1. GOVERNING AGENCIES

Agency: Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD)
Role: Manages community-based residential services under HCBS waivers (NOW, COMP)

Agency: Georgia Department of Community Health (DCH) — Healthcare Facility Regulation Division (HFRD)
Role: Licenses Assisted Living Communities, Personal Care Homes, and Nursing Facilities

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight for Medicaid-funded residential settings, ensuring HCBS and institutional compliance

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2. RESIDENTIAL CARE SERVICE OVERVIEW

Residential Care Services support individuals living in community or facility-based settings by providing:

• 24-hour supervision and health/safety monitoring
• Assistance with Activities of Daily Living (ADLs) such as bathing, dressing, toileting, mobility, and eating
• Support with Instrumental Activities of Daily Living (IADLs) such as cooking, cleaning, laundry, and shopping
• Medication administration and health oversight (delegated or nursing tasks depending on setting)
• Transportation and assistance with community participation
• Skill-building activities to encourage independence
• Emergency response and crisis intervention when needed

Service types can include:

• Community Residential Alternatives (group homes or shared living under NOW/COMP waivers)
• Supported Living Arrangements
• Personal Care Homes (small licensed facilities)
• Assisted Living Communities (for seniors and individuals with disabilities)
• Nursing Facilities (for those needing skilled nursing oversight)

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3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Georgia Secretary of State
• Obtain EIN from the IRS and NPI (Type 2)
• Apply for applicable facility license (Personal Care Home License, Assisted Living License) through DCH HFRD
• Enroll as a Medicaid provider through the Georgia Medicaid Management Information System (GAMMIS) if participating in HCBS or LTC Medicaid
• Complete DBHDD Provider Enrollment if providing services under NOW/COMP waivers
• Maintain general liability, professional liability, and property insurance
• Meet Life Safety Code standards (NFPA compliance) for licensed facilities
• Develop comprehensive policies for health and safety, medication management, emergency response, and resident rights

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4. DBHDD/DCH PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Submit Letter of Intent to DBHDD for HCBS residential services, or application to HFRD for licensed facility services
• Complete required pre-qualification documentation including business registration and insurance verification

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, organizational structure, staff plans, policies and procedures manuals
• Provide sample service plans, emergency protocols, and quality assurance plans

Site Readiness Inspection:

• Fire Marshal Inspection
• Life Safety Code compliance review
• DBHDD site certification (for HCBS settings)

Approval & Medicaid Enrollment:

• Upon state licensing and/or DBHDD approval, finalize Medicaid enrollment through GAMMIS
• Configure billing systems according to service type (CRA, ALF, PCH, NF billing codes)

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5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Georgia Secretary of State)
• IRS EIN confirmation
• NPI confirmation
• Facility License (if required: PCH, ALF, NF)
• Proof of insurance

DBHDD-Compliant and/or HFRD-Compliant Policy & Procedure Manual including:

• Resident intake, assessment, and individualized service planning
• Medication management and health monitoring policies
• Daily supervision, activity planning, and safety monitoring protocols
• Emergency response, fire evacuation, and crisis management procedures
• Incident reporting and abuse prevention systems
• Staff credentialing, background screening, and training documentation
• Medicaid billing, service documentation, and authorization tracking systems

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6. STAFFING REQUIREMENTS

Role: Residential Manager / Administrator
Requirements: Bachelor’s degree in a human services field preferred for HCBS, Licensed Assisted Living Administrator required for ALFs, background screening clearance

Role: Direct Support Professionals (DSPs) / Personal Care Aides / Certified Nursing Assistants (CNAs)
Requirements: High school diploma or GED, CPR/First Aid certification, background screening clearance

Role: Licensed Nurses (for Nursing Facilities or Delegated Healthcare Tasks)
Requirements: Georgia RN or LPN licensure; background screening clearance

All staff must complete:

• HIPAA confidentiality, resident rights, and abuse prevention training
• Emergency preparedness, CPR/First Aid, and infection control training
• Person-centered planning and community integration training
• Annual continuing education for licensure or Medicaid compliance as applicable

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7. MEDICAID WAIVER SERVICES

Depending on the residential setting, Medicaid coverage may include:

NOW and COMP Waivers (HCBS):

• Community Residential Alternative (CRA)
• Supported Living
• Residential Staff Support

Traditional Medicaid (Institutional Settings):

• Nursing Facility Services
• Assisted Living under State Programs (optional limited support)

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8. TIMELINE TO LAUNCH

Phase: Business Formation and Licensing Setup
Timeline: 2–3 months (longer if facility construction or remodeling is required)

Phase: DBHDD Site Certification and Medicaid Enrollment (HCBS Residential)
Timeline: 90–120 days

Phase: Staff Hiring, Training, and Program Finalization
Timeline: 30–60 days

Phase: Medicaid Billing System Configuration
Timeline: 45–60 days

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9. CONTACT INFORMATION

Georgia Department of Community Health (DCH) – Healthcare Facility Regulation Division (HFRD)
Website: https://dch.georgia.gov/divisionsoffices/hfrd

Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD)
Website: https://dbhdd.georgia.gov/

Georgia Medicaid Management Information System (GAMMIS)
Website: https://www.mmis.georgia.gov/

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10. SCOPE OF WORK

• Business registration and EIN/NPI setup
• Medicaid and/or Residential Facility licensing enrollment assistance
• Development of Residential Care Policy & Procedure Manual
• Staff credentialing templates and participant intake forms
• Medicaid billing system setup and claims management
• Website, domain, and email setup
• Resident intake, care planning, and daily documentation templates
• Emergency response, fire safety, and evacuation system development
• Quality assurance programs for service delivery monitoring

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — GEORGIA RESIDENTIAL CARE SERVICES PROVIDER

We support residential providers, personal care home owners, and community-based living organizations in launching Medicaid-compliant Residential Care Services across Georgia.

​​​​​​​​​​​​​To get started, click the link to request portal access.