Multi-unit assisted housing with services facilities are a type of assisted living residence defined in N.C.
General Statute 131D-2.1(10). This type of assisted living residence is registered with the state, but is not
licensed or inspected by state or county regulatory agencies. In multi-unit assisted housing with services
facilities, hands-on personal care services and nursing services, which are arranged by housing management, are
provided by a licensed home care or hospice agency, through an individualized written care plan. The housing
management has a financial interest/financial affiliation or formal written agreement which makes personal care
services accessible and available through at least one licensed home care or hospice agency. The resident has a
choice of any provider, and the housing management may not combine charges for housing and personal care services.
All residents or their compensatory agents must be capable, through informed consent, of entering into a contract
and must not be in need of 24-hour supervision. Assistance with self-administration of medications may be provided
by appropriately trained staff when delegated by a licensed nurse according to the home care agency’s established
plan of care. Multi-unit assisted housing with services programs are required to register with the Division of
Health Service Regulation, pay registration fee, and provide a disclosure statement.
MUAHS are not licensed adult care homes or licensed assisted living facilities and are not inspected or monitored by state or county regulatory agencies.
Complaints about abuse, neglect or exploitation of an individual living in a MUAHS facility should be
made to Adult Protective Services of the local county Department of
Social Services .
Complaints about a MUAHS facility providing services requiring a license (medication administration, 24
hour supervision) should be made to the DHSR
Complaint Intake Unit .
Individuals with any of the following conditions or care needs should not be cared for in a multi-unit assisted
housing with services facility:
- Ventilator dependency;
- Dermal ulcers III and IV, except those stage III ulcers which are determined by an independent physician to be
healing;
- Intravenous therapy or injections directly into the vein, except for intermittent intravenous therapy managed
by a home care or hospice agency licensed in this state;
- Airborne infectious disease in a communicable state that requires isolation of the individual or requires
special precautions by the caretaker to prevent transmission of the disease, including diseases such as
tuberculosis and excluding infections such as the common cold;
- Psychotropic medications without appropriate diagnosis and treatment plans;
- Nasogastric tubes;
- Gastric tubes except when the individual is capable of independently feeding himself and caring for the tube,
or as managed by a home care or hospice agency licensed in this state;
- Individuals requiring continuous licensed nursing care;
- Individuals whose physician certifies that placement is no longer appropriate;
- Unless the individual’s independent physician determines otherwise, individuals who require maximum
physical assistance as documented by a uniform assessment instrument and who meet Medicaid nursing facility
level-of-care criteria as defined in the State Plan for Medical Assistance. Maximum physical assistance means
that an individual has a rating of total dependence in four or more of the seven activities of daily living as
documented on a uniform assessment instrument;
- Individuals whose health needs cannot be met in the specific multi-unit assisted housing with services as
determined by the residence; and
- Such other medical and functional care needs as the Social Services Commission determines cannot be properly
met in multi-unit assisted housing with services.
Exception: If a physician has certified that appropriate care can be provided on a temporary
basis to meet the resident’s needs and prevent unnecessary relocation, residents with the above listed care
needs may be cared for in a multi-unit assisted housing with services facility.
Definitions of Other Key Terms
The following definitions, in addition to the terms defined in G.S.
131D-2.1, apply to this registration and disclosure information
for multi-unit independent housing with services:
- "Financial or legal relationship" means any corporate or
business relationship, contract, or connection, legal
and or financial, existing between the housing
management and a home care agency.
- "Home care agency" means a private or public organization which provides home care services.
- "Housing management" means any corporation, partnership, proprietor, individual, or other legal entity
owning the
enterprise, business, or service operating as multi-unit assisted housing with services as defined in
N.C. Gen.Stat. § 131D-2.1.
- "Household tasks" means such tasks as using the telephone, managing money, paying bills, taking
prescription medications, shopping, housekeeping, doing laundry and preparing meals.
- "Just cause" means reasons conforming to a standard of
what is reasonable, correct, prudent, or legally
defensible.
- "Personal care services" means hands on services allowed
to be performed as outlined in department rules.
- "Personal care tasks" means such tasks as bathing,
dressing, eating, toileting and ambulation.
- "Relevant household tasks" means those household tasks
which the resident is no longer capable of independently
performing and is currently receiving no assistance in
performing these needed tasks.
- "Rental contract" means a written lease, contract, or
agreement by which the housing management conveys real
estate, equipment, or facilities for a specified term
not to exceed one year and for a specified rent.
- "Compensatory agent” means a spouse, relative or other caretaker who lives with a resident and
provides care to a resident.
- "Resident" means a person living in an assisted living residence for the purpose of obtaining access to
housing and services provided or made available by housing management.
- "Registration" means the submission by the housing management to the Division of Health Service Regulation
of a disclosure statement containing all the information as outlined in N.C. Gen. Stat. § 131D-2.1
Registration
Prior to the operation of a multi-unit assisted housing with services facility, the following must be submitted
to and approved by the Division of Health Service Regulation (DHSR), Adult Care Licensure Section:
Registration Renewal
All multi-unit assisted housing with services facilities are required to renew the facility’s
registration annually by December 31st. The following items are required for registration renewal:
- Multi-unit assisted housing with services renewal registration form
(renewal forms will be mailed to registered facilities approximately 3 months prior to
facility’s registration expiration)
- $350 non-refundable fee made payable to DHSR (no personal checks)
- Updated disclosure statement (only if changes are made)
Note: The facility may revise its disclosure statement any time. If in the opinion of
the facility, revision is necessary to prevent an otherwise current disclosure statement from containing a
material misstatement of fact or omitting a material fact required to be stated therein, it may submit a revised
statement to the Division of Health Service Regulation, Adult Care Licensure Section. Only the most recently
recorded disclosure statement will be considered current.
The facility will make any revised disclosure statement available to all the residents of the facility prior to
or upon the effective date of revisions.
Disclosure Statement
At the time of, or prior to, the execution of a rental
contract for tenancy in a multi-unit assisted housing with services facility,
the housing management will provide a current disclosure statement to the person with whom the rental contract is
to be entered.
- disclosure statement must contain at least:
- identification of the type of emergency response system that
will be available to each resident;
- the charges for services including:
- a list of all services that are not stipulated in the
rental contract which may be purchased directly from
or through the housing management and the associated
fee for each service;
- the housing management's policy, if any, for resident
payment of any contract service(s) the residents chooses
not to use during the term of the service contract;
- the housing management's policy regarding any
compensation to be made to residents for contracted
service that are not subsequently provided by the
housing management in accordance with the terms of the
service contract; and
- the policy for termination of services prior to the end
of the written services contract period for just cause by
either the housing management or the resident or for the
convenience of the resident.
- written policies regarding limitations of services
including:
- a statement indicating any conditions for the provision
of services that may be purchased or arranged for
directly through the housing management;
- a statement indicating the residents' right to obtain
services from any other provider other than the housing
management or affiliated providers; and
- a statement that assistance with self-administration of
medications may be provided by appropriately trained
staff as defined in N.C. Gen.Stat. § 131D-2.1.
-
written policies regarding limitations of tenancy
including:
- a statement that the housing management does not
provide 24-hour supervision;
- a statement that residents are responsible for
arranging assistance with unscheduled personal care
needs that are not of an emergency nature;
- a statement that the housing management may not care
for individuals with any of the conditions or care
needs stipulated as prohibited for multi-unit assisted
housing with services to provide and a list of those conditions, care needs and
exceptions as defined in N.C. Gen.Stat. § 131D-2.1; and
- a statement regarding any other resident entry
restrictions which relate to functional limitations;
- a statement identifying any other resident responsibilities
which are not otherwise stipulated in the rental agreement
or service contract between the housing management and the
resident;
- information regarding the nature of the financial and
legal relationship between the housing management and each
home care agency or hospice agency with which the housing
management has a financial or legal relationship;
- information which includes at a minimum:
- a listing of all licensed home care agencies providing
services in the county;
- the address and telephone number of:
- County Department of Social Services;
- Local Aging Agency (if available);
- County Health Department;
- Area Mental Health Authority;
- Public Transportation available;
- Public library;
- Public Recreation Department (if available);
- Local colleges and universities;
- Local information and referral line (if available); and
- Senior Centers in the county (if any); and
- housing management's written policies concerning tenant
grievances and procedures for review and disposition of
resident grievances.
Statement of Screening Procedures
Resident screening is required prior to resident tenancy and annually once tenancy is established. The
statement of screening procedures must be included in the facility’s disclosure statement.
Procedures must address:
- the purpose of screening which will, at a minimum, be:
- to provide the prospective resident or compensatory
agent with the opportunity to request assistance from
housing management with referral for needed supportive
services through mechanisms defined in the disclosure
statement;
- to identify prospective and existing residents’ need
for referral for an in-depth assessment by a licensed
home care agency to determine the facility's
suitability relative to the prospective residents’
need for assistance. Suitability shall be based on
limitations of tenancy established for multi-unit
assisted housing with services settings in accordance
with G.S. 131D-2.1 as well as any other limitations
of tenancy disclosed by the facility; and
- to identify prospective residents who may have
unmet needs with regard to the ability to manage,
either independently or with help, relevant household
tasks as well as personal care tasks.
- what housing management staff positions will be
responsible for overseeing the screening process;
- what information will be collected through the screening
process as well as the form that housing
management will use to collect the information;
- how screening information will be collected (i.e.
questionnaire completed by the resident; interview
conducted by housing management staff, etc.);
- when initial and annual screening will be conducted;
- assuring confidentiality of screening information;
- criteria to be used by housing management in evaluating
the need for referral for an in-depth assessment by a
licensed home care agency;
- how housing management will refer
residents for an in-depth assessment by a
licensed home care agency other than as a result of
initial or annual screening if necessary;
- how to obtain authorization for an in-depth
assessment from the prospective resident or
compensatory agent;
- how to select the licensed home care agency that will
conduct the assessment;
- criteria to be used by housing management for determining
the facility’s capacity and legal authority as defined
in N.C. Gen. Stat. §131D-2.1 to meet the needs of prospective residents
based on the screening or in-depth assessment
conducted; and
- how to notify prospective residents of housing
management’s decision regarding the suitability
of the facility for the prospective resident based on
the limitations of tenancy established for multi-unit
assisted housing with services in accordance with
with N.C. Gen. Stat.§ 131D-2.1 and any other limitations of tenancy
disclosed by the facility.
