A Metro Atlanta life plan community entrance-fee contract is regulated by Georgia's Insurance Commissioner, not DCH - here's what that changes for families.
By ATL Senior Advisor Care Team · October 27, 2026
Most families touring senior living in Buckhead, Sandy Springs, Johns Creek, or Marietta are comparing month-to-month rents. Then they walk onto a campus that asks for a six-figure check up front and hands over a forty-page agreement. That document is a Metro Atlanta life plan community entrance-fee contract, and it does not sit under the same body of law as the Personal Care Homes and Assisted Living Communities down the road. Georgia treats a promise of future care in exchange for an entrance fee as a financial obligation closer to insurance than to landlord-tenant law. The chapter that governs it, O.C.G.A. Title 33, Chapter 45, lives in the Insurance title of the Georgia Code, and section 33-45-4 assigns its administration to the Insurance Department rather than to the agency that licenses care facilities. Section 33-45-3 is titled, in the statute's own words, a certificate of authority requirement for the operation of life plan communities. That single structural fact is the thing most Atlanta families miss, and it is why a tour checklist built for an assisted living community leaves the biggest commitment on the campus unexamined.
The practical consequence is that you are evaluating two different things at once, with two different sets of public records behind them. The care your parent receives in a personal care unit or a skilled nursing wing on that campus is licensed and inspected by the Georgia Department of Community Health (DCH), Healthcare Facility Regulation Division (HFRD). The promise that the campus will still be solvent enough to deliver that care in 2041, after you have handed over the entrance fee, is supervised by the Commissioner of Insurance. A spotless HFRD inspection record tells you nothing about whether the entrance fee is adequately escrowed, and a healthy reserve filing tells you nothing about staffing on the memory care floor. Families who ask only about one of the two walk into the single largest financial decision of a parent's retirement with half the file.
The most valuable thing in Chapter 45 is that Georgia does not leave the exit terms to the provider's drafting. Under O.C.G.A. 33-45-7(b), a resident may rescind a continuing care agreement without penalty or forfeiture within seven days after signing it. During those seven days the money stays in escrow and the resident cannot be required to move in; if the resident rescinds, the entrance fee comes back within 30 days of the notice. That is a statutory cooling-off window, not a courtesy the sales director is extending, and it exists precisely because these contracts get signed at kitchen tables in Dunwoody and Alpharetta under real time pressure after a hospital stay. Section 33-45-7(d) adds another guardrail: before a provider takes any money beyond an application fee - which is capped at $1,500 - it must hand the prospective resident a copy of the agreement and the disclosure statement and collect signed, dated receipts.
Beyond the seven days, Georgia splits the rules by whether the entrance fee is refundable or not, and section 33-45-7(a)(6) requires the agreement to say which it is. The two formulas are genuinely different bargains, and the table below is the comparison worth taking on a tour. Note the detail in the refundable column: the statute requires the refund terms to appear in type no smaller than the largest type used in the body of the agreement, so if you are squinting at the refund language, something is wrong with the document in your hands.
| Contract type | What Georgia law requires | What the provider may keep |
|---|---|---|
| Nonrefundable entrance fee | A 90-day trial period of residency. The provider, the resident, or whoever paid the fee may cancel after written notice. Refund due within 120 days, calculated pro rata. | No more than 10% of the entrance fee. |
| Refundable entrance fee | At least 30 days' written notice to cancel. Refund due within 120 days of notification. The refund terms must be printed in type no smaller than the largest type used in the body of the agreement. | For an occupied unit: up to 2% per month of occupancy plus a processing fee of up to 4%. Or, if the provider keeps only up to 1% per month, the refund may be deferred until the next entrance fee for a comparable unit is received. |
| Cancellation before you ever move in | Refund paid within 60 days of notice. | A processing fee of up to 4%. |
| Death or disabling illness before occupancy | The agreement is automatically canceled and a full refund is due. | Only costs the resident specifically requested in a separate signed addendum. |
One more clause deserves its own highlight, because it is the one families discover too late. Under 33-45-7(e), if the prospective resident dies before ever occupying the unit, or illness, injury, or incapacity prevents the move, the agreement is automatically canceled and a full refund is due, minus only costs the resident specifically requested in a separate signed addendum. Given that a meaningful share of Metro Atlanta placements begin during a discharge conversation at Piedmont Atlanta Hospital, Emory Saint Joseph's, or Northside Hospital Sandy Springs - when a parent's health is precisely what is unsettled - that protection is not hypothetical.
Life plan communities in Georgia are typically multi-level: independent living apartments or cottages, a personal care or assisted living wing, often a secured memory care area, and sometimes a skilled nursing center, all on one property. Each of those levels carries its own license and its own public record. The assisted living wing is licensed as an Assisted Living Community under Ga. Comp. R. & Regs. 111-8-63, created by O.C.G.A. 31-2-7, or as a Personal Care Home under 111-8-62 - and these are not interchangeable, since an ALC is authorized for a higher level of hands-on care than a PCH. If the campus advertises memory care, confirm whether it holds Georgia's distinct Memory Care Center certification under 111-8-63, which requires a secured environment, enhanced dementia-trained staffing, and disclosure of memory care programming. A skilled nursing center on the same campus is licensed under 111-8-56 and separately certified by CMS, so it appears on Medicare Care Compare while the assisted living wing does not.
This matters because the entrance fee buys access to a continuum, and the continuum is only as good as its weakest licensed level. A family in East Cobb may be sold on the independent living cottages and the proximity to WellStar Kennestone Hospital, and never look at the inspection history of the personal care wing their mother will actually move into in six years. Pull the DCH/HFRD facility record for every licensed level on the property, not just the one you toured, and ask which license number corresponds to which building. Then ask the separate question that only the Insurance Department side answers: does this provider hold a current certificate of authority, and may you inspect the most recent disclosure statement? Section 33-45-7(c) requires the agreement itself to carry a boldface statement that the facility and its agreements are regulated under Chapter 45 of Title 33 and that the resident may inspect that disclosure statement. If no such statement appears in the contract, that is a question for a Georgia elder law attorney before anyone signs.
Georgia requires that any portion of an entrance fee a resident pays be held in an escrow account, under O.C.G.A. 33-45-8, and that the escrow agreement state plainly that it exists to protect the resident. When the provider may take that money out of escrow is the interesting part. For a campus still under construction or in development - and Metro Atlanta's growth corridors in north Fulton, Forsyth, and Cherokee counties see new senior living projects regularly - the statute lets escrowed funds go to the provider only when three conditions are all met: at least 50% of the residential units are presold with deposits of at least 10% each, a first mortgage or other financing commitment is in place with its pre-disbursement conditions substantially satisfied, and entrance fees under binding agreements plus anticipated financing cover at least 90% of acquisition, construction, equipping, and furnishing costs, with at least 90% of estimated start-up funds on hand.
For an operating community, release is tied to the financial reserve requirements of section 33-45-11, with enough left in escrow to cover resident refund obligations. Translated into tour questions: Is this campus pre-opening or operating? If pre-opening, what is the current presale percentage? Who holds the escrow, and may we see the escrow agreement? Does the provider meet its reserve requirement, and what does the most recent annual revised disclosure statement required by section 33-45-6 show? A Decatur or Duluth family that asks those four questions will learn more about the real risk in the contract than a dozen questions about dining hours. And a sales office that cannot answer them, or treats them as impolite, has told you something useful. Separately, keep in mind that none of this is covered by Georgia's Medicaid programs: neither the Community Care Services Program (CCSP) waiver nor SOURCE pays room and board in a PCH or ALC, and an entrance fee is not a Medicaid-eligible expense, so the money in that check is money leaving the estate.
The sections of a continuing care agreement that govern change are where families feel the contract years later, and Georgia requires most of them to be spelled out. Section 33-45-7(a)(4) requires the agreement to state the resident's property rights in the unit, the health and financial requirements for both admission and continued residence, how units are reassigned, the provider's policies if a resident runs into financial difficulty, and the procedures for relocating a resident for health, safety, or the welfare of the facility. Read that last item slowly. The move from an independent cottage to the assisted living wing, and from there to skilled nursing, is the event the whole entrance fee was supposed to smooth - and the contract, not the brochure, defines who decides when it happens and what the monthly fee becomes afterward.
The money terms are bounded too. Under 33-45-7(a)(8), the provider must give at least 60 days' advance notice of changes in fees or services, except for changes required by state or federal assistance programs, and must disclose how periodic charges may be adjusted and any policy on fees during a voluntary absence. Section 33-45-7(a)(9) bars increases in lump-sum care charges during the agreed care period, again excepting required assistance-program changes. The agreement must also address fees if a resident marries while living there and the terms under which a spouse may enter, under (a)(5), and cancellation on the resident's death, under (a)(7) - which may provide that the entrance fee is treated as earned at death, a provision adult children should read before assuming a refund flows to the estate. For free, unbiased help thinking through the benefits side of any of this, Metro Atlanta families can reach the Atlanta Regional Commission (ARC) Area Agency on Aging, which serves the 10-county region including Fulton, DeKalb, Cobb, Gwinnett, Cherokee, Clayton, Douglas, Fayette, Henry, and Rockdale counties, or the Aging and Disability Resource Connection of Georgia at 1-866-552-4464. GeorgiaCares offers free Medicare counseling through the Georgia Division of Aging Services.
Sequence the visit so the paperwork is not an afterthought on the drive home. Ask for the continuing care agreement and the current disclosure statement by email before the tour, not at the end of it - section 33-45-7(d) means you are entitled to both before any money beyond the capped application fee changes hands, so there is no reason to wait. Read the refund formula and the relocation clause first. Then tour, and spend your questions on the licensed care levels rather than the amenities: which license number covers the assisted living wing, whether memory care carries the Memory Care Center certification, and what the DCH/HFRD record shows for each level. Compare the monthly fee against Metro Atlanta's 2026 market, where assisted living generally runs $3,900 to $5,900 a month, memory care $5,000 to $7,200, and skilled nursing $7,500 to $10,500 - a life plan community's monthly fee should be legible against those numbers even with an entrance fee paid.
Before signing, have a Georgia elder law attorney and, ideally, a financial advisor read the agreement, and build the seven-day rescission window into your plan deliberately rather than treating it as an emergency exit. If a parent is being discharged from Emory University Hospital, Grady Memorial Hospital, or Northside Hospital Gwinnett and the pressure is to sign now, remember that a short-term respite stay or a month-to-month personal care home placement in Brookhaven, Tucker, or Lawrenceville can hold the line while the contract gets a proper read. An entrance fee is one of the few senior care decisions in Georgia that is genuinely hard to undo after the statutory windows close. The families who do best with life plan communities are not the ones who found the prettiest campus - they are the ones who read Chapter 45's protections before they needed them.
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