Personal care homes in Georgia have come under close scrutiny in the last year. For the second time in a little over a year, the Department of Community Health is considering changes to the state rules and regulations for personal care homes, in addition to failed attempts by the legislature to undertake a major overhaul of facilities.
In December 2009, DCH made revisions to the Rules and Regulations for Personal Care Homes ("PCHs"), including moving the rules from § 290 to § 111, and establishing basic standards for memory care services provided by PCHs qualifying as "specialized memory care units." Full compliance with the rule changes were required by March 9, 2010.
Not long after, the legislature sought to enact HB 850 which, in attempting to establish "assisted living facilities," was championed to "bridge the gap" between nursing homes and personal care homes. Under the bill, a personal care home could seek licensure as an assisted living community, provide additional services, including nursing and other health services, and thereby allow residents to "age in place." Although passing through the House's Health and Human Services Committee, HB 850 failed to make it to the House floor, dying on crossover day.
With its revisions in December 2009, the Department of Community Health alluded to a potential overhaul of the Personal Care Home Rules and Regulations. Almost a year later, on November 19, 2010, the Department announced a public hearing set for December 29, 2010. There, the Department will present proposed rule changes to Ga. Admin. Comp. Ch. 111-8-62, up for possible final adoption on January 13, 2010. Under the proposal, the Department seeks to split personal care homes into one of two categories: (1) "Adult Family Care Homes," and (2) "Assisted Living Residences."
Under the proposal, an "Adult Family Care Home" is a personal care home with two to six residents where the owner lives in the facility. The more common facility is likely to be the proposed "Assisted Living Residences" (ALR's), facilities which serve seven or more residents or do not serve as the residence of the owner.
Like current personal care homes, the new homes would prohibit the admission of residents who require continuous medical or nursing care, who are bedbound, or who are incapable of self-preservation in an emergency. However, if a resident following admission becomes no longer able to meet the requirements, the resident will be allowed to remain as long as certain conditions are met. Specifically, a resident may chose a "proxy care giver," or unlicensed person to provide "health maintenance activities" (certain health care services that, but for the disability, a resident could reasonably be expected to do for himself). Should the resident fall below admission requirements, he or she will be allowed to stay in the facility provided "continuous medical services or 24-hour nursing care and treatment" is not required, and so long as the proxy care giver is always available to ensure timely and safe emergency evacuation. Although the proxy is chosen by the resident, is unlicensed, and can be the resident's family member, the facility provides training and oversight.
Finally, under the proposed rules, a PCH will be permitted to provide greater assistance with medications than currently allowed, including employing licensed nurses to administer medications, and unlicensed proxy care givers to administer medications to non-cognitive residents.