What is the difference between an ALC and an ALC-BH license in Kentucky?
A Kentucky ALC (social-model assisted living community) provides help with daily activities, meals, activities and assistance with self-administered medication but not basic health services; an ALC-BH may also provide basic health and health-related services, including monitoring health needs, storing and controlling medications and administering medications.
Both are licensed by OIG under 902 KAR 20:480 and neither has a secured dementia unit (that requires ALC-DC). The distinction is mostly about medications and nursing tasks: an ALC-BH and ALC-DC must have a nurse readily available whenever unlicensed staff perform delegated nursing tasks, and may use certified medication aides to give oral and topical medications and preloaded insulin.
Which Louisville residents need an ALC-BH instead of an ALC?
A resident who needs staff to give medications rather than just remind or hand them over (insulin, eye drops, nebulizer treatments, crushed or mixed doses) or who needs regular health monitoring should look at ALC-BH or ALC-DC licenses, because a social-model ALC is barred from those tasks by KRS 194A.700(4)(e).
People who manage their own medications from a pharmacy blister pack, need help mainly with bathing, dressing and meals, and want a more residential, less clinical setting can do well in a social-model ALC, which is often a smaller building. In Kentucky, a resident may also hire outside licensed providers, such as a home health nurse, if the community's written policy allows it.
How many ALC and ALC-BH licenses are there in the Louisville area?
OIG's October 2026 directory lists 21 social-model ALC licenses and 27 ALC-BH licenses in the seven Louisville-area counties, alongside 28 ALC-DC dementia care licenses.
Use the license-type filter on our assisted living roster to see only ALC-BH licenses, then sort by units to separate large campuses from small buildings.
Can a resident move from an ALC to an ALC-BH as needs change?
Only by moving to a building that holds an ALC-BH or ALC-DC license, unless the same address already carries one; an ALC license cannot simply start administering medications, so a change in medication needs can trigger a written move-out notice.
Ask any ALC what it does when a resident starts needing medication administration, and whether it partners with a home health agency in the meantime. Kentucky requires the community to help a resident who receives a move-out notice find an appropriate new home (KRS 194A.705(5)).
At a glance
| An ALC-BH may | A social-model ALC may not | |
|---|---|---|
| Medications | Administer medications through certified medication aides under a nurse | Do more than assist with self-administered medication |
| Health | Monitor and provide for residents' health care needs | Monitor health as a service |
| Medication storage | Store and control medications | Hold medications except as the resident requests |
| Dementia unit | Not operate a secured unit (needs ALC-DC) | Operate a secured unit |
Sources include KRS Chapter 194A, 902 KAR 20:480, Kentucky CHFS and DMS pages, CareScout and VA rate tables as cited above; see our editorial standards.
