhere to the guidelines set by the Centers for Disease Control and Prevention in regard to communicable diseases. All employees are required to undergo training to learn how to prevent the spread of disease. |
| Medicaid Coverage | Medicaid is available to cover the cost of nursing home care in Medicaid-certified facilities. Individuals must qualify for coverage in order to receive assistance. |
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