Assisted Living in North Carolina

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.

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.

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.

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.

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.

North Carolina COVID-19 Rules for Assisted Living Facilities

Note: The following information was compiled and most recently updated on 2/13/22. Since COVID-19 is a rapidly evolving crisis, be sure to contact your assisted living facility or local Area Agency on Aging for the most up-to-date information.

COVID-19 Rules in North Carolina
Are loved ones allowed to visit residents in their assisted living community?	Yes
Are residents required to quarantine after their loved ones visit?	No
Are loved ones required to wear masks when visiting residents?	Yes
Are Hairdressers and other non-medical contractors allowed in assisted living communities?	Yes
Are visitors screened for elevated temperatures before entering the assisted living community?	Yes
Are residents allowed to leave the assisted living community for non-medical reasons?	Yes
Are residents who leave required to quarantine when they get back to the assisted living community?	No (Conditions Apply)
Are assisted living communities required to cancel all group outings?	No
Are assisted living communities allowed to host group activities within the community?	Yes (Conditions Apply)
Are staff members regularly checked for elevated temperatures?	Yes
Are staff members regularly tested for COVID-19?	Yes (Conditions Apply)
Are residents regularly screened for COVID-19 symptoms?	Yes
Are residents regularly checked for elevated temperatures?	Yes
Are residents regularly tested for COVID-19?	Yes (Conditions Apply)

Sources: covid19.ncdhhs.gov www.cdc.gov