Assisted Living Facility Rules & Regulations in North Carolina

There are two types of assisted living facilities regulated by North Carolina. The first classification is the adult care home, which can include family care facilities serving at least seven patients that focus on the elderly or those with Alzheimer's disease. The second encompasses multi-unit assisted housing with care services. The latter type are run by housing management firms that contract out personal care and nursing services as needed for residents.

Differences in Care

• Multi-unit assisted housing units can not enroll residents who require 24-hour personal attendants or those who cannot provide consent. There are a number of conditions that will cause a patient to be served better at an adult care home, including ventilator needs, dementia and the administration of intravenous medication.

Construction and Safety Equipment

• Each facility must have smoke detectors within every 60 feet of corridor and 30 feet from the end of a hallway, as well as in common areas and food preparation areas. Each resident must have at least 80 square feet of personal space, or 100 square feet if they have their own bedroom. One sink and toilet must be available for every five residents, and one shower or tub must be available for every 10 residents.

Staff and Training

• Staff in assisted living facilities generally do not help with medication management and other medical needs; these are contracted out to home health aides or similar independent workers. Within six months of hire, adult care home staff must complete 80 hours of training, and family care home staff must have finished 25 hours during the same period. Administrators must follow a 120-hour certified training program, and those without experience must complete 30 days of on-site familiarization in addition to continuing education.

Alzheimer's Care Specifics

• All staff serving on Alzheimer's care wings must complete at least six hours of orientation their first week and 20 additional hours of training their first six months on the job. The facility itself must disclose exactly what services are provided to residents and offer increased aide numbers as compared to other, non-dementia areas.

Star System

• North Carolina's Division of Health Service Regulation has a star system that rates assisted living facilities according to criteria put down by the legislature. Facility ratings are confirmed through two or three-day inspections on an annual basis. Ratings may be accessed via the health agency's website and are designed to offer a sense of the quality of a facility's program when inspectors visited.