Opinion: A path toward fixing Ga.’s assisted living system

State Rep. Sharon Cooper (center), R-Marietta, speaks on the panel discussion at Georgia Public Broadcasting on Thursday, October 17, 2019. The Atlanta Journal-Constitution hosted a community conversation about the AJC’s investigation, “Unprotected.” TYSON HORNE / TYSON.HORNE@AJC.COM
State Rep. Sharon Cooper (center), R-Marietta, speaks on the panel discussion at Georgia Public Broadcasting on Thursday, October 17, 2019. The Atlanta Journal-Constitution hosted a community conversation about the AJC’s investigation, “Unprotected.” TYSON HORNE / TYSON.HORNE@AJC.COM

I was deeply troubled when I first learned of the findings from the Atlanta Journal-Constitution’s investigation into Georgia’s senior care industry, especially regarding the shortcomings of the state’s oversight of assisted living facilities. As the aging population in our state continues to increase at one of the highest rates in the U.S., the senior care industry continues to adapt and expand rapidly to meet market demands. However, the state has not adequately kept up with the industry’s development in recent years. These shortcomings include the failure to keep up with the rising senior population, a lack of adequately and appropriate training among nursing staff, how these facilities are licensed and how reports of neglect and abuse within these facilities are handled. Our aging population deserves better protection from our state, and those who are responsible for looking after our senior citizens should be held to the highest standard.

While well-intentioned, the state’s initial plan for establishing the senior care industry appears to have been short-sighted, and as a result, those who live in these facilities, and their families, have suffered. My colleagues and I in the Georgia General Assembly need to reexamine state laws and determine the best legislative solution to these problems in the industry as it continues to grow, as well as ways to support our state agencies, such as the Department of Community Health’s (DCH) Division of Healthcare Facility Regulation (HFR).

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The AJC's reports have highlighted that the state's requirement for skilled nursing staff within the senior care industry must be reevaluated to best meet the changing needs of our aging population. For example, citizens who choose to live in assisted living facilities over nursing homes do so because they do not require as intensive supervision or high-skilled care at that time. But, as their age progresses and their health diminishes, assisted living facilities do not provide the proper nursing staff to meet these needs. To provide adequate care within senior care facilities in Georgia, we need to increase educational and clinical experience requirements, designate levels of attention for each type of senior care facility and improve staff training standards for each level of care. If the state does not improve the senior care workforce requirements and determine levels of care, patients whose needs become more dependent on adequate and appropriately trained nursing staff could face neglect in their care.

One pathway that could improve the educational standards for nursing staff in assisted living facilities is through developing a certified nursing assistant (CNA) concentration for specific skillsets that could be underrepresented in assisted living facilities. Developing these concentrations in areas such as Alzheimer’s and dementia specialized care, could incentivize CNAs to grow in their skillset and help safeguard vulnerable populations in assisted living facilities. These concentrations could also count towards educational requirements for licensed practical nurse (LPN) programs in Georgia. Finally, the state could consider expanding its HOPE Career Grant program, which provides tuition assistance for programs that benefit industries with a workforce shortage in Georgia. Expanding the HOPE Career Grant program to include CNA programs with concentrations in senior care could help increase the number of high-skilled nursing staff available in these facilities.

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The state also needs to evaluate how it handles the licensing of senior care facilities. These providers have adapted their models to meet business demands, but a more in-depth screening process is needed for those seeking to establish a new facility or expand business operations in Georgia. There have been major improvements in state and federal background checks in recent years, but the state should continue to refine this process to ensure that only the best providers are licensed in Georgia. The state’s current criteria to open and operate these facilities is not specific enough, and refining the application process could better equip the licensing process for the HFR.

In addition, we must improve our mandatory reporting laws of neglect, abuse and other issues within the industry. The state has made strides in its mandatory reporting protocol, but there is still a need to address violations within this system. There are online resources for those who wish to file a report through the HFR. However, reports have found that a number of complaints filed with the HFR were never reported to local authorities for further review. The public, especially the families that visit these facilities, act as the eyes and ears for our senior citizens and take note of anything unusual at these facilities, but the HFR must be required to adequately respond to these reports.

I am thankful for the AJC’s investigation and reporting on this issue and bringing these terrible shortcomings to light. I encourage my colleagues in the General Assembly to not turn a blind eye to our aging citizens and the families who have entrusted their loved ones to these organizations. It is time to address the deficits in state law so we can better protect not only those who are currently in senior care homes, but also the growing aging population who may enter these facilities in the future. Georgia’s need for quality senior living care is inevitable, and for this reason, I hope that we will address these concerns through sound legislation during the 2020 legislative session.

State Rep. Sharon Cooper, R-Marietta, is chairman of House Health & Human Services Committee. She is a medical administrator and a registered nurse.