Money Follows the Person: Kentucky Transitions Program for Nursing Home Residents

What Money Follows the Person Means in Kentucky

Money Follows the Person (MFP) is a federal demonstration grant that helps Medicaid beneficiaries living in nursing homes transition back into the community — their own home, a family member's home, or a small community-based residence. The core idea is that Medicaid dollars should follow the person to wherever they can safely live, rather than locking funding into institutional beds.

In Kentucky, MFP operates under the name Kentucky Transitions. The program is administered by the Department for Medicaid Services (DMS) and coordinated through local Aging and Disability Resource Centers (ADRCs) at each Area Agency on Aging.

The practical effect: if your parent meets Kentucky Transitions' eligibility rules — including the 60-day institutional stay and Medicaid-paid services requirement — the program provides a transition coordinator to help make a plan for a safe move into the community.

Eligibility Requirements

To qualify for Kentucky Transitions, your parent must meet all of these criteria:

• Medicaid eligibility and payment — they must meet existing Medicaid eligibility requirements and be receiving Medicaid-paid services at least one day before referral
• Minimum 60 days in a nursing facility — the institutional stay must be at least 60 days, subject to program exclusions that a transition coordinator can explain
• Community ability — they must be able to live in the community with support and services
• Voluntary participation — the resident must consent to the transition; no one can be forced out of a nursing home through this program

The 60-day requirement is an eligibility threshold, not a guarantee of acceptance. Ask the transition coordinator how exclusions and qualifying days apply to your parent's stay.

What the Program Covers

Kentucky Transitions helps build a person-centered transition plan and connects the resident with state and community resources. Once living in the community, an eligible participant may receive services through Kentucky Medicaid's HCB, Acquired Brain Injury Long-Term Care, or Supports for Community Living waiver, depending on eligibility and the approved plan:

• Transition coordination — a designated coordinator helps assess medical, personal-care, and social needs and build the transition plan
• Home safety and accessibility — the coordinator helps identify safe housing and available accessibility supports or modifications
• Community services — the approved waiver and person-centered plan determine which Medicaid-funded services and supports are available after the move

Coverage after the move depends on the applicable Medicaid waiver and person-centered plan; Kentucky Transitions does not create an automatic 365-day HCB period.

How to Start the Process

The transition process begins inside the nursing home. Here is the sequence:

1. Talk to the facility social worker — tell them your parent wants to explore community transition and ask about Kentucky Transitions, community options, and the information needed for a referral.
2. Contact your local ADRC — the Aging and Disability Resource Center at your parent's Area Agency on Aging is the intake point. They will assign a transition coordinator.
3. Housing assessment — the coordinator evaluates whether your parent's prior home (or a new residence) can be made safe with modifications. If no suitable housing exists, they help identify options.
4. Care plan development — the coordinator works with the nursing facility, the parent's care team, and family members to build a community care plan that addresses the parent's medical, personal-care, and social needs.
5. Transition day — the coordinator oversees the physical move, confirms that equipment and supplies are in place, and schedules the post-transition follow-up visits.

When It Does Not Work

Kentucky Transitions is not appropriate for every nursing home resident. The coordinator must determine whether the parent's care needs can be met safely in the community with available supports; complex skilled needs may require additional planning or may make a transition unsafe. The program also does not cover room and board costs in an assisted living community.

Families sometimes confuse MFP with the standard HCB waiver. The key difference: the HCB waiver is a separate program for eligible community-based services, while MFP/Kentucky Transitions helps current institutional residents plan a move and connect with applicable waiver services. Do not assume enrollment in one automatically guarantees enrollment in the other.

If your parent is still living at home and you are weighing whether they need facility care at all, the Choosing Care in Kentucky guide covers the full spectrum of care settings — home care, assisted living, personal care homes, and nursing facilities — with Kentucky-specific licensing rules, cost comparisons, and Medicaid eligibility thresholds.

See more Kentucky guides →