These are a few of the things NCALA has done for our members in 2022:
If the NCALA Provider Members Directory does not appear below, please follow this link to see the directory.
- NCALA continued to discount membership dues by 10% to help off-set the additional costs of the pandemic on our providers.
- NCALA was successful in obtaining $750,000 from the NC DHHS/DHSR budge funds for the Adult Care Home Accreditation Program. (ACHAPP)
- NCALA has submitted a grant request for a $200,000 for recruiting and training Personal Care Aides and Nurse Aides.
- Weekly Association conference call with Public Health, DHSR, and NC Medicaid Division of Health Benefits leadership.
- Quarterly meetings with NC Medicaid, Division of Health Benefits on behalf of communities who serve Medicaid beneficiaries.
- NCALA supported the roll-out of the Medicaid-only Managed Care program.
- Member of the NC Falls Prevention Coalition, which works to reduce the number of injuries and deaths from falls. We are currently involved in a five-year study.
- NCALA President serves on the Special Care Dentistry Advisory Committee, NC DHHS, Division of Public Health, and Oral Health Section.
- NCALA President serves on the “Mouth Care without a Battle for Assisted Living” advisory board. The advisory board is adapting an evidence-based program that improves oral hygiene and health for assisted living residents with dementia. The program will result in a video titled “Mouth Care without a Battle for Assisted Living,” which will be released soon, and Frances will be part of the introductory portion of the video.
- NCALA serves as the host site for the NC DHHS/DHSR/ACLS Rule Readoption Committee. The committee comprises Ombudsman; County DSS Directors; Resident Advocacy groups; Division of Aging representatives; NC Medicaid, Division of Health Benefits; as well as provider representatives. All meetings were held via GoToMeeting, but we hope to resume face to face meetings in 2023.
- NCALA collaborates with and supports resident advocacy agencies such as the Coalition on Aging, Residents of Long-Term Care, and the NC state and regional Ombudsman program.
- NCALA President is approved by NC DHHS/DHSR/ACLS to provide Settlement Agreement training when the state agency agrees to training in lieu of penalty in contested cases and has supported several NCALA providers by conducting settlement-specific training. NCALA provided free settlement training for members during 2022.
- NCALA President participates in face-to-face meetings as well as phone calls throughout the year with the ACLS Chief, Megan Lamphere, and the Assistant Chief, Libby Kinsey. This allows us to present concerns that NCALA members have regarding the survey process or survey outcomes.
- NCALA continues to work closely with other provider groups, resident advocacy leaders, and DHSR ACLS to promote sound rule making.
- NCALA worked with more than 55 Administrator-in-Training (AIT) Preceptors.
- NCALA provided virtual and live training for 71 AIT students.
- NCALA conducted 5 AIT classes.
- NCALA received NAB/NCERS approval for the 2022 Fall Conference. Received approval from the North Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation for the Fall Conference for the 2022 Fall Conference.
- NCALA co-hosted with our Partner Members 9 FREE 1-hour and 1.5-hour webinars for members.
- NCALA served on the North Carolina Essential Jobs, Essential Care Steering Committee and collaborated with Coalition on Aging and PHI International.
- NCALA posted job ads on our Career Center Web page FREE for member providers.
- NCALA continued work on Generation CARE (Connecting Assisted Living
Roles, Education & Employment) collaborative designed as a workforce resource for providers and potential employees.
- NCALA Workforce Development initiatives include partnerships with:
- Capital Area Workforce Development Board
- Wake County Public Schools
- NC Community College System
- Wake Technical Community College
Benefits of Membership
Your support of the North Carolina Assisted Living Association (NCALA) and the assisted living industry is very much appreciated! One of our goals is to educate consumers, regulators, legislators, and the general public about assisted living. Read about some of the ways we accomplish this below.
Specific benefits and services available to you through your NCALA membership include:
- Web Site—NCALA members are featured on www.ncala.org, which receives an average of more than 5,200 page views per month! Features of our Web site include:
- Online Membership Directory—Inclusion in a listing of all NCALA members on this Web site.
- NCALA News/Communication—Updates, newsletters, and articles of interest relevant to issues specific to North Carolina; regional and state-wide meeting notices; immediate contact with NCALA via e-mail; and legislative updates and contacts. The NCALA Advisor—our quarterly e-newsletter, dealing with issues specific to North Carolina’s assisted living industry.
- NCALA Legislative Updates—sent to members via e-mail.
- Other notification e-mails concerning upcoming training, emergency alerts, important reminders, etc.
- NCALA members can post job openings in the Career Center section of ncala.org free of charge.
- Training Courses/Regional Meetings—provided through our state-wide conferences and regional training events, which are approved through the NC Division of Health Service Regulation for required Continuing Education Credits (CEUs).
- Administrator Certification Program offered several times each year.
- Reduced rates on all training events and materials.
- Consumer Referrals—referrals to family members seeking an assisted living community and/or seeking industry vendors.
- For Partner Members (vendors), the annual membership fee includes the cost of an exhibitor booth at our annual Fall Conference & Trade Show.
- Legislative Monitoring and Involvement—The NCALA staff and Government Affairs consultant work tirelessly to educate legislators about industry-specific issues, to lobby for adequate reimbursement rates, and to address other specific issues as they relate to the assisted living industry in North Carolina.
- National Legislative Monitoring and Involvement—through Argentum to address national issues that affect the assisted living industry nation-wide.
- Operational and Licensure Technical Assistance—available through the NCALA office.
- Member Involvement—opportunities for involvement in committees and leadership at the national and state level.
Membership eligibility requirements generally include assisted living communities that provide assisted living services to the frail elder population and companies that provide appropriate services and/or supplies to the assisted living industry.
Membership Categories and Applications
There are five categories of NCALA membership. Please read the information below to find out which membership category is right for you.
Please download and print the applicable form and fax the completed form to NCALA at (919) 467-5132. If you have questions about completing or submitting the application form, please contact us.
There are five categories of NCALA membership:
- Provider Members include assisted living communities (Adult Care Homes, 7 or more beds), where frail elder residents receive help with their activities of daily living. This category includes continuing care retirement communities (CCRC) and other providers with licensed assisted living beds. Providers can apply for membership using the Provider Membership Application (paper form), or online here. (Not included in this category are Multi-unit Assisted Housing with Services [MAHS] and Independent Living [IL] communities [see below].)
- Family Care Home Provider Members include assisted living communities with 2–6 licensed beds, where frail elder residents receive help with their activities of daily living. Family Care Homes can apply for membership using the FCH Provider Membership Application (paper form), or online here.
- MAHS/IL Members include congregate housing serving the 55-plus population and any other provider whose building does not fit into another license category. MAHS/IL providers can apply for membership using the MAHS/IL Membership Application (paper form), or online here.
- Partner Members include companies that provide appropriate services and/or supplies to the assisted living industry. Partner Members may request a free booth at the NCALA Fall Conference & Trade Show. Limited number of booths available, first-come/first-served; available to members only. Partners can apply for membership using the Partner Membership Application (paper form), or online here.
Please either use the links (above) to join online; or, if you prefer the paper form, complete the appropriate form (linked above) and fax your completed form to NCALA at: (919) 467-5132.
Must the names of staff on duty be posted in the facility?
No. GS 131D-4.3(a)(5) requires homes to post information on required staffing that indicates the number, not names, of direct care staff and supervisors that must be on each shift.
What are the staff requirements for employees from staffing agencies?
Employees from staffing agencies must meet the appropriate qualifications in the rules for the position they are filling. The facility must have the appropriate documentation of staff qualifications (usually obtained from the employment agency) on file in the facility.
Who is subject to being reported to the Health Care Personnel Registry?
Under General Statute 131E-256 Health Care Personnel Registry, the facility is obligated to report to the Health Care Personnel Registry allegations that appear to be related to the neglect or abuse of a resident, misappropriation of property, diversion of drugs, and fraud by healthcare personnel. Healthcare personnel in adult care homes are defined in this statute as “adult care personal care aide who is any person who either performs or directly supervises others who perform task functions in activities of daily living which are personal functions essential for the health and well being of residents …” Since the definition says “any person,” the person does not have to be an employee or payroll staff of the facility for the facility to report an allegation. Even if the person is employed from a staffing agency by a family member of the resident and this person is performing tasks as stated in the law, the facility is responsible for reporting any allegations specified in the law against this individual. The facility is responsible for the safety and protection of residents under its care and, therefore, is responsible for reporting according to the requirements of the law, regardless of the employment status of the individual authorized to provide or supervise personal care tasks.
Can respite care in adult care homes be used for day or partial-day stays in the facility, as well as overnight stays?
Respite care in adult care homes is intended for a short-term stay that does not exceed 30 days. A respite care period must be established by contract that specifies the date of admission and discharge as required in Rules 13F and 13G .0907. Subsequent respite care stays by the same resident must also be established by separate contracts and all the requirements of the respite rule would apply, i.e., admission, discharge dates, current FL-2, short-term assessment, verification of orders if not signed and dated within 7 days prior to admission, etc, for each separate respite stay period. The person is to be admitted as a respite resident, not a daily visitor, for a limited time period (30-day maximum) as specified in the contract, and provided care, services, and accommodations as any resident is entitled to receive according to law and rule. The respite resident must have a resident-designated bedroom and must be counted as a resident of the home for capacity, census, and staffing purposes. The rule does not allow for a contract to provide unlimited respite care throughout the year, whether it is on a daily or overnight basis. Each respite stay must be contracted and time-limited. How the respite period, as specified in the contract with an admission and discharge date, is used by the caregiver seeking respite, e.g., overnight stays or day/partial-day stays, depends on that caregiver.
To whom can resident records be released?
Resident records can be released to the resident, guardian of the resident, or the resident’s power of attorney/healthcare power of attorney, provided the POA/HCPOA documentation authorizes such disclosure. Pursuant to Resident Right #6 (GS 131D-21), the resident may identify to whom he/she wants the records to be released. Additionally, most HIPPA forms allow the resident to name persons with whom he/she wants the records shared. If the resident is deceased, the personal representative of the estate (court-appointed administrator or executor of the will) is the person who is authorized to request records.
What are the record retention requirements for Adult Care Homes in NC?
10A NCAC 13F .0302: Design and Construction—The community shall have current sanitation and fire and building safety inspection reports maintained in the community and available for review.
10A NCAC 13F .0501: Personal Care Training and Competency—Documentation of the successful completion of the 80-hour training and competency evaluation program shall be maintained in the community and available for review. Documentation of the on-the-job training shall be maintained in the community and available for review.
10A NCAC 13F .0502: Personal Care Training Content and Instructors—The training provider shall maintain copies of the certificates and the skills evaluation checklists for a minimum of five years.
10A NCAC 13F .0503: Medication Administration Competency—A copy of the certificate (written exam) shall be maintained and available for review in the community.
10A NCAC 13F .1002: Medication Orders—Documentation of training attended by staff shall be maintained in the community.
10A NCAC 13F .1007: Medication Disposition—These records shall be maintained in the community for a minimum of one year.
10A NCAC 13F .1008: Controlled Substance—Records of controlled substances returned to the pharmacy or destroyed by the community shall be maintained by the community for a minimum of three years.
10A NCAC 13F .1202: Disposal of Resident Records—Shall be filed at the community for at least one year and then stored for at least two more years.
10A NCAC 13F .1213: Availability of Corrective Action and Survey Reports—Make available to residents and their families or responsible persons and to prospective residents and their families or responsible persons, upon request and within the community, corrective action reports by the county departments of social services and community survey reports by state licensure consultants that have been approved by the Adult Care Licensure Section of the Division of Health Service Regulation within the past 12 months.
What is the facility’s responsibility for residents who refuse to follow physician orders or refuse to pay for medications?
Refusal to follow medication orders must be documented on the MAR as required by Rules 13F and 13G .1004(j)(7). In order to comply with Rules 13F and 13G .0902, the facility should notify the resident’s physician about refusals. The facility should advise the resident about the importance of following physician’s orders and what the health repercussions are of not following orders. The resident’s responsible person should also be informed. If the physician does not change the order and the resident continues to refuse, the facility should continue to document refusals and inform the resident that a discharge may be necessary because the facility is unable to meet the resident’s needs. Depending on the circumstances, i.e., how serious a health threat it is, the facility can do less than a 30-day discharge according to Part (b)(1) of the rule or a 30-day discharge according to Part (b)(6) of the rule. For refusal of payment (not lack of funds to pay), the facility must follow 30-day discharge procedures according to Part (b)(5) of the rule. The facility is still responsible for assuring medications are administered as ordered, as long the person is a resident of the facility, regardless of refusal or inability to pay.
What are the time frames for implementation of medication orders?
While such time frames are not specified in the rules, it is highly recommended that the facility’s policies and procedures address time lapses for starting administration of new orders such as emergency or stat orders, antibiotics, routine medication, and methods of legal borrowing of doses. The type of medication as well as the resident’s condition should be considered. For example, the facility’s policy for medications prescribed for acute problems, such as antibiotics, would require a more timely start of administration than for routine medications or those for chronic conditions. It is recommended that the facility get the assistance of a licensed health professional, such as a pharmacist, in determining an appropriate lapse time for starting new orders since it is the facility’s responsibility to assure the availability of medication in a time frame that would not put the residents’ health or safety at risk.
Are MARs and counting of medications required for residents who self-administer?
No, although it would be a good practice because it would provide a list of the medications that the resident is taking. If a MAR is maintained, it is also good practice to indicate self-administration on the form, especially if staff document when the resident takes his/her medication, or so staff will know why there is no documentation on the MAR, especially when a resident self-administers some medications but not all of them. The resident’s ability to self-administer should be evaluated on an ongoing basis.
What should happen if a resident or staff member refuses a vaccine required by law?
Residents and staff are to be notified of the immunization requirements according GS 131D-9 (pneumococcal vaccine for residents and flu vaccine for residents and employees). The law requires facilities to notify residents and employees of the immunization requirements and request that they be immunized, but they can refuse immunization after being fully informed of the health risks. If a person refuses immunization, the facility must document refusal by, at a minimum, a statement signed by the person refusing immunization stating that he/she was notified of the immunization requirement and fully informed of the health risks of not being immunized. This documentation should be maintained in the resident’s record or personnel file.