RESIDENTIAL CARE SERVICES PROVIDER IN GEORGIA

PROVIDING SAFE, SUPPORTIVE LIVING ARRANGEMENTS FOR INDIVIDUALS WITH DISABILITIES, AGING NEEDS, AND CHRONIC CONDITIONS

Residential Care Services in Georgia offer structured, supportive living environments where individuals with disabilities, chronic illnesses, or aging-related needs can receive assistance with daily living activities, health maintenance, and community participation. These services are authorized under Georgia’s Medicaid programs, including both Home and Community-Based Services (HCBS) waivers and traditional Medicaid for Nursing Facilities or Assisted Living programs.

​​1. GOVERNING AGENCIES

Agency: Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD)

Role: Manages community-based residential services under HCBS waivers (NOW, COMP)

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

Role: Licenses Assisted Living Communities, Personal Care Homes, and Nursing Facilities

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight for Medicaid-funded residential settings, ensuring HCBS and institutional compliance

2. RESIDENTIAL CARE SERVICE OVERVIEW

Residential Care Services support individuals living in community or facility-based settings by providing:

• 24-hour supervision and health/safety monitoring

• Assistance with Activities of Daily Living (ADLs) such as bathing, dressing, toileting, mobility, and eating

• Support with Instrumental Activities of Daily Living (IADLs) such as cooking, cleaning, laundry, and shopping

• Medication administration and health oversight (delegated or nursing tasks, depending on the setting)

• Transportation and assistance with community participation

• Skill-building activities to encourage independence

• Emergency response and crisis intervention when needed

Service types can include:

• Community Residential Alternatives (group homes or shared living under NOW/COMP waivers)

• Supported Living Arrangements

• Personal Care Homes (small licensed facilities)

• Assisted Living Communities (for seniors and individuals with disabilities)

• Nursing Facilities (for those needing skilled nursing oversight)

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register your business with the Georgia Secretary of State

• Obtain EIN from the IRS and NPI (Type 2)

• Apply for applicable facility license (e.g., Personal Care Home License, Assisted Living License) through DCH HFRD

• Enroll as a Medicaid provider through the Georgia Medicaid Management Information System (GAMMIS) if participating in HCBS or LTC Medicaid

• Complete DBHDD Provider Enrollment if providing services under NOW/COMP waivers

• Maintain general liability, professional liability, and property insurance

• Meet Life Safety Code standards (NFPA compliance) for licensed facilities

• Develop comprehensive policies for health and safety, medication management, emergency response, and resident rights

4. DBHDD/DCH PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Submit a Letter of Intent to DBHDD for HCBS residential services, or an application to HFRD for licensed facility services

• Complete required pre-qualification documentation, including business registration and insurance verification

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, organizational structure, staff plans, policies, and procedures manuals

• Provide sample service plans, emergency protocols, and quality assurance plans

Site Readiness Inspection:

• Fire Marshal Inspection

• Life Safety Code compliance review

• DBHDD site certification (for HCBS settings)

Approval & Medicaid Enrollment:

• Upon state licensing and/or DBHDD approval, finalize Medicaid enrollment through GAMMIS

• Configure billing systems according to service type (CRA, ALF, PCH, NF billing codes)

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Georgia Secretary of State)

• IRS EIN confirmation

• NPI confirmation

• Facility License (if required: PCH, ALF, NF)

• Proof of insurance

• DBHDD-Compliant and/or HFRD-Compliant Policy & Procedure Manual including:

  • Resident intake, assessment, and individualized service planning

  • Medication management and health monitoring policies

  • Daily supervision, activity planning, and safety monitoring protocols

  • Emergency response, fire evacuation, and crisis management procedures

  • Incident reporting and abuse prevention systems

  • Staff credentialing, background screening, and training documentation

  • Medicaid billing, service documentation, and authorization tracking systems

6. STAFFING REQUIREMENTS

Role: Residential Manager / Administrator

Requirements: Bachelor’s degree in a human services field preferred for HCBS; Licensed Assisted Living Administrator required for ALFs; background screening clearance

Role: Direct Support Professionals (DSPs) / Personal Care Aides / Certified Nursing Assistants (CNAs)

Requirements: High school diploma or GED; CPR/First Aid certification; background screening clearance

Role: Licensed Nurses (for Nursing Facilities or Delegated Healthcare Tasks)

Requirements: Georgia RN or LPN licensure; background screening clearance

All staff must complete:

• HIPAA confidentiality, resident rights, and abuse prevention training

• Emergency preparedness, CPR/First Aid, and infection control training

• Person-centered planning and community integration training

• Annual continuing education for licensure or Medicaid compliance, as applicable

7. MEDICAID WAIVER SERVICES

Depending on the residential setting, Medicaid coverage may include:

• NOW and COMP Waivers (HCBS):

  • Community Residential Alternative (CRA)

  • Supported Living

  • Residential Staff Support

• Traditional Medicaid (Institutional Settings):

  • Nursing Facility Services

  • Assisted Living under State Programs (optional limited support)

8. TIMELINE TO LAUNCH

Phase: Business Formation and Licensing Setup

Timeline: 2–3 months (longer if facility construction or remodeling is required)

Phase: DBHDD Site Certification and Medicaid Enrollment (HCBS Residential)

Timeline: 90–120 days

Phase: Staff Hiring, Training, and Program Finalization

Timeline: 30–60 days

Phase: Medicaid Billing System Configuration

Timeline: 45–60 days

9. CONTACT INFORMATION

Georgia Department of Community Health (DCH) – Healthcare Facility Regulation Division (HFRD)Website: https://dch.georgia.gov/divisionsoffices/hfrd

Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD)Website: https://dbhdd.georgia.gov/

Georgia Medicaid Management Information System (GAMMIS)Website: https://www.mmis.georgia.gov/

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — GEORGIA RESIDENTIAL CARE SERVICES PROVIDER

WCG supports residential providers, personal care home owners, and community-based living organizations in launching Medicaid-compliant Residential Care Services across Georgia.

Scope of Work:

• Business registration and EIN/NPI setup

• Medicaid and/or Residential Facility licensing enrollment assistance

• Development of Residential Care Policy & Procedure Manual

• Staff credentialing templates and participant intake forms

• Medicaid billing system setup and claims management

• Website, domain, and email setup

• Resident intake, care planning, and daily documentation templates

• Emergency response, fire safety, and evacuation system development

• Quality assurance programs for service delivery monitoring

• Community networking and case management referral strategies

Continue To Our Client Portal To Get Started

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