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North Carolina Assisted Living Facilities

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Cost of North Carolina Assisted Living Facilities

According to the 2015 Genworth Financial cost of care survey, the average cost of assisted living in North Carolina is $3,000 per month.

The monthly base rate for North Carolina assisted living is typically lower when compared to neighboring states. North Carolina is also less expensive compared to the national average.

This cost is the base cost for a one-bedroom assisted living unit in North Carolina. Additional fees beyond the base rate may apply.

More info on Assisted Living Costs

Monthly Costs Compared to Neighboring States

North Carolina$3,000
South Carolina$3,125

Assisted Living Regulations

North Carolina defines an assisted living facility as a facility which offers group housing, housekeeping services, at least one meal a day, personal care and supportive services, either through the facility itself or through an agreement with a home health agency.

North Carolina Assisted Living Facilities Scope of Care

Personal care and some supportive health services are allowed, but home health agencies must come in a provide services that unlicensed staff are not allowed to perform.

North Carolina Assisted Living Admission Requirements

Residents of a North Carolina assisted living facility must be able to sign an informed consent form and they must not be in need of continual nursing care. With very few exceptions, residents may not be admitted to an assisted living facility if they have IV therapy, are ventilator dependent, have stage III or IV pressure sores, nasogastric tubes, gastric tubes, airborne infectious disease, or needs compete support for four or more ADL's.

North Carolina Assisted Living Care Plan Requirements

An initial assessment is required at admission, again at 30 days, and then annually to make sure that the resident's needs are being adequately cared for. In some cases, a home health care agency will make an assessment as well.

North Carolina Assisted Living Medication Management Requirements

Medications can be administered by licensed and trained staff who operate under the direction and supervision of a licensed nurse.

North Carolina Assisted Living Facility Requirements

Private units must allow for at least 100 square feet of livable floor space, while double occupancy units must allow for at least 80 square feet of livable floor space per person. A tub or shower must be provided for every 10 residents, and a toilet and sink must be available for every five residents. Smoke detectors must be in all corridors.

North Carolina Assisted Living Staffing Requirements

Direct care staff must be sufficient in number to meet the needs of the residents 24 hours a day. Specific ratios are spelled out regarding the type of staff required to be president based on the number of residents, as well as the time of day. Staff must receive at least 80 hours of training within six months of hire. Administrators must complete 120 hours of training in order to be certified by the state. All staff must complete annual continuing education courses.

North Carolina Assisted Living Medicaid Policy

Personal care services in assisted living homes are covered by a state care plan through Medicaid.

North Carolina Alzheimer's Unit Requirements

If a North Carolina assisted living facility has an Alzheimer's unit, then certain written disclosures are required. Additionally, staff who work in the unit must have specific training for working with that population. Additional policies apply to these units.

North Carolina Medicaid Coverage of Assisted Living and Related Services

The State of North Carolina pays for personal care irrespective of the type of housing or assisted living community in which they reside. The Medicaid waiver is called the CAP/ DA Waiver. There is one exception; they cannot live in a nursing home facility.

The North Carolina CAP/DA Waiver, the Community Alternative Program for Disabled Adults (CAP/DA), is intended to deliver alternative care to nursing home placement for low income, disabled state residents. It allows recipients to remain at home or in a private residence as an alternative to nursing facility care. The waiver gives medical and personal care services to increase independence.

In addition to the CAP/DA waiver, North Carolina offers the Community Alternative Program for Choice (CAP/Choice). The plan gives another option to recipients who prefer to self-direct some of the care services needed. Under this model, individuals are allowed to hire family members, or whomever they choose, to provide personal assistance services. In other words, the state will pay adult children of aging parents to be their caregivers.

CAP Services and Benefits

The services offered by CAP/DA and CAP/Choice include the following:

- Adult Day Care

- Case Management

- Homemaker Service

- In-Home Aide Services

- Meal Delivery

- Personal Care

- Personal Emergency Response Service (PERS)

- Respite Care (to relieve the primary caregiver)

How to apply - the CAP/DA and the CAP/Choice programs are accessible throughout the state of North Carolina and limit the number of participants so it is possible that a waiting list exists.

To apply for these programs, one should contact the lead agency in their county. A list with contact information is available for download here list of all CAP/DA Lead Agencies throughout North Carolina.

North Carolina also has a Medicaid plan called the Adult Care Home Assistance program. This program provides elderly and low income individuals with monetary assistance to pay for the costs of adult foster care. It is designed for recipients needing personal care and supervision but not medical care on a daily basis. It applies to; the elderly individuals that have limited mobility, persons with Alzheimer's or dementia are good applicants for the Adult Care Home Assistance.

This program is under the management Division of Aging and Adult Services and is also referred to as State / County Special Assistance Adult Care Home Program (SA/ACH).

How to apply for the Adult Care Home Assistance - contact the county Department of Social Services - learn about this program on the Division of Aging and Adult Services website. You can also download a brochure here.

Department of Health and Human Services, Division of Health Service Regulation

Phone (919) 855-3765

Contact: Doug Barrick Phone (919) 855-3778


Web Site:

What is the best number to call to get started? 1-919-855-4100 and 1- 919-855-4000.

Is there a website?

North Carolina Contacts

North Carolina Department of Health and Human Services, Division of Health Service Regulation

Phone: (919) 855-3765

Doug Barrick
Phone: (919) 855-3778

Much of the information above was adapted from the National Center of Assisted Living 2010 Regulatory Review.

License information source: North Carolina Department of Health and Human Services

North Carolina Assisted Living Facilities by City