Glossary

Administrator means a person approved by the Department of Health and Human Services who has the responsibility for the total operation of a licensed domiciliary home. (G.S. 131D-2.1)

Administrator means an administrator of a facility. (G.S. 131E-116)

Adult care home is an assisted living residence in which the housing management provides 24-hour scheduled and unscheduled personal care services to two or more residents, either directly or, for scheduled needs, through formal written agreement with licensed home care or hospice agencies. Some licensed adult care homes provide supervision to persons with cognitive impairments whose decisions, if made independently, may jeopardize the safety or well-being of themselves or others and therefore require supervision. Medication in an adult care home may be administered by designated, trained staff. Adult care homes that provide care to two to six unrelated residents are commonly called family care homes. (G.S. 131D-2.1, G.S. 131D-20)

Adult care home as distinguished from a nursing home, means a facility operated as a part of a nursing home and which provides residential care for aged or disabled persons whose principal need is a home with the shelter or personal care their age or disability requires. Medical care in an adult care home is usually occasional or incidental, such as may be required in the home of any individual or family, but the administration of medication is supervised. Continuing planned medical and nursing care to meet the resident's needs may be provided under the direct supervision of a physician, nurse or home health agency. Adult care homes are to be distinguished from nursing homes subject to licensure under this part. (G.S. 131E-101)

Adult care home means a facility with seven or more beds licensed under Part 1 of Article 1 of Chapter 131D of the General Statutes or G.S. Chapter 131E that provides residential care for aged or disabled persons whose principal need is a home which provides the supervision and personal care appropriate to their age and disability and for whom medical care is only occasional or incidental. (G.S. 131E-176)

Assisted living residence means any group housing and services program for two or more unrelated adults, by whatever name it is called, that makes available, at a minimum, one meal a day and housekeeping services and provides personal care services directly or through a formal written agreement with one or more licensed home care or hospice agencies. The department may allow nursing service exceptions on a case-by-case basis. Settings in which services are delivered may include self-contained apartment units or single or shared room units with private or area baths. Assisted living residences are to be distinguished from nursing homes subject to provisions of G.S. 131E-102. Effective October 1, 2005, there are two types of assisted living residences: adult care homes and adult care homes that serve only elderly persons. Elderly person means:

1. Any person who has attained the age of 55 years or older and requires assistance with activities of daily living, housing, and services, or
2. Any adult who has a primary diagnonsis of Alzheimer's disease or other form of dementia who requires assistance with activities of daily living, housing, and services provided by a licensed Alzheimer's and dementia care unit.

Effective July 1, 1996, there is a third type, multiunit assisted housing with services. (G.S. 131D-2.1, G.S. 131D-20)

Change in bed capacity means

1. any relocation of health service facility beds, or dialysis stations from one licensed facility or campus to another, or
2. any redistribution of health service facility bed capacity among the categories of health service facility bed as defined in G.S. 131E-176(9c), or
3. any increase in the number of health service facility beds, or dialysis stations in kidney disease treatment centers, including freestanding dialysis units. (G.S. 131E-176)

Chemical dependency treatment facility means a public or private facility, or unit in a facility, which is engaged in providing 24-hour a day treatment for chemical dependency or substance abuse. This treatment may include detoxification, administration of a therapeutic regimen for the treatment of chemically dependent or substance abusing persons and related services. The facility or unit may be:

1. A unit within a general hospital or an attached or freestanding unit of a general hospital licensed under Article 5, Chapter 131E, of the General Statutes,
2. A unit within a psychiatric hospital or an attached or freestanding unit of a psychiatric hospital licensed under Article 1A of General Statutes Chapter 122 or Article 2 of General Statutes Chapter 122C,
3. A freestanding facility specializing in treatment of persons who are substance abusers or chemically dependent licensed under Article 1A of General Statutes Chapter 122 or Article 2 of General Statutes Chapter 122C; and may be identified as chemical dependency, substance abuse, alcoholism, or drug abuse treatment units, residential chemical dependency, substance abuse, alcoholism or drug abuse facilities, or by other names if the purpose is to provide treatment of chemically dependent or substance abusing persons, but shall not include social setting detoxification facilities, medical detoxification facilities, halfway houses or recovery farms. (G.S. 131E-176)

Commission means the North Carolina Medical Care Commission. (G.S. 131E-76, G.S. 131E-101, G.S. 131E-116, G.S. 131E-136, G.S. 131E-146, G.S. 131E-154.2, G.S. 131E-155, G.S. 131E-201)

Commission means the North Carolina Medical Care Commission, created by Part 10 of Article 3 of chapter 143B of the General Statutes, or, should said commission be abolished or otherwise divested of its functions under this chapter, the public body succeeding it in its principal functions, or upon which are conferred by law the rights, powers and duties diven by this chapter to the commission. (G.S. 131A-3)

1. Is attributed to a mental or physical impairment or combination of mental and physical impairments;
2. Is manifested before the person attains age 22;
3. Is likely to continue indefinitely;
4. Results in substantial functional limitations in three or more of the following areas of major life activity:
   1. self-care
   2. receptive and expressive language
   3. learning
   4. mobility
   5. self-direction
   6. capacity for independent living
   7. economic self-sufficiency;
   8. Reflects the person's need for a combination and sequence of special, interdisciplinary, or generic care, treatment, or other services which are of lifelong or extended duration and are individually planned and coordinated.

Expedited review means the status given to an application's review process when the applicant petitions for the review and the department approves the request based on findings that all of the following are met:

1. The review is not competitive.
2. The proposed capital expenditure is less than five million dollars ($5,000,000).
3. A request for a public hearing is not received within the time frame defined in G.S. 131E-185.
4. The agency has not determined that a public hearing is in the public interest.

(G.S. 131E-176)

Facility means a nursing home and a home for the aged or disabled licensed pursuant to G.S. 131E-102, and also means a nursing home operated by a hospital which is licensed under Article 5 of G.S. Chapter 131E. (G.S. 131E-116)

Facility means an adult care home licensed pursuant to G.S. 131D-2.4. (G.S. 131D-20)

Health Care Facility means a hospital, psychiatric facility; rehabilitation facility; long-term care facility; home health agency; intermediate care facility for the mentally retarded; chemical dependency treatment facility; and ambulatory surgical facility. (G.S. 131E-154.2)

The following are considered to be health care facilities:

1. Adult care homes as defined in G.S. 131D-2.1
2. Hospitals as defined in G.S. 131E-76.
3. Home care agencies as defined in G.S. 131E-136.
4. Nursing pools as defined by G.S. 131E-154.2.
5. Hospices as defined by G.S. 131E-201.
6. Nursing facilities as defined by G.S. 131E-255.
7. State-operated facilities as defined in G.S. 122C-3(14)f
8. Residential facilities as defined in G.S. 122C-3(14)e
9. 24-hour facilities as defined in G.S. 122C-3(14)g
10. Licensable facilities as defined in G.S. 122C-3(14)b.
11. Multiunit assisted housing with services as defined G.S. 131D-2.1.
12. Communited-based providers of services for the mentally ill, the developmentally disabled and substance abusers that are not required to be licensed under Article 2 of Chapter 122C of the General Statutes.
13. Agencies providing in-home aide services funded through the Home and Community Care Block Grant Program in accordance with G.S. 143B-181.1(a)11. (G.S. 131E-256)

Home care services means any of the following services and directly related medical supplies and appliances, which are provided to an individual in a place of temporary or permanent residence used as an individual's home:

1. Nursing care provided by or under the supervision of a registered nurse;
2. Physical, occupational, or speech therapy, when provided to an individual who also is receiving nursing services, or any other of these therapy services, in a place of temporary or permanent residence used as the individual's home;
3. Medical social services;
4. In-home aide services that involve hands-on care to an individual;
5. Infusion nursing services; and
6. Assistance with pulmonary care, pulmonary rehabilitation or ventilation.

The term does not include; health promotion, preventative health and community health services provided by public health departments; maternal and child health services provided by public health departments, by employees of the Department of Health and Human Services under G.S. 130A-124, or by developmental evaluation centers under contract with the Department of Health and Human Services to provide services under G.S. 130A-124; hospitals licensed under Article 5 of Chapter 131E of the General Statutes when providing follow-up care initiated to patients within six months after their discharge from the hospital; facilities and programs operated under the authority of G.S. 122C and providing services within the scope of G.S. 122C; schools, when providing services pursuant to Article 9 of Chapter 115C; the practice of midwifery by a person licensed under Article 10A of Chapter 90 of the General Statutes; hospices licensed under Article 10 of Chapter 131E of the General Statutes when providing care to a hospice patient; an individual who engages solely in providing his own services to other individuals; incidental health care provided by an employee of a physician licensed to practice medicine in North Carolina in the normal course of the physician's practice; or nursing registries if the registry discloses to a client or the client's responsible party, before providing any services, that (i) it is not a licensed home care agency, and (ii) it does not make any representations or guarantees concerning the training, supervision, or competence of the personnel provided. (G.S. 131E-136)

Home health agency means a home care agency which is certified to receive Medicare and Medicaid reimbursement for providing nursing care, therapy, medical social services, and home health aide services on a part-time, intermittent basis as set out in G.S. 131E-176(12), and is thereby also subject to Article 9 of Chapter 131E. (G.S. 131E-136)

Home health agency means a private organization or public agency, whether owned or operated by one or more persons or legal entities, which furnishes or offers to furnish home health services. (G.S. 131E-176)

Home health services means items and services furnished to an individual by a home health agency, or by others under arrangements with such others made by the agency, on a visiting basis, and except for paragraph e., in a place of temporary or permanent residence used as the individual's home as follows:

1. Part-time or intermittent nursing care provided by or under the supervision of a registered nurse;
2. Physical, occupational or speech therapy;
3. Medical social services, home health aid services, and other therapeutic services;
4. Medical supplies, other than drugs and biologicals and the use of medical appliances;
5. Any of the foregoing items and services which are provided on an outpatient basis under arrangements made by the home health agency at a hospital or nursing home facility or rehabilitation center and the furnishing of which involves the use of equipment of such a nature that the items and services cannot readily be made available to the individual in his home, or which are furnished at such facility while he is there to receive any such item or service, but not including transportation of the individual in connection with any such item or service. (G.S. 131E-176)

Hospital means any facility which has an organized medical staff and which is designed, used, and operated to provide health care, diagnostic and therapeutic services, and continuous nursing care primarily to inpatients where such care and services are rendered under the supervision and direction of physicians licensed under Chapter 90 of the General Statutes, Article 1, to two or more persons over a period in excess of 24 hours. The term includes facilities for the diagnosis and treatment of disorders within the scope of specific health specialties. The term does not include private mental facilities licensed under Article 2 of Chapter 122C of the General Statutes, nursing homes licensed under G.S. 131E-102, and adult care homes licensed under Part 1 of Article 1 of Chapter 131D. (G.S. 131E-76)

Hospital means a public or private institution which is primarily engaged in providing inpatients, by or under supervision of physicians, diagnostic services and therapeutic services for medical diagnosis, treatment, and care of injured, disabled, or sick persons, or rehabilitation services for the rehabilitation of injured, disabled, or sick persons. The term includes all facilities licensed pursuant to G.S. 131E-77 of the General Statutes, except long-term care hospitals. (G.S. 131E-176)

Medical Review Committee means any of the following committees formed for the purpose of evaluating the quality, cost of, or necessity for hospitalization or health care, including medical staff credentialing:

1. A committee of a state or local professional society.
2. A committee of a medical staff of a hospital.
3. A committee of a hospital or hospital system, if created by the governing board or medical staff of the hospital or system or operating under written procedures adopted by the governing board or medical staff of the hospital or system.
4. A committee of a peer review corporation or organization. (G.S. 131E-76)

1. Emergency response system;
2. Charges for services offered;
3. Limitations of tenancy;
4. Limitations of services;
5. Resident responsibilities;
6. Financial/legal relationship between housing management and home care or hospice agencies;
7. A listing of all home care or hospice agencies and other community services in the area;
8. An appeals process; and
9. Procedures for required initial and annual resident screening and referrals for services.

North Carolina State Health Coordinating Council means the council that prepares, with the Department of Health and Human Services, the State Medical Facilities Plan. (G.S. 131E-176)

The council is a twenty-seven member advisory board, appointed by the governor, to work with the Department of Health and Human Services in preparation of the annual State Medical Facilities Plan. Members are from communities across the state and include consumers, business and industry representatives, health care services providers, and legislators. Members serve for four-year terms, on a staggered appointment schedule, or until their successors are appointed and duly qualified. Members may be re-appointed. Most of the council's work is accomplished through three standing committees: the Acute Care Services Committee, the Long-Term Behavioral Health Committee, and the Technology and Equipment Committee. All council and committee meetings are open to the public.

Nursing care means:

1. Skilled nursing care and related services for residents who require medical or nursing care;
2. Rehabilitation services for the rehabilitation of injured, disabled, or sick persons; or
3. Health-related care and services provided on a regular basis to individuals who because of their mental or physical condition require care and services above the level of room and board, which can be made available to them only through institutional facilities.

These are services which are not primarily for the care and treatment of mental diseases. (G.S. 131E-176)

Nursing home means a facility, however named, which is advertised, announced, or maintained for the express or implied purpose of providing nursing or convalescent care for three or more persons unrelated to the licensee. A nursing home is a home for chronic or convalescent patients, who, on admission, are not as a rule, acutely ill and who do not require special facilities such as an operating room, X-ray facilities, laboratory facilities, and obstetrical facilities. A nursing home provides care for persons who have remedial ailments or other ailments, for which medical and nursing care are indicated; who, however, are not sick enough to require general hospital care. Nursing care is their primary need, but they will require continuing medical supervision. (G.S. 131E-101)

Nursing home means a nursing home licensed under this Chapter and includes an adult care home operated as part of a nursing home. (G.S. 131E-128.1)

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. (G.S. 131D-2.1)

Resident means an aged or disabled person who has been admitted to a facility. (G.S. 131D-20)

Resident means a person who has been admitted to a long-term care facility. (G.S. 131E-231)

This is an annual document which contains policies and methodologies used in determining the need for new health care facilities and services in North Carolina. Need determinations and, where appropriate, Certificate of Need application due dates are listed in each service area chapter. The plan also contains background information on the N. C. State Health Coordinating Council, on the annual planning cycle, and general policies related to implementing the planning cycle. The State Medical Facilities Plan is prepared by the Department of Health and Human Services and the North Carolina State Health Coordinating Council, and approved by the governor. Each plan takes effect on January 1st and expires on December 31st. Copies may be ordered from the Medical Facilities Planning Section. An order form is available.

State Medical Facilities Plan means the plan prepared by the Department of Health and Human Services and the North Carolina State Health Coordinating Council, and approved by the governor. In preparing the plan, the department and the N.C. State Health Coordinating Council shall maintain a mailing list of persons who have requested notice of public hearings regarding the plan. Not less than 15 days prior to a scheduled public hearing, the department shall notify persons on its mailing list of the date, time, and location of the hearing. The department shall hold at least one public hearing prior to the adoption of the proposed plan and at least six public hearings after the adoption of the proposed plan by the N.C. State Health Coordinating Council. The council shall accept oral and written comments from the public concerning the plan. (G.S. 131E-176)

1. Orally and immediately inform the administrator of the facility of the specific findings and what must be done to correct them and set a date by which the violation must be corrected;
2. Within 10 working days of the investigation, confirm in writing to the administrator the information provided orally under sub-subdivision a. of this subdivision; and
3. Provide a copy of the written confirmation required under sub-subdivision b. of this subdivision to the department.

The department shall impose a civil penalty in an amount not less than five hundred dollars ($500.00) nor more than ten thousand dollars ($10,000.00) for each Type A violation. (G.S. 131E-129)

Type A Violation means a violation by a facility of the regulations, standards, and requirements set forth in G.S. 131D-21 or applicable state or federal laws and regulations governing the licensure or certification of a facility which results in death or serious physical harm, or results in substantial risk that death or serious physical harm will occur. Type A violations shall be abated or eliminated immediately. The department shall require an immediate plan or correction for each Type A violation. The person making the findings shall do the following:

1. Orally and immediately inform the administrator of the facility of the specific findings and what must be done to correct them, and set a date by which the violation must be corrected;
2. Within 10 working days of the investigation, confirm in writing to the administrator the information provided orally under sub-subdivision a. of this subdivision; and
3. Provide a copy of the written confirmation required under sub-subdivision b. of this subdivision to the department.

The department shall impose a civil penalty in an amount not less than five hundred dollars ($500.00) nor more than ten thousand dollars ($10,000) for each Type A violation in homes licensed for six or fewer beds. The department shall impose a civil penalty in an amount not less than one thousand dollars ($1,000) nor more than twenty thousand dollars ($20,000) for each Type A violation in facilities licensed for seven or more beds. (G.S. 131D-34)

Type B Violation means a violation by a facility's licensee of the regulations, standards and requirements set forth in G.S. 131E-117 or applicable state or federal laws and regulations governing the licensure or certification of a facility which presents a direct relationship to the health, safety, or welfare of any resident, but which does not result in substantial risk that death or serious physical harm will occur. The department shall require a plan of correction for each Type B violation and may require the facility to establish a specific plan of correction within a specific time period to address the violation. (G.S. 131E-129)

Type B Violation means a violation by a facility of the regulations, standards and requirements set forth in G.S. 131D-21 or applicable state or federal laws and regulations governing the licensure or certification of a facility which present a direct relationship to the health, safety, or welfare of any resident, but which does not result in substantial risk that death or serious physical harm will occur. The department shall require a plan of correction for each Type B violation and may require the facility to establish a specific plan of correction within a reasonable time period to address the violation. The required plan cannot exceed requirements imposed by existing rule or law. (G.S. 131D-34)