Bill Text: GA SB178 | 2011-2012 | Regular Session | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Health Care Facilities; regulation/licensing of assisted living communities; procedures/criteria

Spectrum: Partisan Bill (Republican 6-0)

Status: (Passed) 2011-07-01 - Effective Date [SB178 Detail]

Download: Georgia-2011-SB178-Introduced.html

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11 LC 33 4096

Senate Bill 178

By: Senators Grant of the 25th, Williams of the 19th, Hill of the 32nd, Murphy of the 27th, Jackson of the 24th and others

A BILL TO BE ENTITLED
AN ACT

To amend Chapter 7 of Title 31 of the Official Code of Georgia Annotated, relating to health care facilities, so as to provide for the regulation and licensing of assisted living communities; to provide for procedures and criteria; to provide for requirements for medication aides; to revise provisions relating to personal care homes; to amend various provisions of the Official Code of Georgia Annotated, so as to provide changes for purposes of consistency and conformity; to provide for related matters; to repeal conflicting laws; and for other purposes.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:

SECTION 1.

Chapter 7 of Title 31 of the Official Code of Georgia Annotated, relating to health care facilities, is amended by adding a new Code section to read as follows:

"31-7-12.2.

(a) As used in this Code section, the term:

(1) 'Ambulatory' means the ability to move from place to place by walking, either unaided or aided by a prosthesis, brace, cane, crutches, walker, or hand rails, or by propelling a wheelchair and to respond to an emergency condition, whether caused by fire or otherwise, and escape with minimal human assistance using the normal means of egress.

(2) 'Assisted living care' includes:

(A) Personal services as defined by paragraph (2) of subsection (a) of Code Section 31-7-12;

(B) The administration of medications by a medication aide in accordance with this Code section; and

(C) The provision of assisted self-preservation in accordance with this Code section.

(3) 'Assisted living community' means a personal care home with a minimum of 25 beds that is licensed as an assisted living community pursuant to Code Section 31-7-3.

(4) 'Assisted self-preservation' means the capacity of a resident to be evacuated from an assisted living community, to a designated point of safety and within an established period of time as determined by the Office of the Safety Fire Commissioner. Assisted self-preservation is a function of all of the following:

(A) The condition of the individual;

(B) The assistance that is available to be provided to the individual by the staff of the assisted living community; and

(C) The construction of the building in which the assisted living community is housed, including whether such building meets the state fire safety requirements applicable to an existing health care occupancy.

(5) 'Continuous medical or nursing care' means medical or nursing care required other than on a periodic basis or for a short-term illness.

(b) An assisted living community shall not admit or retain an individual who is not ambulatory unless the individual is capable of assisted self-preservation. In the event that the department determines that one or more residents of an assisted living community are not capable of assisted self-preservation due to the condition of the resident, the capabilities of the staff of the assisted living community, the construction of the building in which the assisted living community is housed, or a combination of these factors, the department shall have the authority to order any of the following actions:

(1) An increase in the staffing of the assisted living community to a level that is sufficient to ensure that each resident is capable of assisted self-preservation;

(2) A change in the staffing assignments of the assisted living community if such change would ensure that each resident is capable of assisted self-preservation;

(3) A change in rooms or the location of residents as necessary to ensure that each resident is capable of assisted self-preservation;

(4) The utilization of any specialized equipment that would ensure that each resident is capable of assisted self-preservation;

(5) A cessation in the further admission of individuals who are not ambulatory until such time that the assisted living community has taken actions necessary to ensure that all residents are capable of assisted self-preservation;

(6) The transfer or discharge of any resident who is not capable of assisted self-preservation; and

(7) Any action set forth in Code section 31-2-11.

(c) An assisted living community shall provide to the department on a quarterly basis a list of all residents who are not ambulatory but who are capable of assisted self-preservation.

(d) An assisted living community shall maintain fire detection and prevention equipment, including visual signals with alarms for hearing impaired residents, in accordance with manufacturer instructions and the requirements of the Office of the Safety Fire Commissioner.

(e) An assisted living community shall not admit or retain an individual who is in need of continuous medical or nursing care. Other than as permitted by a medication aide pursuant to paragraph (7) of subsection (f) of this Code section, medical, nursing, health, or supportive services required on a periodic basis, or for short-term illness, shall not be provided as services of an assisted living community. When such services are required, they shall be purchased by the resident or the resident's representative or legal surrogate, if any, from appropriately licensed providers managed independently from the assisted living community. An assisted living community may assist in arranging for such services, but not in the provision of such services.

(f)(1) An assisted living community may employ certified medication aides for the purpose of performing the technical aspects of the administration of certain medications in accordance with this subsection. An assisted living community that employs one or more certified medication aides must have a safe medication and treatment administration system that meets all the requirements of this subsection.

(2) The department shall establish and maintain a medication aide registry containing the names of each individual in Georgia who is certified by the department as a medication aide. An assisted living community may not employ an individual as a medication aide unless the individual is listed in the medication aide registry in good standing.

(3) An applicant for certification as a medication aide shall meet the following qualifications:

(A) Be a Georgia certified nurse aide with current certification in good standing;

(B) Have successfully completed a state-approved medication aide training program administered by a Georgia licensed registered nurse, pharmacist, or physician;

(C) Have successfully passed, with a minimum passing score of 80 percent, a written competency examination; and

(D) Have demonstrated the requisite clinical skills to serve as a medication aide in accordance with a standardized checklist developed by the department.

(4) A record of the successful completion of the written competency examination and clinical skills standardized checklist by an applicant for certification as a medication aide shall be included in the medication aide registry within 30 business days of evaluation. Each candidate for certification as a medication aide shall have the opportunity to take the written competency examination three times before being required to retake and successfully complete the medication aide training program.

(5) An assisted living community shall annually conduct a comprehensive clinical skills competency review of each medication aide employed by the assisted living community.

(6) Certificates issued pursuant to this subsection shall be renewed annually according to schedules and fees approved by the department.

(7) A medication aide who meets the criteria established in this subsection shall be permitted to perform the following tasks in an assisted living community in accordance with the written instructions of a physician:

(A) Administer physician ordered oral, ophthalmic, topical, otic, nasal, vaginal, and rectal medications;

(B) Administer insulin and epinephrine pursuant to physician direction and protocol;

(C) Administer medication via a metered dose inhaler;

(D) Conduct finger stick blood glucose testing following established protocol;

(E) Administer a commercially prepared disposable enema as ordered by a physician; and

(F) Assist residents in the supervision of self-administration of medication.

(8) A medication aide shall record in the medication administration record all medications that the medication aide has personally administered to a resident of an assisted living community and any refusal of a resident to take a medication. A medication aide shall observe a resident to whom medication has been administered and report any changes in the condition of such resident to the personal representative or legal surrogate of the resident.

(9) All medication administered by a medication aide in accordance with this Code section shall be in unit or multidose packaging.

(10) An assisted living community that employs one or more medication aides to administer medications in accordance with this subsection shall secure the services of a licensed pharmacist to perform the following duties:

(A) Perform a quarterly review of the drug regimen of each resident of the assisted living community and report any irregularities to the assisted living community administrator;

(B) Remove for proper disposal any drugs that are expired, discontinued, in a deteriorated condition, or where the resident for whom such drugs were ordered is no longer a resident;

(C) Establish or review, through the appropriate committee of the assisted living community, policies and procedures for safe and effective drug therapy, distribution, use, and control; and

(D) Monitor compliance with established policies and procedures for medication handling and storage.

(11) An assisted living community that employs one or more medication aides to administer medications in accordance with this subsection shall ensure that each medication aide receives ongoing medication training as prescribed by the department. A registered professional nurse or pharmacist shall conduct random medication administration observations on a quarterly basis and report any issues to the assisted living community administrator.

(g) An assisted living community shall establish a written care plan for each resident. Such care plan shall describe the needs of the resident and how such needs will be met.

(h) An assisted living community shall not be permitted to enroll as a provider of medical assistance, as defined in paragraph (6) of Code Section 49-4-141, or receive any funds authorized or paid pursuant to Title XIX of the Social Security Act.

(i) The department shall adopt rules and regulations to implement this Code section. Such rules shall establish meaningful distinctions between the levels of care provided by assisted living communities and nursing homes but shall not curtail the scope or levels of services provided by nursing homes as of June 30, 2011."

SECTION 2.

Code Section 10-1-393 of the Official Code of Georgia Annotated, relating to unfair or deceptive practices in consumer transactions unlawful, is amended by revising paragraph (26) of subsection (b) as follows:

"(26) With respect to any individual or facility providing personal care services or assisted living care:

(A) Any person or entity not duly licensed or registered as a personal care home or assisted living community formally or informally offering, advertising to, or soliciting the public for residents or referrals; or

(B) Any personal care home, as defined in subsection (a) of Code Section 31-7-12, or any assisted living community, as defined in paragraph (3) of Code Section 31-7-12.2, offering, advertising, or soliciting the public to provide services:

(i) Which are outside the scope of personal care services or assisted living care, respectively; and

(ii) For which it has not been specifically authorized.

Nothing in this subparagraph prohibits advertising by a personal care home or assisted living community for services authorized by the Department of Community Health under a waiver or variance pursuant to subsection (b) of Code Section 31-2-9;.

(C) For purposes of this paragraph, 'personal care' means protective care and watchful oversight of a resident who needs a watchful environment but who does not have an illness, injury, or disability which requires chronic or convalescent care including medical and nursing services, and 'assisted living care' includes services provided for in Code Section 31-7-12.2. The provisions of this paragraph shall be enforced following consultation with the Department of Community Health which shall retain primary responsibility for issues relating to licensure of any individual or facility providing personal care services;"

SECTION 3.

Code Section 16-5-23 of the Official Code of Georgia Annotated, relating to simple battery, is amended by revising subsection (g) as follows:

"(g) A person who is an employee, agent, or volunteer at any facility licensed or required to be licensed under Code Section 31-7-3, relating to long-term care facilities, or Code Section 31-7-12.2, relating to assisted living communities, or Code Section 31-7-12, relating to personal care homes, or who is required to be licensed pursuant to Code Section 31-7-151 or 31-7-173, relating to home health care and hospices, who commits the offense of simple battery against a person who is admitted to or receiving services from such facility, person, or entity shall be punished for a misdemeanor of a high and aggravated nature."

SECTION 4.

Code Section 16-5-23.1 of the Official Code of Georgia Annotated, relating to battery, is amended by revising subsection (k) as follows:

"(k) A person who is an employee, agent, or volunteer at any facility licensed or required to be licensed under Code Section 31-7-3, relating to long-term care facilities, or Code Section 31-7-12.2, relating to assisted living communities, or Code Section 31-7-12, relating to personal care homes, or who is required to be licensed pursuant to Code Section 31-7-151 or 31-7-173, relating to home health care and hospices, who commits the offense of battery against a person who is admitted to or receiving services from such facility, person, or entity shall, upon conviction thereof, be punished by imprisonment for not less than one nor more than five years, or a fine of not more than $2,000.00, or both."

SECTION 5.

Code Section 16-6-5.1 of the Official Code of Georgia Annotated, relating to sexual assault against persons in custody, sexual assault against person detained or patient in hospital or other institution, and sexual assault by practitioner of psychotherapy against patient, is amended by revising subsection (d) as follows:

"(d) A person who is an employee, agent, or volunteer at any facility licensed or required to be licensed under Code Section 31-7-3, or 31-7-12, or 31-7-12.2 or who is required to be licensed pursuant to Code Section 31-7-151 or 31-7-173 commits sexual assault when he or she engages in sexual contact with another individual who the actor knew or should have known had been admitted to or is receiving services from such facility or the actor."

SECTION 6.

Code Section 25-2-13 of the Official Code of Georgia Annotated, relating to buildings presenting special hazards to persons or property and requirements as to construction, maintenance, and use generally, is amended by revising subparagraph (b)(1)(J) as follows:

"(J) Personal care homes and assisted living communities required to be licensed as such by the Department of Community Health and having at least seven beds for nonfamily adults, and the Commissioner shall, pursuant to Code Section 25-2-4, by rule adopt state minimum fire safety standards for those homes, and any structure constructed as or converted to a personal care home on or after April 15, 1986, shall be deemed to be a proposed building pursuant to subsection (d) of Code Section 25-2-14 and that structure may be required to be furnished with a sprinkler system meeting the standards established by the Commissioner if he deems this necessary for proper fire safety."

SECTION 7.

Code Section 26-4-5 of the Official Code of Georgia Annotated, relating to definitions relative to the "Georgia Pharmacy Practice Act," is amended by revising paragraph (18.1) as follows:

"(18.1) 'Institution' means any licensed hospital, nursing home, assisted living community, personal care home, hospice, health clinic, or prison clinic."

SECTION 8.

Code Section 26-4-191 of the Official Code of Georgia Annotated, relating to definitions relative to the "Utilization of Unused Prescription Drugs Act," is amended by revising paragraph (2) as follows:

"(2) 'Health care facility' means an institution which is licensed as a nursing home, intermediate care home, assisted living community, personal care home, home health agency, or hospice pursuant to Chapter 7 of Title 31."

SECTION 9.

Code Section 26-4-212 of the Official Code of Georgia Annotated, relating to definitions relative to the "Safe Medications Practice Act," is amended by revising paragraph (3) as follows:

"(3) 'Institution' means any licensed hospital, nursing home, assisted living community, personal care home, or hospice."

SECTION 10.

Code Section 31-2-14 of the Official Code of Georgia Annotated, relating to records check requirement for certain facilities, is amended by revising paragraph (4) of subsection (a) as follows:

"(4) 'Facility' means a:

(A) Personal care home required to be licensed or permitted under Code Section 31-7-12;

(B) Assisted living community required to be licensed under Code Section 31-7-12.2;

(B)(C) Private home care provider required to be licensed under Article 13 of Chapter 7 of this title; or

(C)(D) Community living arrangement subject to licensure under paragraph (8) of subsection (d) of Code Section 31-2-4."

SECTION 11.

Code Section 31-7-1 of the Official Code of Georgia Annotated, relating to definitions relative to health care facilities, is amended by revising subparagraph (A) of paragraph (4), as follows:

"(4) 'Institution' means:

(A) Any building, facility, or place in which are provided two or more beds and other facilities and services that are used for persons received for examination, diagnosis, treatment, surgery, maternity care, nursing care, assisted living care, or personal care for periods continuing for 24 hours or longer and which is classified by the department, as provided for in this chapter, as either a hospital, nursing home, assisted living community, or personal care home;"

SECTION 12.

Said chapter is further amended by revising subsection (d) of Code Section 31-7-3, relating to requirements for permits to operate institutions, as follows:

"(d)(1) When an application for licensure to operate a personal care home, as defined in subsection (a) of Code Section 31-7-12, or an assisted living community, as defined in paragraph (3) of Code Section 31-7-12.2, has been made, the department shall inform the office of the state long-term care ombudsman of the name and address of the applicant prior to issuing authority to operate or receive residents and shall provide to the ombudsman program an opportunity to provide to the department information relevant to the applicant's fitness to operate as a licensed personal care home or an assisted living community.

(2) The department may consider any information provided under this subsection, where verified by appropriate licensing procedures, in determining whether an applicant meets the requirements for licensing.

(3) The department shall promulgate regulations setting forth the procedures by which the long-term care ombudsman program shall report information to the department or its designee as required by this subsection, including a consistent format for the reporting of information, safeguards to protect confidentiality, and specified types of information which shall be routinely provided by the long-term care ombudsman program.

(4) Nothing in this subsection shall be construed to provide any authority to the long-term care ombudsman program to license or refuse to license the operation of a personal care home or an assisted living community."

SECTION 13.

Code Section 31-7-12 of the Official Code of Georgia Annotated, relating to personal care homes, is amended as follows:

"31-7-12.

(a) As used in this Code section, the term:

(1) 'Personal care home' means any dwelling, whether operated for profit or not, which undertakes through its ownership or management to provide or arrange for the provision of housing, food service, and one or more personal services for two or more adults who are not related to the owner or administrator by blood or marriage. This term shall not include host homes, as defined in paragraph (18) of subsection (b) of Code Section 37-1-20.

(2) 'Personal services' includes, but is not limited to, individual assistance with or supervision of self-administered medication and essential activities of daily living such as eating, bathing, grooming, dressing, and toileting.

(b) All personal care homes shall be licensed as provided for in Code Section 31-7-3, except that, in lieu of licensure, the department may require persons who operate personal care homes with two or three beds for nonfamily adults to comply with registration requirements delineated by the department. Such registration requirements within this category shall authorize the department to promulgate pursuant to Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act,' reasonable standards to protect the health, safety, and welfare of the occupants of such personal care homes.

(c) Upon the designation by the department and with the consent of county boards of health, such boards may act as agents to the department in performing inspections and other authorized functions regarding personal care homes licensed under this chapter. With approval of the department, county boards of health may establish inspection fees to defray part of the costs of inspections performed for the department.

(d) The state ombudsman or community ombudsman, on that ombudsman's initiative or in response to complaints made by or on behalf of residents of a registered or licensed personal care home, may conduct investigations in matters within the ombudsman's powers and duties.

(e) A personal care home shall not admit or retain an individual who is in need of continuous medical or nursing care, as defined in Code Section 31-7-12.2. Medical, nursing, health, or supportive services required on a periodic basis or for a short-term illness shall not be provided as services of a personal care home. When such services are required, they shall be purchased by the resident or the resident's representative or legal surrogate, if any, from appropriately licensed providers managed independently from the personal care home. A personal care home may assist in arranging for such services, but not in the provision of such services.

(f) A personal care home shall not admit or retain a resident who is not ambulatory, as defined in Code Section 31-7-12.2, unless such personal care home is licensed as an assisted living community and is in compliance with Code Section 31-7-12.2.

(e)(g) The department shall promulgate procedures to govern the waiver, variance, and exemption process related to personal care homes pursuant to Chapter 2 of this title. Such procedures shall include published, measurable criteria for the decision process, shall take into account the need for protection of public and individual health, care, and safety, and shall afford an opportunity for public input into the process."

SECTION 14.

Said chapter is further amended by revising paragraph (1) of subsection (a) of Code Section 31-7-111, relating to findings and declaration of policy under the "Residential Care Facilities for the Elderly Authorities Act," as follows:

"(1) There exists in this state a seriously inadequate supply of and a critical need for facilities which can furnish the comprehensive services required by elderly persons in a single location, including, without limitation, residential care and the types of services provided in skilled nursing homes, intermediate care homes, assisted living communities, and personal care homes (hereinafter referred to as 'residential care facilities for the elderly');"

SECTION 15.

Said chapter is further amended by revising subparagraph (A) of paragraph (7) of Code Section 31-7-112, relating to definitions relative to the "Residential Care Facilities for the Elderly Authorities Act," as follows:

"(A) Any one or more buildings or structures to be used in providing at a single location the comprehensive services required by the elderly, including, without limitation, residential care and the types of services provided in skilled nursing homes, intermediate care homes, assisted living communities, and personal care homes supplied with all necessary or useful furnishings, machinery, equipment, parking facilities, landscaping, and facilities for outdoor storage, all as determined by the authority, which determination shall be final and not subject to review; provided, however, that no single project or residential care facility shall be required to render all types of services and levels of care referred to above. There may be included as part of any such project all improvements necessary to the full utilization thereof, including, without limitation, site preparation; roads and streets; sidewalks; water supply; outdoor lighting; belt line railroad; railroad sidings and lead tracks; bridges; causeways; terminals for railroad, automotive, and air transportation; transportation facilities incidental to the project; and the dredging and improving of harbors and waterways. However, none of the aforementioned improvements shall be the primary purpose of any project;"

SECTION 16.

Said chapter is further amended by revising paragraph (4) of Code Section 31-7-172, relating to definitions relative to the "Georgia Hospice Law," as follows:

"(4) 'Health care facility' means hospitals; other special care units, including but not limited to podiatric facilities; skilled nursing facilities; intermediate care facilities; assisted living communities; personal care homes; ambulatory surgical or obstetrical facilities; health maintenance organizations; home health agencies; and diagnostic, treatment, or rehabilitation centers."

SECTION 17.

Code Section 31-8-51 of the Official Code of Georgia Annotated, relating to definitions regarding the long-term care ombudsman program, is amended by revising paragraph (2) as follows:

"(2) 'Long-term care facility' means any skilled nursing home, intermediate care home, assisted living community, or personal care home now or hereafter subject to regulation and licensure by the Department of Community Health."

SECTION 18.

Code Section 31-8-81 of the Official Code of Georgia Annotated, relating to definitions regarding the 'Long-term Care Facility Resident Abuse Reporting Act,' is amended by revising paragraph (3) as follows:

"(3) 'Long-term care facility' or 'facility' means any skilled nursing home, intermediate care home, assisted living community, personal care home, or community living arrangement now or hereafter subject to regulation and licensure by the department."

SECTION 19.

Code Section 31-8-102 of the Official Code of Georgia Annotated, relating to definitions regarding the 'Bill of Rights for Residents of Long-term Care Facilities,' is amended by revising paragraph (3) as follows:

"(3) 'Long-term care facility' or 'facility' means any assisted living community, intermediate care home, skilled nursing home, or intermingled home subject to regulation and licensure by the department."

SECTION 20.

Code Section 31-36A-5 of the Official Code of Georgia Annotated, relating to certification by physician under the "Temporary Health Care Placement Decision Maker for an Adult Act," is amended by revising paragraph (2) as follows:

"(2) It is the physician's belief that it is in the adult's best interest to be discharged from a hospital, institution, medical center, or other health care institution providing health or personal care for treatment of any type of physical or mental condition and to be transferred to or admitted to an alternative facility or placement, including, but not limited to, nursing facilities, assisted living communities, personal care homes, rehabilitation facilities, and home and community based programs."

SECTION 21.

Code Section 31-36A-7 of the Official Code of Georgia Annotated, relating to petition for order by health care facility, is amended by revising paragraph (2) of subsection (b) as follows:

"(2) It is the physician's belief that it is in the adult's best interest to be admitted to or discharged from a hospital, institution, medical center, or other health care institution providing health or personal care for treatment of any type of physical or mental condition or to be transferred to an alternative facility or placement, including, but not limited to, nursing facilities, assisted living communities, personal care homes, rehabilitation facilities, and home and community based programs; and"

SECTION 22.

Code Section 35-3-34.1 of the Official Code of Georgia Annotated, relating to circumstances when exonerated first offender's criminal record may be disclosed, is amended by revising paragraph (2) of subsection (a) as follows:

"(2) The request for information is an inquiry about a person who has applied for employment with a nursing home, assisted living community, personal care home, or a person or entity that offers day care for elderly persons and the person who is the subject of the inquiry to the center was prosecuted for the offense of sexual battery, incest, pimping, pandering, or a violation of Code Section 30-5-8; or"

SECTION 23.

Code Section 35-3-174 of the Official Code of Georgia Annotated, relating to time for reporting elopement of disabled person from personal care home, is amended as follows:

"35-3-174.

The staff of personal care homes and assisted living communities shall call the local police department to report the elopement of any disabled person from the home within 30 minutes of the staff's receiving actual knowledge that such person is missing from the home."

SECTION 24.

Code Section 37-4-21 of the Official Code of Georgia Annotated, relating to admission of developmentally disabled persons to facilities for purposes of temporary supervision and care, is amended by revising subsection (c) as follows:

"(c) An admission for respite care shall be for no longer than two weeks, provided that a person may be admitted for additional periods of respite care; provided, further, that there shall be no more than two admissions for respite care within any six-month period, counted from the first day of such an admission. Any such admission which exceeds limits provided in this Code section must be in accordance with the procedure in Code Section 37-4-20 or 37-4-40. This Code section shall not apply when the person sought to be admitted is living in a nursing home, as defined in paragraph (2) of Code Section 43-27-1, or a personal care home, as defined in subsection (a) of Code Section 31-7-12, or an assisted living community, as defined in paragraph (3) of Code Section 31-7-12.2."

SECTION 25.

Code Section 38-4-2 of the Official Code of Georgia Annotated, relating to powers and appointment of executive directors of veterans' homes, is amended by revising paragraph (4) of subsection (a) as follows:

"(4) To construct and operate hospitals, nursing homes, nursing care homes, assisted living communities, and personal care homes for the use and care of war veterans discharged under other than dishonorable conditions and to pay the cost of construction of the hospitals, nursing homes, nursing care homes, assisted living communities, and personal care homes. The term 'cost of the construction' as used in this paragraph shall embrace the cost of construction; the cost of all lands, properties, rights, and easements acquired; the cost of all machinery and equipment; and the cost of engineering, architectural, and legal expenses and of plans and specifications and other expenses necessary or incident to determining the feasibility or practicability of the construction of any hospitals, nursing homes, nursing care homes, assisted living communities, and personal care homes. The term shall also include administrative expense and such other expenses as may be necessary or incident to the construction of any hospitals, nursing homes, nursing care homes, assisted living communities, and personal care homes; the placing of the same in operation; and the condemnation of property necessary for such construction and operation."

SECTION 26.

Code Section 42-8-63.1 of the Official Code of Georgia Annotated, relating to discharges disqualifying individuals from employment, is amended by revising paragraph (3) of subsection (a) as follows:

"(3) The employment is with a nursing home, assisted living community, personal care home, or a person or entity that offers day care for elderly persons and the defendant was discharged under this article after prosecution for the offense of sexual battery, incest, pimping, pandering, or a violation of Code Section 30-5-8; or"

SECTION 27.

Code Section 48-13-9 of the Official Code of Georgia Annotated, relating to limitation on authority of local government to impose regulatory fee and examples of businesses or practitioners of professions or occupations which may be subject to fees, is amended by revising paragraph (14) of subsection (b) as follows:

"(14) Nursing homes, assisted living communities, and personal care homes;"

SECTION 28.

Code Section 51-1-29.5 of the Official Code of Georgia Annotated, relating to limitation on health care liability claim to gross negligence in emergency medical care, is amended by revising paragraph (8) of subsection (a) as follows:

"(8) 'Health care institution' means:

(A) An ambulatory surgical center;

(B) A personal care home licensed under Chapter 7 of Title 31;

(B.1) An assisted living community licensed under Chapter 7 of Title 31;

(C) An institution providing emergency medical services;

(D) A hospice;

(E) A hospital;

(F) A hospital system;

(G) An intermediate care facility for the mentally retarded; or

(H) A nursing home."

SECTION 29.

All laws and parts of laws in conflict with this Act are repealed.