What should I know about long-term care options in Georgia?

Contents

• What is long-term care?
• What should I know about nursing homes in Georgia?
• What should I know about assisted living facilities and personal care homes in Georgia?
• What should I know about home and community-based care services?

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What is long-term care?

Long-term care refers to services for people who need help caring for themselves. These services might include:

• Medical, 

• Rehabilitative, 

• Social, or

• Support services.

 

Usually services are needed because of physical or mental disabilities. Long-term care services can be delivered in a wide variety of settings, including:

• Nursing homes,

• Assisted living facilities,

• Personal care homes,

• In a person’s own home. This is known as home health care. 

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What should I know about nursing homes in Georgia?

A nursing home is a residential setting where residents get:

• nursing care, 

• related health care services, and 

• rehabilitation services. 

 

Nursing homes also provide: 

• physical and speech therapy, 

• supervision of diet and medications, and 

• personal care such as help with dressing and bathing.

 

How do I choose a nursing home?

Start by looking at a list of facilities in the best location for the resident. If possible, choose an area where family and friends can visit conveniently. Get a list of facilities in your area by contacting your local long-term care ombudsman program. Visits to the facility and observe:

• the appearance of the facility and residents, 

• interactions between staff and residents, and 

• review posted notices about activities and food menus. 

 

Ask about any violations identified by state inspectors. You can find a list of violations on the Department of Community Health website.

 

Be aware that many facilities have waiting lists.

 

How do I pay for a nursing home in Georgia?

Most nursing home residents in Georgia receive Medicaid benefits to cover the cost of their care. The resident's monthly income goes toward part of the cost and the rest of the cost is paid by Medicaid. Medicare pays for only a limited number of days in a nursing home and for only certain types of services. For example, Medicare will pay if you need "skilled care" after a hospital stay. Some residents pay for their care privately. They may receive benefits from a long-term care insurance policy.

 

What are my rights as a nursing home resident in Georgia?

The Long-Term Care Residents' Bill of Rights in Georgia is a state law listing certain basic rights of all nursing home residents, such as:

• the right to privacy

• the right to enter and leave the home as one chooses

• the right to choose or refuse medical treatment

• the right to adequate notice before being transferred or discharged

 

The complete list of rights must be posted in the facility and given to residents when they are admitted.

 

You have the right to be free from discrimination. Federal and Georgia laws prohibit discrimination against residents or people seeking care. You cannot be discrimated against on the basis of race, national origin, age, religion, sex, color or disability. 

• Discrimination Based On Disability. People seeking nursing home care may find it difficult to gain admission to a facility. This is especially true if they need a lot of care, need specialized services, or have certain types of medical conditions. This type of discrimination is illegal. Nursing homes can refuse to admit people who need more care than they can provide.

• Discrimination Based On Age. Medicare/ Medicaid approved nursing homes cannot discriminate against you because of your age. Some facilities prefer not to admit younger applicants. This type of discrimination is also illegal.

• Discrimination Based On Race, Color or National Origin. Medicare/Medicaid approved nursing homes cannot discriminate against you based on your race, color or national origin.

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What should I know about assisted living facilities and personal care homes in Georgia?

Both assisted living and personal care homes provide meals and personal care. The facilities are for those who need some supervision or help with their daily personal needs.  Although similar, there are some differences. A personal care home does not provide nursing or medical care. Assisted living facilities may provide some medical care, but not to the level of a nursing home. Assisted living facilities generally offer more privacy than personal care homes. 

 

How do I choose an assisted living facility or personal care home in Georgia?

Personal care homes and assisted living facilities vary widely in size, cost, and quality. It is very important to visit a number of facilities before choosing one. Visits to the facility are important to see: 

• the appearance of the facility and residents,

• interactions between staff and residents, and 

• whether the environment is a good fit. 

 

Get a list of facilities in your area by contacting your local long-term care ombudsman program. 

 

Review admissions agreements carefully. Compare to determine what services are provided and at what cost. Also, always check to make sure that the facility is licensed by the Department of Human Resources.

 

How do I pay for an assisted living or personal care home in Georgia?

Personal care homes and assisted living facilities are almost entirely private pay and rates vary greatly. 

• Some provide services to the resident for the amount of their monthly Social Security or Supplemental Security Income (SSI) income. 

• Few long-term care insurance policies cover personal care home or assisted living services. 

• Medicare does not reimburse these providers for their services. 

• In Georgia, personal care home providers are generally not reimbursed by Medicaid.  This is true except for those  in the Medicaid-funded Alternative Living Services.

 

What are my rights as a resident of a personal care home or assisted living facility in Georgia?

Residents in these facilities have rights provided by state law. These rights include:

• the right to be free from physical and chemical restraints

• the right to privacy

• the right to consent to or refuse medical treatment

 

You should get this list of rights from your facility or your local ombudsman program.

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What should I know about home and community based care services?

Home and community based care services allow people who need care to live in the community. 

 

What is the Community Care Services Program (CCSP)?

The Community Care Services Program (CCSP) helps older Georgians live at home. This is for people who need help to live in their homes but do not need the care provided in a nursing home. The CCSP was developed to give older Georgians a greater choice in deciding where they live and what help they need.

 

Services Provided

The CCSP provides a range of home and community-based services which include: 

• Adult Day Health, 

• Alternative Living Services, 

• Care Coordination, 

• Emergency Response Services, 

• Home Delivered Meals, 

• Home Delivered Services, 

• Personal Support Services, and 

• Respite Care Services.

 

Eligibility

To be eligible for CCSP, you must:

• Be certified for intermediate nursing home care;

• Be assessed by the CCSP nurse. They must find that you have health and personal needs that can be met in the community within cost limits; and

• Be an eligible Medicaid recipient or potentially eligible for Medicaid.

 

What are other home and community based care options?

Besides the CCSP, there are other publicly funded home and community based services, as well as many private pay options.

 

To find out what home based care options are available to you, contact the Area Agency on Aging in your area. There may be waiting lists for some or all of these services, or  some of the services may not be available at this time.

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Contents

• What is the long-term care ombudsman program?
• How do I make a complaint about my long-term care facility?
• What can I do if I am discriminated against in a Medicare/Medicaid facility?
• How do I apply for CCSP and other home or community-based services?

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What is the long-term care ombudsman program?

The Long-Term Care Ombudsman Program advocates for residents of long-term care facilities. Their goal is to improve residents' quality of life. An ombudsman acts on behalf of anyone who needs help or has a complaint about their facility. 

 

Ombudsmen work to resolve residents' complaints. Complaints may be small or serious. They advocate for residents' rights before staff, community groups and government agencies.

 

Ombudsmen also investigate and work to: 

• resolve complaints affecting residents, 

• provide information to the public, and 

• encourage long-term care facilities to improve their services to residents.

 

In Georgia, there are fifteen community ombudsman programs. You can find more information by contacting your local long-term care ombudsman program.

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How do I make a complaint about my long-term care facility?

Contact a nursing home abuse and neglect attorney if you or a loved one is: 

• injured, 

• mistreated, 

• abused, or 

• dies unexpectedly from neglect while living in a Georgia nursing facility. 

 

An attorney can help you get the compensation you may deserve.

 

To make a complaint about your nursing home, assisted living facility or personal care home:

• For informal investigation and discussion of the problem: 

  • Discuss the complaint directly with the facility staff or administration or with the local long-term care ombudsman program, an advocacy program which serves residents of long-term care facilities.

• For formal investigation make a complaint either: 

  • online or 

  • by calling the Office of Regulatory Services, Georgia Department of Human Resources at 1-800-878-6442.

• To enforce those rights listed in the Long-Term Care Residents' Bill of Rights ask for a hearing before an Administrative Law Judge.

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What can I do if I am discriminated against in a Medicare/Medicaid facility?

You may file a lawsuit or a complaint with the Office for Civil Rights. File if you have been discriminated against by a Medicare/Medicaid approved facility because of your:

• race, 

• color, 

• national origin, 

• age, 

• sex, 

• handicap or 

• religion.

 

Your complaint must:

• Be filed in writing. You can file by mail, fax, e-mail, or through the OCR Complaint Portal.

• Name the health care or social service provider involved. 

• Describe the discrimination,

• Be filed within 180 days of the violation. 

 

Before filing a complaint, you may want to consult an attorney to talk about your rights and options. 

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How do I apply for CCSP and other home or community-based services?

To apply for CCSP or other home and community-based services, contact the Area Agency on Aging in your area.

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