Assisted Living in Georgia

Agency: Georgia Department of Community Health, Healthcare Facility Regulation Division
Phone: (404) 657-4076
Website: www.dch.ga.gov

Personal care homes provide housing, food services, and one or more personal services, including supervision of self-administered medication; assistance with ambulation and transfers; and essential activities of daily living (ADLs) such as eating, bathing, grooming, dressing, and toileting.

Facility Scope of Care:
The personal services provided by the homes must include 24- hour responsibility for the well-being of the residents and protective care and watchful oversight.

Move-In/Move-Out Requirements:
Residents must be ambulatory and may not require the use of physical or chemical restraints, isolation, or confinement for behavioral control. Residents must not be bedridden or require continuous medical or nursing care and treatment.

Resident Assessment:
There is no regulatory requirement for a specific resident assessment form. A sample physician's report form is available at the agency Web site under Long Term Care Programs, Personal Care Homes. The new Additional Requirements for Specialized Memory Care Units or Homes specify that a physical examination completed within 30 days prior to admission must be provided to the facility and must clearly reflect that the resident has a diagnosis of probable Alzheimer's disease or other dementia and has symptoms that demonstrate a need for placement in the specialized unit. In addition, there is a postadmission assessment requirement that addresses family supports, ADLs, physical care needs, and behavior impairment

Medication Management:
All medications must be self-administered by the resident except when the resident requires administration of oral or topical medication by or under the supervision of a functionally literate staff person. There are, however, two exceptions. Staff may administer epinephrine and insulin under established medical protocols. Further, licensed nursing staff of a specialized memory care unit or home may administer medications to residents who are incapable of self-administration of medications

Physical Plant Requirements:
Private and shared resident units must provide a minimum of 80 square feet per resident. There are additional physical plant requirements for a specialized memory care unit or home including secured outdoor spaces, high visual contrasts between floors and walls and doorways and walls, individually identified entrances to residents' rooms, and an effective automated device or system to alert staff to individuals entering or exiting the building in an unauthorized manner.

Residents Allowed Per Room:
A maximum of four residents is allowed per resident unit. In specialized memory care units or homes, a maximum of two residents is allowed per room.

Life Safety:
Personal care homes licensed for two to six beds must meet all local fire safety ordinances. Facilities licensed for seven or more beds must comply with state fire safety regulations. Sprinkler systems are required in all homes with seven or more beds and in areas where local ordinances require such systems. All personal care homes, regardless of size, must have sufficient smoke detectors that are hard wired into the building's electrical system with a battery back up. Georgia has adopted the 2000 edition of the National Fire Protection Association (NFPA) 101 Life Safety Code.

Alzheimer's Unit Requirements:
New rules for Specialized Memory Care Units or Homes include requirements concerning disclosure of information; physical design, environment, and safety; staffing and initial staff orientation; initial staff training; special admission requirements for unit placement, post-admission assessment, individual service plans, and therapeutic activities. Facilities that serve residents who have cognitive deficits that may place them at risk for unsafe wandering behavior must have safety devices on doors and current pictures of residents on file, and train staff on elopement procedures.

Staff Training for Alzheimer's Care:
In addition to the requirements for all staff, staff in facilities that serve residents with cognitive deficits must develop and train staff on policies and procedures to deal with residents who may elope from the facility. Staff of a specialized memory care unit or home must also have training on the facility's philosophy of care for residents with dementia, common behavior problems, behavior management techniques, the nature of Alzheimer's disease and other dementias, communication skills, therapeutic interventions and activities, the role of the family, environmental modifications that create a more therapeutic environment, development of service plans, new developments in diagnosis and therapy, skills for recognizing physical or cognitive changes that warrant medical attention, and skills for maintaining resident safety.

Staffing Requirements:
At least one administrator, on-site manager, or responsible staff person, all of whom must be at least 21 years of age, must be on the premises 24 hours a day. There should be a minimum of one on-site staff person per 15 residents during awake hours and one staff person per 25 residents during sleeping hours. Additionally, there must be sufficient staff to meet residents' needs.

Staff Education Training:
All persons working in the facility must receive work-related training acceptable to the state Department of Community Health within the first 60 days of employment. Training is required in six areas: CPR, first aid, emergency procedures, medical and social needs and characteristics of the resident population, residents' rights, and the long term care resident abuse reporting act

Medicaid Policy and Reimbursements:
A Medicaid home and community-based services waiver reimburses two models of personal care homes.