Georgia officials will weigh whether to roll back staffing requirements for assisted living and personal care homes across the state, a move that advocates for seniors worry will make the facilities less safe.
Rep. Sharon Cooper, R-Marietta, drafted legislation in 2020 to address many of the problems an Atlanta Journal-Constitution investigative series uncovered in these facilities, including nearly 700 cases of neglect and abuse and more than 20 deaths linked to breakdowns in care.
Ultimately, the state Legislature passed a law to increase staffing levels, and state regulators with the Department of Community Health (DCH) enacted new rules. They included new staffing requirements designed to increase safety and improve care, especially in homes that care for residents with dementia.
Now, the Georgia Senior Living Association — an industry trade group — is pushing for a rule change to relax some of staffing requirements. The rules implemented after the 2020 legislation called for two workers in memory care units, and two additional workers present in other parts of the facility. The proposed changes would lower the minimum requirements to one staff member in memory care units and at least one other worker in the facility. The 2020 reforms called for improved staffing ratios and those are not changing under the proposed rule change.
The state has opened a comment period, allowing the public to offer feedback on the proposed changes until next Wednesday.
An official with Georgia’s Alzheimer’s Association as well as a key legislative sponsor said they feared the proposed changes would hurt the care that seniors in these facilities receive. The proposal is also prompting a discussion as to whether state regulators with DCH correctly interpreted the Legislature’s intent when the bill passed.
“The point was to increase the quality of care, and there’s literature out there that shows that higher staffing levels are tied to quality of care, not only for the residents, but for the staff,” said Nancy Pitra, director of government affairs for the Alzheimer’s Association, Georgia Chapter.
Rep. Sharon Cooper, R-Marietta, was more blunt: she described the legislation and the resulting rules that came from it as the “bare minimum.”
“It’s very frustrating to me, because it’s hard for me to believe that human beings, with any amount of sympathy or respect for our elders — after seeing those articles and listening to the families of those patients who are being harmed — would be hell-bent on reducing minimum staffing (requirements).” she said.
Catie Ramp — president and CEO of the Georgia Senior Living Association, which is pushing for the change — said these changes should not impact the quality of care, but rather make sure residents are being cared for without passing on additional costs to them.
The sector is plagued by staffing shortages that were worsened by the pandemic. Requiring more workers than what is needed only drives up costs, Ramp said. Proponents of changing the rule argue that, as currently written, there would be two workers in a dementia care unit, even if there was just one resident present.
“We’re talking about elderly people who are on limited income — if you change their monthly budget by $7, by $50, by $200 — that’s significant to someone who lives in care,” Ramp said in an interview, later adding, “This is not about saving a bottom dollar, it’s about caring for people in the very best way possible.”
State Rep. John LaHood, R-Valdosta, a GSLA board member whose family owns and operates several senior care homes, worked closely with Cooper on the 2020 legislation. He said he supports changing the rule and believes it is not in line with the legislative intent. LaHood noted that the staffing-to-resident ratios were 20-to-1 before the reforms and were lowered to 12-to-1. Those remain the same under the proposed changes.
The legislation, he said, was “a big improvement and a lot of labor cost for the industry to absorb.” The current rules on the books resulted in “an unattainable staffing threshold for small memory care centers and wings with a low number of residents.”
Public comment on the proposal can be submitted in writing, and a meeting to hear from the public will be held on Monday, Dec. 11th via Zoom. After the public comment period, the DCH board is scheduled to vote on the proposal at its next meeting, on Jan. 11.
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