How to start a hospice in Georgia

Georgia requires a Hospice license (initial 6-month license, then regular license; inpatient/residential services covered under the same license) from Georgia Department of Community Health, Healthcare Facility Regulation Division to operate a hospice.

License required

Yes

License

Hospice license (initial 6-month license, then regular license; inpatient/residential services covered under the same license)

Issuing agency

Georgia Department of Community Health, Healthcare Facility Regulation Division

Medicare oversight

CMS places hospices in this state that newly enroll in Medicare, reactivate, or change ownership into a Provisional Period of Enhanced Oversight (medical review such as prepayment review). It began 2025-12-30 for Georgia.

Medicare certification

Medicare certification is separate from the state license (state survey or CMS-approved accreditor). CMS imposed a nationwide 6-month moratorium on new Medicare hospice enrollments (including new practice locations) effective 2026-05-13, extendable in 6-month increments; applications received by the Medicare contractor before that date are still processed, accreditation cannot be used for deemed-status entry during the moratorium, and a hospice undergoing a non-exempt ownership change within 36 months of enrollment must re-enroll as new and is therefore blocked. The federal notice leaves Medicaid/CHIP hospice moratoria to each state.

Regulation

Ga. Comp. R. & Regs. ch. 111-8-37 (Rules and Regulations for Hospices); O.C.G.A. § 31-7-170 et seq. (Georgia Hospice Law)

1. File the Department's initial application at least 30 days before the planned opening, signed by the administrator or governing-body executive
2. Include proof of ownership/legal existence, counties to be served, and any additional hospice care facility locations and bed counts
3. Receive a 6-month initial license after showing substantial compliance
4. Become eligible for a regular license once fully operational and compliant
5. Report changes of ownership, lease or location at least 30 days ahead with a new application

Staffing

• Administrator: a Georgia-licensed health care professional with 1 year of hospice supervisory/management experience, or someone trained in health service administration with 2 years of hospice supervisory/management experience
• Medical director who is a Georgia-licensed physician
• Written designee to act for the administrator when absent

Program

Georgia Medicaid and PeachCare for Kids (Department of Community Health)

Enrollment portal

Georgia Medicaid Management Information System (GAMMIS) — Enrollment Wizard

Fiscal agent

Gainwell Technologies (GAMMIS fiscal agent / third-party administrator; also handles CVO credentialing help)

Application fee

Georgia's Part I manual requires the fee from new, re-enrolling, revalidating and re-credentialing providers in the categories of service it lists, unless exempt, or a hardship waiver request instead. Applications without either are not processed, the fee is generally non-refundable, and an exempt provider pays once per service location even with several categories of service. Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.

Fingerprinting

Georgia's high categorical risk categories are community mental health centers, newly enrolling home health agencies, and newly enrolling DME/orthotic and prosthetic supplier facilities. Georgia defines a criminal background check as a state and/or national fingerprint-based check. Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.

Site visit

DCH may do pre- and post-enrollment, unscheduled and unannounced site visits. Moderate-risk categories include ambulance providers, hospices, independent clinical labs, physical therapists, and revalidating home health agencies and DME suppliers. Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.

Revalidation

DCH suspended providers that had not revalidated as of July 1, 2026; claims for dates of service from then on are not paid until the provider revalidates, and the new effective date is the revalidation submission date. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.

Full Georgia Medicaid enrollment guide →

CON program

Yes

Program

Certificate of Need

Agency

Georgia Department of Community Health (DCH), Office of Health Planning

Services covered

• hospitals (including destination cancer hospitals)
• special care units
• skilled nursing facilities
• intermediate care facilities
• personal care homes of 25 or more beds
• ambulatory surgical or obstetrical facilities
• freestanding emergency departments off a hospital's primary campus
• home health agencies
• health maintenance organizations
• certain diagnostic, treatment or rehabilitation centers
• bed capacity increases and new clinical services

Georgia certificate of need details →

State minimum wage

$7.25 an hour

Effective

2009-07-24

Scheduled increases

No scheduled change found in the official sources reviewed.

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Hospice agencies (community based) — active organization NPIs (NPPES)

696 (as of Sep 13, 2026)

Medicare-certified hospices (CMS Care Compare)

261 (as of Aug 19, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

1,817,766 (as of Jun 1, 2026)

All Georgia Hospice Medicaid rates, ranked →