N.C. has over 400 nursing homes with over 30,000 residents. About 18% of those have an overall 5-star rating. Approximately one-third of the skilled nursing home care facilities have received more than 3 complaints annually. With the National average of 1 in every 10 people over the age of 65 spending some of their life in a nursing home, you would hope that the laws and regulations set in place are enough to keep them protected.
North Carolina requires that all facilities be licensed through the NC Division of Health Service Regulation. There are different licenses depending on how many residents you plan on having in your facility. They also require, and offer, that all staff undergo the proper training needed to operate at an adult care facility. The courses include infection control, medication aide training, and their 1068 training that covers abuse, neglect, and exploitation. Again, these are state-mandated programs from House Bill 1068 from the 2001 session of the N.C. General Assembly. The N.C. Division of Health Service Regulation is required to offer these training courses at least twice a year for ACLS consultants, adult home specialists, and adult care home providers. That also includes administrators, supervisors, medication aide, PCAs, and resident care coordinators.
North Carolina is also required to fall in line with all federal laws pertaining to elderly care. This includes the Elder Justice Act (EJA). The EJA was introduced in March of 2010 and was the first piece of federal legislation passed that authorized a source of federal funds to address elderly abuse, neglect, and exploitation. The EJA is as follows:
Fines and penalties are imposed on those facilities that do not meet the standards of what is expected by state and federal laws. N.C. inspects adult care facilities and fines them if they find any violations. There is a Type A violation which means that a condition or conditions have resulted in a death or serious physical injury to a resident. The penalty for a Type A violation is between $1,000 and $20,000. Revocation of license and/or jail time is also an option depending on the severity of the violation. There is also a Type B violation.
A Type B violation is an identified condition that impacts the quality of care of the residents in the facility, but has not been corrected by the facility after the state has notified them of this violation. Penalties for a Type B violation are up to $400 per day for each day the facility fails to correct the issue. Adult care facilities also have the right to appeal any claims against them with the North Carolina Office of Administrative Hearings. If a fine is appealed, it can go to a hearing or a settlement may be reached outside of court between the facility and the state.