Kentucky Personal Care Home and Assisted Living Pre-Admission Exam: What KRS 216.765 Requires

What the Law Requires

KRS 216.765(1) applies to admission to a Kentucky personal-care home or assisted living community. Before admission, an individual must have a medical examination that includes a medical history, physical examination, and diagnosis. If completed within fourteen (14) days before admission, the evaluation may include a copy of the individual's discharge summary or health and physical report from a physician, hospital, or other health care facility.

This is a pre-admission requirement. KRS 216.765 does not create a 30-day-before or 48-hour-after window, and this subsection does not limit the examination to an MD or DO. Confirm the receiving facility's documentation requirements before scheduling.

What the Exam Covers

The required evaluation must include a medical history, physical examination, and diagnosis. For the facility's admission assessment and initial care plan, the facility may also request:

• Current diagnoses — every active medical condition, including chronic conditions that may not be the primary reason for admission
• Medication list — all current prescriptions, dosages, and administration schedules
• Functional status — the patient's ability to perform activities of daily living (eating, bathing, dressing, toileting, transferring, mobility)
• Cognitive status — any dementia diagnosis, behavioral health conditions, or cognitive impairment
• Communicable disease screening — tuberculosis testing is standard; the facility may require additional screening depending on the patient population
• Dietary needs — allergies, texture modifications (pureed, mechanical soft), and any nutritional supplements
• Treatment orders — ongoing therapies, wound care protocols, IV access, oxygen requirements

The exam results feed directly into the facility's admission assessment and the initial nursing care plan. Inaccurate or incomplete documentation creates a mismatch between what the facility plans for and what your parent actually needs.

How to Prepare

Because the examination must occur before admission, schedule it with enough time for the facility to review the documentation.

When scheduling, ask the physician's office specifically for a "KRS 216.765 medical examination" and tell them it must satisfy KRS 216.765. Bring:

• A complete medication list with pharmacy contact information
• Recent hospital discharge summaries (if any hospitalizations in the past year)
• Specialist reports for any conditions the PCP does not manage directly
• Vaccination records, particularly influenza, pneumococcal, and COVID-19
• Contact information for all family members involved in care decisions

If your parent is being admitted directly from a hospital stay, ask whether a discharge summary or health and physical report completed within fourteen (14) days before admission can be used as part of the evaluation under KRS 216.765(1). Confirm that the documentation is sent to the receiving facility before the transfer.

The Functional Needs Assessment

For an assisted living community, separately from the KRS 216.765 examination, KRS 194A.705(6) requires the community to complete a Functional Needs Assessment upon move-in and at least once every 12 months thereafter. This assessment evaluates the resident's ongoing care needs in more detail than the medical examination.

The functional assessment determines the resident's care tier, which affects monthly costs in facilities that use tiered pricing. A higher care tier means more staff time and higher monthly charges. Families should ask to see the functional assessment results and understand how the care tier was assigned — and request a reassessment if the resident's needs change.

What Happens Without the Exam

If a facility admits your parent without a completed pre-admission exam, it is operating out of compliance with Kentucky licensing requirements. During an OIG inspection, this would be cited as a deficiency. For families, the practical risk is that the facility builds a care plan on incomplete clinical information, which can lead to medication errors, missed diagnoses, or inappropriate care settings.

If you are comparing facilities and one does not mention the pre-admission physical during the admissions process, that is a red flag. A well-run facility will walk you through the exam requirement, provide the documentation forms, and coordinate with your parent's physician.

The Choosing Care in Kentucky guide includes a pre-admission medical exam preparation checklist with everything the physician needs to document, plus communication templates to send to the physician's office ahead of the appointment.

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