NURSING FACILITY SERVICES PROVIDER IN GEORGIA

Fatumata Kaba
Jul 14
4 min read

DELIVERING 24-HOUR SKILLED NURSING CARE TO SUPPORT HEALTH, SAFETY, AND QUALITY OF LIFE FOR INDIVIDUALS WITH COMPLEX NEEDS

Nursing Facility Services in Georgia provide comprehensive, round-the-clock medical care, rehabilitation, and personal care for individuals with serious health conditions or disabilities who require ongoing clinical oversight. These services are authorized under Georgia’s Medicaid program and are a critical component of the state’s long-term care system, supporting individuals who cannot safely live independently.

1. GOVERNING AGENCIES

Agency: Georgia Department of Community Health (DCH) — Healthcare Facility Regulation Division (HFRD)

Role: Licenses and inspects Nursing Facilities, oversees quality standards, and ensures regulatory compliance

Agency: Georgia Department of Community Health (DCH) — Medicaid Division

Role: Manages Medicaid enrollment, service authorization, and reimbursement for Nursing Facility Services

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight for Medicare and Medicaid-certified Nursing Facilities, ensuring compliance with federal regulations

2. NURSING FACILITY SERVICE OVERVIEW

Nursing Facility Services offer comprehensive care designed to meet the medical, nursing, rehabilitative, and personal care needs of residents with complex, ongoing health issues.

Approved providers deliver:

24-hour skilled nursing care and medical supervision
Medication management and administration
Physical, occupational, and speech therapy (as needed)
Nutritional support, including therapeutic diets
Wound care, IV therapy, respiratory support, and tracheostomy care
Assistance with activities of daily living (ADLs) such as bathing, dressing, and toileting
Social activities, community integration, and psychological support
End-of-life (palliative) care and hospice coordination when appropriate

All services must be provided according to an individualized care plan developed through a comprehensive assessment process involving the resident, family, interdisciplinary team, and attending physician.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Georgia Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Apply for and obtain a Nursing Facility License through DCH’s Healthcare Facility Regulation Division (HFRD)
Comply with the federal Nursing Home Reform Act (OBRA 1987) standards
Meet Life Safety Code and Physical Environment standards (NFPA compliance)
Obtain Medicare and Medicaid certification through CMS for dual participation (optional but highly recommended)
Maintain general liability, professional liability, and property insurance
Develop comprehensive operational, clinical, and emergency management policies

4. DCH PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Submit Certificate of Need (CON) application (required for new Nursing Facilities in Georgia)
Apply for Nursing Facility licensure through DCH HFRD
Complete Pre-Licensure Survey and readiness inspection by HFRD

Application and Documentation Submission:

Submit business incorporation documents, staffing plans, floor plans, insurance coverage, emergency preparedness plans, and life safety inspection documentation
Provide resident care policies, quality assurance plans, and infection control protocols

Licensing and Certification Survey:

Pass an unannounced inspection to assess compliance with state and federal standards
Undergo CMS Certification Survey if pursuing Medicare and Medicaid certification

Medicaid Enrollment:

After licensure and (optional) CMS certification, complete Medicaid provider enrollment through GAMMIS
Set up billing systems and Resident Assessment Instrument (RAI) Minimum Data Set (MDS) submission systems

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business License (Georgia Secretary of State)
IRS EIN confirmation
NPI confirmation
Certificate of Need (CON) approval
Nursing Facility License (DCH HFRD)
Proof of general, professional, and property insurance
DCH-Compliant Policy & Procedure Manual including:
- Resident assessment, admission, and individualized care planning
- Medication management, infection control, and fall prevention protocols
- Emergency preparedness, evacuation plans, and disaster recovery strategies
- Staff credentialing, training, and continuing education records
- Quality Assurance and Performance Improvement (QAPI) Program
- Resident rights, HIPAA compliance, and grievance procedures
- Medicaid billing, MDS submission tracking, and documentation retention systems

6. STAFFING REQUIREMENTS

Role: Nursing Home Administrator

Requirements: Georgia Nursing Home Administrator License; experience managing long-term care operations; background screening clearance

Role: Director of Nursing (DON)

Requirements: Active Georgia RN license; management experience in skilled nursing; background screening clearance

Role: Registered Nurses (RNs) and Licensed Practical Nurses (LPNs)

Requirements: Active Georgia nursing licenses; CPR certification; background screening clearance

Role: Certified Nursing Assistants (CNAs)Requirements: Georgia CNA certification; background screening clearance

All staff must complete:

Resident rights, HIPAA confidentiality, and abuse prevention training
Emergency preparedness and infection control training
Clinical competency assessments and ongoing annual training
Specialized dementia care training (for facilities serving individuals with Alzheimer’s or related disorders)

7. MEDICAID WAIVER SERVICES

Although Medicaid Waivers (like COMP, NOW) provide home and community-based care to avoid institutionalization, Nursing Facility Services are covered under Georgia’s Traditional Medicaid Long-Term Care (LTC) Program, not through waivers.

Covered services include:

Nursing and medical care
Therapy services
Pharmacy services
Nutritional and dietary services
Behavioral health services (if needed)
Social services and community re-engagement support

8. TIMELINE TO LAUNCH

Phase: Business Formation and Certificate of Need (CON) Approval

Timeline: 3–6 months

Phase: Facility Construction/Modification and Licensing Application

Timeline: 6–12 months (depending on scope)

Phase: Pre-Licensure Survey and CMS Certification Survey (if applicable)

Timeline: 3–6 months

Phase: Medicaid Enrollment and Billing System Setup

Timeline: 2–3 months

9. CONTACT INFORMATION

Georgia Department of Community Health (DCH) – Healthcare Facility Regulation Division (HFRD)

Website: https://dch.georgia.gov/divisionsoffices/hfrd

Georgia Department of Community Health (DCH) – Medicaid Division

Website: https://dch.georgia.gov/

Georgia Medicaid Management Information System (GAMMIS)

Website: https://www.mmis.georgia.gov/

Georgia Board of Nursing

Website: https://sos.ga.gov/

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov/

NURSING FACILITY SERVICES PROVIDER IN GEORGIA

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — GEORGIA NURSING FACILITY SERVICES PROVIDER

WCG supports long-term care agencies, healthcare entrepreneurs, and investors in launching Medicaid- and Medicare-compliant Nursing Facility Services under Georgia’s Traditional Medicaid Long-Term Care Program.

Scope of Work: