Subject 111-8-65 RULES AND REGULATIONS FOR PRIVATE HOME CARE PROVIDERS
These rules are adopted and published pursuant to the Official Code of Georgia Annotated (O.C.G.A.) § 31-7-300et seq.
These rules shall be known as the Rules and Regulations for Private Home Care Providers. The purposes of these rules are to provide for the licensing and inspection of private home care providers.
In these rules, unless the context otherwise requires, the words and phrases set forth herein shall mean the following:
|(a)|| "Ambulation and transfer" means the act
of moving or walking about or walking or being moved from place to place with
or without assistance.
In these rules, unless the context otherwise requires, the words and phrases set forth herein shall mean the following.
|(b)|| "Applicant" means:
|(c)||"Companion or sitter tasks" means the following tasks which are provided to elderly, handicapped, or convalescing individuals: transport and escort services; meal preparation and serving; and household tasks essential to cleanliness and safety.|
|(d)||"Criminal history background check" means a search as required by law of the criminal records maintained by law enforcement authorities to determine whether the applicant has a criminal record as defined in these rules.|
|(e)|| "Criminal record" means:
|(f)||"Department" means the Department of Community Health.|
|(g)||"Director" means the chief administrative or executive officer or manager.|
|(h)||"Home health agency" means a facility licensed as a home health agency in accordance with the applicable licensing statutes and associated rules.|
|(i)||"Home management" means those activities normally performed by a homemaker for the maintenance of a home's essential services, including but not limited to activities such as meal planning, shopping, and bill paying; any employee that is authorized unlimited access to a client's personal funds for home management shall be bonded through the provider.|
|(j)||"Housekeeping or housekeeping tasks" means those activities performed for the upkeep and cleanliness of the home, including but not limited to such activities as laundry, changing linens, trash disposal, and cleaning.|
|(k)||"Inspection" means any examination by the department or its representatives of a provider, including but not necessarily limited to the premises, and staff, persons in care, and documents pertinent to initial and continued licensing so that the department may determine whether a provider is operating in compliance with licensing requirements or has violated any licensing requirements. The term inspection includes any survey, monitoring visit, complaint investigation, or other inquiry conducted for the purposes of making a compliance determination with respect to licensing requirements.|
|(l)||"Medically frail or medically compromised client" means a client whose health status, as determined by appropriate provider staff in accordance with accepted standards of practice, is likely to change or has changed because of a disease process, injury, disability or advanced age and underlying disease process(es).|
|(m)||"Medically related activities" means activities such as but not limited to observing and reporting changes in a client's condition, arranging trips to the doctor, picking up prescription drugs, accompanying clients on medical appointments, documenting client's food and/or liquid intake or output, reminding clients to take medication, and assisting with self-administration of medication; such activities shall not include professional services that are subject to regulation under professional practice and licensing statutes and associated rules.|
|(n)|| "Owner" means any individual or any
person affiliated with the corporation, partnership, or association with 10
percent or greater ownership interest in a business or agency licensed as a
private home care provider and who:
|(o)||"Personal care home" means a facility licensed as a personal care home in accordance with the applicable licensing statutes and associated rules.|
|(p)||"Personal care tasks" means assistance with bathing, toileting, grooming, shaving, dental care, dressing, and eating; and may include but are not limited to proper nutrition, home management, housekeeping tasks, ambulation and transfer, and medically related activities, including the taking of vital signs only in conjunction with the above tasks.|
|(q)|| "Private home care provider" means any
person, business entity, corporation, or association, whether operated for
profit or not for profit, that directly provides or makes provision for private
home care services through:
|(r)|| "Private home care services" means those
items and services provided at a patient's residence that involve direct care
to that patient and includes, without limitation, any or all of the following:
|(s)||"Records check application" means two sets of classifiable fingerprints, a records search fee to be established by the department by rule and regulation, payable in such form as the department may direct to cover the cost of a fingerprint records check, and an affidavit by the applicant disclosing the nature and date of any arrest, charge, or conviction of the applicant for the violation of any law, except for motor vehicle parking violations, whether or not the violation occurred in this state, and such additional information as the department may require.|
|(t)||"Residence" means the place where an individual makes that person's permanent or temporary home, whether that person's own apartment or house, a friend or relative's home, or a personal care home, but shall not include a hospital, nursing home, hospice, or other health care facility licensed under O.C.G.A. § 31-7-1et seq.|
|(u)||"Responsible Party" means any person authorized in writing by the client or appointed by an appropriate court to act upon the client's behalf; the term shall include a family member of a physically or mentally impaired client unable to grant the above authorization.|
|(v)||"Satisfactory criminal history background check determination" means a written determination that a person for whom a records check was performed was found to have no criminal record which includes one of the covered crimes outlined in O.C.G.A. § 31-2-9, if applicable.|
|(w)||"Transport and escort services" means accompanying clients or providing or arranging transportation for clients to places outside of their residences for purposes such as appointments, entertainment, exercise, recreation, shopping, or social activities. If the mode of transportation is not owned by the client and is operated by an employee of the provider, the provider shall either obtain a signed waiver by the client of any claims for damages arising out of the operation of the vehicle or make reasonable efforts to insure that there is current motor vehicle insurance that will provide medical coverage for the client, in the event that the vehicle is involved in an accident causing injuries to the client.|
|(x)||"Unsatisfactory criminal history background check determination" means a written determination that a person for whom a records check was performed has a criminal record which includes one of the covered crimes outlined in O.C.G.A. § 31-2-9, if applicable.|
Each private home care provider shall have a governing body empowered and responsible to determine all policies and procedures and to ensure compliance with these rules.
|(1)|| No private home
care provider shall operate without a license or provisional license issued by
|(2)|| Qualifications Requirement. In order to
obtain or retain a license or provisional license, the provider's administrator
and its employees must be qualified, as defined in these rules, to direct or
work in a program. However, the department may require additional reasonable
verification of the qualifications of the administrator and employees either at
the time of application for a license or provisional license or at any time
during the license period whenever the department has reason to believe that an
administrator or employee is not qualified under these rules to direct or work
in a program.
|(1)||Initial applications for a license as a private home care provider must be submitted to the department on forms provided by the department, and shall include the submission of an application fee and a license fee established by the Board of Community Health, and a records check application for the owner. Such application shall include a description of the private home care provider services to be offered by the applicant and the geographic area that will be served.|
|(2)||Renewal of Licenses. Licenses shall be renewed by the department periodically from the date of initial issuance upon submission of a renewal application, and a license renewal fee established by the Board of Community Health. Such renewal application shall include a description of the private home care provider services offered by the licensee and the geographic area served.|
|(3)||Fees. Fees shall be reasonable and shall be set so that the total of the fees approximates the total of the direct and indirect costs to the state of the licensing program. Fees may be refunded for good cause as determined by the department.|
|(4)||False or Misleading Information. The application for any license or renewal must be truthfully and fully completed. In the event that the department has reason to believe that any application has not been completed truthfully, the department may require additional reasonable verification for the facts alleged. The department may refuse to issue or renew any license where false statements have been made in connection with the application or any other documents required by the department.|
|(1)|| These rules
shall not apply to private home care services which are provided under the
|(2)||A certificate of need issued pursuant to O.C.G.A. § 31-6-1et seq. is not required for licensure so long as the provider does not operate as a licensed home health agency or personal care home.|
|(1)|| Providers shall be inspected by the
department periodically; provided, however, the department may exempt a
provider from such periodic inspections if it is certified or accredited by a
certification or accreditation entity recognized and approved by the
|(2)|| Consent to Entry and Access. An
application for a license or the issuance and renewal of any license by the
department constitutes consent by the applicant or licensee and the owner of
the premises for the department's representatives to enter the premises for the
purpose of conducting any inspection during regular business hours.
|(3)||Cooperation with Inspection. All provider staff shall cooperate with any inspection conducted by the department and shall provide, without unreasonable delay, any documents to which the department is entitled hereunder.|
|(4)||If as a result of the inspection, violations of these licensure regulations are identified, the provider will be given a written report of the inspection which identifies the licensure regulations violated. The provider must submit a written plan of correction (improvement) in response to the inspection report which states what the provider will do when to correct each of the violations identified. The provider may offer any explanation or dispute the findings of violations in the written plan of correction so long as an acceptable plan of correction is submitted within ten days of the receipt of the written report of licensure inspection.|
|(1)||Services Description. A provider shall establish and implement written policies and procedures that define the scope of private home care services it offers and the types of clients it serves. No provider shall provide services that are prohibited by these rules, the applicable legal authority, or other laws.|
|(2)|| Service Agreements. No provider shall
offer to provide a client any private home care services that it cannot
reasonably expect to deliver in accordance with these rules.
|(3)|| Administrator. The governing body shall
appoint an administrator who shall have full authority and responsibility for
the operation of the private home care provider.
|(4)|| Record keeping.
Staffing. The provider shall have sufficient numbers of qualified staff as
required by these rules to provide the services specified in the service
agreements with its clients. In the event that the provider becomes aware that
it is unable to deliver the specified services to the client because of an
unexpected staff shortage, the provider shall advise the client and refer the
client to another provider if the client so desires.
|(6)|| Staff Training.
Prior to working with clients, all employees hired or used on or after the
effective date of these rules and who provide services to clients shall be
oriented in accordance with these rules and shall thereafter receive additional
training in accordance with these rules.
|(7)||Contracted Services. If a provider arranges with independent contractors, individuals, or agents for them to provide any authorized private home care services on behalf of the provider in any way, such arrangements shall be set forth in writing detailing the services to be provided. The provider must assure that the independent contractor, individual, or agent supplying the services follow the provisions of these rules and are qualified to provide the services. The services must be supervised, as outlined in rule .10(2) (Supervision of Services), by a supervisor of the licensed provider.|
|(1)|| A provider may provide three categories
of home care services as defined in these rules.
of Services. Services shall be supervised by qualified staff of the provider.
Each staff member providing services to a client shall be evaluated in writing
by his or her supervisor, at least annually, either through direct observation
or demonstration, on the job tasks the staff member is required to perform. No
supervisor shall knowingly permit an employee who has been exposed to
tuberculosis or hepatitis or diagnosed with the same to provide services to
clients until it is determined that the employee is not contagious.
|(3)||Documentation of Home Care Services Provided. A provider shall establish and implement written policies and procedures for documenting the services actually performed for its clients each day. Such documentation shall be incorporated into the client's file in accordance with rule .09(4)(a).|
|(4)||Quality Improvement Program. The provider must have and maintain documentation reflecting that there is an effective quality improvement program that continuously monitors the performance of the program itself and client outcomes to ensure that the care provided to the clients meets acceptable standards of care and complies with the minimum requirements set forth in these rules. At a minimum, the quality improvement program must document the receipt and resolution (if possible) of client complaints, problems with care identified and corrective actions taken.|
|(1)|| Service Plan Content. A provider shall
establish and implement written policies and procedures for service planning. A
written plan of service shall be established in collaboration with the client
and the responsible party, if applicable, and the client's personal physician
if the services to be provided are nursing services and the client has a
|(2)||Service plans shall be completed by the service supervisor within seven working days after services are initially provided in the residence. Service plans for nursing services shall be reviewed and updated at least every sixty-two days. Other service plans shall be reviewed and updated at the time of each supervisory visit. Parts of the plans must be revised whenever there are changes in the items listed in rules .11(l)(a)and(b), above.|
|(1)||A provider shall establish and implement written policies and procedures regarding the rights and responsibilities of clients, and the handling and resolution of complaints.|
|(2)|| Such policies and
procedures shall include a written notice of rights and responsibilities which
shall be provided to each client or responsible party, if applicable, when the
service agreement described in rule .09(2) is completed. The required notice
shall include the following items:
|(3)||Such policies shall also include procedures for clients and others to present complaints, either orally or in writing, about services and to have their complaints addressed and resolved as appropriate by the provider in a timely manner.|
|(4)||A provider shall supply all clients and responsible parties, if applicable, with the specific telephone number of the provider for information, questions or complaints about services being delivered by the provider.|
|(1)||Enforcement of these rules and regulations shall be conducted in accordance with Rules and Regulations for Enforcement of Licensing Requirements,|
|(2)||If the department finds that an applicant for a license has violated any provisions of these rules or other laws, rules, regulations, or formal orders related to initial or continued licensing, it may, subject to notice and an opportunity for hearing, refuse to grant any license or limit or restrict any license.|
|(3)||If the department finds that a provider has violated any provision of these rules or other laws, rules, regulations, or formal orders related to initial or continued registration, it may, subject to notice and an opportunity for hearing, take any of the following actions: administer a public reprimand; limit or restrict a license; suspend a license; impose a fine; refuse to renew a license; or revoke a license.|
|(1)||The department may, in its discretion, grant waivers and variances of specific rules upon application or petition being filed on forms provided by the department. The department may establish conditions which must be met by the provider in order to operate under the waiver or variance granted. Waivers and variances may be granted in accordance with the following conditions:|
|(2)||Variance. A variance may be granted by the department upon a showing by the applicant or petitioner that the particular rule or regulation that is the subject of the variance request should not be applied as written because strict application of the rule would cause undue hardship. The applicant or petitioner must also show that adequate standards affording protection for the health, safety and care of persons in care exist and will be met in lieu of the exact requirements of the rule or regulation in question.|
|(3)||Waiver. The department may dispense entirely with the enforcement of a rule or regulation by granting a waiver upon a showing by the applicant or petitioner that the purpose of the rule or regulation is met through equivalent standards affording equivalent protection for the health, safety and care of persons in care.|
|(4)||Experimental Variance or Waiver. The department may grant waivers and variances to allow experimentation and demonstration of new and innovative approaches to delivery of services upon a showing by the applicant or petitioner that the intended protections afforded by the rule or regulation which is the subject of the request are met and that the innovative approach has the potential to improve service delivery.|
|(1)||In the event that any rule, sentence, clause or phrase of any of these rules and regulations may be construed by any court of competent jurisdiction to be invalid, illegal, unconstitutional, or otherwise unenforceable, such determination or adjudication shall in no manner affect the remaining rules or portions thereof.|
|(2)||The remaining rules or portions thereof shall remain in full force and effect, as if such rule or portions thereof so determined, declared, or adjudged invalid or unconstitutional were not originally a part of these rules.|