When a loved one can no longer live independently, an assisted living provider can be a good option. Assisted living residences are for residents who would like to maintain some independence. Still, they need help with meals, housekeeping, and some of the activities of daily living (ADLs), such as showering, getting dressed, or personal hygiene.

Assisted living in Georgia

Georgia’s Department of Community Health issues licenses to two types of care homes: assisted living communities and personal care homes. These communities are licensed to provide care, including personal services, medication administration (by a certified medical aide), and assisted self-preservation.

Difference Between Assisted Living and Personal Care Homes

An assisted living community in Georgia is a type of personal care home, so it’s important to differentiate the two. A personal care home provides or arranges housing, food, and personal services for two or more adults. Assisted living communities in Georgia are personal care homes that serve 25 or more persons. The personal services include assistance with ADLs (activities of daily living) and individual assistance or supervision of self-administration of medications.

A memory care unit is a specialized unit within a personal care home or assisted living community that provides personal services in a secure environment to persons diagnosed with Alzheimer’s or another form of dementia. Memory care provides additional oversight systems, programs, activities, and devices that are required for residents with issues with memory, language, thinking, reasoning, or impulse control which places the resident at risk of wandering outside the home.

Assisted Living Admission Restrictions

All prospective residents must be evaluated before move-in. This assessment must be conducted by a licensed physician, nurse practitioner, or physician’s assistant. The purpose of this assessment is to determine if the prospective resident is capable of transferring with minimal assistance and can participate in the facility’s social activities. If prospective residents require continuous medical or skilled nursing care services, they are not eligible to move into the facility.

Assisted Living Service Requirements

All assisted living facilities must provide the following services: They must provide personal services, assistance with self-preservation, and medication administration by a certified medication aide. As ALFs are also personal care homes, they must provide social activities to their residents.

If the ALF has a memory care unit, those units must provide specialized services for residents.  They must provide and adapt activities to the individual residents to participate in some therapeutic activities at least once a week. These activities include:

• Motor activities, such as dancing, exercise, gardening, and cooking.
• Activities of daily living (ADLs), such as dressing, personal hygiene, and grooming.
• Social activities, such as games and music.
• Sensory activities.

Each resident must have a written care plan that documents the resident’s functional capacity.  This plan must include information regarding the residents’ abilities regarding ADLs, any physical care needs, medical needs, cognitive or behavioral impairments, personal preferences related to their care, and whether or not there is familial support. Residents may hire a third party as a proxy caregiver to assist in the facility’s requirements.

Assisted Living Medication Provisions

Assisted living facility residents will fall under one of two medication situations: The resident will either be able to self-administer medications or the facility will provide medication administration.

To self-administer medication, the resident must have the cognitive and functional ability to do so. They can store and self-administer medications, but the communities must assist upon request.  

If the facility provides medication assistance, certified aides must be employed. These certified aides can perform the following tasks using only unit-dose or multi-dose packaging:

• Administer physician-ordered medications.
• Administer insulin, epinephrine, and B-12 per physicians’ orders and protocols.
• Administer medications via a metered dose inhaler.
• Conduct finger stick blood glucose testing.
• Administer a commercially prepared disposable enema ordered by a physician.

A licensed pharmacist must review each resident’s drug regimen quarterly and report any irregularities to community administration. They must remove any drugs that have expired or been discontinued and monitor compliance for proper handling and storage of medications.

Assisted Living Food Requirements

All ALFs must provide three meals, a nutritious snack, and health-care provider-ordered therapeutic diets to all residents daily.

Assisted Living Staffing Requirements

There are three types of staff designated for assisted living communities in Georgia. There must be a full-time administrator who is responsible for daily operations. When that administrator is absent, a house manager must be designated responsible for these operations.  Direct care staff assists with personal services (ADLs) but not health maintenance activities.  Certified medical aides may administer medications in assisted living communities.

Proxy caregivers are not permitted to administer medications but may assist residents with self-administrating them. These caregivers must possess the necessary skills and knowledge (through training) from a licensed health care professional to perform any health maintenance activities. The resident or their representative must also provide written consent before using a proxy caregiver.

Facilities must have adequate staffing to meet the needs of their residents. An administrator manager or responsible staff member must be on-site 24 hours a day. Minimum staff ratios must be 1:15 staff-to-resident during waking hours and 1:25 staff-to-resident during non-waking hours. If necessary, the facility must exceed these staffing levels in meeting its residents’ needs.

All staff, administrators, and managers must have a criminal history background check performed.

Assisted Living Staff Training Requirements

In the first 60 days of employment, all staff must have training on the following topics:

• Residents’ rights and identifying abuse, neglect, or exploitation of residents.
• Infection control principles, including hand hygiene and attendance policies when ill.
• Training to carry out assigned job duties.
• Emergency preparedness.
• Medical and social needs of the resident population, including the special needs of residents with dementia.
• Certification to provide emergency first-aid and CPR.
• Direct care staff and proxy caregivers must have training in health maintenance activities.

All ALF staff offering hands-on personal services must complete 24 hours of continuing education in their first year of service and 16 hours after their first year.

Assisted Living Housing Requirements

Living units in ALFs in Georgia may be either single or double occupancy. Apartment-style units are not required. Based on the facility’s licensed capacity, there must be at least one toilet and sink for every four residents and at least one shower/bathing room for every eight residents.  Facilities that allow residents in wheelchairs or those that use walkers must have accessible bathrooms for their use.

What Is Included With Assisted Living Care In Georgia?

There are several requirements that each assisted living community must provide for its residents. The facility must offer both general observations and health supervision to assist in identifying each resident’s health condition and ability to function. The facility must assist residents with all ADLs and medication services and assess the need for medication attention or nursing services.

Each facility must also provide services such as laundry, housekeeping, medical transportation coordination, and a level of social activity for the residents.

Before admission, each resident must have a medical examination by a physician. This examination will be used to develop a care plan to be reviewed with the resident and any representative, if necessary.

Health Care Services

In Georgia, ALFs must provide care and services in the resident’s care plan. This can include coordinating medical care and appointments. Communities may also deliver health services, with 58% of communities providing skilled nursing. Many have health care specialists and on-site services, with 38% of communities offering dental care. In addition, 53% of ALFs have hospice services.

Mental health issues are a growing consideration for communities, and services to address these concerns are becoming more common. In Georgia, 88% of communities conduct depression screenings, and 40% offer mental health counseling. Social work programs are also found in 39% of ALFs. Social workers can provide counseling, conduct assessments, and help ensure residents access all the necessary resources.

Activities of Daily Living (ADLs) Assistance Services

A primary service of assisted living that benefits residents is receiving help with activities of daily living (ADLs). These are fundamental tasks that a person must do regularly to sustain life and general health, including toileting, bathing or showering, dressing, transferring (getting in and out of bed or a chair), ambulating (walking), and eating. Signs that a person may benefit from living in assisted living include increased isolation, loss of mobility, noticeable weight loss or gain, and/or neglecting household chores. 

Residents in Georgia assisted living facilities often receive help with their ADLs. In Georgia, 12% of residents need help with eating. Other commonly used services include bed transfer (22%), toileting (28%), and walking (67%). Caregivers in ALFs help 43% of residents dress and 59% of residents bathe.

Medication Assistance

Residents can either administer medication to themselves or have medication assistance from the facility. Residents deemed “aware” of their medications can self-administer or receive assistance from a staff member. The term “aware” means that the resident can control their medications without creating a risk for themself. Injections, drops, inhalers, and suppositories are not included in the types of medications that residents can administer themselves. Assistance by unlicensed personnel is only permitted if the resident is in total control and direction of administering the medication.

Residents not aware of their medications can receive medication assistance from the licensed health professional on staff. If the facility manages and regulates a resident’s medications, specific requirements must be met:

• The medication must be packaged on a unit-dose or multi-dose basis.
• The facility will assist, including reminders, bringing the container to the resident and opening it, including liquids.

Cost Of Assisted Living Care In Georgia

Georgia’s average cost of assisted living care is $3,535. This cost is $965 lower than the monthly national average of $4,500 per month. The cost of living in Georgia is less than the national average by 11.2%, with health care costs less than the national average by 3.3% and housing costs less than the national average by 25.6%.

The level of care a person requires impacts the cost of care, as does where you live. The cost of assisted living ranges from a low of $2,750 in the Warner Robins area to a high of $5,300 per month in the Brunswick area of Georgia.

How Costs Compare In Nearby States

Living close to one of Georgia’s borders may make assisted living in a neighboring state an affordable option. Alabama is the only border state with a lower average monthly cost for assisted living at $3,503. The average monthly cost in South Carolina is slightly higher than in Georgia, with an average cost of $3,612. Florida and Tennessee have an average monthly cost of over $4,000, with Tennessee averaging $4,105 and Florida averaging $4,000.

How to Pay for Assisted Living

Georgia Assisted Living Oversight

The Georgia Bureau of Public Health oversees the state’s assisted living communities. Georgia also has a long-term care ombudsman program to handle complaints against long-term care facilities and advocate for assisted living residents. The Georgia Area Agencies on Aging provide information and access to resources for older adults. The Assisted Living Association of Georgia is a nonprofit organization that provides information regarding assisted living communities in the state to help people find the right community to meet their needs.

Legal Resources for Seniors in Georgia

Older adult Georgia residents are particularly vulnerable to fraud, exploitation, scams, and abuse. This issue has resulted in the elder law evolving to safeguard older adults and their families from harm. The Georgia Department of Senior Services’ Legal Assistance Program provides free services to adults at least 60 years of age to protect and secure their rights, benefits, and dignity. These services include advice and counseling, document preparation, legal representation, estate planning, Medicaid, and housing.

Georgia also offers legal help for low-income residents. Legal Services Georgia provides older adults with legal aid, assistance in civil matters, and other resources available throughout the state.

Quality and Safety of Assisted Living Facilities in Georgia

Under Chapter 420-5-4 of the Georgia Code of Regulations, all assisted living communities must be licensed and meet certain quality and safety standards. For example, each community must maintain written fire safety and emergency plan. The Bureau of Health Provider Standards of the Georgia Bureau of Public Health keeps residents safe by conducting periodic inspections and complaint investigations.

All staff members must receive initial and ongoing training on required care and safety topics. Administrators must also complete six hours of continuing education each year. To increase safety and ensure high-quality care, assisted living communities may not hire anyone whose name appears on the Georgia Department of Public Health Nurse Aide Abuse Registry.