Georgia House Bill 987 Proposes Increased Regulation of Assisted Living Communities and Personal Care Homes

The Georgia House of Representatives, Health and Human Services Committee, chaired by Representative Sharon Cooper, unanimously approved House Bill 987 on February 25, 2020 (“HB 987” or the “Bill”), proposing a number of new measures intended to increase protection for residents in assisted living communities and personal care homes.  The Bill, which would amend Title 31 of the Georgia Code (O.C.G.A.), is seen as a direct response to the Atlanta Journal-Constitution’s investigation into alleged deficient practices in some of Georgia’s senior care facilities.  The Bill now moves to the House Rules Committee.

The Bill in its current form proposes the following changes, among others:

• Fines: Increases the maximum fines for violations cited by the Department of Community Health (DCH) to up to $2,000 per day for each violation, and up to a total of $40,000. The Bill also imposes a mandatory fine of no less than $5,000 for a violation that has caused death or serious physical harm to a resident.
• Nursing Services: Provides for the provision of limited nursing services in assisted living communities. HB 987 defines “Limited nursing Services” to mean “the assessment of the physical, mental, and emotional status to determine the appropriate level of care for an individual; the performance of health maintenance activities, as [currently defined by statute]; and the provision of any nursing care within the direct care staff person’s scope of practice that can be completed within seven days or intermittently.”
• Staffing Requirements, Training, and Financial Stability Requirements:
  • Proposed Staffing Requirements
    • Personal care homes with 25 or more beds and assisted living communities are required to have a minimum on-site staffing ratio of one direct care staff person for every 15 residents during all waking hours, and one direct care staff person for every 20 residents during all non-waking hours.
    • A personal care home that operates a memory care center may employ certified medication aides (CMAs) for the purpose of performing the technical aspects of administration of certain medications. If a personal care home employs one or more CMAs, it must also secure the services of a licensed pharmacist to perform certain duties.
    • Assisted living communities must have at least two on-site direct care staff persons at all times.
    • Assisted living communities must have a registered professional nurse or licensed practical nurse on-site, as follows:
      • 1-30 residents: a minimum of eight hours per week
      • 31-60 residents: a minimum of 16 hours per week
      • 61-90 residents: a minimum of 24 hours per week
      • More than 90 residents: a minimum of 40 hours per week
  • Proposed Training Requirements: Each direct care staff person is required to receive initial and annual training covering topics specified by DCH to ensure a demonstrated knowledge and understanding of caring for elderly and disabled adults.
  • Proposed Financial Requirements:
    • Applicants for licensure would be required to provide a financial stability affidavit from a certified public accountant affirming the applicant’s ability to operate for two years.
    • Proposes a minimum of 60 days’ written notice to DCH and all residents of “any impending bankruptcy or property eviction that may force discharge or relocation of residents or otherwise adversely impact the provision of safe care and oversight.”
    • Proposes a minimum of 14 days’ advance written notice to the DCH and all residents of any change of ownership that may force discharge or relocation of residents or otherwise adversely impact the provision of safe care and oversight.
• Proposed Memory Care Requirements
  • Requires a certificate issued by DCH to operate a memory care center beginning July 1, 2021.
    • Proposed Staffing for Memory Care:
      • Minimum on-site staffing ratio of one direct care staff person for every 12 residents on-site at all times.
      • Two on-site direct care staff persons at all times.
      • One registered professional nurse, licensed practical nurse, or certified medication aide on-site at all times; and
      • One registered professional nurse or licensed practical nurse on-site or available in the building at all times as follows:
        • 1-12 residents: a minimum of eight hours per week
        • 13-30 residents: a minimum of 16 hours per week
        • 31-40 residents: a minimum of 24 hours per week
        • More than 40 residents: a minimum of 40 hours per week
    • Proposed Training: All staff, regardless of role, are required to have at least four hours of dementia-specific orientation within the first seven days of working in the center. All direct care staff personnel are required to receive initial orientation training prior to caring for residents independently; and are required complete a minimum of 16 hours of specialized training in dementia care prior to working independently with residents with Alzheimer’s or other dementias, and a minimum of eight hours of such specialized training in dementia care annually thereafter.

• Proposes a licensure requirement for assisted living community administrators and certain personal care home administrators effective July 1, 2021, within 60 days of the date of hire. The bill also changes the name of the State board of Nursing Home Administrators to the State Board of Long-Term Care Facility Administrators, and changes the composition of the board.
• Proposes that language be added to the “Disabled Adults and Elder Persons Protection Act“ to state that “No person shall discriminate or retaliate in any manner against: (1) Any person who makes a report pursuant to this chapter, who testifies in any judicial proceeding arising from the report, who provides protective services, who participates in an investigation, or who participates on an Adult Abuse, Neglect, and Exploitation Multidisciplinary Team under the provisions of this chapter; or (2) Any disabled adult or elder person who is the subject of a report.”

If the Bill passes, most changes will go into effect, July 1, 2021.  To track the progress of HB 987, please click here.