Assisted Living in North Carolina
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Families looking for assisted living in North Carolina (NC) have a wide array of communities to choose from, since estimated that there are more than 30,000 assisted living communities serving seniors across the U.S., and over 561 statewide. The state is also home to a rapidly growing number of senior citizens, with adults over 65 making up an estimated 15.9 percent of the population. A resident in an assisted living community in North Carolina will pay $3,250 per month on average.
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What You Should Know About Assisted Living in North Carolina
In North Carolina, assisted living residences are commonly called adult care homes (ACHs). Seniors and their loved ones seek out adult care homes in this state because communities are economically priced and meet a high standard of care for residents. While many states have no regulations regarding how many caregivers must be on site at a given time, North Carolina has strict regulations regarding resident/staff ratios to ensure that residents’ needs are met.
Financial Assistance for Assisted Living in North Carolina
North Carolina has subsidy programs that can assist low-income seniors in paying for assisted living.
Special Assistance Program (For Adult Care Home Residents)
This program covers room and board costs in licensed assisted living residences, as well as adult foster care and group homes. Seniors who are eligible for this program are also eligible for Medicaid, which may also help pay for their care and medical needs.
Who Is Eligible?
Applicants must be at least 65 years of age unless they are designated as disabled by Social Security, in which case they must be at least 18. They must be U.S. citizens and residents of North Carolina for at least 90 days prior to applying. Their monthly income cannot exceed $1,228, and they must have less than $2,000 in assets, excluding their home, vehicle, and personal belongings.
Eligible seniors are those who have a medically documented need for the level of care provided by assisted living but do not need nursing home care. They must also choose an assisted living community that is authorized to receive payments from this program.
How to Apply
Seniors who meet the eligibility requirements can apply by submitting an application in person to their county Department of Social Services.Those needing memory care may be able to apply for additional support. For more information, see our North Carolina Memory Care page.
More Ways to Finance Assisted Living
While many families use their own funds or personal assets to pay for assisted living, there are plenty of additional options to cover these costs. Visit our 9 Ways to Pay for Assisted Living page for more information.
Free Assisted Living Resources in North Carolina
North Carolina has a variety of free resources that provide information and support for seniors.
North Carolina Area Agencies on Aging
Area Agencies on Aging focus on promoting the independence and dignity of seniors. This network provides a variety of services, including transportation, senior activities and support groups and prescription drug programs.
125 Bonnie Lane, Sylva, NC 28779
339 New Leicester Highway, Suite 140, Asheville, NC 28806
468 New Market Boulevard, Boone, NC 28607
1880 Second Ave, NW, Hickory, NC 28601
111 West Court Street, Rutherfordton, NC 28139
525 North Tryon Street, Charlotte, NC 28202
1398 Carrollton Crossing Drive, Kernersville, NC 27284
1724 Graham Avenue, Henderson, NC 27536
4307 Emperor Blvd., Suite 110, Durham, NC 27703
130 Gillespie Street, Fayetteville, NC 28301
30 CJ Walker Road, Pembroke, NC 28372
121 W. Nash Street, Wilson, NC 27894
1480 Harbour Drive, Wilington, NC 28401
512 South Church Street, Hertford, NC 27944
1385 John Small Avenue, Washington, NC 27889
233 Middle Street, New Bern, NC 28563
VA centers in North Carolina help veterans and their spouses connect with programs that can help them pay for medical care and assisted living. They can also help veterans ensure that they get the most from the benefits they are already receiving or are eligible to receive.
2114 Ben Craig Dr., Suite 300, Charlotte, NC 28262
2301 Robeson St., Suite 103, Fayetteille, NC 28305
3515 W Market St., Suite 120, Greensboro, NC 27406
1021 WH Smith Blvd., Suite #100, Greenville, NC 27834
110A Branchwood Dr, Jacksonville, NC 28546
8851 Ellstree Lane, Suite 122, Raleigh, NC 27617
303 Fairground Road, Spindale, NC 28160
Local social security offices can help seniors understand and apply for government programs and subsidies that they are eligible for, including those that can help them pay for assisted living.
1231 W First St, Ahoskie, NC 27910
202 Charter St, Albemarle, NC 28001
157 K Dublin Square Rd, Asheboro, NC 27203
800 Centre Park Drive, Asheville, NC 28805
5800 Executive Ctr Dr, Charlotte, NC 28212
830 Florence St NW, Concord, NC 28027
3004 Tower Blvd, Durham, NC 27707
1865 W City Dr, Elizabeth City, NC 27909
145 Rowan St, Fayetteville, NC 28301
2123 Lakeside Dr, Franklin, NC 28734
609 Cotton Blossom Cir, Gastonia, NC 28054
915 W New Hope Rd, Goldsboro, NC 27534
6005 Landmark Center Blvd, Greensboro, NC 27407
2805 S Charles Blvd, Greenville, NC 27858
858 S Beckford Dr, Henderson, NC 27536
205 S Grove St, Hendersonville, NC 28792
2559 N Queen Street, Kinston, NC 28501
4430 Kahn Drive, Lumberton, NC 28358
1187 North Andy Griffith Parkway
1420 McCarthy Blvd, New Bern, NC 28562
4701 Old Wake Forest, Raleigh, NC 27609
2402 Freeway Dr, Reidsville, NC 27320
833 Gregory Drive, Roanoke Rapids, NC 27870
220 East Greene St, Rockingham, NC 28379
1071 Hunter Hill Rd, Rocky Mount, NC 27804
1840 Jake Alexander Blvd W, Salisbury, NC 28147
401 Tiffany Dr, Sanford, NC 27330
707 Schenck Street, Shelby, NC 28150
633 Venture Dr, Smithfield, NC 27577
2038 Davie Ave, Statesville, NC 28625
1633 John Small Ave, Washington, NC 27889
204 South Lee Street, Whiteville, NC 28472
1517 River St, Wilkesboro, NC 28697
1528 S 16th St, Wilmington, NC 28401
1911 Westwood Ave W, Wilson, NC 27893
1370 Lockland Ave, Winston Salem, NC 27103
North Carolina’s assisted living ombudsman program supports seniors by answering their questions regarding the long-term care system, explaining to them their personal rights, and outlining the rules and regulations that long-term care communities must follow. They can also act as an advocate when a senior’s rights or interests have been violated.
Assisted Living Laws and Regulations in North Carolina
Assisted Living Service Plan Requirements
Assessments are required to assist in creating service plans which are individualized written programs that detail the care each resident needs. An initial assessment is performed within 72 hours of admission with a more detailed evaluation occurring within 30 days of the move-in date. Assessments are also repeated annually and in any instance where a significant change occurs in a resident’s health condition. Thanks to these assessments and in-depth care plans, ACHs are able to make sure they provide the necessary assistant each resident needs during their daily activities.
Assisted Living Admission Requirements
As is common in most states, residents looking to be admitted to an ACH should not require full-time skilled nursing care, ventilators, or intravenous therapy. Exceptions can be made on a short term basis with a physician’s cooperation. Mental illness, drug or alcohol abuse and communicable disease infections may also disqualify a senior from being admitted to an adult care home.
Assisted Living Scope of Care
Residents of ACHs receive 24-hour supervision along with assistance in transportation, housekeeping, personal care regimens and occasionally short-term periods of nursing care. Residents may also contract with other service agencies for personal and nursing care.
Assisted Living Medicaid Policy
The North Carolina Medicaid plan pays for personal care services received by eligible residents in an ACH. In addition, there is a state/county sponsored supplemental assistance program for low-income seniors and medically disabled residents.
Assisted Living Facility Requirements
Private rooms are not required and residents may share a bedroom with up to 4 individuals depending upon the date the ACH was licensed. There must be a toilet and a sink for every 5 residents and a tub or shower for every 10 individuals.ACHs in North Carolina are required to provide three meals and three snacks each day. They must be able to serve modified or therapeutic diets when ordered by a physician, and there should be a registered dietitian on staff to review these meals. There must be enough staff available to provide individual feeding assistance as needed.
Medication Management Regulations
Before a staff member is responsible for administering or supervising the administration of medications, they’re required to undergo community-provided orientation. If an unlicensed staff member will be performing any task related to medication administration, then they must receive a competency validation by an RN.
Any staff members who administers or supervises the administration of medication must successfully complete the clinical skills validation portion of North Carolina’s competency evaluation. Residents are permitted to self-administer their medications as long as a physician deems them competent and physically able.Residents’ medication orders and the ACH’s medication procedures are reviewed quarterly by a licensed pharmacist, prescriber, or RN. Special diabetic training must be provided to unlicensed staff before they are allowed to assist with insulin injections and blood glucose monitoring.
North Carolina has relatively strict guidelines for staff ratios. Communities that have between 20 and 30 residents must have 16 hours of personal care aide (PCA) time on the first and second shifts and eight hours on the third shift. A community with 131 to 140 residents must have 96 PCA hours. The larger the community, the greater the number of PCA hours required.Assisted living communities must have one administrator or acting administrator on site 24 hours a day to ensure that residents are never alone and duties are being performed. Communities must also have an activity director on staff.In communities with at least 31 beds, the first and second shifts must have at least one supervisor. Communities with at least 91 beds must have a supervisor on site for all shifts. The supervisor cannot simultaneously serve as the administrator, though they can be an acting administrator.Communities must have at least one staff member onsite at all times who has completed a course on choking management and cardiopulmonary resuscitation within the last 24 months.
Staff Training Requirements
North Carolina ensures that residents receive quality care thanks to a comprehensive competency evaluation program, which is established by the state. Administrators must complete 30 hours of continuing education every two years. Acting administrators must complete 12 hours of continuing education every year.
Staff members who provide personal care or supervise those that do must complete 80 hours of personal care training that includes 34 hours of classroom instruction and 34 hours of supervised practical experience.
This training also includes instruction for handling conditions like diabetes and the need for restraints, as well as an in-depth look at resident rights, personal care skills and interventions for residents with mental disabilities.
Background Checks for Assisted Living
Every employee of a licensed facility must undergo an extensive background check and have no instances of abuse or neglect listed on the North Carolina Health Care Personnel Registry. Administrators must also have a criminal background fingerprint check.
Requirements for Reporting Abuse
North Carolina law has provisions to protect seniors and disabled individuals from abuse and neglect. To report a possible abuse situation contact the local county office of the Department of Social Services. For additional help you can call a toll-free CARE-LINE within North Carolina at 1-800-662-7030.
Assisted Living Facilities in North Carolina
Top-Rated Caring Stars Winners in North Carolina
Caring.com’s Caring Stars award program recognizes the best assisted living facilities across the U.S. based on reviews from family caregivers and older adults. This award is meant to help older adults and their loved ones find the best assisted living or in-home care option in their area. The list below shows up to 10 listings that have won the most Caring Stars annual awards in their state, sorted by their current overall average rating. For a complete list of Caring Stars winners for each year, please visit our Caring Stars info center.
LiveWell at Birchwood Lake Estates
Chapel Hill, NC $$
Brookdale South Charlotte
Charlotte, NC $$$
The Perryman House
Thomasville, NC $$$$
Deerfield Ridge Assisted Living
Boone, NC $$$
Carillon Assisted Living of Lincolnton
Lincolnton, NC Cost Levels
Warren Care Services
Burlington, NC $
Fayetteville, NC $$$$
New Bern, NC $$
Morningside of Concord
Concord, NC Cost Levels
Fox Hollow Senior Living Community
Pinehurst, NC Cost Levels