|
Division of Health Service Regulation
courtesy Division of Health Service Regulation
The Division of Health Service Regulation (DHSR) is divided into to several sections/branches
to handle the oversight and regulation of Adult Care Homes. Some
of them are:
Certificate of Need Section |
|
Construction Section |
|
Adult Care Licensure Section |
Certificate
of Need Section
"The North Carolina Certificate of Need Law prohibits health
care providers from acquiring, replacing, or adding to their facilities
and equipment, except in specified circumstances, without the
prior approval of the Department of Health and Human Services.
The law restricts unnecessary increases in health care costs and
limits unnecessary health services and facilities based on geographic,
demographic and economic considerations. The fundamental premise
of the CON Law is that increasing health care costs may be controlled
by governmental restrictions on the unnecessary duplication of
medical facilities." So, in order for an adult care
home to legally exist, the agency must apply for a Certificate
of Need from the Department of Health and Human Services (Division of Health Service Regulation), and be approved. This section
will tell the applicant how many adult care home beds they may
offer.
Construction
Section
Architects and engineers, funded by state appropriations, review
plans and specifications, both for new and existing buildings,
for facilities applying to be licensed by the Division.
They perform an on-site inspection in conjunction with local building
inspectors and fire code inspectors as well. Their purpose
is to insure compliance with state licensure regulations for safety
standards.
When
all reviews are completed and approved, the section recommends
licensure to the Adult Care Home Licensure Section, which at that
time assesses the program aspects of licensure that relate to
delivery of resident services in order to issue a new or revised
license to the applicant. Licensure is a two part process.
The Construction Section evaluates for building safety
and codes and then makes a recommendation to the Adult
Care Home Licensure Section which then makes a separate
evaluation to assess the applicant's ability to deliver resident
services in accordance with current rules and procedures.
(Read more about this process)
After
a facility is licensed to operate, construction inspections are
made, as time permits, to verify continued compliance
with construction and safety standards. Adult care homes
are generally scheduled for bi-annual inspections for compliance
with construction and safety standards. Other inspections are
made when indicated by complaints, requests by other agencies,
and/or a facility's request.
Adult
Care Licensure Section
This section is responsible for licensing and regulating
assisted living facilities called adult care homes, the registration
of assisted living facilities called multi-unit housing with
services, and the certification of administrators.
When
the Construction Section makes
a favorable recommendation for licensure to the Adult Care Home
Licensure Section, the second part of the process begins. This
section determines if the agency, group, or individual applying
for licensure is able to deliver resident services in accordance
with current rules and procedures. A Registered Nurse, a pharmacist,
a dietician, and a local Adult Home Specialist (Department of
Social Services) work together to conduct the evaluation. If
they find that the applicant is able to deliver both a safe
environment and quality care, the applicant is then licensed
to provide services.
Adult
care homes are governed by state rules and regulations, not
federal. There is no certification
process for Medicare/Medicaid reimbursement for adult care
homes. What this means is that residents are responsible for
paying for care versus having Medicare or Medicaid pay for care,
as may be the case in nursing homes. However, since 1996, adult
care homes may apply to the Division
of Medical Assistance to enroll, versus being certified,
as a Medicaid provider. The Division of Medical Assistance offers
a program called State/County Special
Assistance to pay for some personal care services
for eligible individuals paid for with Medicaid dollars. (This
same program may also be used to help some eligible individuals
pay for total care in an adult care home, though reimbursement
is made directly to the individual.) If an adult care home is
enrolled as a Medicaid provider, some residents may be eligible
to have some personal care paid for by Medicaid. For eligibility
questions related to Medicaid or state/county special assistance,
contact your local county Department
of Social Services. They are also the contact agency for
complaints and concerns.
There
are two types of adult care homes:
|
Overview of Adult Care Home Regulation |
The
North Carolina legislature specifically authorized county Departments
of Social Service to supervise adult care homes under rules made
by the
Medical
Care Commission.
The
Division of Health Service Regulation:
-
works with the county Departments of Social Services to ensure
the bi-monthly monitoring of facilities is completed
-
performs inspections of homes when needed or requested
- may
levy penalties against homes out of compliance with the regulations
- provides
oversight for the Adult Home Specialist's annual assessment
and monitoring plan
|
