Nursing Homes and Personal Care Homes

INTRODUCTION

A "nursing home" provides medical and nursing care to residents. The care provided may be skilled care on a 24-hour basis by registered nurses or intermediate care on a less than 24-hour basis by licensed practical nurses, or both. A nursing home also may provide physical and speech therapy, diet supervision, and help with dressing, bathing, and medication.

A "personal care home" provides personal care services for unrelated residents who are not bedridden. Although "personal care home" is the official name in Georgia, other names used include "assisted living," "residential care facility," and "board and care."

A personal care home is not licensed to provide medical or nursing care. Instead, it provides meals, personal care, and companionship for people who need some supervision and help with daily personal needs. A person will not be allowed to live in a personal care home unless he or she can live without a lot of supervision and can leave the building quickly with little help.

REGULATION

The Office of Regulatory Services ("ORS") of the Georgia Department of Human Resources ("DHR") licenses nursing homes and personal care homes. The licensing requirements are minimum standards for items like construction, staffing, diet, and nursing procedures. The federal government also requires nursing homes to meet minimum standards in order to be certified for the Medicare and Medicaid programs.

In general, nursing homes and personal care homes in Georgia are licensed by the State. However, there are some personal care homes in Georgia that are not licensed. If you are considering living in a group home and paying for personal care provided by the home, you should make sure that the home is licensed by the State as a personal care home. Otherwise, the ORS will not be able to monitor the quality of services provided by the home.

Although licensing is important, you should not judge the quality of a nursing home or personal care home solely by the fact that the home is licensed. Also, you should not judge the quality of a nursing home solely by the fact that it is certified for Medicare and Medicaid. The licensing and Medicare/Medicaid requirements are only the most basic standards.

LONG-TERM CARE OMBUDSMAN

The "Long-term Care Ombudsman" Program is a federal and state program that is designed to help protect the rights of residents of nursing homes and personal care homes. If a resident has a problem or a concern, a Long-term Care Ombudsman may, with the resident's permission, investigate and try to resolve the problem or concern. A Long-term Care Ombudsman also has the right to visit and to inspect any nursing home or personal care home with no notice to the home.

In most areas, the Area Agencies on Aging ("AAA"s) provide for the Long-term Care Ombudsman Program through contracts with non-profit organizations. To contact the Georgia Long-term Care Ombudsman program, call 1-888-454-5826 or (404) 463-8383.

CHOOSING A NURSING HOME OR PERSONAL CARE HOME

Choosing the best nursing home or personal care home for yourself, a friend, or a family member is a difficult and challenging job. The future resident and his or her family members, friends, and doctor should participate in this process. First, the persons involved should take the time to understand the medical and physical needs and financial situation of the future resident. Then, they should get information about suitable homes and visit the homes that may be the best.

Getting Information about Suitable Homes

It is important to try to find a nursing home or personal care home near the friends and relatives of the future resident. Visits from friends and relatives are very important to a resident's morale and well-being. The following describes some sources you can use to get information about suitable nursing homes or personal care homes in a good location. After you receive information about suitable nursing homes or personal care homes, you should call or write the homes to get more information about their basic costs and services and "extra" charges the resident must pay for items like laundry.

1. The Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services has a very helpful web site at www.medicare.gov (click on "Nursing Home Compare") which contains specific information about every nursing home in the country which is certified for Medicare and/or Medicaid. Here you can read findings from recent inspection reports about a specific home's deficiencies in categories such as quality of care, resident rights, mistreatment, and nutrition. You can also find out the percentage of residents in a particular home with pressure sores, or with physical restraints and see how this percentage compares with the state and national averages. There is also information about the staff, the number of beds, and the type of ownership. This is a very important and helpful source for anyone seeking information about a suitable nursing home.

2. DHR (Department of Human Resources) puts out a list of licensed nursing homes in Georgia. The list describes the level of care provided by each nursing home and gives the number of beds, name of the administrator, and county in which the home is located. To obtain this list, write to the Standards and Licensure Section, Office of Regulatory Services, Georgia Department of Human Resources, 2 Peachtree Street, N.E., 22nd Floor, Atlanta, Georgia 30303 or call (404) 657-5850. There is a small charge for the list.

Or, you may access this information by logging on to www.state.ga.us/departments/dhr/ors.

3. DHR also puts out a list of licensed personal care homes in Georgia. To obtain this list, write to the Georgia Department of Human Resources, Office of Regulatory Services, Personal Care Home Unit, 2 Peachtree Street, N.E., 21st Floor, Atlanta, Georgia 30303 or call (404) 657-4074. There is a small charge for the list. Or, you may access this information by logging on to www.state.ga.us/departments/dhr/ors.

4. The Long-term Care Ombudsman Program in your area may provide lists of licensed nursing homes and personal care homes in your area. The program also can help with tips for choosing a nursing home or personal care home. To contact the Georgia Long-term Care Ombudsman program, call 1-888-454-5826 or (404) 463-8383.

5. You can click on "Selecting a Nursing Home" or "Selecting a Personal Care Home" on the home page of this web site to see a brochure published by the Elder Law Committee, Young Lawyers Division, of the State Bar of Georgia.

Visiting the Home

If you are interested in a nursing home or personal care home after obtaining information about it, make an appointment to visit the home and meet the administrator or manager. Then, go unannounced on a second visit for a "closer look." The things you should ask about and look for are described below.

When visiting a nursing home or personal care home, ask questions and ask for written materials in the following important areas. The areas marked with an asterisk (*) may not apply to personal care homes.

 

1. Important Questions

Licensing. The home is required to be licensed. Is the home's license about to be suspended or revoked? Nursing Homes are required to post a notice regarding the availability of the most recent inspection report and must make the results available for examination in a place readily accessible to residents. Technically, though, a home doesn't have to post the actual results unless a sanction (other than a plan of correction) has resulted from the survey. However, the results from the nursing home's latest inspection report are available on www.medicare.gov, provided the home is certified for Medicare or Medicaid. This is an excellent site for detailed information.

*Nursing Service. What level of care is provided? Does it meet the needs of the future resident?

*Physician Services. Is there a staff doctor or medical director who helps set policies and provides for emergency calls? How does the home provide for medical follow-up by a family doctor?

Activities Program. Are there organized activities? What are they? Is there a regular schedule? What religious services are available?

*Rehabilitation and Physical Therapy. What facilities and staff are available for rehabilitation and physical therapy services? Do they meet the needs of the future resident as prescribed by his or her doctor?

Visiting Hours. When are visiting hours? Is there a limit on the number of visitors?

*In-Service Education. Does the home have continuing in-service education programs for its staff members so that they can keep up-to-date on new techniques?

Meals. Does the home serve meals that are planned by a registered dietician? Are special diets available? Ask to see a copy of the planned menus.

Safety. Are the staff members and residents trained in fire safety?

Cost and Charges. What services are included in the "basic daily charge" of the nursing home or personal care home? You should try to get this information in writing from the administrator or manager. What services are provided for "extra" charges? Do these extra charges include all expenses that are necessary for the services? Remember that the higher the level of care, the higher the costs are likely to be.

Deposits. How much money is required in advance? How will the deposit be returned? NOTE: A resident who is eligible for nursing home Medicaid cannot be charged a deposit. Please see the MEDICAID Section in this Web site for information on nursing home Medicaid.

*Medications. How will the resident get needed medications? Usually a nursing home will require that the home supply all medications, which is convenient for residents and provides for faster emergency treatment. However, because getting medications through the home may cost more, the resident may wish to buy his or her own. NOTE: If the resident chooses to buy his or her own medications, a clear agreement with the home that allows its staff members to supply emergency medications will be needed.

*Affordability. Can the future resident afford the home? Does the home take residents enrolled for Medicare or nursing home Medicaid? What is the nursing home's policy when a Medicare or private-pay resident can no longer afford to pay?

Alzheimer's Patients. Does the facility have a special unit for those residents suffering from Alzheimer's Disease or a related disorder? Is it a locked facility? If not, are measures taken to assure that these residents are properly supervised?

 

2. Important Things to Look For

In general, a nursing home or personal care home will look well-maintained and pleasant to the visitor. However, in order to get a feel for the home from a resident's viewpoint, try to observe closely the following key areas:

Safety. Although safety is a concern for everyone, it is an even greater concern for older persons who may have limited mobility, eye problems and other disabilities. Look for fire hazards, blocked fire doors, and smoking restrictions that are ignored. Make sure that stairways are well-lighted and hallways are free of obstacles like light cords, throw rugs, torn carpets and cracked tiles. Is there an adequate fire safety system that includes smoke and heat detectors, sprinklers and approved fire-resistant construction? Is there a plan posted for quick evacuation in case of fire? Are there hand rails in the hallways and grab bars next to bathtubs, showers, and toilets?

Cleanliness. Does the home smell of urine or heavy "cover-up" deodorant? Check out window sills, counter tops, and bedside tables for dirt and dust. Kitchens, nursing stations, lounges and residents' bathrooms must be clean.

Pleasantness. Flowers, pictures, seasonal decorations, and general orderliness are all important in providing a happy and comfortable atmosphere for a resident.

Convenience and Operating Order. There should be drinking fountains, lounges, and telephones available for use by the residents. The radios and televisions in the lounges should work properly.

Morale. Regularly scheduled activities with participation encouraged by staff members can boost morale for residents. Check to see if staff members have a positive attitude toward the residents. Indifferent or sullen staff members can destroy morale. Take a good look at how the residents act and how they are dressed. Do they appear to be happy, interested and involved with what is going on?

Privacy and Respect. Residents are entitled to be treated with respect and to have as much privacy as possible. When a bath or other personal care is given in bed, curtains should be drawn to protect the privacy of the resident. Staff members should knock before entering a resident's room and should address residents by their names. Staff members should treat each resident like an adult, not a child. Actions of the staff members that show respect give an idea of how the home's administration or management feels about the residents. Watch and talk to the staff members to get an idea of their attitudes towards their jobs and the residents.

RESIDENTS' RIGHTS

It is very important to know that it is illegal for anyone to abuse a resident of a nursing home or a personal care home or to violate a resident's civil or property rights in any other way. A person who enters a nursing home or personal care home does not lose his or her civil and property rights guaranteed by the United States Constitution and federal and state laws. There are laws that specifically forbid violation of residents' rights and provide for enforcement of residents' rights.

Nursing Home Residents' Bill of Rights.

Georgia has a law called the Nursing Home Residents' Bill of Rights, which gives to each nursing home resident a right to:

1. Exercise his or her civil and property rights, like voting, making a will, managing his or her personal affairs and finances, practicing his or her religion, and meeting and associating with people of his or her choice.

2. Know in detail what his or her medical condition is, what treatments are possible, and what the side effects and risks of each treatment are.

3. Receive care, treatment, and services adequate and appropriate for his or her condition.

4. Choose among different forms of treatment, participate in a care and treatment plan, refuse treatment by a particular doctor and request a different doctor, or refuse treatment altogether.

5. Object to an involuntary discharge or transfer from the home and have 30 days advance, written notice of an involuntary discharge or transfer.

6. Be given 15 days advance, written notice of a proposed involuntary transfer to another bed in the same nursing home.

7. Read all printed forms he or she is asked to sign.

8. Be treated with dignity and respect, and be free from any physical or chemical restraint or any form of isolation used for convenience or discipline.

9. Have restraints used only to protect the resident from immediate injury to himself or herself or others, only with prior examination and authorization by a doctor, and only for a specified time period.

10. Be examined in private and have privacy for personal visits, telephone calls, writing and reading of mail, dressing, bathing, and using the toilet.

11. Visit privately with the resident's spouse and share a room with the spouse if both are residents and space permits.

12. Have medical records kept confidential.

13. Refuse to be used as a subject for teaching or research purposes.

14. Use tobacco and consume alcoholic beverages (with certain limits).

15. Wake up and go to sleep at times of his or her choice.

16. Enter and leave the home as he or she chooses.

17. Keep and use personal belongings as space permits.

18. Have visitation hours for at least 12 straight hours per day.

19. Inspect and receive a copy of his or her medical reports.

20. Choose his or her pharmacy.

21. Voluntarily discharge himself or herself.

22. Voice grievances and participate in a voluntary residents' council. (Families may participate in a voluntary family council as well.)

23. Know when a staff member enters the resident's room, unless he or she is asleep or there is an emergency situation.

24. Be permitted to manage his or her own financial affairs.

25. Have any funds over $150 kept in an interest-bearing account insured by agencies of, or corporations chartered by, the state or federal government.

26. In the event of the resident's involuntary discharge or transfer from the nursing home, have help in finding an appropriate, alternative place to live.

To obtain the booklet "Long-Term Care Facilities: Residents' Bill of Rights," which lists the rights described above, contact the Standards and Licensure Section, Office of Regulatory Services, Georgia Department of Human Resources, 2 Peachtree Street, N.E., 31st Floor, Atlanta, Georgia 30303 or call (404) 657-5850. There is a small charge for the booklet. You can also click on "Legal Rights of Nursing Home Residents" on the home page of this web site to see the contents of a pamphlet compiled and published by the Elder Law Committee, Young Lawyers Division of the State Bar of Georgia.

Medicare/Medicaid Rights of Nursing Home Residents

Federal law gives each resident of a nursing home that participates in the Medicare and/or Medicaid program a right to:

1. Choose his or her personal doctor.

2. Have full information, in advance, about his or her care and treatment, and participate in planning and making any changes in his or her care and treatment.

3. Live and receive services with reasonable allowance by the nursing home for his or her needs and preferences.

4. Voice grievances about care or treatment received or not received without being discriminated against, or punished, and receive a prompt response to any grievance from the nursing home.

5. Organize and participate in resident groups. (Families may organize family groups as well.)

6. Participate in social, religious and community activities as he or she wants.

7. Receive medical treatment in private, and have privacy for sleeping, bathing, and using the toilet, and other living activities, personal visits, telephone calls, reading and writing mail, and meetings of resident and family groups.

8. Have personal and medical records kept confidential.

9. Be free from physical or mental abuse, bodily punishment, involuntary isolation, or restraints used for discipline.

10. Be free from restraints used for the convenience of the nursing home, rather than the resident's well-being, and have restraints used only under a doctor's written order for treatment and for the resident's safety and the safety of other residents.

11. Be given results of the latest inspection of the nursing home and any plan of correction submitted by the home.

12. Be notified in advance of any plans to change his or her room or roommate.

13. Be informed of his or her rights at admission and, upon request, be given a written copy of his or her rights.

14. Be given written and oral information about how to apply for and use Medicaid and how to receive a refund for previous private payments that Medicaid will pay for retroactively.

15. Be given a written list, at admission and during his or her stay, of the services available under the basic rate and any extra charges for other services. Also, if the resident is a Medicaid resident, be given a written list of services covered by Medicaid and those for which there is an extra charge.

16. (a) Be permitted immediate visits by his or her personal doctor, people from the ORS (which licenses nursing homes) or a Long-term Care Ombudsman, (b) be permitted immediate visits by his or her relatives, (c) be permitted visits by others under reasonable limits, and (d) be permitted reasonable visits by people or organizations providing health, social, legal, or other services.

17. Have a Long-term Care Ombudsman review the resident's medical records with his or her consent.

18. Be allowed to remain in the nursing home and not be transferred or discharged unless: (a) the transfer or discharge is necessary for the resident's welfare and the resident's needs cannot be met by the facility; (b) the resident no longer needs nursing home care; (c) the health or safety of other residents is in danger; or (d) the resident has not paid an allowable charge for an item or service requested by the resident after the resident has received reasonable notice of the payment due.

19. Have 30 days advance, written notice of an involuntary transfer, which gives the reasons for the transfer, the resident's right to appeal the transfer, and the name, address and phone number of the Long-term Care Ombudsman program and other protection and advocacy programs.

20. Request that the resident's bed be held, (if the resident is hospitalized, for example) and request information about how many days Medicaid will pay for the bed to be held, the home's policy about holding beds, and the right to return to the next available bed if Medicaid bed-holding coverage ends.

21. Not be required to deposit personal funds with the nursing home.

22. If the resident chooses to deposit personal funds with the nursing home, (a) have the funds held under a written agreement with the home, (b) have the funds kept in an account separate from the home's account, which bears interest if the funds are over $50, and (c) have the home keep a complete and separate accounting of the funds, with a written record of all transactions, available for review by the resident (and his or her representative).

Important: Also, under federal law, a nursing home may not discriminate against Medicaid patients. In particular, (1) the home must keep the same policies and practices about transfers, discharges and providing Medicaid-required services for all residents no matter who pays their bills; (2) the home cannot require residents to waive their rights to Medicaid; (3) the home cannot require a third party to guarantee payment as a condition of admission or continued stay; and (4) the home cannot charge or accept gifts, money, donations or other "consideration" in order for a Medicaid resident to continue to stay in the home.

Finally, under a federal law called the Patient Self-Determination Act, a new resident is entitled to receive from the nursing home information on his or her right to have a durable power of attorney for health care ("DPAHC") or a living will. A nursing home may not require you to have either a DPAHC or a living will in order to be admitted. Please see the Section on POWERS OF ATTORNEY in this Website for information on DPAHCs and living wills.

Conflict in Laws

There may be a conflict between the Georgia Nursing Home Residents' Bill of Rights and federal law for residents in a nursing home that participates in the Medicare and/or Medicaid program. In general, if there is a conflict between the Georgia law and federal law, the right that provides more protection for the resident or is more restrictive for the nursing home will apply.

Personal Care Home Regulations Regarding Residents.

Georgia has regulations regarding Personal Care Home Residents, which give to each personal care home resident a right to:

1. Be fully informed about his or her rights in a way that the resident will understand, and receive copies of:

a. The Personal Care Home regulations regarding residents;

b. All procedures and policies of the home concerning resident conduct and responsibilities;

c. The services available in the home; and

d. The current schedule of all fees and charges.

The resident must state in writing before he or she is admitted to the home that he or she has been informed of these items.

2. Participate in drawing up the terms of the admission agreement with the home manager, including provisions for transfer and discharge, obtaining medication, and arranging for medical treatment.

3. Receive adequate and appropriate care and services that comply with federal and state law, without discrimination based on age, gender, race, physical or mental disability, religion, sexual orientation, national origin, marital status or the source of payment for the service.

4. Receive or reject medical care, dental care, or other services, if allowed by law.

5. Choose and retain the services of a personal doctor and any other health care professional and choose any health care service.

6. Be fully informed about his or her care and any changes in that care, and have access to all information in his or her medical records.

7. Fully participate in the planning of her or his care.

8. Have 30 days advance, written notice of any involuntary transfer or discharge, except where immediate transfer is required. The home may arrange an immediate transfer if the resident develops a physical or mental condition requiring continuous medical or nursing care or if the resident's continuing behavior or condition directly and substantially threatens the health, safety and welfare of the resident or other residents. In cases of immediate transfer, the home must document the reasons for the transfer and arrange to transfer the resident to an appropriate facility where his or her needs can be met.

9. Have 60 days advance, written notice of any increase in fees or charges.

10. Voice grievances and recommend changes in policies and services to the staff members of the home, including the manager, without fear of restraint or punishment.

11. Be informed by the home manager of procedures for registering complaints confidentially.

12. Be free from punishment or harassment by the home, its agents, or employees because of the resident's efforts to enforce her or his rights.

13. Manage his or her financial affairs, including the right to keep and spend his or her own money. If the resident makes a written request for help in managing his or her financial affairs, the home must keep a written record of transactions with itemized receipts in the resident's file maintained by the manager.

14. Be free from coercion to assign or to transfer to the home any money, valuables, benefits, property or anything of value, other than payment for services rendered by the home.

15. Have a personal needs allowance for the free use of the resident in the amount of $5 per week, distributed by the administrator, the on-site manager, or a responsible staff member.

16. Be free from mental and physical abuse, neglect and exploitation, humiliation, withholding of money, whether actual or threatened, physical or chemical restraint, any form of isolation, or any other punishment, including interference with the daily functions of living, like eating and sleeping.

17. Have personal information in his or her resident's file kept confidential and disclosed only to him or her, management of the home, the ORS, and anyone who has the resident's written permission.

18. Be treated with consideration, respect, and full recognition of his or her dignity and individuality.

19. Interact with members of the community both inside and outside the home and participate fully in the life of the community.

20. Be free to practice religious beliefs as the resident chooses, and participate in social, religious, and community activities that do not interfere with the rights of other residents.

21. Choose activities and schedules that the resident desires.

22. Choose aspects of his or her life in the home that are significant to the resident.

23. Exercise his or her federal and state constitutional rights including, the right to vote.

24. Have privacy for sleeping and for storage space of personal belongings, and have notice that a staff member wishes to enter the resident's room by the staff member's knocking on the resident's door first.

25. Have free access to day rooms, dining and other group living or common areas at reasonable hours, and be free to come and go from the home in any reasonable way.

26. Have privacy and freedom for the use of bathrooms at all hours.

27. Be treated with respect and be given privacy in the provision of personal care.

28. Share a room with his or her spouse who is a resident of the home, if they both desire.

29. Wear his or her clothes and keep and use his or her personal possession, including toilet articles, as space permits.

30. Have reasonable safeguards for the protection and security of his or her personal possessions.

31. Send and receive unopened mail.

32. Have reasonable access to a telephone to make and receive personal calls in privacy, and have a private telephone at the resident's expense.

33. Associate and communicate privately with people of his or her choice.

34. Have visitors at agreed-upon hours without advance notice to the home.

35. Be free from performing services for the home, unless the resident and the home manager agree that the resident will perform certain activities or services in the home.

36. Voluntarily discharge or transfer himself or herself under the home's policies and procedures, unless the resident has been committed to the facility by a court order or has a legal representative who has specific written authority to admit, discharge, or transfer the resident.

37. Have access to the Long-term Care Ombudsman Program.

38. Form a residents' council and have meetings in the home outside the presence of the home owner(s), management, or staff members.

To obtain the booklet "Rules and Regulations for Personal Care Homes," which lists the rights described above, please contact the Georgia Department of Human Resources, Office of Regulatory Services, Personal Care Home Unit, 2 Peachtree Street, N.E., 31st Floor, Atlanta, Georgia 30303 or call (404) 657-4074. There is a small charge for the booklet.

ENFORCING A NURSING HOME RESIDENT'S RIGHTS

To enforce his or her rights, a nursing home resident has the choices described below:

1. The nursing home must have a grievance procedure that the resident may use or a residents' council that the resident may consult.

2. The resident has the right to make an oral or written complaint to the nursing home administrator, who must respond within 3 business days.

3. The resident, or another concerned person, may contact the Long-term Care Ombudsmen program for the county in which the home is located. A Long-term Care Ombudsman will investigate the problem and will try to resolve it for the resident. To contact the Georgia Long-term Care Ombudsman program, call 1-888-454-5826 or (404) 463-8383.

4. The resident has the right to an informal hearing in the nursing home before an impartial hearing officer when the resident's rights have been violated. The Long-term Care Ombudsman Program can provide additional information.

5. If the problem has not been resolved, the resident should file a complaint with the ORS by calling 1-800-878-6442. The ORS may cite the nursing home for being out of compliance with its licensing requirements. The result may be sanctions against the home, like limitations on its admissions.

6. The resident has the right to a formal hearing held at the Office of State Administrative Hearings before an administrative law judge. The resident (or his or her representative) must file a request for this hearing with the Georgia Department of Human Resources, Office of Legal Services, 2 Peachtree St. N.W., 29th Floor, Atlanta, Ga. 30303, or by calling (404) 656-4344. The resident may have anyone he or she chooses, including a lawyer, represent the resident at a hearing. It is recommended that the resident contact a lawyer or a legal services program for help with a hearing.

7. The resident may file an action in court. A contract exists between a nursing home and a resident, which the resident can enforce in court. Also, because the nursing home provides care to its residents, it can be liable in a damage suit for its failure to do so. Finally, the home may be liable for injuries to a resident intentionally caused by employees of the home. However, if there has been a violation of the Nursing Home Residents' Bill of Rights, the resident may, but is not required to, request a hearing, as described in item 6 above, before filing an action in court.

8. In the case of an assault, battery, theft or violation of the Georgia Health Code, the resident may seek criminal penalties.

ENFORCING A PERSONAL CARE HOME RESIDENT' RIGHTS

To enforce his or her rights, a personal care home resident has the choices described below:

1. The personal care home must have a grievance procedure that the resident may use.

2. The resident has a right to make an oral or written complaint to the personal care home's manager, who must respond within 5 business days.

3. The resident, or another concerned person, may contact the Long-term Care Ombudsmen Program for the county in which the home is located. A Long-term Care Ombudsman will investigate the problem and will try to resolve it for the resident. To contact the Georgia Long-term Care Ombudsman program, call 1-888-454-5826 or (404) 463-8383.

4. If the problem has not been resolved, the resident should file a complaint with the ORS by calling 1-800-878-6442. The ORS may cite the personal care home for being out of compliance with its licensing requirements. The result may be sanctions against the home.

5. The resident has a right to a formal hearing at the Office of State Administrative Hearings before an administrative law judge. The resident (or his or her representative) must file a request for this hearing with the Georgia Department of Human Resources, Office of Legal Services, 2 Peachtree St. N.W., 29th Floor, Atlanta, Georgia 30303, or by calling (404) 656-4344. The resident may have anyone he or she chooses, including a lawyer, represent the resident at a hearing. It is recommended that the resident contact a lawyer or a legal services program for help with a hearing.

6. The resident may file an action in court. A contract exists between a personal care home and a resident, which the resident can enforce in court. Also, the home may be liable for injuries to a resident intentionally caused by employees of the home. However, if there has been a violation of the Personal Care Home regulations regarding residents, the resident may, but is not required to, request a hearing, as described in item 5 above, before filing an action in court.

7. In the case of an assault, battery, theft or violation of the Georgia Health Code, the resident may seek criminal penalties.

FINANCIAL HELP FOR NURSING HOME RESIDENTS

Both Medicare and Medicaid will help pay for care in a nursing home for an eligible resident. If certain conditions are met, Medicare will pay all of a resident's expenses in a skilled nursing home for up to 20 days. After 20 days, Medicare will only pay covered expenses over a certain amount ($101.50 in 2002)for up to the next 80 days. Please see the MEDICARE Section in this Website for more details on this matter.

If a resident qualifies for Nursing Home Medicaid, it will pay the difference between the "Medicaid-approved" billing rate of a nursing home (either skilled or intermediate care) and the resident's income less certain deductions. Also, Adult Medically Needy Medicaid (or spend-down Medicaid) may pay part of the resident's nursing home expenses in months in which his or her nursing home and other medical expenses are greater than a certain amount. Please see the MEDICAID Section in the Website for more information.

RESOURCES AND LINKS
NURSING HOMES AND PERSONAL CARE HOMES

1. For detailed information about specific nursing homes, click on www.medicare.gov and then choose "Nursing Home Compare." This is an excellent site with current information on every certified nursing home in the country. You can find out the results of the latest inspection reports on that home, the percentage of residents in that home with bedsores, for example, or in physical restraints, and comparison of these numbers with state and national averages. You can also find out what deficiencies that home was cited for in the latest inspection and whether these have been corrected.

 

2. If you need a problem investigated involving a nursing home or personal care home resident, contact the Georgia Long-Term Care Ombudsman Program, by calling 1-888-454-5826 or (404) 463-8383.

 

3. The Office of Regulatory Services (ORS) provides the following services: To file a Complaint against a Georgia nursing home or personal care home, call 1-800-878-6442  To request a list of state licensed nursing homes and personal care homes, or a copy of residents' rights, call (404) 657-5850. Or log on to www.state.ga.us/Departments/dhr/ors. For information on filing a Complaint, access Frequently Asked Questions under the Table of Contents.


4. For a list of member facilities of the Assisted Living Association of Georgia, log on to www.alag.org


5. For a list and information on Nursing Homes and Personal Care Homes in the 10 county metro Atlanta area, call the Aging Connection with the Atlanta Regional Commission at (404) 463-3333. - or log on to www.agingatlanta.com , click on Search, then Online Search


6. Outside the metro Atlanta area, for information on Nursing Homes and Personal Care Homes in your area, contact your local Area Agency on Aging (AAA). Or call the Georgia Division of Aging Services at (404) 657-5258 for  assistance in contacting your local agency. - or go to www.state.ga.us/departments/dhr , click on Aging Services, and then on Local Area Agencies on Aging


7. For general or legal questions involving nursing homes and personal care homes, contact the Georgia Senior Legal Hotline at 1-888-257-9519 or e-mail them at seniorlegalhotline@yahoo.com.
 

8. For consumer pamphlets on "Legal Rights of Nursing Home Residents,"Selecting a Nursing Home," or "Selecting a Personal Care Home," click on the appropriate choice on the home page of this web site. These pamphlets were compiled and published by the Elder Law Committee, Young Lawyers Division of the State Bar of Georgia.