---
title: HB 904. Health; certificate of need requirements concerning life plan communities; revise an exemption
collection: bills
id: 2025-2026/hb904
cite_as: HB 904, 2025-2026 Regular Session (Ga.)
canonical_url: https://georgiacommons.org/bills/2025-2026/hb904
md_url: https://georgiacommons.org/bills/2025-2026/hb904.md
text_url: https://georgiacommons.org/bills/2025-2026/hb904/text
source_url: https://www.legis.ga.gov/legislation/71977
date: 2026-01-12
status: introduced
corpus_version: bills-2026-09-13
license: Public record of the Georgia General Assembly, via LegiScan; see about.md
publisher: Georgia Commons, an independent project of Georgia Civic Data. Not the State of Georgia. Not legal advice.
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omitted: votes and history
omitted_chars: 129
omitted_url: https://georgiacommons.org/bills/2025-2026/hb904.md?full=1
bill_number: HB 904
session: 2025-2026 Regular Session
session_slug: 2025-2026
chamber: House
bill_type: bill
status_date: 2025-04-02
last_action: House Second Readers
sponsors:
- Deborah Silcox
- Sharon Cooper
text_version: Introduced
has_text: true
legiscan_url: https://legiscan.com/GA/bill/HB904/2025
upstream_id: 2019456
summaries_model: claude-sonnet-5
topic_tags:
- certificate of need
- life plan communities
- skilled nursing facilities
- senior care
- Medicaid and Medicare rules
---
# HB 904. Health; certificate of need requirements concerning life plan communities; revise an exemption
## Text
House Bill 904
By: Representatives Silcox of the 53rd and Cooper of the 45th
A BILL TO BE ENTITLED
AN ACT
To amend Code Section 31-6-47 of the Official Code of Georgia Annotated, relating to
exemptions from the certificate of need program, so as to revise an exemption from
certificate of need requirements concerning life plan communities; to provide for a definition;
to provide for related matters; to repeal conflicting laws; and for other purposes.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION 1.
Code Section 31-6-47 of the Official Code of Georgia Annotated, relating to exemptions
from the certificate of need program, is amended by revising paragraph (17) of subsection
(a) as follows:
"(17) Life plan communities, provided that the skilled nursing component of the facility
is primarily utilized by for the exclusive use of residents of the life plan community and
that a written exemption is obtained from the department; provided, however, that new.
New sheltered skilled nursing home facility beds may be used on a limited basis by
persons who are not residents of the life plan community for a period up to five years
after the date of issuance of the initial nursing home license, but such beds shall not be
eligible for Medicaid reimbursement. For the first year after the date of issuance of the
initial skilled nursing facility license, the life plan community sheltered skilled nursing
facility may utilize not more than 50 percent of its licensed beds for new patients who are
not residents of the life plan community. In the second year of operation, the life plan
community shall allow not more than 40 percent of its licensed beds for new patients who
are not residents of the life plan community. In the third year of operation, the life plan
community shall allow not more than 30 percent of its licensed beds for new patients who
are not residents of the life plan community. In the fourth year of operation, the life plan
community shall allow not more than 20 percent of its licensed beds for new patients who
are not residents of the life plan community. In the fifth year of operation, the life plan
community shall allow not more than 10 percent of its licensed beds for new patients who
are not residents of the life plan community. At no time during the first five three years
of operation shall the life plan community sheltered skilled nursing facility occupy more
than 50 percent of its licensed beds with patients who are not residents under contract
with the life plan community. At the end of the five-year three-year period, the life plan
community sheltered skilled nursing facility shall be utilized exclusively primarily by
residents of the life plan community, and at no time shall the life plan community skilled
nursing facility occupy more than (i) 25 percent of its skilled nursing facility beds with
patients requiring long-term care and who are not residents under contract with the life
plan community; and (ii) the greater of five beds or 10 percent of its skilled nursing
facility beds with patients requiring short-term rehabilitation who are not residents under
contract with the life plan community. At no time shall a resident of a life plan
community be denied access to the sheltered skilled nursing facility. At no time nor shall
any existing patient be forced to leave the life plan community to comply with this
paragraph. The department is authorized to promulgate rules and regulations regarding
the use and definition of the term 'sheltered nursing facility' in a manner consistent with
this Code section. Agreements to provide continuing care include agreements to provide
care for any duration, including agreements that are terminable by either party. As used
in this paragraph, the term 'short-term rehabilitation' means skilled nursing facility beds
which may be occupied for not more than 100 days per benefit period, the cost of which
is covered under Part A of Title XVIII of the federal Social Security Act (Medicare) or
paid privately;"
SECTION 2.
All laws and parts of laws in conflict with this Act are repealed.
## Summaries written by Georgia Commons
The following was written by claude-sonnet-5 from the text above and is not part of the bill. Quote the text, not the summary.
House Bill 904 would rewrite the rules that let life plan communities in Georgia run skilled nursing facilities without a certificate of need, shortening the phase-in period and setting new limits on outside patients.
### Plain-language summary
Georgia's certificate of need law (O.C.G.A. § 31-6-47) normally requires health facilities to get state approval before adding services like nursing beds, but life plan communities (retirement communities offering a continuum of care) get an exemption for skilled nursing facilities that mainly serve their own residents. This bill rewrites that exemption.
Currently the law allows a five-year phase-in during which a portion of beds can go to non-residents, stepping down from 50 percent to 10 percent, with an overall cap of 50 percent non-resident use during that period. The bill shortens this to a three-year phase-in (50 percent, 40 percent, then 30 percent) and removes the fourth and fifth year steps. After the three years, it sets permanent caps: no more than 25 percent of beds for non-resident long-term care patients, and the greater of five beds or 10 percent for non-resident short-term rehabilitation patients, defined as care covered by Medicare Part A or paid privately for up to 100 days per benefit period. It also renames 'sheltered nursing facility' to 'skilled nursing facility' throughout and removes the Department of Community Health's authority to define that former term.
### What it does
- Shortens the exemption's phase-in period for outside (non-resident) patients from five years to three years before permanent limits kick in.
- Sets new permanent caps after the phase-in: no more than 25 percent of beds for non-resident long-term care patients and the greater of five beds or 10 percent for non-resident short-term rehabilitation patients.
- Adds a definition of 'short-term rehabilitation' as skilled nursing facility care covered by Medicare Part A or paid privately, capped at 100 days per benefit period.
- Replaces the term 'sheltered nursing facility' with 'skilled nursing facility' throughout the exemption and removes state rulemaking authority over the old term.
- Changes the requirement that the facility be used exclusively by life plan community residents after the phase-in to 'primarily' used by them, a looser standard.
- Removes the prior fourth and fifth year percentage limits (20 percent and 10 percent) since the phase-in is now only three years.
### Who it affects
Life plan communities (retirement communities that offer housing plus a continuum of care) and their skilled nursing facilities, current and prospective residents of those communities, outside patients seeking short-term rehabilitation or long-term nursing care, and the Georgia Department of Community Health, which administers the certificate of need program.
### Why it matters
The change affects how many beds in life plan community nursing facilities can be filled by people who are not community residents, both during a new facility's early years and permanently afterward, which could shape access to skilled nursing and rehabilitation beds for both residents and the broader public in areas served by these communities.
### Key provisions
- Section 1 amends paragraph (17) of subsection (a) of O.C.G.A. § 31-6-47 to shorten the phase-in period for non-resident bed use from five years to three years.
- During the phase-in, non-resident new-patient limits are set at 50 percent in year one, 40 percent in year two, and 30 percent in year three, with an overall 50 percent cap on non-resident occupancy at any time.
- After the three-year period, the facility must be 'primarily' (rather than 'exclusively') used by life plan community residents.
- New permanent caps apply after the phase-in: 25 percent of beds for non-resident patients needing long-term care, and the greater of five beds or 10 percent of beds for non-resident short-term rehabilitation patients.
- Adds a definition of 'short-term rehabilitation' as skilled nursing facility beds occupied for up to 100 days per benefit period, covered by Medicare Part A or paid privately.
- Removes the Department of Community Health's authority to make rules defining 'sheltered nursing facility' and eliminates that term in favor of 'skilled nursing facility.'
- Section 2 repeals conflicting laws, a standard closing provision.
## Status
- Status: Introduced (2025-04-02)
- Last action: House Second Readers (2026-01-12)
- Sponsors: Deborah Silcox, Sharon Cooper
- Official page: https://www.legis.ga.gov/legislation/71977
> The history, votes, and amendments (129 characters) are at https://georgiacommons.org/bills/2025-2026/hb904.md?full=1