Choosing Long Term Care

Choosing Long Term Care is usually a very difficult decision.  When a loved one requires more care than the family can adequately provide or has a medical crisis, long term care is often the only choice.  Families may have to make a decision regarding nursing home care on very short notice.

This guide is intended to help you identify appropriate Long Term Care for your needs and to help you evaluate the quality of care, educate you on available resources, and learn how to pay for care.

Types of Care
There are two main types of Residential Long Term Care: Nursing Homes and Assisted Living.  Nursing homes provide skilled nursing for people with chronic problems.  Assisted Living facilities are considered non-medical facilities intended for people who are unable to care for themselves but do not need 24 hour medical care.

Identifying Long Term Care Facilities
A list of licensed facilities by county can be found on the NC Division of Health Services Regulation website.
Or search the Centers for Medicare and Medicaid Services.

Evaluating Long Term Care Facilities
Once you, along with your physician, have identified facilities in the community that appear to meet the potential resident’s needs, affordability issues and have a vacancy, there are several other things to consider and research.

  1. Visit the Facility: It cannot be emphasized enough the need for consumers to ALWAYS visit facilities more than once, observe how residents are treated, speak with staff, ask questions and use their five senses when evaluating a facility. Don’t be afraid to ask questions.  Look for cleanliness, residents’ privacy when . Try to get a sense of the quality of care.AARP offers a Nursing Home Checklist and an Assisted Living Evaluation checklist.
  2. Recent implementation of federal star ratings for nursing homes and state star ratings for adult care homes provide a “snapshot view” of facilities as a good starting place to provide consumers with information with which to make informed choices about placement. For NC Assisted Living ratings, check the NC Assisted Living Facility Star Ratings System.
    For Nursing Home Ratings visit the Federal Nursing Home Compare site.

It is important to remember that these ratings are only a part of the information available to you and there is often more to the story.  For example, the current Assisted Living Star Ratings are based only on inspections that occurred since 2009.  For more information on the Rating Systems visit nursing home and adult care home ratings system guide.

  1. Review Public Records:  Has the facility been cited for non-compliance?  Penalties are listed by county:
    http://www.dhhs.state.nc.us/dhsr/acls/adultcarepenalties.html
  2. Check Community Advisory Committee Reports:
    Each county has a volunteer Community Advisory Committee that conducts unannounced inspections of Adult Care Homes and Nursing Homes.  Often they post these reports on the county’s Department of Human or Social Services website.   Find your county’s Department of Social Services.
  3. Contact your Regional Long Term Care Ombudsman:
    Each county in North Carolina has a long term care ombudsman program through each Area Agency on Aging.  LTC ombudsman are advocates for nursing home and adult care home residents.  They investigate and help resolve complaints made by or on behalf of a resident. For more information on the ombudsman program and to locate your regional ombudsman visit http://www.dhhs.state.nc.us/aging/ombud.htm.

    To find your Area Agency on Aging visit:
    www.eldercare.gov

    For more information on finding a nursing home visit:
    http://www.ncdhhs.gov/aging/faq.htm#q100