Types Of Long-Term Care

For more detailed information, please see our 2013 Consumer Guide for Long-Term Care.


Home and Community Based Care

If you ask people where they want to receive care and services, most will say in my own home.The increasing availability of Home and Community Based Services (HCBS) has enabled many consumers to receive long-term care while remaining in their own homes and continuing to enjoy their independence. For many people it is less expensive to receive care in their home than to move into a facility, such as a nursing home or assisted living center.

More information is available on our Fact Sheet: North Carolina Home and Community Based Services.

There are many types of Home and Community Based Services including

Personal Care Services are provided by a personal care aide, also called a home health aide.  Typically, an aide will go to an individual's home for several hours a day to provide assistance with household chores and activities of daily living such as meal preparation, bathing, dressing, etc.  Personal care aides are usually not nurses and usually cannot provide skilled nursing care.  

Transportation and Meal Services are available in many counties.  Some people can continue to live independently in their own homes by receiving at least one nutritionally sound meal delivered daily or by arranging transportation for medical appointments and errands.   

Adult Day Care, similar to adult day health care, provides supervision and activities for 4 or more hours a day at a community center, senior center, or similar location.  Providers offer referral to and assistance in using other community resources. Transportation to and from the program may be provided or arranged. For more information about adult day care and adult day health care, visit http://www.ncdhhs.gov/aging/adhsvc.htm

Respite Care is short-term, temporary supervision or care of an individual when the primary caregiver cannot be there or needs a break or time offfrom caregiving responsibilities.  An individual can receive respite care in-home or in a facility. 

Assisted Living Facilities

Assisted Living provides group housing for 2 or more unrelated adults along with services including meals, housekeeping, and personal care services provided directly or through written agreement with a licensed home care agency. Assisted living facilities provide a different level of care than nursing homes. Assisted living facilities do not provide ongoing skilled nursing care.

There are three types of assisted living facilities:

Adult Care Homes serve 7 or more adults who may require 24-hour supervision and/or assistance with personal care needs. Individuals live in a group residence where there is a common dining area and common areas for social and recreational activities. Staff provide personal care and supervision and health care services. Other services include three meals per day, laundry and housekeeping services, and a program of individual and group activities. Some facilities provide special units for persons with Alzheimer’s Disease and other related disorders. Such units are usually in a secure part of the facility and have activity programs specifically designed for persons with dementia. 

Family Care Homes serve 2 to 6 adults who may require 24-hour supervision and/or assistance with personal care needs. Individuals live in the home of an unrelated individual. Staff provide the same basic services as those provided in adult care homes.

Multi-Unit Assisted Housing with Services are unlicensed facilities that house adults who do not require 24-hour supervision and/or assistance with personal care needs. Individuals typically live in their own apartment within a multi-unit complex with protective oversight. If personal care and nursing services are needed, they are arranged by housing management and provided by a licensed home care or hospice agency through an individualized written care plan. 

Skilled Nursing Facilities

Nursing Homes, also called skilled nursing facilities, provide services and supports to people who need ongoing nursing care provided by a skilled nursing professional. They provide a standard set of core services that include room and board, personal care, nursing services, dietary services, social services, activities, and housekeeping. Nursing homes must also provide or arrange for therapy, such as physical therapy, occupational therapy or speech/language therapy; dental care; podiatry services; optometry services and transportation to medical appointments. Some nursing homes provide skilled nursing care and rehabilitation therapy after an injury or hospital stay. Others may have a special unit for residents with Alzheimer’s disease or another form of dementia. These units may be referred to as memory care,dementia,” “Alzheimer’s” or “behavioral” units. 

Continuing Care Retirement Communities (CCRCs)

Continuing Care Retirement Communities are housing communities that offer several levels of care in one location. Where people live depends on the level of care they need. In the same community, there may be individual homes or apartments for residents who still live on their own, an assisted living facility for people who need some help with daily care, and a nursing home for those who require higher levels of care. Residents move from one level of care to another based on their needs but still stay within the CCRC campus or location.

CCRCs generally charge a large payment before a person moves in (called an entry or entrance fee) and then charge monthly fees. The fees vary according to whether the resident owns or rents the living space, the size and location of the residence, the amenities chosen, whether the living space is for one or two individuals, the type of service contract chosen, and the current risk for needing intensive, long-term care.

CCRCs in North Carolina are regulated by the Department of Insurance. Any questions about CCRCs may be directed to the Dept. of Insurance at (919) 807-6612.