A proposed rule change in response to the inclusion of “stringent language” inserted into a bill governing staffing levels in Georgia’s senior living communities goes back to the intention of the original bill of providing proper care at an affordable price, say the senior living groups behind the proposal.
Passed by the Georgia legislature in 2020, HB 987 imposed staffing, training and financial reporting requirements on the state’s assisted living communities, personal care homes and memory care communities. State senior living associations at the time supported the bill, saying that it “appropriately” enhanced safeguards designed to protect residents.
But when the bill was written into rules, two changes were inserted that were not part of the original bill, creating what senior living groups said were significant operational inefficiencies.
Proposed changes
The first change redefined the definition of “on site.” The rules say communities must have two caregivers on site at all times, which Georgia Senior Living Association President and CEO Catie Ramp said is defined as inside of a memory care unit, separate from assisted living or the community as a whole.
The proposed change would allow for required staff members to be present in a senior living community and available for “timely access” rather than physically present in the memory care unit at all times.
Another change to the original language added the word “per occupied floor,” which Ramp said requires communities to have staff on a floor even if there are no specific care needs for residents at the time.
“It’s extremely inefficient,” Ramp said, adding that staff members would be required even when residents are away from floors during dining or activities.
Access to specialized memory care would be negatively affected, as the current rules are “operationally prohibitive and constrain the evolution of person-directed care,” a spokeswoman for the Georgia Center for Assisted Living told McKnight’s Senior Living.
“We believe the initial rule exceeded the intent of the legislature with the inclusion of stringent language that discourages innovation in care delivery models and inhibits center leadership to make operational decisions based upon the unique characteristics of the greater community and population served,” GCAL Communications Director Devon Barill said. “Given the workforce crisis all long-term care settings are experiencing, this rule change would allow for required staff to provide valuable care and services in other areas of the facility while on shift, in addition to the memory care unit.”
Support for original bill
In a Dec. 11 letter to the Georgia Department of Community Health Board, LeadingAge Georgia said that it advocated for passage of HB 987 and believed it was “a good bill that improved staffing ratios to reflect the needs of residents.” President Ginny Helms said that although there is recognition that there have been cases of poor care in some senior living communities that have caused advocates to oppose the revised rules, good providers should not be penalized for the poor care of other providers.
Ramp said that the senior living industry is adamant about keeping language regarding staffing to the “specific and unique” needs of residents and called the improved staffing ratios that came with HB 987 “extremely valuable.”
“It’s about keeping memory care residents safe, but the language that was added, in terms of on site and floor, made us now sometimes double staff or duplicate roles,” Ramp said. “The cost is significant.”
Ramp said that operators can’t absorb all of these costs, which inevitably would be passed on to residents.
“We’re already at a place where access and affordability can feel really tight,” she said. “There’s no need for us to add more barriers to someone living in a choice-driven space.”
The comment period on the bill ended Wednesday. The measure will go before the Community Health Board for a vote on Jan. 11. Ramp said her hope is that the board will move forward with the rules as submitted.
