Ga. Comp. R. & Regs. R. 111-8-62-.10 - Staffing

(1) Homes licensed for less than 25 beds must maintain a minimum on-site staff to resident ratio of one awake direct care staff person per 15 residents during waking hours and one awake direct care staff person per 25 residents during non-waking hours where the residents have minimal care needs. Homes licensed for 25 or more beds must maintain an average monthly minimum on-site staff to resident ratio of one awake direct care staff person per 15 residents during waking hours and one awake direct care staff person per 20 residents during non-waking hours. Average monthly minimum staffing levels shall be calculated and documented by the home using methods and forms specified by the department. Notwithstanding the above requirements, all homes must staff above these minimum on-site staff ratios to meet the specific residents' ongoing health, safety and care needs.
(a) Staff, such as cooks and maintenance staff, who do not receive on-going direct care training and whose job duties do not routinely involve the oversight or delivery of direct personal care to the residents, must not be counted towards these minimum staffing ratios. Personnel who work for another entity, such as a private home care provider, hospice, or private sitters cannot be counted in the staff ratios for the home.
(b) At least one administrator, on-site manager, or a responsible staff person must be on the premises 24 hours per day and available to respond to resident needs, with a minimum of one staff person per occupied floor. Homes licensed for 25 beds or more must ensure that at least two on-site administrators or on-site direct care staff persons are present on the premises at all times with at least one staff person on each occupied floor and that person shall be required to remain posted on their designated floor at all times; provided, however, that the staff person posted on the designated floor may move about the premises as necessary if the personal care home has implemented a medical alert system and each resident has been offered a wearable device that connects to such system when activated to alert an administrator or direct care staff person of a medical emergency.
(c) Residents must be supervised consistent with their needs.
(2) All staff, including the administrator or on-site manager, who offer direct care to the residents on behalf of the home, must maintain an awareness of each resident's normal appearance and must intervene, as appropriate, if a resident's state of health appears to be in jeopardy.
(3) For purposes of these regulations, a resident must not be considered a staff person.
(4) All homes must develop and maintain accurate staffing plans that take into account the specific needs of the residents and monthly work schedules for all employees, including relief workers, showing planned and actual coverage for each day and night.
(5) The home must retain the completed staff schedules for a minimum of one year.
(6) Sufficient staff time must be provided by the home such that each resident:
(a) Receives treatments, medications and diet as prescribed.
(b) Receives proper care to prevent pressure ulcers and contractures.
(c) Is kept comfortable and clean.
(d) Is treated with dignity, kindness, and consideration and respect.
(e) Is protected from avoidable injury and infection.
(f) Is given prompt, unhurried assistance if she or he requires help with eating.
(g) Is given assistance, if needed, with daily hygiene, including baths, oral care.
(h) Is given assistance with transferring when needed.
(7) The administrator, on-site manager, or staff person must not be under the influence of alcohol or other controlled substances while engaged in any work-related activity on behalf of the home.
(8) A home licensed to serve more than 24 residents must ensure that staff wear employee identification badges which are readily visible.
(9) Medical Alert Systems. Homes utilizing medical alert systems to allow on-site staff to move about as specified in Rule 111-8-62-.10(1)(b) must meet the following requirements:
(a) The medical alert system must include a wearable sensor device that enables the resident to request help when needed.
(b) The home may encourage, but not require, residents to wear the sensor device and must ensure that residents who do not consistently wear the sensor device receive appropriate monitoring from staff.
(c) The wearable sensor device must be programmed to immediately notify appropriate staff, and to identify the specific resident or location from which the alert signal has been made, by:
(i) activating a portable electronic device worn by the administrator and/or a direct care staff person with an audible tone or vibration; or
(ii) sending a signal to a stationary electronic device located in a designated area monitored by staff.
(d) The home must establish policies and procedures which address the following requirements and must maintain documentation to demonstrate compliance with such policies and procedures:
(i) routine testing and maintenance of the medical alert system;
(ii) initial training for residents and staff on use of the system and additional training as needed;
(iii) procedures for electrical outages or severe weather events that include making more frequent rounds to check on residents if the system is not working, as well as testing the system following such events to ensure operability; and
(iv) a process for reviewing any documentation produced by the system for opportunities to enhance individualized care and service.
(e) The department may prohibit a home from using or relying on a medical alert system if the above requirements are not met.

Notes

Ga. Comp. R. & Regs. R. 111-8-62-.10
O.C.G.A. §§ 31-2-7, 31-2-9, 31-7-1 et seq., 31-7-250 et seq.
Original Rule entitled "Personnel" adopted. F. Nov. 19, 2009; eff. Dec. 9, 2009. Amended: New Title "Staffing". F. Dec. 19, 2012; eff. Jan. 8, 2013. Amended: F. Aug. 24, 2021; eff. Sept. 13, 2021. Amended: F. May 1, 2025; eff. May 21, 2025.

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