Greensboro Senior AdvisorWhat rights does North Carolina guarantee adult care home residents?
G.S. 131D-21 sets out a Declaration of Residents' Rights covering dignity and privacy, freedom from abuse and neglect, information about charges and services, management of one's own money, private communication and visits, freedom to practice religion, the right to present grievances, and protection from transfer or discharge except for permitted reasons.
The home must post the declaration and give a copy at admission. Nursing home residents have a parallel Patients' Bill of Rights in G.S. 131E-117 plus federal rights for certified homes. These rights belong to the resident; a family member holding power of attorney acts on the resident's behalf but cannot sign them away.
What should a Greensboro residency agreement spell out?
The monthly rate and exactly what it includes, charges for extra services or higher levels of care, how and when rates may rise and with how much notice, the deposit and refund terms, and the reasons and process for discharge.
Ask for the current rate sheet in writing and compare it with the agreement. Many homes in the three counties price care in levels or points that rise after reassessment, so ask what triggers a reassessment and how the family hears about a change. If something in the agreement contradicts the residents' rights, the rights win, but it is far easier to fix before signing.
Can an adult care home manage a resident's money?
Only with written authorization: a resident may manage his or her own funds, and a home that holds money for a resident must keep it separate, account for every transaction and make records available to the resident or legal representative.
Special Assistance residents keep a $70 monthly personal needs allowance, and that money belongs to them for clothing, haircuts, snacks and other personal items. Ask how the home tracks it and how often you will see a statement.
Can residents leave the home, have visitors and keep their own things?
Yes, within the home's reasonable rules: residents may come and go, receive visitors, communicate privately, and keep personal possessions and furnishings as space allows, unless a specific limit is in the care plan for safety reasons.
Special care units restrict exit for safety, and that restriction must be part of the unit's approved program and the resident's plan. If a home limits visiting hours or personal items in ways that surprise you, ask to see the written policy, and bring the question to the ombudsman if the answer seems unreasonable.
Who helps when the agreement and the rights collide?
Start with the administrator in writing, then call the regional long-term care ombudsman at the Piedmont Triad Regional Council (336-904-0300), and file with DHSR's Complaint Intake Unit (1-800-624-3004) if a rule appears to have been broken.
For contract questions with real money at stake, such as entrance-fee refunds at a continuing care retirement community, an elder law attorney is worth the fee. Continuing care communities in North Carolina are also overseen by the Department of Insurance, which handles their disclosure statements and financial filings.
Side by side
| A residency agreement can | A residency agreement cannot | |
|---|---|---|
| Charges | Set rates, levels of care and extra fees | Hide charges that were not disclosed |
| Rules | Set reasonable house rules | Waive the Declaration of Residents' Rights |
| Money | Describe how funds are held with consent | Take control of funds without authorization |
| Discharge | Explain the process | Allow discharge without notice or appeal |
Drawn from G.S. Chapter 131D, 10A NCAC 13F and 13G, DHSR and NCDHHS publications, NC Medicaid, CareScout, CMS, the VA and the Piedmont Triad aging agency cited in the text; our editorial standards explain how we check them.
