State inspection reports say that Autumn Leaves of Stockbridge, a dementia care facility, once went three months without an on-site manager. The facility has changed hands after the parent company filed for bankruptcy. (Hyosub Shin / Hyosub.Shin@ajc.com)
Photo: HYOSUB SHIN / AJC
Photo: HYOSUB SHIN / AJC

Most states have higher standards for directors of senior care homes

The state of Georgia requires licensing and testing before workers can get all sorts of jobs that could place consumers at risk. Even nail technicians must meet training requirements, pass tests and get a license.

But state lawmakers don’t require a license or certification for those who manage assisted living communities or personal care homes, even those filled with more than 100 vulnerable residents, many with dementia or who need a careful regimen of medications.

In Georgia, someone with a GED and enough experience working in a senior care home or any health care setting meets the minimum requirement.

» SEARCHABLE DATABASE: Details on every facility studied by the AJC

» MORE: The ‘Unprotected’ investigative series

At Brasstown Manor, a receptionist was promoted in late 2016 to be director. At Summer’s Landing in Vidalia in 2018, a person who did marketing was asked to “come and run things in this building for a while.” Autumn Leaves of Stockbridge, a dementia care facility, once went three months with no administrator.

Summer’s Landing and Autumn Leaves are now under new operators.

Bobbie Rohr said she moved up from receptionist/office manager to director at Brasstown Manor out of necessity when the previous director left suddenly. She had been at the facility for more than a decade and served on an interim basis until she earned the director’s job permanently. “I felt like I had the qualifications,” she said. “A lot of it is hands-on work. A lot of it is you are learning new things every day.”

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Even when directors meet the minimum combination of education and experience, that doesn’t mean they have a grasp of state rules, the AJC found in its review of thousands of inspection reports. In case after case, administrators told inspectors they didn’t know about various requirements for residents’ protection.

The AJC found that 35 states demand more of on-site administrators.

In Alabama and South Carolina, administrators must pass a state exam and be licensed. In Arkansas, administrators must be state certified after 24 hours of training about the intricacies of state rules, legal and ethical responsibilities and more. 

Florida requires administrators to pass a competency test. North Carolina requires candidates to complete a 120-hour administrator-in-training program and pass a written exam. Virginia sets higher educational standards and also requires licensing.

» MORE: Gaps in Georgia laws leave residents with dementia most at risk

» CONSUMER GUIDE: Resources for finding and evaluating a senior care facility

Ginny Helms, president of LeadingAge Georgia, an association of not-for-profit and other mission-driven organizations that provide services to seniors, said a qualified director is essential. “It’s the biggest issue in assisted living: You have to understand the acuity of your residents and be able to care for them,” Helms said.

Ginny Helms is president of LeadingAge Georgia, an association of non-for-profit and other mission-driving organizations that provide services to seniors
Photo: The Atlanta Journal-Constitution

She said the General Assembly should upgrade the requirements as part of a reform package.

State Rep. John LaHood, R-Valdostawhose family has run senior care facilities for decades, said he also supports certification for facility directors.

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