{"data":{"id":"us-ky/krs-216b.457","jurisdiction":"us-ky","citation":"KRS 216B.457","heading":"Certificate -of-need requirement for Level II psychiatric residential","body":"treatment facilities -- Beds and locations permitted -- Contents of certificate\napplication -- Criteria -- Staffing requirements -- Criminal records check --\nTreatment plan -- Duties of Level II facility -- Administrative regulations --\nAnnual report.\n(1) A certificate of need shall be required for all Level II psychiatric residential\ntreatment facilities. The need criteria for the establishment of Level II psychiatric\nresidential treatment facilities shall be in the state health plan.\n(2) An application for a certificate of need for Level II psychiatric residential treatment\nfacilities shall not exceed fifty (50) beds. Level II facility beds may be located in a\nseparate part of a psychiatric hospital, a separate part of an acute care hospital, or a\nLevel I psychiatric residential treatment facility if the Level II beds are located on a\nseparate floor, in a separate wing, or in a separate building. A Level II facility shall\nnot refuse to admit a patient who meets the medical necessity criteria and facility\ncriteria for Level II facility services. Nothing in this section and KRS 216B.450 and\n216B.455 shall be interpreted to prevent a psychiatric residential treatment facility\nfrom operating both a Level I psychiatric residential treatment facility and a Level\nII psychiatric residential treatment facility.\n(3) The application for a Level II psychiatric residential treatment facility certificate of\nneed shall include formal written agreements of cooperation that identify the nature\nand extent of the proposed working relationship between the proposed Level II\npsychiatric residential treatment facility and each of the following agencies,\norganizations, or entities located in the service area of the proposed facility:\n(a) Regional interagency council for children with emotional disability or severe\nemotional disability created under KRS 200.509;\n(b) Community board for mental health or individuals with an intellectual\ndisability established under KRS 210.380;\n(c) Department for Community Based Services;\n(d) Local school districts;\n(e) At least one (1) psychiatric hospital; and\n(f) Any other agency, organization, or entity deemed appropriate by the cabinet.\n(4) The application for a certificate of need shall include:\n(a) The specific number of beds proposed for each age group and the specific,\nspecialized program to be offered;\n(b) An inventory of current services in the proposed service area; and\n(c) Clear admission and discharge criteria, including age, sex, and other\nlimitations.\n(5) All Level II psychiatric residential treatment facilities shall comply with the\nlicensure requirements as set forth in KRS 216B.105.\n(6) All Level II psychiatric residential treatment facilities shall be certified by the Joint\nCommission, the Council on Accreditation of Services for Families and Children,\nor any other accrediting body with comparable s tandards that are recognized by the\nCenters for Medicare and Medicaid Services.\n(7) A Level II psychiatric residential treatment facility shall be under the clinical\nsupervision of a qualified mental health professional with training or experience in\nmental health treatment of children and youth.\n(8) Treatment services shall be provided by qualified mental health professionals or\nqualified mental health personnel. Individual staff who will provide educational\nprograms shall meet the employment standards out lined by the Kentucky Board of\nEducation and the Education Professional Standards Board.\n(9) A Level II psychiatric residential treatment facility shall meet the following\nrequirements with regard to professional staff:\n(a) A licensed psychiatrist, who is board-eligible or board -certified as a child or\nadult psychiatrist, shall be employed or contracted to meet the treatment needs\nof the residents and the functions that shall be performed by a psychiatrist;\n(b) If a Level II psychiatric residential treatment facility has residents ages twelve\n(12) and under, the licensed psychiatrist shall be a board -eligible or board -\ncertified child psychiatrist; and\n(c) The licensed psychiatrist shall be present in the facility to provide\nprofessional services to the facility's residents at least weekly.\n(10) A Level II psychiatric residential treatment facility shall:\n(a) Prepare a written staffing plan that is tailored to meet the needs of the specific\npopulation of children and youth that will be admitted to the facility  based on\nthe facility's admission criteria. The written staffing plan shall include but not\nbe limited to the following:\n1. Specification of the direct care per -patient staffing ratio that the facility\nshall adhere to during waking hours and during sleeping hours;\n2. Delineation of the number of direct care staff per patient, including the\ntypes of staff and the mix and qualifications of qualified mental health\nprofessionals and qualified mental health personnel, that shall provide\ndirect care and will comprise the facility's per-patient staffing ratio;\n3. Specification of appropriate qualifications for individuals included in the\nper-patient staffing ratio by job description, education, training, and\nexperience;\n4. Provision for ensuring compliance with it s written staffing plan, and\nspecification of the circumstances under which the facility may deviate\nfrom the per-patient staffing ratio due to patient emergencies, changes in\npatient acuity, or changes in patient census; and\n5. Provision for submission of  the written staffing plan to the cabinet for\napproval as part of the facility's application for initial licensure.\nNo initial license to operate as a Level II psychiatric residential treatment\nfacility shall be granted until the cabinet has approved the facility's written\nstaffing plan. Once a facility is licensed, it shall comply with its approved\nwritten staffing plan and, if the facility desires to change its approved per -\npatient staffing ratio, it shall submit a revised plan and have the plan approved\nby the cabinet prior to implementation of the change;\n(b) Require full -time professional and direct care staff to meet the continuing\neducation requirements of their profession or be provided with forty (40)\nhours per year of in-service training; and\n(c) Develop and implement a training plan for all staff that includes but is not\nlimited to the following:\n1. Behavior-management procedures and techniques;\n2. Physical-management procedures and techniques;\n3. First aid;\n4. Cardiopulmonary resuscitation;\n5.  Infection-control procedures;\n6. Child and adolescent growth and development;\n7. Training specific to the specialized nature of the facility;\n8. Emergency and safety procedures; and\n9. Detection and reporting of child abuse and neglect.\n(11) A Level II psychiatric residential treatment facility shall require a criminal records\ncheck to be completed on all employees and volunteers. The employment or\nvolunteer services of an individual shall be governed by KRS 17.165, with regard to\na criminal records check. A new criminal records check shall be completed at least\nevery two (2) years on each employee or volunteer.\n(12) (a) Any employee or volunteer who has committed or is charged with the\ncommission of a violent offense as specified in KRS 439.3401, a sex crime\nspecified in KRS 17.500, or a criminal offense against a victim who is a minor\nas specified in KRS 17.500 shall be immediately removed from contact with a\nchild within the residential treatment center until the employee or volunteer is\ncleared of the charge.\n(b) An employee or volunteer under indictment, legally charged with felonious\nconduct, or subject to a cabinet investigation shall be immediately removed\nfrom contact with a child.\n(c) The employee or volunteer shall not be allowed to work with the child until a\nprevention plan has been written and approved by the cabinet, the person is\ncleared of the charge, or a cabinet investigation reveals an unsubstantiated\nfinding, if the char ge resulted from an allegation of child abuse, neglect, or\nexploitation.\n(d) Each employee or volunteer shall submit to a check of the central registry. An\nindividual listed on the central registry shall not be a volunteer at or be\nemployed by a Level II psychiatric residential treatment facility.\n(e) Any employee or volunteer removed from contact with a child pursuant to this\nsubsection may, at the discretion of the employer, be terminated, reassigned to\na position involving no contact with a child, or pla ced on administrative leave\nwith pay during the pendency of the investigation or proceeding.\n(13) An initial treatment plan of care shall be developed and implemented for each\nresident, and the plan of care shall be based on initial history and ongoing\nassessment of the resident's needs and strengths, with an emphasis on active\ntreatment, transition planning, and after -care services, and shall be completed\nwithin seventy-two (72) hours of admission.\n(14) A comprehensive treatment plan of care shall be devel oped and implemented for\neach resident, and the plan of care shall be based on initial history and ongoing\nassessment of the resident's needs and strengths, with an emphasis on active\ntreatment, transition planning, and after -care services, and shall be co mpleted\nwithin ten (10) calendar days of admission.\n(15) A review of the treatment plan of care shall occur at least every thirty (30) days\nfollowing the first ten (10) days of treatment and shall include the following\ndocumentation:\n(a) Dated signatures o f appropriate staff, parent, guardian, legal custodian, or\nconservator;\n(b) An assessment of progress toward each treatment goal and objective with\nrevisions as indicated; and\n(c) A statement of justification for the level of services needed, including\nsuitability for treatment in a less -restrictive environment and continued\nservices.\n(16) A Level II psychiatric residential treatment facility shall provide or arrange for the\nprovision of qualified dental, medical, nursing, and pharmaceutical care for\nresidents. The resident's parent, guardian, legal custodian, or conservator may\nchoose a professional for nonemergency services.\n(17) A Level II psychiatric residential treatment facility shall ensure that opportunities\nare provided for recreational activities that are appropriate and adapted to the needs,\ninterests, and ages of the residents.\n(18) A Level II psychiatric residential treatment facility shall assist residents in the\nindependent exercise of health, hygiene, and grooming practices.\n(19) A Level II ps ychiatric residential treatment facility shall assist each resident in\nsecuring an adequate allowance of personally owned, individualized, clean, and\nseasonal clothes that are the correct size.\n(20) A Level II psychiatric residential treatment facility sha ll assist, educate, and\nencourage each resident in the use of dental, physical, or prosthetic appliances or\ndevices and visual or hearing aids.\n(21) The cabinet shall promulgate administrative regulations that include but are not\nlimited to the following:\n(a) Establishing requirements for tuberculosis skin testing for staff of a Level II\npsychiatric residential treatment facility;\n(b) Ensuring that accurate, timely, and complete resident assessments are\nconducted for each resident of a Level II psychiatric residential treatment\nfacility;\n(c) Ensuring that accurate, timely, and complete documentation of the\nimplementation of a resident's treatment plan of care occurs for each resident\nof a Level II psychiatric residential treatment facility;\n(d) Ensuring that  an accurate, timely, and complete individual record is\nmaintained for each resident of a Level II psychiatric residential treatment\nfacility;\n(e) Ensuring that an accurate, timely, and complete physical examination is\nconducted for each resident of a Level II psychiatric residential treatment\nfacility;\n(f) Ensuring accurate, timely, and complete access to emergency services is\navailable for each res ident of a Level II psychiatric residential treatment\nfacility; and\n(g) Ensuring that there is accurate, timely, and complete administration of\nmedications for each resident of a Level II psychiatric residential treatment\nfacility.\n(22) The cabinet shall, within ninety (90) days of July 15, 2010, promulgate\nadministrative regulations in accordance with KRS Chapter 13A to implement this\nsection and KRS 216B.450 and 216B.455. When promulgating the administrative\nregulations, the cabinet shall not consider onl y staffing ratios when evaluating the\nwritten staffing plan of an applicant, but shall consider the applicant's overall ability\nto provide for the needs of patients.\n(23) The cabinet shall report, no later than August 1 of each year, to the Interim Joint\nCommittee on Health Services regarding the implementation of this section and\nKRS 216B.450 and 216B.455. The report shall include but not be limited to\ninformation relating to resident outcomes, such as lengths of stay in the facility,\nlocations residents w ere discharged to, and whether residents were readmitted to a\nLevel II psychiatric residential treatment facility within a twelve (12) month period.","path":["KRS Chapter 216B"],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=53704","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:52:24Z","sha256":"95520707a59d80646556e3a31ae05a3f0c1069cecf45c28e116721723da5efc9","source_id":"us-ky","stale":false,"prev":"us-ky/krs-216b.455","next":"us-ky/krs-216b.459"},"notice":"GroundRules: Original legal text. Not legal advice."}