SB 95: Certificate of Need Program; an exemption from certificate of need requirements concerning life plan communities; revise

Georgia's certificate of need law (O.C.G.A. § 31-6-47) generally requires health facilities to get state approval before adding services like nursing beds, but it exempts skilled nursing facilities inside life plan communities (retirement communities that offer housing plus a path to nursing care) as long as certain conditions are met. Currently that exemption applies to life plan communities generally. This bill rewrites the exemption so it explicitly covers both for-profit and not-for-profit life plan communities. It keeps the existing rule that a nonprofit life plan community's nursing beds are for residents only, with a five-year phase-in allowing a shrinking share of beds to go to non-residents, none of which can be billed to Medicaid. The bill adds a new provision saying that in for-profit life plan communities, sheltered nursing beds used by non-residents also cannot be billed to Medicaid. The bill repeals conflicting laws and does not state a delayed effective date.

• Extends the certificate of need exemption for life plan community nursing facilities to for-profit communities, which were not previously named in the exemption.
• Keeps the requirement that a nonprofit life plan community must get a written exemption from the Department of Community Health and reserve nursing beds mainly for its own residents.
• Applies the existing five-year declining-percentage schedule for admitting non-resident patients only to not-for-profit life plan communities.
• Adds a new rule that for-profit life plan communities cannot get Medicaid reimbursement for sheltered nursing beds used by people who are not residents of the community.
• Keeps the existing rule that no current resident can be forced to leave a life plan community because of this law.

Owners and operators of life plan communities (retirement communities offering housing and nursing care) in Georgia, both nonprofit and for-profit, along with their residents and the Georgia Department of Community Health, which issues the written exemptions and Medicaid reimbursement rules.

For-profit life plan communities would gain a clear path to operate skilled nursing facilities without going through Georgia's certificate of need approval process, similar to nonprofit communities, but any beds they fill with non-residents would not qualify for Medicaid payment, which could affect how they staff and price those beds.

• Section 1 revises paragraph (17) of O.C.G.A. § 31-6-47 to cover 'for profit and not for profit life plan communities' instead of just life plan communities generally.
• The requirement that skilled nursing beds be for exclusive resident use and that a written exemption be obtained from the department is now specified to apply to not-for-profit communities.
• The five-year declining schedule (50 percent, 40 percent, 30 percent, 20 percent, then 10 percent of beds available to non-residents) is limited by the bill's language to not-for-profit life plan communities.
• A new sentence states that sheltered nursing home beds in a for-profit life plan community used by non-residents are not eligible for Medicaid reimbursement.
• Section 2 repeals all laws in conflict with the Act; the bill does not specify a delayed effective date.

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 homes
• Medicaid reimbursement
• health facility regulation