Proposed New Rules to Add Long-Term Care Safety Requirements in Georgia

The Georgia Department of Community Health (“DCH”) board recently introduced proposed updates to long-term care facility standards, impacting background check requirements, care models for at-risk youth, and staffing guidelines for personal care homes, assisted living communities, and memory care centers.

Expanded Background Checks and Youth Care Models

The proposed updates include adding adult residential mental health programs to the list of facilities subject to Georgia’s long-term care (“LTC”) background check requirements. These changes would require staff in these programs to undergo background checks consistent with other LTC facilities.

Additionally, the DCH board approved for final adoption a state plan amendment to incorporate therapeutic care models (“TCMs”) into the Medicaid plan. TCMs are multidisciplinary programs designed to reduce residential treatment for vulnerable youth by providing community-based care.

Alignment With House Bill 1335: Revised Staffing Requirements

In alignment with House Bill 1335, which became effective July 1, 2024, the DCH board has proposed rule updates to revise staffing requirements for personal care homes, assisted living communities, and memory care centers.

Key provisions include:

• Minimum Staffing Levels: Facilities with 25 or more beds would be required to have at least two on-site administrators or direct care staff members present at all times.
• Floor-Specific Staffing: At least one staff member would be required on each occupied floor to provide immediate assistance and oversight.
• Flexibility With Medical Alert Systems: Staff assigned to specific floors would be permitted to move throughout the premises if the facility is equipped with a medical alert system.

Analysis: Potential Impact on Georgia’s Long-Term Care Sector

These regulatory updates stem from ongoing legislative actions designed to address long-term care safety. They follow earlier legislation, HB 987, known as the “Disabled Adults and Elder Persons Protection Act,” which was introduced after the Atlanta Journal-Constitution’s 2019 “Unprotected” investigative series raised concerns about safety and care standards in Georgia’s long-term care facilities.

Notably, the introduction of TCMs aligns with a national trend in healthcare toward community-based interventions. This amendment to the state plan may influence how residential treatment is utilized in Georgia and could impact funding allocations within the state’s Medicaid system.

Finally, the revised staffing requirements establish minimum levels for on-site administrators and direct care staff, which could influence facility staffing models and budgets. If approved, facilities, particularly those with 25 or more beds, may need to reassess their staffing strategies to comply with the new regulations.

Next Steps and Public Feedback

The DCH board is accepting public feedback on the proposed updates, with comments due by March 7, 2025. Stakeholders, including facility operators, healthcare professionals, and residents’ families, are encouraged to provide input.

For additional information, please contact AGG Change of Ownership (“CHOW”) team attorneys Hedy Rubinger and Grace Gluck.

The Arnall Golden Gregory CHOW team leads all regulatory aspects of healthcare transactions for investors, operators, managers, capital partners, and developers of every size in all 50 states. The team streamlines the regulatory process so that clients close their transactions on or ahead of schedule. Whether obtaining licensure and Medicare/Medicaid approvals, structuring transactions to expedite closings, anticipating issues to minimize cash flow disruption, negotiating regulatory terms in deal documents, creatively resolving diligence issues, or advising on CHOW guidelines and compliance, the team provides extensive experience and practical solutions. To date, the CHOW team has served as primary regulatory counsel in transactions valued at more than $35 billion.