Winston-Salem Senior AdvisorWhat paperwork does a North Carolina adult care home need before admission?
A current FL-2, the state's medical and level-of-care form completed by a physician, physician assistant or nurse practitioner, plus the home's own admission documents; the FL-2 tells the home what care the resident needs and whether an adult care home is the right level.
After move-in, the home assesses the resident and writes a care plan, usually within the first month, and updates it when needs change. The FL-2 also matters for money: Special Assistance and Medicaid personal care services both depend on documented need. If a parent is in the hospital, ask the discharge planner at Baptist or Forsyth Medical Center to complete the FL-2 before discharge, because getting one afterwards can take days.
What should a Winston-Salem family look for in the residency agreement?
The agreement must state the monthly charges and what they include, what costs extra, how and when rates can rise, the refund and notice terms, and the home's discharge policy; read all of it at home before signing.
Pay attention to care-level charges. Many homes quote a base rent and then add monthly fees as needs increase, so a parent who needs help with bathing and medications next year may pay noticeably more than the first quote. Ask for the current fee schedule in writing, ask how much notice is given before an increase, and ask whether the home holds residents' money and how that account is handled.
What rights do adult care home residents have in North Carolina?
N.C.G.S. 131D-21 gives every resident a bill of rights: to be treated with dignity, to privacy, to manage their own money unless a legal representative does, to see visitors, to take part in their care plan, to voice grievances without retaliation, and to receive notice before a transfer or discharge.
The home must post the rights and give a copy at admission, along with its grievance procedure. A resident can also take a concern to the regional long-term care ombudsman or to the county's adult care home community advisory committee, volunteers appointed to visit homes and speak up for residents. None of these steps requires a lawyer, and none of them can lawfully cost a resident their place.
How much notice must an adult care home give before discharging a resident?
Generally 30 days' written notice, with a shorter notice allowed only in narrow situations such as an immediate threat to health or safety; the notice must give the reason and explain the resident's right to appeal.
Lawful reasons include needs the home cannot meet, unpaid charges after notice, or danger to the resident or others. A discharge notice is not the end of the conversation. Call the regional ombudsman through the Piedmont Triad Regional Council at (336) 904-0300 the day it arrives; the ombudsman can explain the appeal and help negotiate a safe plan. Ask the home, too, what changes would let the resident stay.
Can an adult care home refuse a resident who uses Special Assistance?
Yes. Each home decides whether to accept State/County Special Assistance, and many larger private-pay buildings in Forsyth County do not; that is why the payment question belongs in the very first phone call, not after a tour.
Even homes that accept Special Assistance may limit how many such residents they take or require a period of private payment first. If there is any chance money will run short, get the home's policy in writing: whether a current resident who becomes eligible can stay, and whether the home's rate above the Special Assistance amount would be waived or billed to family.
What it is, and what it is not
| North Carolina's admission and discharge rules do | North Carolina's admission and discharge rules do not | |
|---|---|---|
| Paperwork | Require an FL-2 and a written care plan | Let a home admit with no medical information |
| Contract | Require written charges and terms | Cap what a private-pay home charges |
| Discharge | Require written notice and a right to appeal | Let a home discharge on a day's notice for convenience |
| Payment | Let each home choose whether to take Special Assistance | Force every home to accept it |
Based on N.C.G.S. Chapter 131D, 10A NCAC 13F and 13G, DHSR and NCDHHS documents, NC Medicaid, CMS, the VA, CareScout and the local agencies named above; see our editorial standards for how each is checked.
