Long Term Care & Housing Options

Long term care encompasses a wide array of topics from consumer protection to advance directives, level of care needed and costs.

What type of care do I need?

Assisted Living residence means “Any group housing and services program for two or more unrelated adults, by whatever name it is called.” N.C. Division of Facility Services, 1998

The assisted living program makes available at a minimum one meal a day, housekeeping services, and provides personal care services directly or through a formal written agreement with one or more licensed home health agencies. Nursing services provided to an individual in an assisted living residence may not exceed those allowed under Medicare home health regulations.

There are two types of assisted living residences:

Adult Care Home:

Adult care home is an assisted living residence in which the housing management provides 24-hour scheduled and unscheduled personal care services to two or more residents, either directly or through formal written agreements with licensed home care or hospice agencies. Formerly called Domiciliary Homes, adult care homes are commonly called “Rest Homes” and are licensed by the North Carolina Department of Health and Human Services to provide assistance with activities of daily living and are monitored by county Department of Social Services for compliance with minimum regulatory standards.

Family Care Home:

Family care home is a small adult care homethat cares for two to six unrelated residents in a family-like setting. The homes are often found in residential communities and have around the clock or live-in staff that prepare meals, give medications and provide help with activities of daily living. They are licensed by the North Carolina Department of Health and Human Services for compliance with minimum regulatory standards.

Multi Unit Assisted Housing with Services:

Multi unit assisted housing with services provides hands-on personal care services and nursing services, which are arranged by housing management and are provided by a licensed home care or hospice agency through an individualized care plan. The .C. Department of Health and Human services maintains a registry of these facilities. THEY ARE NOT LICENSED OR MONITORED BY ANY SOURCE.

Understanding Nursing Facilities & the Costs

Nursing Facilities, often called Nursing Homes, provide extensive and professional medical care to people of all ages. For reimbursement purposes, residents in the nursing homes are classified as needing skilled nursing care or intermediate nursing care. Those receiving skilled care have acute medical needs that require constant (24 hour) professional nursing or licensed staff monitoring. Residents in intermediate care have needs that require the services of a professional nurse at least 8 hours a day.

  • Nursing home beds can be found in combination homes that offer assisted living as part of their campus and Life Care and/or Continuing Care Retirement Communities.
  • Many nursing homes have special units to care for:
    • Residents who are acutely ill
    • Residents who can benefit from rehabilitation
    • Residents who are younger than the average resident (under 50)
    • Residents with dementia
  • The cost of nursing home care often seems overwhelming , with most facilities charging from $6,000 to $10,500 a month.
    • The cost covers around-the-clock care, room and board. Some therapies require additional charges. There may be fees for laundry, haircuts, personal items and supplies.
    • Prescriptions are not covered in the monthly charges

Comparative Websites, Resources and Rating Systems

How Do the Nursing Facilities Compare?
Nursing Home Compare website

Adult Care Home Rating System

The Star Rated Certificate Program for Adult Care Homes in NC began on January 1st. Facilities will not receive a rating until they have had their first annual inspection in 2009. After a survey team has completed the survey, ratings will be posted monthly. Click here to access to the NC State ACH ratings page.

Nursing Home Compare

The Nursing Home Compare Website features a rating system that gives each nursing home a rating between 1 and 5.
Nursing Home Star Ratings compare nursing homes with one another. The ratings are based on minimum standards. Click here to access the Nursing Home Compare Website.

Facilities in the Region

For additional resources on housing options, visit the All About Seniors website and scroll down to Housing and Care Community Choices.


Centralina Ombudsman work with consumers before, during and as they consider placement. For more information on how the Ombudsman program can assist you, click here.