A state audit of Georgia’s personal care home program, which includes assisted living, has found that the state oversight agency should meet already-established timelines for monitoring, assess more penalties, and formalize policies and procedures for core operations.
The audit by the Georgia Department of Audits & Accounts evaluated the Healthcare Facility Regulation Division’s efficiency and effectiveness related to conducting routine inspections, addressing complaints and ensuring that violations are corrected within state-licensed residential facilities, including assisted living communities, personal care homes and community living arrangements.
The state’s senior living associations said they support transparency and accountability for personal care homes and other long-term care settings but said that the audit’s findings reinforce the need for the state to comprehensively review the oversight and enforcement system.
“The regulatory burden, reporting requirements and enforcement actions have significantly expanded over time but have not produced meaningful change,” Georgia Health Care Association Vice President of Operations Sylvia Barnes told McKnight’s Senior Living. “A punitive and inconsistent oversight process does not contribute to sustained quality improvement, nor does it enhance residents’ quality of life.”
LeadingAge President and CEO Ginny Helms similarly said that a quality improvement approach, rather than a punitive approach, improves care. Both associations said they routinely work with the state agency to improve care and identify innovative solutions to promote resident safety and prevent common citations.
The audit found that over the past six years, HFRD has not routinely inspected many senior living communities or fully used its authority to assess penalties for identified violations. According to the report, of the 2,540 communities due for a routine inspection, 43% had no inspection between January 2019 and November 2024. Of the 1,440 that were inspected, 63% were not inspected within the agency’s established 18-month goal.
During that five-year time period, HFRD prioritized complaint investigations over routine inspections, but the audit found that the agency did not monitor its complaint process to ensure that all serious complaints were investigated.
Among the audit’s recommendations are that the HFRD perform routine inspections within its established timeframe and that lawmakers consider codifying a required frequency for inspections. The audit also called for prioritizing complaints and appropriately penalizing communities that fail to meet state requirements.
Although the Department of Community Health, which oversees HFRD, did not dispute most of the findings and recommendations in the report, it expressed concerns about codifying the frequency of routine inspections, saying that additional staff members would be needed to meet any new requirement.
Source: McKnights Seniorliving
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