Personal Care Home Rules and Regulations in Georgia

Personal care home rules and regulations in Georgia are set and enforced by the Department of Community Health (DCH) through its Healthcare Facility Regulation Division (HFRD), which licenses every home in the state and inspects it against Georgia Administrative Code Rule 111-8-62. Operators must meet standards for staffing, training, medication handling, resident rights, fire safety, and building accessibility, and homes that accept Medicaid face an added layer of federal requirements. Penalties for violations reach up to $601 per day and can include license revocation.¹

What Counts as a Personal Care Home

Under O.C.G.A. § 31-7-12, a personal care home is any dwelling that provides or arranges housing, meals, and at least one personal service for two or more adults who are not related to the owner or operator. Personal services means hands-on help with daily activities like bathing, grooming, dressing, and mobility.

These are not medical facilities. A personal care home does not provide skilled nursing or round-the-clock medical treatment, and if a resident’s condition deteriorates to that level, the home must arrange a transfer to an appropriate facility. The same core rules under Rule 111-8-62 apply whether a home serves three residents or fifty.

Licensing Through DCH

HFRD handles licensing from application through ongoing compliance.¹ An applicant submits information about the facility’s location, ownership, and planned services along with a non-refundable application fee based on the number of residents.

Once filed, HFRD conducts an on-site survey. Inspectors review records, observe conditions, and interview staff and residents to verify the home meets state standards for safety, staffing, and physical conditions. Licensure is not a one-time hurdle. HFRD returns for compliance surveys, follow-up visits, and complaint-based investigations throughout the life of the license.¹

Every home must maintain written policies covering medication handling, emergency preparedness, and individualized care plans for each resident. Documentation gaps are among the most common findings during surveys, so accurate records are not optional.

Staff Training, Qualifications, and Background Checks

Rule 111-8-62-.09 requires all direct-care employees to complete initial training before working unsupervised. Topics include emergency first aid, CPR, infection control, and resident rights.² Annual continuing education keeps staff current, and homes must keep detailed records of every employee’s training history and certifications.

All staff are also subject to criminal background checks, which are meant to keep anyone with a history of abuse, neglect, or exploitation from working with vulnerable adults. Hiring someone who fails a background check can jeopardize the home’s license.

Day-to-Day Operating Rules

Medications

Because personal care homes are not medical facilities, there is a firm line between assistance and administration. Staff may help residents self-administer medications by opening bottles, reading labels, and reminding residents when doses are due. They may not go further than that. Improper medication handling is one of the most cited violations in Georgia surveys. Each home must have written medication management policies, and every staff member involved in medication assistance must be trained on them.

Meals and Dietary Care

Homes must provide meals that meet residents’ nutritional needs, including any special diet a physician prescribes. Food preparation and storage must follow safe handling practices, from refrigeration temperatures to sanitary kitchen conditions, and menus and dietary modifications must be documented.

Emergency Preparedness

Every home must maintain a written emergency plan covering natural disasters, fires, medical emergencies, and utility failures. Staff must be trained on the plan, and the home must run regular drills. The plan has to account for residents with mobility limitations or cognitive impairments who need extra help during an evacuation.

Resident Rights

Under Rule 111-8-62-.25, every resident must receive a written copy of the Resident’s Bill of Rights at admission. If a resident cannot read it, the home manager must take additional steps to communicate its contents.³

Residents control their own finances unless a court has declared them incompetent, and they cannot be coerced into signing over money, property, or benefits beyond what they owe for services. They have the right to accept or refuse medical and dental care, to privacy, and to make their own choices about daily activities and social interactions.³ Homes must clearly communicate their services and fees, and informed consent is required before starting or changing a care plan.

Georgia’s Long-Term Care Ombudsman Program is the outside channel for residents and families who have concerns. Ombudsman representatives investigate complaints about anything that may affect a resident’s health, safety, welfare, or rights, from abuse and neglect to billing disputes, care changes, and visitor restrictions.⁴ Homes are required to post the ombudsman’s name, address, and phone number where residents can see it.³

Reporting Abuse and Neglect

Personal care homes are directly responsible for protecting residents from abuse, neglect, and exploitation. Under O.C.G.A. § 30-5-4, when a facility staff member has reasonable cause to believe a disabled adult or elder person needs protective services, that person must notify the person in charge, who must then file or cause a report to be filed with Adult Protective Services.⁵ The Remedies for Residents of Personal Care Homes Act (O.C.G.A. § 31-8-131 et seq.) provides additional legal protections and enforcement tools for residents who experience mistreatment.³

Fire Safety and Accessibility

Georgia’s Office of Insurance and Safety Fire Commissioner oversees fire safety. Homes must install and maintain smoke detectors, fire alarms, and, depending on building size and classification, automatic sprinkler systems. If a fire alarm or sprinkler system is out of service for more than four hours within a 24-hour period, the building must either be evacuated or placed under a fire watch until the system is restored.⁶ Regular drills are required, and staff must know how to assist residents with mobility limitations during an evacuation.

Buildings must also meet accessibility standards. Georgia’s Accessibility Code (Rule 120-3-20) works alongside federal ADA requirements to keep entrances, hallways, bathrooms, and common areas accessible to residents with physical disabilities.⁷ The federal Fair Housing Act separately requires housing providers to allow residents to make reasonable modifications at the resident’s own expense, such as installing grab bars, and to make reasonable accommodations in policies, such as allowing a service animal in a facility that otherwise prohibits pets.⁸

Facilities that receive federal financial assistance, including Medicaid payments, take on additional obligations under Section 504 of the Rehabilitation Act: providing care in the most integrated setting appropriate to each resident’s needs, ensuring effective communication with residents who have hearing, vision, or speech disabilities, and avoiding segregated environments that isolate residents from the broader community.⁹

Extra Rules for Medicaid-Participating Homes

A personal care home that accepts Medicaid payments through Georgia’s Home and Community-Based Services (HCBS) waiver programs must meet federal setting requirements on top of state licensing. The setting has to feel like a home rather than an institution: integrated into the broader community, allowing full access to community life, and supporting individual choice and autonomy.¹⁰

A setting that isolates residents from people who do not receive Medicaid services, or that shares a building with an institutional facility, is presumed institutional and will not qualify for HCBS reimbursement unless the state proves otherwise through a heightened scrutiny review. For provider-owned residential settings, which covers most personal care homes, the federal rules add specific requirements:

A written residency agreement giving residents the same eviction protections as tenants under Georgia landlord-tenant law.
An entrance door to each resident’s unit that the resident can lock, with only appropriate staff holding keys.
A say for residents in who their roommate is, when a unit is shared.
Support for individual initiative and independence rather than rigid schedules or routines.

These sit on top of everything a home already does to keep its state license, and Medicaid-participating homes should expect additional scrutiny during surveys.¹⁰

Penalties for Non-Compliance

DCH enforces the rules through penalties that escalate with the severity and persistence of violations. Financial penalties can reach up to $601 per day for serious violations.¹ Daily fines add up quickly, which is the point: a facility that drags its feet on correcting a dangerous condition feels the financial pressure within weeks.

For the most serious infractions, including documented abuse or neglect, DCH can suspend or revoke a license. The process typically involves an investigation, a chance for the facility to present a corrective plan, and a determination on whether the facility can operate safely. If violations are not corrected or are too severe to correct, revocation leads to closure and the discharge of residents to other facilities.

Fire safety and building code violations carry separate penalties through the Office of Insurance and Safety Fire Commissioner, which can impose fines or order a facility closed independently of the DCH licensing process. A home that loses its fire safety certification cannot operate regardless of its DCH license status.

Tax Note for Families Paying the Bill

Some personal care home costs may qualify as deductible medical expenses on federal tax returns. The IRS allows a deduction for expenses of care in a nursing home or similar institution, including meals and lodging, when the principal reason for residing there is to receive medical care.¹¹

If the resident is in the home primarily for personal reasons rather than medical necessity, only the portion of costs attributable to medical or nursing care is deductible, not room and board. To deduct the full cost including room and board, the resident generally needs to be a chronically ill individual, meaning a licensed health care practitioner has certified within the past 12 months that the person either cannot perform at least two activities of daily living without substantial help for at least 90 days, or requires substantial supervision due to severe cognitive impairment.¹¹ Medical expenses are deductible only to the extent they exceed 7.5 percent of adjusted gross income, and you must itemize on Schedule A to claim them.

1
Georgia Department of Community Health. Personal Care Homes
2
Cornell Law School. Georgia Comp. R. and Regs. R. 111-8-62-.09
3
Cornell Law School. Georgia Comp. R. and Regs. R. 111-8-62-.25 – Supporting Residents Rights
4
eCFR. 45 CFR Part 1324 Subpart A – State Long-Term Care Ombudsman Program
5
Justia Law. Georgia Code 30-5-4 – Reporting of Need for Protective Services
6
Office of the Commissioner of Insurance and Safety Fire. Healthcare Facilities (CMS)
7
State of Georgia ADA Coordinator’s Office. Georgia Accessibility Code
8
U.S. Department of Housing and Urban Development. Additional Protection If You Have a Disability
9
U.S. Department of Health and Human Services. Section 504 of the Rehabilitation Act of 1973 Final Rule Fact Sheet
10
Federal Register. Medicaid Program – Home and Community-Based Services and Setting Requirements
11
Internal Revenue Service. Publication 502 – Medical and Dental Expenses