Georgia home care policies and procedures: what Chapter 111-8-65 requires

Governing body sets policy

A governing body that adopts every policy and procedure and is responsible for compliance.

"Each private home care provider shall have a governing body empowered and responsible to determine all policies and procedures and to ensure compliance with these rules."

Administrator appointment

Appoint an administrator with full authority. DCH checks the signed job description at application.

"The governing body shall appoint an administrator who shall have full authority and responsibility for the operation of the private home care provider."

License display

Display the license at the licensed location.

"The license shall be prominently and appropriately displayed at the private home care providers licensed location."

Changes of location

Give DCH 15 days’ notice before moving. Changes of name, location or ownership return the license.

"The department shall be provided 15 days notice in advance of any providers change in location."

Inspection cooperation

All staff cooperate with inspections and hand over documents without delay.

"All provider staff shall cooperate with any inspection conducted by the department and shall provide, without unreasonable delay, any documents to which the department is entitled hereunder."

Plan of correctionafter an inspection cites a violation

A written plan of correction within 10 days of an inspection report that cites violations.

"The provider must submit a written plan of correction (improvement) in response to the inspection report"

Contracted servicesif the agency uses contractors

Put every arrangement with contractors in writing, detailing the services.

"such arrangements shall be set forth in writing detailing the services to be provided."

Scope of services

Written policies defining the services you offer and the clients you serve.

"A provider shall establish and implement written policies and procedures that define the scope of private home care services it offers and the types of clients it serves."

Only offer what you can deliver

Do not offer services you cannot reasonably expect to deliver under the rules.

"No provider shall offer to provide a client any private home care services that it cannot reasonably expect to deliver in accordance with these rules."

Service agreements

Written policies for service agreements. Every service is based on a written agreement with ten required elements.

"A provider shall establish and implement policies and procedures for service agreements. All services provided to a client shall be based on a written service agreement"

Late agreements

If the agreement cannot be completed on time for good cause, document why in the client file.

"If the provider is unable to complete the service agreement for good cause, the provider will document such reason(s) in the client's file."

Cancellation

Clients may cancel at any time and pay only for services already given.

"A client has the right to cancel any service agreement at any time and shall only be charged for services actually rendered"

Client rights and complaints

Written policies on client rights and responsibilities and on handling complaints.

"A provider shall establish and implement written policies and procedures regarding the rights and responsibilities of clients, and the handling and resolution of complaints."

Written notice of rights

A written notice of 11 rights and responsibilities, given when the service agreement is completed.

"Such policies and procedures shall include a written notice of rights and responsibilities which shall be provided to each client or responsible party"

Complaint procedure

Clients and others can complain orally or in writing and have complaints resolved in a timely way.

"Such policies shall also include procedures for clients and others to present complaints, either orally or in writing"

Provider phone number

Give every client the agency’s phone number for questions and complaints.

"A provider shall supply all clients and responsible parties, if applicable, with the specific telephone number of the provider"

Complaint files

Keep files documenting every complaint.

"The provider shall maintain files of all documentation of complaints submitted pursuant to rule .12(2)."

Following the service planif personal care is offered

Aides follow the service plan and report changes in the client’s condition and any problems.

"In addition to following the service plan, a PCA must report on the personal care needs of the client, on changes in the client's condition, and on any observed problems that affect the client."

Access to client fundsif staff handle client funds

Written authorization before staff access a client’s money for home management.

"Authorization from client or responsible party, if applicable, for access to client's personal funds when home management services are to be provided"

Bondingif staff have unlimited access to client funds

Bond any employee with unlimited access to a client’s funds.

"any employee that is authorized unlimited access to a client's personal funds for home management shall be bonded through the provider"

Transporting clientsif staff drive clients

Get a signed waiver or check motor insurance when staff drive clients in a vehicle that is not the client’s.

"the provider shall either obtain a signed waiver by the client of any claims for damages arising out of the operation of the vehicle or make reasonable efforts to insure that there is current motor vehicle insurance"

Staffing and shortages

Enough qualified staff for every service agreement. Tell clients and offer a referral if you cannot deliver.

"the provider shall advise the client and refer the client to another provider if the client so desires."

Personnel records

A separate record for each employee with nine required items.

"A provider shall maintain separate written records for each employee and the records shall include the following"

TB and health screening

The rule as printed requires TB screening on hire and every year. The 2026 amendment replaces this with a health screening program and pre-employment TB screening.

"Documentation of a satisfactory TB screening test upon employment and annually thereafter"

Competency evaluation

A written evaluation showing a supervisor observed each employee perform their job tasks competently.

"The written evaluation must reflect that the employee's performance of required job tasks was observed personally by a supervisor either by demonstration or observation"

Nursing staffif nursing services are offered

Anyone giving nursing services holds a Georgia license.

"Any persons employed by the provider to provide nursing services shall be licensed in Georgia"

Aide qualification and trainingif personal care is offered

Aides qualify through one of four routes, including a 40-hour agency course directed by an RN.

"A training program described in rule .09(5)(c)1. (iv) must be conducted under the direction of a licensed registered professional nurse"

Companion trainingif companion or sitter tasks are offered

Companions complete training or show competency in seven areas.

"Successfully complete training or demonstrate understanding and practical competency in the following areas"

Orientation

Orientation before client work, covering your policies, duties, reporting and emergencies, and exposure reporting.

"Prior to working with clients, all employees hired or used on or after the effective date of these rules and who provide services to clients shall be oriented in accordance with these rules"

Annual training

At least 8 hours of training a year after the first year.

"a minimum of eight clock hours of training or instruction shall be provided annually for each employee after the first year of employment."

Registry checks

Check the registries for owners, administrators and employees before the fingerprint check.

"Prior to a criminal background check required by these rules, the facility shall perform a registry check of the owner, administrator, onsite manager, director, and employees."

Background check evidence

Keep each employee’s determination, registry check and license check in the personnel file.

"evidence of each employee's satisfactory determination, registry check, and licensure check, if applicable."

Employment application notice

Print the required background check notice on job applications.

"FOR THIS TYPE OF EMPLOYMENT, STATE LAW REQUIRES A NATIONAL AND STATE BACKGROUND CHECK AS A CONDITION OF EMPLOYMENT."

Annual written evaluation

Supervisors evaluate each staff member in writing every year.

"Each staff member providing services to a client shall be evaluated in writing by his or her supervisor, at least annually"

TB and hepatitis exposure

Keep exposed or diagnosed staff away from clients until they are known not to be contagious.

"No supervisor shall knowingly permit an employee who has been exposed to tuberculosis or hepatitis or diagnosed with the same to provide services to clients until it is determined that the employee is not contagious."

RN supervision of nursingif nursing services are offered

A Georgia RN supervises nursing services and the staff who give them.

"it shall employ fully licensed Georgia registered professional nurse to supervise the provision of such services"

Nurse supervision for frail clientsif personal care is offered to medically frail clients

An RN or LPN supervises personal care for medically frail clients, and an RN writes their first service plan.

"A licensed registered professional or practical nurse shall supervise the provision of personal care tasks for clients determined to be medically frail or medically compromised."

Supervisory visits (personal care)if personal care is offered

A supervisory home visit at least every 92 days, with a check of condition, vital signs and satisfaction.

"The appropriate supervisor shall make a supervisory home visit to each client's residence at least every 92 days"

Supervisory visits (companion)if companion or sitter tasks are offered

A supervisory home visit at least every 122 days, or after a serious complaint.

"at least every 122 days starting from date of initial service in the residence or when the provider receives a complaint concerning services"

On-call nurse accessif personal care is offered to medically frail clients

Someone on call who can reach a nurse supervisor when aides serve medically frail clients.

"the provider shall have a representative on call and accessible who shall be able to contact a nurse supervisor by telephone or other means"

Daily service documentation

Written policies for documenting the services actually performed each day.

"A provider shall establish and implement written policies and procedures for documenting the services actually performed for its clients each day."

Quality improvement

A documented quality improvement program, including complaints, care problems and corrective action.

"The provider must have and maintain documentation reflecting that there is an effective quality improvement program that continuously monitors the performance of the program itself and client outcomes"

Service planning

Written policies for service planning. Each plan is made with the client and covers limitations, services, frequency, goals and discharge.

"A provider shall establish and implement written policies and procedures for service planning. A written plan of service shall be established in collaboration with the client"

Service plan timing

Plans done within 7 working days. Nursing plans reviewed every 62 days; others at each supervisory visit.

"Service plans shall be completed by the service supervisor within seven working days after services are initially provided in the residence."

Client records

A separate file for each client with nine required items.

"A provider shall maintain a separate file containing all written records pertaining to the services provided for each client that it serves"

Records security, release and retention

Written policies on who keeps records, who can see them and how long they are kept (at least five years).

"Written policies and procedures shall be established and implemented for the maintenance and security of client records specifying who shall supervise the maintenance of records, who shall have custody of records, to whom records may be released and for what purposes and how long the records will be retained."

Confidentiality

Staff disclose client information only to appropriate agency staff or as allowed.

"Employees of the provider shall not disclose or knowingly permit the disclosure of any information in a client record except to appropriate provider staff"

Mandated reporting of abuse

Employees of an agency giving health-related services to older people or adults with disabilities must report suspected abuse, neglect or exploitation.

"employees of a public or private agency engaged in professional health-related services to elder persons or adults with disabilities"

Where abuse reports go

Report to Adult Protective Services and to law enforcement or the prosecuting attorney, orally or in writing.

"shall be made to an adult protection agency providing protective services as designated by the department and to an appropriate law enforcement agency or prosecuting attorney"

Clients living in a long-term care facility

For a client who lives in a personal care home or other long-term care facility, report abuse or exploitation immediately by phone or in person to DCH and to law enforcement, then in writing to DCH within 24 hours.

"shall also make a written report to the department within 24 hours after making the initial report"

Medical emergencies

Orientation covers reporting progress and problems and the procedures for handling medical emergencies or other incidents.

"procedures for handling medical emergencies or other incidents that affect the delivery of services in accordance with the client's services plan"

Incident reports

Keep incident reports for at least five years.

"A provider shall also maintain on file for a minimum of five years all incident reports or reports of unusual occurrences"