Nursing Home Rules

Rule 10A NCAC 13D .2111, Administrative Penalty Determination Process, has been modified to be consistent with changes to G.S. 131E-129, which was amended in 2011. Rule 10A NCAC 13D .2402. Preservation of Medical Records, has been updated and the length of time for record storage for discontinued facilities was reduced to lessen the burden upon licensed facilities. This change makes the licensure rule consistent with the federal record retention requirement for nursing homes that participate in Medicare and Medicaid.

Additionally, over the past 16 years, significant changes have been made in the design and construction of nursing home facilities. In particular, the nursing home industry is moving away from an institutional model of facility design to a household model. In the household model, 15 to 30 people live in one housing unit with patient rooms clustered around a small kitchen, dining room and living area, which are open to the corridor. Decentralized kitchens and small dining rooms help to create the feeling of a home. This "culture change" movement toward the household model of design is very strong in the United States today.

All of the proposed rule changes were made in collaboration with stakeholders such as the Construction and Nursing Home Licensure and Certification Sections of the North Carolina Division of Health Service Regulation, the North Carolina Division of Aging and Adult Services, the State Long Term Care Ombudsman, the North Carolina Health Care Facilities Association, the Society for the Advancement of Gerontological Environments (SAGE), the North Carolina Coalition for Long Term Care Enhancement, architects and engineers, and nursing home providers. The proposed changes allow for innovations in nursing home facility design, update the rules for technical changes, clarify and modify rule language to align with current standards of practice, and align rule language with current administrative procedures.