North Carolina Adult Care Homes

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North Carolina Adult care homes: How to pay for, Laws and Regulations and Questions to ask…

North Carolina is a beautiful place full of majestic scenery, a cheerful climate and is home to 1.75 million senior citizens. It’s an ideal place for seniors and retirees to enjoy their lives. From the Smoky Mountains to the Cape Hatteras National Seashore, people from all around seek out North Carolina for the incredible fresh air and scenery. It is natural our senior and aging adult population may require care at some point. An adult care home may be ideal for a senior who can no longer manage their health and safety in their own home, and may need care. Adult care homes are an excellent housing option for aging adults because they offer private residencies in a home-like environment. These residences are not nursing homes.

Adult Care Homes in North Carolina

These are private residences that provides a home-like setting, and typically care for 2 to 6 residents (There are facilities like assisted living in North Carolina that house up to 100 residents and may be called adult care homes. Typically residents in a nursing home require a higher level of care. In an adult care home, residents may require very light assistance or may be more dependent with several care needs. It is best to ask individual locations as you look for care about their specific policies and licenses.

What are the terms you may here to describe adult care homes

These homes are found in normal residential neighborhoods. You may drive past an adult care home each day on your commute. As you look for adult care homes in your community, it is good to know the other terms/names you may hear: 

  • Residential care home
  • Care Home
  • Adult family home 
  • Board and care home 
  • Adult foster home
  • Nursing Home (although this is an outdated and not an accurate term for this level of care)
Adult care homes offer a comfortable environment for seniors to receive care

North Carolina adult care home licensing

There are over 1,200 adult care homes in North Carolina. The Division of Health Service Regulation is responsible for all licensing of adult care homes. The Department of Human Resources oversees these residences in the state of North Carolina. There are statutes in place which allow county department of social services to supervise all adult care homes in the state.

Staffing

For the safety of residents, operators must be licensed in their state and participate in on-going training.
Staff must have hands-on experience providing care for the population they intend to serve, as well as on-going training. 

Grievances

The Long-term care Ombudsman Program is there to support all residents of adult care homes in North Carolina. They are there to assist with grievances.

Adult care home care services in North Carolina

  • The adult care home provider will typically provide meals, housekeeping, and limited activities.
  • Caregivers may perform several functions: personal hygiene and mobility and eating and dressing and toileting and behavior management.
  • Similar to a nursing home, residents receive 24-hour care all in a single-family environment.
  • And in addition each home has an operator who may employ additional caregivers to support with the care of residents. 

Caregivers in an adult care home may assist with activities of daily living and other needs

  • Personal care
  • Housekeeping
  • Activities
  • Group meals
  • Mobility
  • Behavior management
  • Eating
  • Dressing
  • Toileting
  • Personal hygiene
  • Cognitive support and redirection

How much should you expect to pay for an adult care home in North Carolina?

The average cost per month for an adult care home in North Carolina is about $3,100 per month. The cost will vary throughout the state, as is common with all senior care. By comparison, one month of care in assisted living community is above $4,800 per month. Nursing homes average $7,000 or more per month in North Carolina.

How to pay for an adult care home?

You want to consider your payment options for assisted living, memory care, and care homes. For these services, Medicare is NOT an option for payment.

The most common payment for these services would be out of pocket Private Pay and assessing a combination of retirement funds, personal savings, and pension payments.

Medicaid can also be an option, be sure to see if you or a loved one qualifies.

Long-Term Care insurance is also a possible option in cases of chronic conditions, be sure to see if you or a loved one qualifies.

For our Veterans and spouses of veterans, be sure to assess Veteran Aid and your eligibility for these benefits.

Medicare – NO:

  • Medicare does NOT pay for Assisted Living.
  • People 65 years and older and individuals with end stage renal disease are eligible for Medicare benefits, no matter their income.
  • Coverage is meant for people in need of short-term care.

Private pay – YES:

  • Many families pay for assisted living with private funds.
  • Private pay can be a combination of retirement funds, personal savings, and pension payments.
  • Family members may contribute funds to pay for assisted living or other senior housing and care.

Medicaid – MAYBE:

  • Medicaid provides health coverage to millions of Americans. Eligible participants include: low-income adults, elderly adults and people with disabilities.
  • Medicaid is administered by state, according to federal requirements. The program is funded jointly by each state and the federal government.
  • Every state has their own individual Medicaid assistance program.
  • National guidelines are in place do decipher how states must spend Medicaid money, but with allowances toward the guidelines.
  • The state determines what levels of care will be covered by Medicaid, who is eligible, and how much the state will reimburse the care community.
  • If you are unsure whether you qualify for Medicaid, you should apply. You may be eligible depending on your household income, family size, age, disability and other factors.

Long-term Care Insurance – MAYBE:

Long term care insurance is a great way to pay for assisted living, and planning ahead is important when considering how to pay for senior housing and care. Nearly 75% of people over the age of 65 will require long-term care and services at some point. Buying into long-term care insurance when a person is in their 50s and 60s is the most common time to do so.

  • Long-term care insurance helps cover the costs of chronic medical conditions.
  • Individuals and couples with the ability to pay into long-term care insurance have the advantage of a head start in allocating funds for senior care.

Veteran Aid and Assistance – MAYBE:

This benefit is available to some military veterans and surviving spouses who live in an assisted living community and those who have in-home care.

  • There are specific guidelines, but a veteran may qualify for as much as $2,050 each month.
  • A veteran with a sick spouse may be eligible for $1,600 per month.
  • If a veteran has passed, their surviving spouse can qualify for $1,300 per month.

Questions to Ask

Finding an assisted living community can be overwhelming. Here are some tips on things to be observant of:

  • Make sure the facility is clean and well maintained. You can tell a lot about the operation by noting what is clean and maintained. Are doorknobs loose or damaged? Do you see any frayed carpet or trip hazards?
  • Visit during lunch hour to observe what the residents are eating. Ask questions about the nutrition program. Is there diversity in meals, healthy fruits and vegetables served at all meals, drink options?
  • Speak to residents and/or family members to learn their perspective.
  • Ask about staff and resident engagement. Get a feel for how staff interact with residents.
  • Ask about the life enrichment programs. Activities are crucial when it comes to quality of life and play a key role in care for older adults.
  • And finally (along with a plethora of more things to consider), get to know the leadership in the building. If you feel good around the Executive Director, Head Nurse, Lead Activities Director and even the Chef or Janitor, it is a good sign you can trust them with the care of your loved one.

Eldercare Locator is a nationwide service that connects older Americans and their caregivers with trustworthy local support resources. Connect with services such as meals, home care or transportation, or a caregiver education or respite from caregiving responsibilities. The Eldercare Locator is a public service of the Administration on Aging (AoA), an agency of the U.S. Administration for Community Living.

Medicare provides a search feature to find & compare providers near you, most senior housing and care providers are included on CareAvailability.com. Find & compare plans in your area. Determine if you qualify for premium savings

Medicaid offers information on how to apply for Medicaid, eligibility criteria, links to local state offices, and additional resources.

The Alzheimer’s Association is the leading voluntary health organization in Alzheimer’s care, support and research. Whether you are living with Alzheimer’s or caring for someone with the disease, information and resources are available. 

NCDHHS Division of Aging and Adult Services

North Carolina Health and Social Services

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Written by The Care Availability Team
Experts in the senior care & retirement living industries

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