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Home care staff requirements in Kentucky

Kentucky licenses home health agencies and certifies non-medical personal services agencies through the Cabinet for Health and Family Services. Before a worker gives direct care, personal services agencies need a criminal record check, two registry checks, a drug test, and a TB risk assessment, and home health agencies need pre-employment abuse registry and criminal background checks. Both types of agency must give dementia training to staff who serve clients with dementia symptoms.

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Licenses

Home health agencies are licensed by the Cabinet for Health and Family Services under 902 KAR 20:081 (902 KAR 20:081).
Personal services agencies (non-medical in-home help) must be certified, rather than licensed, by the Cabinet's Office of Inspector General (906 KAR 1:180, Section 1(3)).

Background checks

Before a personal services agency worker gives direct services, the agency must complete a Kentucky criminal record check, a check of the nurse aide and home health aide abuse registry, a check of the caregiver misconduct registry, and a substance abuse test (906 KAR 1:180, Section 6(2)(a)-(d)).
A personal services agency may not employ or keep a direct-care worker who has a disqualifying conviction under KRS 216.710(3), appears on either registry, or tests positive for an illegal drug (906 KAR 1:180, Section 6(4)).
Repeat checks after hire are at the personal services agency's discretion (906 KAR 1:180, Section 6(3)).
Home health agencies must run pre-employment abuse registry checks and pre-employment criminal background checks, and may not hire someone for direct services who has a felony related to theft, illegal drugs, abuse or neglect, or a sexual crime, or a misdemeanor related to adult abuse, neglect, or exploitation (902 KAR 20:081, Section 4(1)(g)-(h)).
Private home health agencies and personal services agencies may voluntarily join Kentucky's National Background Check Program, which uses fingerprint-based state police and FBI checks plus registry checks (906 KAR 1:190, Sections 1(6), 1(8), 2(1)).
Under that program, an applicant cleared on the registries may work provisionally for up to 60 days from fingerprinting, but may not have routine unsupervised contact with clients during that time (906 KAR 1:190, Section 6).

Training and competency

Before giving direct services, each personal services agency employee must be trained on reporting abuse, neglect, or exploitation, on the agency's medication self-administration procedures if staff help with medications, and on communication tailored to each client (906 KAR 1:180, Section 7(1)).
A personal services agency must evaluate each employee's competency on every task before the employee does it without direct supervision, and the training and evaluation must be documented, dated, signed, and kept for at least five years (906 KAR 1:180, Section 7(3)-(4)).
Direct-care staff who serve clients with signs of Alzheimer's disease or dementia must complete 6 hours of initial dementia training before serving them and 3 hours every year (906 KAR 1:180, Section 7(2); 902 KAR 20:081, Section 4(5)(b)).
Home health agencies must make sure each aide completes a training and competency evaluation program covering self-reliance, nutrition and meals, aging and illness, a clean environment, reporting changes, the health team, and ethics, confidentiality, and record keeping (902 KAR 20:081, Section 4(5)(a)).
Home health agency personnel policies must include plans for orientation and on-the-job training (902 KAR 20:081, Section 4(1)(d)).

Health screening

Before hire, personal services agency workers need a TB risk assessment by a physician, APRN, physician assistant, or registered nurse, followed by a skin test or blood test if at higher risk, and anyone who tests positive needs an evaluation and chest x-ray and cannot work with clients until cleared (906 KAR 1:180, Section 6(2)(e)).
Personal services agency managers and direct-care workers must have a TB risk assessment every year (906 KAR 1:180, Section 6(5)).
Home health agencies must have a plan for a pre-employment medical exam and a follow-up exam at least every three years for staff who serve patients in their homes (902 KAR 20:081, Section 4(1)(b)).
Home health agencies must provide annual tuberculin screening under 902 KAR 20:205 (902 KAR 20:081, Section 4(1)(c)).

Also in the personnel file

Personal services agencies must keep the results of every background check, registry check, drug test, and TB document in employee records (906 KAR 1:180, Section 6(6)).
Personal services agencies must keep employee records for at least five years (906 KAR 1:180, Section 6(7)).
A personal services agency or its employee may not serve as a client's guardian, power of attorney, or conservator (906 KAR 1:180, Section 6(8)).
For home health aides, a registered nurse or qualified practitioner must make a supervisory visit at least every two weeks when the patient gets skilled care, or at least every 60 days with the aide present when the patient gets aide services only (902 KAR 20:081, Section 4(4)(c)-(d)).
Home health agencies must do annual employee performance evaluations and keep job descriptions for each type of health worker (902 KAR 20:081, Section 4(1)(e)-(f)).

Common questions

What background checks do home care aides need in Kentucky?

Before a personal services agency worker gives direct services, the agency must complete a Kentucky criminal record check, a check of the nurse aide and home health aide abuse registry, a check of the caregiver misconduct registry, and a substance abuse test (906 KAR 1:180, Section 6(2)(a)-(d)).

How much training do home care aides need in Kentucky?

Before giving direct services, each personal services agency employee must be trained on reporting abuse, neglect, or exploitation, on the agency's medication self-administration procedures if staff help with medications, and on communication tailored to each client (906 KAR 1:180, Section 7(1)).

Do home care workers in Kentucky need a TB test?

Before hire, personal services agency workers need a TB risk assessment by a physician, APRN, physician assistant, or registered nurse, followed by a skin test or blood test if at higher risk, and anyone who tests positive needs an evaluation and chest x-ray and cannot work with clients until cleared (906 KAR 1:180, Section 6(2)(e)).

Which license does a home care agency need in Kentucky?

Home health agencies are licensed by the Cabinet for Health and Family Services under 902 KAR 20:081 (902 KAR 20:081).

Some rules for Kentucky weren't confirmed from an official source. Check with the state before relying on this page.

Sources

This page summarizes state licensing rules in plain words, with links to the rules themselves. It is not legal advice, rules change, and your license type decides what applies: check the linked source and your licensing agency. Medicare-certified home health agencies also follow 42 CFR 484.80. Checked October 2026.

More for Kentucky

Kentucky background check laws · Kentucky drug testing laws · Medicare home health aide rules · All states

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