(1) A home which serves residents with cognitive deficits which place the residents at risk of eloping,
i.e. engaging in unsafe wandering activities outside the home must do the following:
(a) develop, train and enforce policies and procedures for staff to deal with residents who may elope
from the facility including what actions, as specified in rule XXXX are to be taken if a resident elopes from
the facility
(b) utilize appropriate effective safety devices, which do not impede the residents’ rights to mobility and
activity choice or violate fire safety standards, to protect the residents who are at risk of eloping from the
1. If the safety devices include locks used on exit doors, as approved by the fire marshal having
jurisdiction over the home, then the locking device shall be electronic and release whenever the following
occurs: activation of the fire alarm or sprinkler system, power failure to the facility or by-pass for routine
use by the public and staff for service using a key button/key pad located at the exit or continuous
pressure for thirty (30) seconds or less.
2. If the safety devices include the use of keypads to lock and unlock exits, then directions for their
operations shall be posted on the outside of the door to allow individuals’ access to the unit. However, if
the unit is a whole facility, then directions for the operation of the locks need not be posted on the outside
of the door. The units shall not have entrance and exit doors that are closed with non-electronic keyed
locks nor shall a door with a keyed lock be placed between a resident and the exit.
(2) A home serving residents who are at risk of eloping from the premises shall retain on file at the
facility a current picture of any resident at risk of eloping.
Authority: O.C.G.A. §§ 31-2-9, 31-7-1, 31-7-2.1 and 31-7-12.
111-8-62-.20 Additional Requirements for Specialized Memory Care Units or Homes.
(1) In addition to all other requirements contained in this Chapter, where a home holds itself out as
providing additional or specialized care to persons with probable diagnoses of Alzheimer’s Disease or
other dementia or charges rates in excess of that charged other residents because of cognitive deficits
which may place the residents at risk of eloping, the home shall meet these additional requirements:
(a) Written Description. The home shall develop an accurate written description of the special care
unit that includes the following:
1. a statement of philosophy and mission;
2. how the services of the special care unit are different from services provided in the rest of the
assisted living program if ;
3. staffing including job titles of staff who work in the Unit, staff training and continuing education
4. admission procedures, including screening criteria;
5. assessment and service planning protocol, including criteria to be used that would trigger a
reassessment of the resident’s status before the customary quarterly review;
6. staffing patterns, including the ratio of direct care staff to resident for a 24-hour cycle, and a
description of how the staffing pattern differs from that of the rest of the program;
7. a description of the physical environment including safety and security features;
8. a description of activities, including frequency and type, how the activities meet the needs of
residents with dementia, and how the activities differ from activities for residents in other parts of the
9. the program’s fee or fee structure for all services provided by the unit or facility;
10. discharge criteria and procedures;
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11. the procedures that will be utilized for handling emergency situations; and
12. the involvement of the Unit with families and family support programs.
(b) Disclosure of Description. An assisted living program with an Alzheimer’s special care unit shall
disclose the written description of the special care unit to:
1. any person on request; and
2. the family or resident’s representative before admission of the resident to the Memory Care Unit or
(c) Physical Design, Environment, and Safety. The memory care unit or special care unit shall be
designed to accommodate residents with severe dementia or Alzheimer’s Disease in a home-like
environment which includes the following:
1. multipurpose room(s) for dining, group and individual activities which are appropriately furnished to
accommodate the activities taking place;
2. secured outdoor spaces and walkways which are wheel chair accessible and allow residents to
ambulate safely but prevent undetected egress;
3. high visual contrasts between floors and walls and doorways and walls in resident use areas except
for fire exits, door and access ways which may be designed to minimize contrast to conceal areas where
the residents should not enter;
4. adequate and even lighting which minimizes glare and shadows;
5. the free movement of the resident, as the resident chooses, between the common space and the
resident’s own personal space in a bedroom that accommodates no more than two (2) residents;
6. individually identified entrances to residents’ rooms to assist residents in readily identifying their own
personal spaces;
7. an effective automated device or system to alert staff to individuals entering or leaving the building in
an unauthorized manner. A facility need not use an automated alert for an exit door when the particular
exit is always staffed by a receptionist or other staff member who views and maintains a log of individuals
entering and leaving the facility. If the exit door is not always staffed, then the facility must activate an
automated alert when the door is not attended;

8. communication system(s) which permit staff in the unit to communicate with other staff outside the
unit and with emergency services personnel as needed; and

9. a unit or home which undergoes major renovation or is first constructed after the effective date of
these rules, the unit shall be designed and constructed in compliance with the current “Guidelines for
Design and Construction of Healthcare Facilities”, applicable to assisted living facilities with particular
attention to the requirements for a facility choosing to provide Alzheimer’s and dementia care, published
by the American Institute of Architects Press.
(d) Staffing and Initial Staff Orientation. The home shall ensure that the contained unit is staffed
with sufficient specially trained staff to meet the unique needs of the residents in the unit, including the
1. a licensed registered nurse or a licensed practical nurse who is working under the supervision of a
licensed physician or registered nurse shall administer medications to the residents who are incapable of
self-administration of medications;
2. at least one awake staff member who is supervising the unit at all times and sufficient numbers of
trained staff on duty at all times to meet the needs of the residents;
3. staff who, prior to caring for residents independently, have successfully completed an orientation
program that includes at least the following components in addition to the general training required in
Rule 111-8-62-.10 :
(i) the facility’s philosophy related to the care of residents with dementia in the unit;
(ii) the facility’s policies and procedures related to care in the unit and the staff’s particular
responsibilities including wandering and egress control; and
(iii) an introduction to common behavior problems characteristic of residents residing in the unit and
recommended behavior management techniques.
(e) Initial Staff Training. Within the first six months of employment, staff assigned to the Unit shall
receive training in the following topics:
1. the nature of Alzheimer’s Disease and other dementias, including the definition of dementia, the
need for careful diagnosis and knowledge of the stages of Alzheimer’s Disease;
2. common behavior problems and recommended behavior management techniques;
3. communication skills that facilitate better resident-staff relations;
4. positive therapeutic interventions and activities such as exercise, sensory stimulation, activities of
daily living skills;
5. the role of the family in caring for residents with dementia, as well as the support needed by the
family of these residents;
6. environmental modifications that can avoid problematic behavior and create a more therapeutic
7. development of comprehensive and individual service plans and how to update or provide relevant
information for updating and implementing them consistently across all shifts, including establishing a
baseline and concrete treatment goals and outcomes;
8. new developments in diagnosis and therapy that impact the approach to caring for the residents in
the special unit;
9. skills for recognizing physical or cognitive changes in the resident that warrant seeking medical
attention; and
10. skills for maintaining the safety of residents with dementia.
(f) Special Admission Requirements for Unit Placement. Ninety days after the effective date of
these rules, residents first admitted to the memory care unit, shall have a physician’s report of physical
examination completed within 30 days prior to admission on forms provided by Department. The physical
examination must clearly reflect that the resident has a diagnosis of probable Alzheimer’s Disease or
other dementia and has symptoms which demonstrate a need for placement in the specialized unit.
However, the unit may also care for a resident who does not have a probable diagnosis of Alzheimer’s
Disease or other dementia, but desires to live in the unit as a companion to a resident with a probable
diagnosis of Alzheimer’s Disease or other dementia with whom the resident has a close personal
relationship. In addition, the physical examination report must establish that each potential resident of the
unit does not require 24-hour skilled nursing care.
(g) Post-Admission Assessment. The facility shall assess each resident’s care needs to include the
following components: resident’s family supports, level of activities of daily living functioning, physical
care needs and level of behavior impairment.
(h) Individual Service Plans. The post-admission assessment shall be used to develop the resident’s
individual service plan within 14 days of admission. The service plan will be developed by a team with at
least one member of the direct care staff participating and input from each shift of direct care staff that
provides care to the resident. All team members participating shall sign the service plan and the service
plan will be shared with the direct care staff providing care to the resident and serve as a guide for the
delivery of services to the resident. The service plan shall include the following:
1. a description of the resident’s care and social needs and the services to be provided, including
frequency to address care and social needs;
2. resident’s particular preferences regarding care, activities and interests;
3. specific behaviors to be addressed with interventions to be used;
4. names of staff primarily responsible for implementing the service plan;
5. evidence of family involvement in the development of the plan when appropriate; and
6. evidence of the service plan being updated at least quarterly or more frequently if needs of resident
change substantially.
(i) Therapeutic Activities. The unit shall provide activities appropriate to the needs of the individual
residents and adapt the activities, as necessary, to encourage participation of the residents in the
following at least weekly with at least some therapeutic activities occurring daily:
1. gross motor activities; e.g. exercise, dancing, gardening, cooking, etc;
2. self-care activities; e.g. dressing, personal hygiene/grooming;
3. social activities; e.g. games, music;
4. crafts; e.g. decorations, pictures;
5. sensory enhancement activities, e.g. distinguishing pictures and picture books, reminiscing and
scent and tactile stimulation; and
6. outdoor activities; e.g. walking outdoors, field trips.

(2) Ninety days after the effective date of these rules, no licensed personal care home shall hold itself
out as providing specialized care for residents with probable Alzheimer’s disease or other dementia or
charge a differential rate for care of residents with cognitive deficits that place the residents at risk of
engaging in unsafe wandering activities (eloping) unless it meets the additional requirements specified in
Rule 111-8-62-.20(1) and its subparagraphs (a) through (i) above.