Georgia Department of Community Health Board Authorizes Final Adoption of New Staffing Rules for Assisted Living Communities and Personal Care Homes

The Georgia Department of Community Health (“DCH”) board recently authorized the final adoption of new staffing rules for personal care homes and assisted living communities. These rules are designed to implement a July 1, 2024, statutory change.¹ The new staffing rules took effect on May 21, 2025.

Key Updates

DCH currently requires personal care homes and assisted living communities with 25 or more beds to have at least two on-site administrators or direct care staff members present at all times, with at least one staff member on each occupied floor.

The updated rules will allow a staff member assigned to a specific floor to move throughout the building, as necessary, if the personal care home or assisted living community has implemented a medical alert system that enables residents to alert appropriate staff members of a medical emergency.

Analysis and Takeaways

Although the new rules offer greater flexibility on staffing “floor” requirements, this flexibility will only be available to facilities that satisfy extensive requirements on implementing and maintaining a medical alert system. Facilities must ensure that the medical alert system, among other things, incorporates the following:

• Each resident must be offered an electronic device that enables the resident to alert appropriate staff of a medical emergency by causing an audible ping or vibration of a device worn by appropriate staff member. The system must be capable of identifying the specific resident or location from which the alert signal was made.
• Routine testing and maintenance of the medical alert system is required.
• There must be initial and continuing training for residents and staff on proper use of the medical alert system.
• Procedures must be in place to address electrical outages or severe weather events that may impair the system.
• A process must be in place to review any documentation produced by the medical alert system that could enhance individualized care.

The new rules note that the medical alert system must be approved for efficacy by DCH in its sole discretion. Additionally, facilities must establish policies and procedures to ensure the above requirements are satisfied, while also maintaining documentation to demonstrate compliance with the same. For residents admitted after July 1, 2025, the admission agreement must include information about the medical alert system, including a statement that the resident is not required to use the wearable device offered by the facility. Furthermore, steps must be taken to ensure that residents who do not use the device continue to receive appropriate care.

Personal care homes and assisted living communities should assess their staffing plans, policies and procedures, and admission agreements to ensure compliance with the new rules.

For additional information, please contact AGG Change of Ownership (“CHOW”) team attorneys Hedy Rubinger or Cody Davis.

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.

[1] AGG discussed DCH’s proposed updates to the assisted living communities and personal care home staffing rules in a previous publication, which is available here.

Author:

Hedy Rubinger, Partner 
Email: hedy.rubinger@agg.com 

Cody Davis, Associate 
Email: cody.davis@agg.com