North Carolina is a vast state with diverse populations and areas. Adults over the age of 55 comprise 15.4% of the population and the state has made sure to invest in this population by offering many programs aimed at seniors such as the Senior Community Employment Program and Living Healthy Workshop. The state boasts farmland, mountains, small towns, and bustling metropolitan centers which ensures that it is an ideal retirement location.

Directory of Assisted Living Facilities in North Carolina

Our directory of facilities located in North Carolina is comprehensive and convenient. Finding the right assisted living facility can be something of a daunting task, using the tools provided below to locate the right amenities, services, pricing and more can make the research process easier.

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Paying For Assisted Living in North Carolina

Cost of Assisted Living in North Carolina

The median cost of assisted living in North Carolina is $3,693, lower than that of the national average of $4,000. Among its neighbors, it sits in the middle in terms of cost with Georgia being the lowest at $3,100, followed by South Carolina at $3,500. Tennessee and Virginia are significantly higher at $3,920 and $4,451, respectively.


North Carolina is a large and varied state, and the cost of the assisted living can reflect that. Raleigh, the state capital and the second most populous city, has the highest median at $5,700, significantly higher than both the state and national average. Goldsboro with a population of only 36,000 has the least expensive median at $2,750.


Median costs for assisted living in North Carolina are lower than those associated with other types of care except for independent living, and it is considerably less expensive than a semi-private room in a nursing care facility.

Financial Assistance for Assisted Living in North Carolina

Special Assistance

The Special Assistance program is a supplemental social security income program that helps low-income seniors who reside or plan to reside in a licensed long-term care facility may be able to qualify for. The program is 50% funded by the state, with the remaining balance funded by the counties. Special assistance will pay for rent and meals and provides a small monthly cash allowance so that recipients may purchase any sundry items they would like. Those that are eligible for special assistance will automatically qualify for Medicaid.

Who Is Eligible?

Any low-income adult over the age of 65 and living, or planning to live in an assisted living facility is eligible. Although Special Assistance is a form of supplemental insurance (SI), you do not have to already be receiving SI, but should be eligible. Those that are ineligible for SI should be ineligible solely due to income requirements.

Special assistance income eligibility is based on the adult care home rate set by the state government of $1,182 plus a $46 personal needs allowance, recipients must have a monthly income that falls below $1,228.

How to Apply

Applications for Special Assistance must be submitted in person at your local Department of Social Services office following an interview.

More Ways to Finance Assisted Living

Some additional ways to finance assisted living costs include:

  • Veterans Benefits: Veterans can take advantage of several different pension programs to help cover the cost of assisted living. For more information, see the article on benefits.va.gov.
  • Life Insurance Policies: Even if a spouse or loved one hasn’t died, certain types of life insurance policies can be used to pay for assisted living. More information is available at longtermcare.acl.gov
  • Long-Term Care Insurance: Long-term care insurance is a type of insurance policy that pays for long-term care when it becomes necessary, including the cost of assisted living. For more information on the benefits and drawbacks of this financing method, visit longtermcare.acl.gov.
  • Reverse Mortgages: Reverse mortgages allow seniors to access the equity from a home that they own, and these funds can be used to pay for assisted living. The U.S. Department of Housing and Urban Development offers a federally insured reverse mortgage program.

Free Assisted Living Resources in North Carolina

Long-Term Care Ombudsman Program

The office of the long-term care ombudsman is an advocacy agency that is tasked with ensuring the safety and well-being of seniors in assisted living and other long-term care facilities. In North Carolina, there is one state and 16 regional offices that take and resolve complaints of abuse, or substandard care lodged against facilities. The offices also provide services pertaining to residents rights, Medicare qualifications, and assistance with wills and guardianship. For assistance with any of the above issues, you may contact the ombudsman at (919) 855-3400.

Area Agencies on Aging

Like all other states, North Carolina has local area agencies on aging that provide necessary services to the senior population that include transportation, meal delivery if living at home, caregiver and personal care support services. In addition to the standard programs that are offered in each agency, some county agencies offer additional programs such as grandparent fostering that pairs at-risk children with seniors 55 and older, or the Senior Companion program that connects adults over 55 with each other.

Find your county office in the list below, to determine what programs or services may be available to you.

Area Agency On AgingAddressPhone Number

Albemarle Commission

(Serving the counties of Camden, Chowan, Currituck, Dare, Gates, Hyde, Pasquotank, Perquimans, Tyrrell, and Washington)

512 South Church Street
Hertford, NC 27944

(252) 426-5753

Cape Fear Council of Governments

(Serving the counties of Brunswick, Columbus, New Hanover, and Pender)

1480 Harbour Drive
Wilmington, NC 28401

(910) 395-4553

Centralina Council of Governments

(Serving the counties of Anson, Cabarrus, Gaston, Iredell, Lincoln, Mecklenburg, Rowan, Stanly, Union)

525 North Tryon Street
Charlotte, NC 28202

(704) 372-2416

Eastern Carolina Council of Governments

(Serving the counties of Carteret, Craven, Duplin, Greene, Jones, Lenoir, Onslow, Pamlico, and Wayne)

233 Middle Street
New Bern, NC 28563

(252) 638-3185

High Country Council of Governments

(Serving the counties of Alleghany, Ashe, Avery, Mitchell, Watauga, Wilke and Yancey)

468 New Market Boulevard
Boone, NC 28607

(828) 265-5434

Isothermal Planning & Development Commission

(Serving the counties of Cleveland, McDowell, Polk and Rutherford)

111 West Court Street
Rutherfordton, NC 28139

(828) 287-2281

Kerr Tar Regional COG

(Serving the counties of Franklin, Granville, Person, Vance and Warren)

1724 Graham Avenue
Henderson, NC 27536

(252) 436-2040

Land-of-Sky Regional Council

(Serving the counties of Buncombe, Henderson, Madison and Transylvania)

339 New Leicester Highway Suite 140
Asheville, NC 28806

(828) 251-6622

Lumber River Council of Governments

(Serving the counties of Bladen, Hoke, Richmond, Robeson and Scotland)

30 CJ Walker Road
Pembroke, NC 28372

(910) 618-5533

Mid-Carolina Council of Governments

(Serving the counties of Cumberland, Harnett and Sampson)

130 Gillespie Street
Fayetteville, NC 28301

(910) 323-4191

Mid-East Commission

(Serving the counties of Beaufort, Bertie, Hertford, Martin and Pitt)

1385 John Small Avenue
Washington, NC 27889

(252) 946-8043

Piedmont Triad Regional Council

(Serving the counties of Alamance, Caswell, Davidson, Davie, Forsyth, Guilford, Montgomery, Randolph, Rockingham, Stokes, Surry and Yadkin)

1398 Carrollton Crossing Drive
Kernersville, NC 27284

(336) 904-0300

Southwestern Commission Area Agency on Aging

(Serving the counties of Cherokee, Clay, Graham, Haywood, Jackson, Macon, Swain and the Eastern Band Cherokee Nation)

125 Bonnie Lane
Sylva NC 28779

(828) 586-1962

Triangle J Council of Governments

(Serving the counties of Chatham, Durham, Johnston, Lee, Moore, Orange and Wake)

4307 Emperor Blvd., Suite 110
Durham, NC 27703

(919) 558-2711

Upper Coastal Plain Council of Governments

(Serving the counties of Edgecombe, Halifax, Nash, Northampton and Wilson)

121 W. Nash Street
Wilson, NC 27894

(252) 234-5952

Western Piedmont Council of Governments

(Serving the counties of Alexander, Burke, Caldwell and Catawba)

1880 2nd Avenue NW

Hickory, NC 28601

(828) 322-9191

Veterans Affairs

An increased pension amount is one of the benefits that U.S. Armed Services Veterans that are pension eligible may receive. This additional benefit has traditionally been used for nursing home care, but can be used to cover the cost of assisted living as well. Since Veterans Affairs does not classify assisted living facilities as nursing homes, veterans must be rated to qualify to use pension fund benefits in this way. Veterans that wish to find out if they can be rated to use benefits in this way should visit one of the local facilities listed below.

VA OfficeAddressPhone Number

Alamance Vet Office

201 W. Elm Street
Graham, NC 27253

(336) 570-6763 Or

(336) 570-6734

Alexander Vet Office

621 Liledoun Road, Box 8
Taylorsville, NC 28681

(828) 632-5411

Alleghany Vet Office

348 S. Main St.
Sparta, NC 28765

(336) 372-4850

Anson Vet Office

111 North Greene Street
Wadesboro, NC 28170

(704) 694-4418

Ashe Vet Office

150 Government Circle Suite 2100
Jefferson, NC 28640

(336) 846-5575

Avery Vet Office

175 Linville Street
Newland, NC 28657

(828) 733-8211

Beaufort Vet Office

1308 Highland Drive Suite 104
Washington, NC 27889

(252) 946-8016

Bertie Vet Office

106 Dundee Street
Windsor, NC 27983

(252) 794-5304

Bladen Vet Office

301 S. Cypress Street
Elizabethtown, NC 28337

(910) 862-6781

Brunswick Vet Office

#10 Referendum Dr. Ne Building F
Bolivia, NC 28422

(910) 253-2233

Buncombe Vet Office

199 College Street
Asheville, NC 28802

(828) 250-5726

Burke Vet Office

501 North Green St
Morganton, NC 28655

(828) 439-4376

Cabarrus Vet Office

363 Church Street N Suite 180
Concord, NC 28025

(704) 920-2869

Caldwell Vet Office

905 West Avenue Nw
Lenoir, NC 28645

(828) 757-1345

Camden Vet Office

Assistance Provided by the Elizabeth City VSC

(252) 331-4741

Carteret Vet Office

3710-B John Platt Drive
Morehead City, NC 28557

(252) 728-8440

Caswell Vet Office

649 Firetower Rd.
Yanceyville, NC 27379

(984) 232-7060

Catawba Vet Office

25 Government Drive
Newton, NC 28658

(828) 465-8255

Chatham Vet Office

964 East Street, Suite 209
Pittsboro, NC 27312

W. Chatham Sen Ctr 112 Village Lake Road
Siler City, NC 27344

(919) 545-8334

(919) 545-8334

Cherokee Vet Office

75 Peachtree Street
Murphy, NC 28906

(828) 835-8663

Chowan Vet Office

305 Freemason St., Suite 1148
Edenton, NC 27932

(252) 482-1033

Clay Vet Office

54 Church Street
Hayesville, NC 28904

(828) 389-3355

Cleveland Vet Office

311 E. Marion Street
Shelby, NC 28150

(704) 484-4803

Columbus Vet Office

805 Pinckney Street
Whiteville, NC 28472

(910) 640-6638

Craven Vet Office

2402 Dr. Mlk Jr. Blvd
New Bern, NC 28562

(252) 636-6611

Cumberland Vet Office

301 E. Russell Street
Fayetteville, NC 28301

(910) 677-2970

Currituck Vet Office

Assistance Provided by the Elizabeth City VSC

(252) 331-4741

Dare Vet Office

107 Exeter Street
Manteo, NC 27954

(252) 475-5604

Davidson Vet Office

913 Greensboro Street Suite 101
Lexington, NC 27292

(336) 242-2037

Davie Vet Office

277 Meroney Street
Mocksville, NC 27028

(336) 753-6225

Duplin Vet Office

169 Mallard St.
Kenansville, NC 28349

(910) 296-2114

Durham Vet Office

414 E. Main Street 1st Floor
Durham, NC 27701

(919) 560-8387

Edgecombe Vet Office

201 St. Andrews Street
Tarboro, NC 27886

(252) 641-6286

Forsyth Vet Office

3802-C Clemmons Rd.
Clemmons, NC 27012

(336) 766-1496

Franklin Vet Office

Court House Annex, 113 S. Main Street Room 103
Louisburg, NC 27549

(919) 496-1939

Gaston Vet Office

965 Roberts Drive
Gastonia, NC 28054

(704) 866-3606

Gates Vet Office

112 Court Street
Gatesville, NC 27938

(252) 357-1780

Graham Vet Office

12 North Main Street
Robbinsville, NC 28771

(828) 646-6937

Granville Vet Office

107 Lanier Street
Oxford, NC 27565

(919) 693-1484

Greene Vet Office

229 Kingold Blvd, Greene County Office Complex
Snow Hill, NC 28580

(252) 747-7320

Guilford Vet Office

1203 Maple Street
Greensboro, NC 27405

325 E. Russell Ave Room 145
High Point, NC 27260

(336) 641-2957

(336) 641-7929

Halifax Vet Office

26 North King Street
Halifax, NC 27839

(252) 583-1688 Option 1

Harnett Vet Office

817 S 8th Street
Lillington, NC 27546

(910) 893-7574

Haywood Vet Office

215 North Main Street
Waynesville, NC 28786

(828) 452-6634

Henderson Vet Office

1200 Spartanburg Highway Suite 200
Hendersonville, NC 28792

(828) 697-4817

Hertford Vet Office

704 North King Street
Winton, NC 27986

(252) 358-7811

Hoke Vet Office

129 West Elwood Ave.
Raeford, NC 28376

(910) 875-2147

Hyde Vet Office

1223 Main St.
Swan Quarter, NC 27885

(252) 926-4383

Iredell Vet Office

200 S. Center Street Statesville, NC 28677

610 E Center Ave.
Mooresville, NC 28115

(704) 878-3135

(704) 664-3869

Jackson Vet Office

100 County Services Park
Sylva, NC 28779

(828) 631-2231

Johnston Vet Office

309 E. Market Street
Smithfield, NC 27577

(919) 989-5067

Jones Vet Office

418 Hwy 58 N Unit D
Trenton, NC 28585

(252) 448-1121

Lee Vet Office

1615 South 3rd Street Lee County Enrichment Center
Sanford, NC 27330

(919) 776-0501 Ext. 2209

Lenoir Vet Office

1136 Hwy 268 North
Kinston, NC 28504

(252) 522-5050

Lincoln Vet Office

206 Gamble Drive Suite A
Lincolnton, NC 28092

(704) 736-8506

Macon Vet Office

104 East Main Street
Franklin, NC 28734

(828) 349-2151

Madison Vet Office

462 Long Branch Road
Marshall, NC 28753

(828) 649-2722

Martin Vet Office

205 E. Main Street
Williamston, NC 27892

(252) 789-4398

McDowell Vet Office

100 Spaulding Road
Marion, NC 28752

(828) 659-0833

Mecklenburg Vet Office

700 N. Tryon Street
Charlotte, NC 28202

(704) 336-2102

Mitchell Vet Office

130 Forest Service Drive
Bakersville, NC 28705

(828) 688-2200

Montgomery Vet Office

219 South Main St.
Troy, NC 27371

(910) 576-4711

Moore Vet Office

707 Pinehurst Avenue
Carthage, NC 28327

(910) 947-3257

Nash Vet Office

120 W. Washington Street
Nashville, NC 27856

(252) 462-2720

Northampton Vet Office

100 West Jefferson Street
Jackson, NC 27845

(252) 534-2621

Onslow Vet Office

234 Nw Corridor Blvd Suite 201
Jacksonville, NC 28540

(910) 347-3309

Orange Vet Off

113 Mayo Street
Hillsborough, NC 27278

(919) 245-2890

Pamlico Vet Office

828 Alliance Main Street
Bayboro, NC 28515

(252) 745-4086

Pasquotank Vet Office

1023 Us 17 South, Suite 2
Elizabeth City, NC 27909

(252) 331-4741

Pender Vet Office

805 S. Walker Street
Burgaw, NC 28425

(910) 270-5005

Perquimans Vet Office

104 Dobbs Street
Hertford, NC 27944

(252) 426-1796

Person County Vet Office

216 Barden Place
Roxboro, NC 27573

(336) 597-7891

Pitt Vet Office

1717 West 5th Street
Greenville, NC 27834

(252) 902-3090

Polk Vet Office

75 Carmel Lane
Columbus, NC 28722

(828) 894-0003

Randolph Vet Office

158 Worth Street
Asheboro, NC 27203

(336) 318-6909

Richmond Vet Office

1401 Fayetteville Road
Rockingham, NC 28379

(910) 997-8232

Robeson Vet Office

113 W. Eighth Street
Lumberton, NC 28358

(910) 671-3070

Rockingham Vet Office

335 County Home Road
Reidsville, NC 27320

(336) 342-8449

Rowan Vet Office

1935 Jake Alexander Blvd West Suite A-2
Salisbury, NC 28147

(704) 216-8138

Rutherford Vet Office

303 Fairground Road
Spindale, NC 28160

(828) 287-6185

(828) 287-6064

Samson Vet Office

335 County Complex Road, Suite 100
Clinton, NC 28328

(910) 592-2862

Scotland Vet Office

507 West Covington Street
Laurinburg, NC 28352

(910) 277-2597

Stanly Vet Office

1000 North First Street, Suite 6
Albemarle, NC 28001

(704) 986-3694

Stokes Vet Office

1012 Main St, Room 156
Danbury, NC 27016

(336) 593-2468

Surrey Vet Office

1218 State Street Suite 700
Mt. Airy, NC 27030

(336) 783-8820

Swain Vet Office

101 Mitchell Street
Bryson City, NC 28713

(828) 646-6937

Transylvania Vet Office

106 E Morgan Street Room 237
Brevard, NC 28712

(828) 884-3276

Tyrell Vet Office

106 Water Street
Columbia, NC 27925

(252) 796-0000

Union Vet Office

407 N. Main Street
Monroe, NC 28112

(704) 283-3807

Vance Vet Office

300 South Garnett Street Henry A. Dennis Bldg Room 115
Henderson, NC 27536

(252) 438-4619

Wake Vet Office

3000 Falstaff Road Raleigh, NC 27610

(919) 212-8387

Warren Vet Office

109 S. Main Street
Warrenton, NC 27589

(252) 257-3385

Washington Vet Office

112 Latham Avenue
Plymouth, NC 27962

(252) 799-9764

Watauga Vet Office

126 Poplar Grove Road Suite 203
Boone, NC 28607

(828) 265-8065

Wayne Vet Office

2001 E. Ash Street Suite D
Goldsboro, NC 27530

(919) 731-1490

Wilkes Vet Office

109 North Street
Wilkesboro, NC 28697

(336) 651-7327

Wilson Vet Office

113 East Nash Street Suite 404
Wilson, NC 27893

(252) 237-2422

Yadkin Vet Office

101 South State Street, Room 103
Yadkinville, NC 27055

(336) 849-7914

Yancey Vet Office

110 Town Square Drive Room 12
Burnsville, NC 28714

(828) 682-1514

Social Security Offices

Social Security benefits are another option for financing assisted living costs. To gain better insight into what programs or benefits are available to you or a loved one, visiting or calling one of the offices on the list below may be helpful.

Social Security OfficeAddressPhone Number

Ahoskie Social Security Office

1231 W First St
Ahoskie, North Carolina 27910

(866) 828-3810

Albemarle Social Security Office

202 Charter St Brookwood Executive Pk
Albemarle, North Carolina 28001

(866) 828-3810

Asheboro Social Security Office

157 Dublin Square Rd Suite K
Asheboro, North Carolina 27203

(866) 828-3810

Ashville Social Security Office

800 Centre Park Drive
Asheville, North Carolina 28805

(866) 828-3810

Charlotte Social Security Office

2201 Coronation Blvd. Suite 100
Charlotte, North Carolina 28227

(866) 828-3810

Concord Social Security Office

830 Florence St Nw
Concord, North Carolina 28027

(866) 828-3810

Durham Social Security Office

3511 Shannon Rd Suite 200
Durham, North Carolina 27707

(866) 828-3810

Elizabeth City Social Security Office

1865 West City Drive
Elizabeth City, North Carolina 27909

(866) 828-3810

Fayetteville Social Security Office

145 Rowan St
Fayetteville, North Carolina 28301

(866) 828-3810

Franklin Social Security Office

2123 Lakeside Dr
Franklin, North Carolina 28734

(866) 828-3810

Gastonia Social Security Office

609 Cotton Blossom Cir
Gastonia, North Carolina 28054

(866) 828-3810

Goldsboro Social Security Office

915 W New Hope Road
Goldsboro, North Carolina 27534

(866) 828-3810

Greensboro Social Security Office

6005 Landmark Ctr Blvd
Greensboro, North Carolina 27407

(866) 828-3810

Greenville Social Security Office

2805 S Charles Blvd
Greenville, North Carolina 27858

(866) 828-3810

Henderson Social Security Office

858 S Beckford Dr
Henderson, North Carolina 27536

(866) 828-3810

Hendersonville Social Security Office

205 S Grove Street
Hendersonville, North Carolina 28792

(866) 828-3810

Hickory Social Security Office

1050 Us Hwy 321 Nw
Hickory, North Carolina 28601

(866) 828-3810

Kinston Social Security Office

2559 N Queen Street
Kinston, North Carolina 28501

(866) 828-3810

Lumberton Social Security Office

4430 Kahn Drive
Lumberton, North Carolina 28358

(866) 828-3810

Mount Airy Social Security Office

Griffith Parkway 1187 North Andy
Mount Airy, North Carolina 27030

(866) 828-3810

New Bern Social Security Office

1420 Mccarthy Blvd
New Bern, North Carolina 28562

(866) 828-3810

Raleigh Social Security Office

4701 Old Wake Forest R
Raleigh, North Carolina 27609

(866) 828-3810

Reidsville Social Security Office

2402 Freeway Dr
Reidsville, North Carolina 27320

(866) 828-3810

Roanoke Social Security Office

833 Gregory Drive
Roanoke Rapids, North Carolina 27870

(866) 828-3810

Rockingham Social Security Office

220 East Greene St
Rockingham, North Carolina 28379

(866) 828-3810

Rocky Mount Social Security Office

1071 Hunter Hill Rd
Rocky Mount, North Carolina 27804

(866) 828-3810

Salisbury Social Security Office

1840 Jake Alexnder Bl W
Salisbury, North Carolina 28147

(866) 828-3810

Sanford Social Security Office

401 Tiffany Dr
Sanford, North Carolina 27330

(866) 828-3810

Shelby Social Security Office

707 Schenck St
Shelby, North Carolina 28150

(866) 828-3810

Smithfield Social Security Office

633 Venture Dr
Smithfield, North Carolina 27577

(866) 828-3810

Statesville Social Security Office

2038 Davie Ave
Statesville, North Carolina 28625

(866) 828-3810

Washington Social Security Office

1633 John Small Ave
Washington, North Carolina 27889

(866) 828-3810

Whiteville Social Security Office

204 South Lee Street
Whiteville, North Carolina 28472

(866) 828-3810

Wilkesboro Social Security Office

1517 River St
Wilkesboro, North Carolina 28697

(866) 828-3810

Wilmington Social Security Office

1528 S 16th St
Wilmington, North Carolina 28401

(866) 828-3810

Wilson Social Security Office

1911 Westwood Ave W
Wilson, North Carolina 27893

(866) 828-3810

Winston- Salem Social Security Office

1370 Lockland Ave Winston
Salem, North Carolina 27103

(866) 828-3810

Assisted Living Laws and Regulations in North Carolina

Assisted living residences in North Carolina are licensed through the Division of Health Services Regulation (DHSR) an agency located under the Department of Health and Human Services (DHHS).

Facilities that fall under the umbrella term of Assisted Living Residences are divided into two separate categories, assisted care homes (ACH) that must obtain licensure and multi-unit assisted housing with services (MAHS) which must register with the DHSR, but are not subject to the same licensure terms as ACH facilities. Both types of facilities are obligated to comply with rules set forth by the DHHS.

All facilities must provide a written copy of house rules and facility policies to residents at the time of move in. This should include a resident’s bill of rights, the facility grievance policy and procedures, as well as contact information for the local ombudsman and area agency on aging. Rates for resident care and services, and what specific needs of the resident cannot be met by the facility should also be included.

Assisted Living Service Plans

All facilities must provide a written copy of house rules and facility policies to residents at the time of move in. This should include a resident’s bill of rights, the facility grievance policy and procedures, as well as contact information for the local ombudsman and area agency on aging. Rates for resident care and services, and what specific needs of the resident cannot be met by the facility should also be included.

Assisted Living Admission Requirements

Assisted care homes may not admit residents that need supervision or care that reaches the level of nursing home care. Individuals with severe mental health or substance abuse issues or those that have a proven record of being a danger to themselves and others are prohibited from being admitted. Facilities cannot admit residents that are unable to comprehend and enter into a contract on their own, or that are totally dependent on personal care to complete at least four necessary tasks per day. Facilities may not admit patients that require ventilator assistance, round the clock nursing or residents with communicable illnesses.

Assisted Living Assessments

A pre-admission assessment must be conducted within 72 hours of moving into an assisted care home, with an additional assessment to be done for each resident before the expiration of the first 30 days of residency.

A physician completed assessment must be furnished to a multi-unit care home to determine the facility’s legal authority and their capacity to serve the needs of the resident, this will also determine if a more in-depth assessment will need to be done by the home health care service contracted by the facility.

In the event that an admitted resident is taken with a long-term illness that is not expected to clear within 90 days, discharge of the patient is mandated. Written notice of discharge is to be given to the resident 30 days before the date of discharge. Reassessments must also be completed no more than 10 days after a resident experiences a change in health status.

Assisted Living Scope of Care

Assisted care homes must provide at least one meal per day and through a written agreement, personal care services in the form of personal hygiene, eating and mobility aid through the facility or a home health agency licensed through the department of health and human services. Nursing care services may be provided on a per case basis. Assisted living residences must provide 24-hour staffing and resident supervision and arrange for transportation, personal care, activities, and housekeeping.

Assisted Living Medicaid Policy

In North Carolina Medicaid will not pay for room and board or meals but will cover personal care services up to 80 hours per month if prescribed by a physician. A resident will have to already be a Medicaid recipient and be able to show the need for help with tasks such as bathing, dressing or eating.

Assisted Living Facility Requirements

No more than two residents may reside in a room at any facility that was constructed after July, 2004. Private units are required to have a minimum of 100 square feet that does not include vestibules, bathrooms, kitchens, and closets. Shared units must have a minimum of 80 square feet per resident. A minimum of one toilet and sink is required per every five residents and 1 tub or shower per every 10 residents.

Smoke detectors are required to be in all hallways and spaced no more than 60 feet apart, and no more than 30 feet away from an end wall. Smoke and fire detection systems must be installed in all kitchens, dining rooms, living rooms, storage closets, laundry facilities, and must be interconnected with the facility alarm system.

Medication Management Regulations

Assisted care homes may offer medication management which may only be performed by staff that has completed a state-developed and mandated 15-hour medication administration course and exam that is state administered. Only after their competency has been verified in the facility of employment by a registered nurse, can staff begin medication administration.

Staffing Requirements

All facilities must at all times have an administrator, an administrator-in-charge or supervisor-in-charge in the facility at all times. A facility that has a memory unit must have specific staff that are trained in the proper care of residents with dementia and Alzheimer’s.

Staff Training Requirements

Administrators must be at least 21 and have successfully completed a 120-hour administrator in training program, hold an associates degree or two years of equivalent coursework at an accredited higher education institution. Administrators-in-charge must complete 12 hours per year of continuing education credits, plus a demonstrated 30 hours of coursework on specific topics. Supervisory staff must complete an 80-hour training program within six months of hire on topics specified by the department of health and human services.

Non-supervisory staff must complete competency evaluation in their specific personal care tasks with definitions and position requirements set forth by the department of health and human services. Medications administrators and their supervisors must complete six hours of continuing education each year.

Background Checks for Assisted Living

All employees in licensed facilities must submit to a criminal background check as well as a registry check and have no reports of abuse or neglect in the North Carolina Health Care Personnel Registry. Administrators must also submit to a fingerprint-based criminal background check as well as a registry check.

Requirements for Reporting Abuse

In North Carolina, anyone working in an assisted living facility is designated a mandatory reporter and may face criminal charges or fines if they fail to report the abuse of a resident. Reportable offenses include financial abuse and physical, sexual or psychological abuse. Anyone wishing to report elder abuse may call the Department of Health and Human Services Care Line at (800) 662-7030. Should the reporter believe that the resident is in immediate danger, he or she should call 911.

Residents may also call 911 or the care line to report the abuse of a fellow resident or themselves. They may also contact their local long-term care ombudsman office to file a report, the number for the county long-term care ombudsman should be prominently displayed in the facility.

Residents or their families may report a facility that falls outside of their scope of licensure or has unsafe environments. An unsafe environment would be anything that constitutes a physical danger to residents such as unkempt grounds, broken walkways, or failure to comply with general fire and safety requirements. To report a facility, you may call the Complaint and Intake Investigations Section at (800) 624-3004 or (919) 855-4500.