SB95: SB95 Certificate of Need Program; an exemption from certificate of need requirements concerning life plan communities; revise

Georgia requires most new health care facilities to get a certificate of need from the state before they can open, a process meant to control the growth of medical services. Life plan communities (retirement communities offering different levels of care from independent living to skilled nursing) have long had a partial exemption for their nursing facilities, but current law ties that exemption mainly to nonprofit communities. This bill rewrites O.C.G.A. § 31-6-47(a)(17) so the exemption applies to both for-profit and nonprofit life plan communities. Nonprofit communities must still get a written exemption from the Department of Community Health, and their nursing beds are subject to a five-year phase-in that limits how many beds can be used by nonresidents, stepping down from 50 percent in year one to 10 percent in year five. For-profit communities are also exempt, but any of their sheltered nursing beds used by nonresidents remain ineligible for Medicaid reimbursement. The bill repeals conflicting laws and does not list a separate effective date.

• Extends the certificate of need exemption for life plan community nursing facilities to for-profit communities, which were not clearly covered before.
• Keeps a requirement that nonprofit life plan communities get a written exemption from the Georgia Department of Community Health for their skilled nursing component.
• Preserves the five-year, step-down schedule limiting the share of nonprofit community nursing beds that nonresidents can occupy, from 50 percent down to 10 percent.
• Bars Medicaid reimbursement for sheltered nursing beds used by nonresidents in both nonprofit and for-profit life plan communities.
• Directs the Department of Community Health to keep making rules defining and regulating the term 'sheltered nursing facility.'
• Repeals any existing state laws that conflict with these changes.

Life plan communities (retirement communities with tiered levels of care) in Georgia, both nonprofit and for-profit, along with their residents and staff, the Georgia Department of Community Health, which administers the certificate of need program and issues exemptions, and nonresident patients who may temporarily use sheltered nursing beds.

For-profit life plan communities would gain the same certificate of need exemption nonprofit ones have used, potentially making it easier and cheaper for them to operate skilled nursing beds without going through the state's full facility approval process, while Medicaid reimbursement restrictions and bed-use limits remain in place.

• Section 1 revises paragraph (17) of O.C.G.A. § 31-6-47(a) to cover 'for profit and not for profit life plan communities' instead of only nonprofit ones.
• Nonprofit life plan communities must still obtain a written exemption from the department and reserve the skilled nursing component for residents, with limited nonresident use for up to five years after initial licensing.
• The bed-use limits for nonresidents in nonprofit communities step down annually: 50 percent in year one, 40 percent in year two, 30 percent in year three, 20 percent in year four, and 10 percent in year five.
• After the five-year period, nonprofit life plan community nursing facilities must be used exclusively by residents, and no existing patient can be forced out to comply.
• Sheltered nursing beds occupied by nonresidents, in either for-profit or nonprofit communities, are not eligible for Medicaid reimbursement.
• The department retains authority to write rules defining 'sheltered nursing facility' consistent with this section.
• Section 2 repeals any conflicting state laws.

1. 2025-02-05Senate Read and Referred (Senate)
2. 2025-02-04Senate Hopper (Senate)

• Ben Watson (R, SD-001)Primary sponsor
• Bo Hatchett (R, SD-050)
• Carden Summers (R, SD-013)
• John Albers (R, SD-056)
• Randy Robertson (R, SD-029)
• Blake Tillery (R, SD-019)
• Bill Cowsert (R, SD-046)
• Kay Kirkpatrick (R, SD-032)
• Matt Brass (R, SD-006)
• Lee Anderson (R, SD-024)
• Drew Echols (R, SD-049)
• Shawn Still (R, SD-048)

• certificate of need
• life plan communities
• nursing home regulation
• Medicaid reimbursement
• health care licensing