Kansas home care administrator and manager requirements

"Each home health agency shall have a governing body having legal authority to operate the home health agency." (K.A.R. 28-51-103(a)) For a one-owner LLC, by our reading, the governing body is the owner or owners. The rule gives it six duties:

1. "Have bylaws or an operating agreement, which shall be renewed annually". KDHE asks for a complete copy, dated and signed, with the six duties written into it (K.A.R. 28-51-103(a)(1)).
2. "employ a qualified administrator and alternate administrator" ((a)(2)).
3. Adopt, revise and approve the agency’s policies and procedures as needed ((a)(3)). KDHE wants it to be clear that submitted policies have been approved by the governing board and are enacted (KDHE Instruction Guide, Additional Help).
4. Give KDHE the name and address of each officer, director and owner ((a)(4)).
5. Disclose each corporate ownership interest of five percent or more ((a)(5)).
6. Disclose past home health agency ownership or management, with the agency’s name, location and current status ((a)(6)).

The administrator is then "an individual who is appointed by the governing body and is directly responsible for the management and day-to-day operations of a home health agency" (K.A.R. 28-51-100(a)). KDHE adds: "The Administrator must be “appointed” by the Governing Body, and this must be in writing." (KDHE Instruction Guide, Administrators)

K.A.R. 28-51-103(b)(1) gives every administrator at least these responsibilities (K.A.R. 28-51-103(b)(1)):

1. "Organize and direct the home health agency’s ongoing functions".
2. Act as a liaison between the governing body and staff.
3. Employ qualified personnel in accordance with job descriptions.
4. "provide written personnel policies and procedures and job descriptions that are made available to all employees" ((b)(1)(D)).
5. Maintain personnel records, administrative records and all the agency’s policies and procedures.
6. "provide orientation for new staff, regularly scheduled in-service education programs, and opportunities for continuing education of the staff" ((b)(1)(F)).
7. Ensure the reports and records KDHE requires are completed, kept and sent.
8. Ensure every client receives the clients’ bill of rights in writing ((b)(1)(H)).

Where KDHE wants them written. "The Administrator and the Alternate Administrator shall have the following responsibilities documented in the job description and either in agency policy or in the appointment letter from the Governing Body" (KDHE Instruction Guide, Governing Body). "Please note that these are minimum responsibilities of the Administrators. Additional responsibilities may be listed in the Job Description if the agency desires." (Administrators (3))

A reporting duty that names the agency head. Kansas’s adult abuse reporting law lists "the chief administrative officer of a licensed home health agency" among the people who must report suspected abuse, neglect or financial exploitation of an adult to DCF (K.S.A. 39-1431(a)(1)(Q)). By our reading that is the administrator, or the alternate while covering.

• All three parts. The rule joins age, experience and education with "and", so by our reading a course certificate replaces a degree but not the year of experience.
• The course. "Relias Academy has created a KDHE-approved Kansas Home Health Administrator training"; KDHE says other courses may be used, but encourages getting its pre-approval before enrolling (KDHE, Training Opportunities).
• "Related health care service" is not defined. The rules do not say what experience counts outside a home health agency. Describe the work, and ask KDHE before you appoint someone whose year was elsewhere.
• A license does not widen what you may do. A nurse or therapist can be your administrator, but the agency still provides no nursing services (K.A.R. 28-51-105(e)).

Drafted, not in force. KDHE’s draft rewrite would raise the bar. For supportive care: at least 21, one year of supervisory experience in personal care as an HHA employee, plus an undergraduate degree in health care services, any undergraduate degree with two years delivering personal care, or home health aide certification with one year of personal care and a KDHE-approved administrator course. KDHE said current administrators keep their eligibility while they stay in the same post with the same agency. (KDHE Summary of Changes, 2025). No official text has been published for comment; see the rule rewrite status.

"The administrator shall reside within the service area." (K.A.R. 28-51-103(b)(2)) The service area is "a geographic region within a 200-mile radius of a home health agency’s parent office" (K.A.R. 28-51-100(vv)). KDHE asks for evidence that the administrator and the alternate each live within a 200-mile radius of the parent office (KDHE Instruction Guide, Governing Body (6)-(7)).

The Kansas border. In its April 2026 answers to providers, KDHE said: "The current regulations require that the administrator and alternate administrator live within the service area, which is a 200-mile radius from the parent office." It added that the service area is also defined by the Kansas borders (KDHE Questions and Feedback, p. 16). The rule text itself does not mention the border, so treat this as KDHE’s reading: plan on an administrator and alternate who live in Kansas.

Drafted, not in force. KDHE’s draft rewrite would let an administrator live outside Kansas in a neighboring county of another state, within 60 minutes of the parent office. Not published or in force. (KDHE Questions and Feedback, p. 16)

KDHE does not list which documents it accepts as evidence of where someone lives. By our reading, a current document showing the home address, such as a driver’s license, lease or utility bill, with account numbers covered, should do.

"An alternate administrator shall be available at any time the administrator is not available and be responsible for all duties of the administrator in the administrator’s absence." (K.A.R. 28-51-103(c)) The applicant attests: "I will appoint and utilize an administrator and an alternate administrator (a person designated to act in the absence of the administrator) who meet the requirements of the Kansas Administrative Regulations" (Attestation Form, p. 1).

• Who appoints the alternate. KDHE says: "The Governing body may appoint the Alternate or simply selected by the Administrator. You must send evidence of each of these appointments." (KDHE Instruction Guide, Administrators)
• Two different people. The rules do not say so in words, but an alternate who covers when the administrator is unavailable cannot be the administrator, by our reading.
• A real backup. The alternate takes over all duties in the administrator’s absence. Choose someone who can step in at short notice, knows the policies and lives within the service area too.

The rules define a manager as an employee of a supportive care agency who "provides supervision and is available to supportive care workers for consultation at all times that supportive care services are provided" and "has at least one year of experience providing home health services, HCBS, or supportive care services" (K.A.R. 28-51-100(aa)). No degree, license or course is set. KDHE’s letter says "Training and supervision are required, and supervision and oversight are provided by the Supervisor or Manager." (Letter of Introduction, Option 2)

Most of the client-facing duties a registered nurse would hold in other states sit with the manager in Kansas:

On call. The agency provides "a manager, who shall be on-call to assist staff providing supportive care services for clients" (K.A.R. 28-51-104(c)(3)(J)), and the rules define on-call as "being available for consultation to the staff whenever home health services, HCBS, or supportive care services are provided" (K.A.R. 28-51-100(gg)). Separately, the agency must "employ a manager who is available to a supportive care worker for questions at all times" (K.A.R. 28-51-117(e)(1)). KDHE asks for "A Policy for On-Call" (Provision of Services (7)).

Not settled: whether "at all times" means 24 hours a day or only while services are being provided, and whether trained office staff may take calls for the manager. The rules do not say. By our reading, if caregivers work evenings or weekends, a qualified manager must be reachable then. KDHE’s draft would specify "specified on-call support requiring a manager to be available at all times and on-call after business hours" (Summary of Changes, 2025), which is not in force.

Supervisory visits. The agency provides "a visit by the manager to each client every three months to provide supervision to each supportive care worker" (K.A.R. 28-51-104(c)(3)(K)), and on-site supervision of each caregiver at least every three months, including an assessment of client satisfaction and the caregiver’s adherence to the plan of care (K.A.R. 28-51-117(e)(2)). The date of each visit goes in the client record (K.A.R. 28-51-110(c)(7)). KDHE says its draft keeps this frequency: "The proposed regulations did not change the frequency for supervisory visits of supportive care workers, which remain at 90 days." (KDHE Questions and Feedback, p. 69)

Not settled: whether "on-site supervision" means watching the caregiver give care, or whether a home visit with the client’s feedback and a record review is enough, and whether every caregiver who serves a client must be seen at that client’s visit. KDHE’s personnel folder asks for supervisory visit records in each file (KDHE Instruction Guide, Personnel Records), so by our reading, plan visits when a caregiver is there.

CareRulebook’s manual keeps a qualified manager on call 24 hours a day with a named backup (Policy 4.7) and tracks a visit for every client and every caregiver at least every three months (Policy 4.10). The 24-hour cover and the tracker are the manual’s choices.

Supportive care services are, by statute, services that "do not require supervision by a healthcare professional, such as a physician assistant or registered nurse" (K.S.A. 65-5101(k)). The rule goes further: "A person that applies for a license to provide only supportive care services shall not provide nursing services." (K.A.R. 28-51-105(e)) And KDHE’s attestation says "Nursing services of any kind are prohibited with a Supportive Care Services license. This includes a nurse providing supervisory, assignment, delegation, oversight, medication administration/set-up, wound care", treatments or assessments (Attestation Form, p. 2).

So the manager supervises the caregivers, not a nurse. If you want nursing, Medicaid waiver work or Veterans Affairs clients, you need the Skilled Services license instead (Letter of Introduction; Option 2), where a registered nurse is available or on call during all hours home health services are provided (K.A.R. 28-51-104(c)(1)(J)).

Not settled: whether someone who holds a nursing license may work as your manager or a caregiver if they never use nursing skills. The rules and KDHE’s forms do not say. Ask KDHE in writing before you hire on that basis.

A new agency may start with only two or three people. What the sources say and do not say:

• Administrator and alternate: two people. The alternate covers when the administrator is unavailable, so by our reading they cannot be the same person, and both must meet the full qualifications.
• Administrator and manager: not addressed. No rule we found stops the administrator or the alternate from also being the manager. KDHE asks for separate job descriptions for each post (Personnel Policies (1)-(3)). If one person holds two posts, they must meet both posts’ qualifications, and the chart and job descriptions should say so.
• A manager who also gives care is a supportive care worker for those visits, by our reading, with the same checks, competency and training (Kansas background checks).
• Someone has to cover the manager. A manager must be available whenever services are provided. If you have only one manager, decide who takes calls when they are ill or on leave, and make sure that person meets the manager definition.