The Nursing Home Licensure and Certification Section licenses nursing homes to operate in the State of North Carolina. A potential owner of a nursing home must apply for and receive a Certificate of Need (CON) prior to applying for a license to operate a nursing home. Once a CON is awarded, the Construction Section oversees the construction of the building and verifies compliance with physical plant requirements. Following those processes, the owner submits required documents to this Section and goes through an initial survey process. During the initial licensure survey, the nursing home's policies and procedures, staff qualifications and operational systems are reviewed to determine compliance with state nursing home rules. Licenses are effective for one year.
Some nursing homes are licensed as a "Combination Home". These homes contain both adult care beds and nursing home beds under one roof.
The Nursing Home Licensure and Certification Section conducts inspections of nursing homes for participation in Medicare and Medicaid under an agreement with the Federal government. Ninety-five percent of the nursing homes in North Carolina participate in the Medicare/Medicaid program. A licensed nursing home applies for certification. Inspectors from this Section, commonly called surveyors, conduct an onsite initial survey to determine whether the home is compliant with federal requirements. When a home is found compliant with federal requirements, the Centers for Medicare and Medicaid Services is notified and a certification is issued.
Routine inspections occur in certified nursing homes every nine - 15 months. Nurses, pharmacists, dietitians and social workers who have passed a federal surveyor qualifications test conduct these inspections. The surveys typically take three days to complete and involve the comprehensive review of a facility's compliance with resident rights, admission and transfer rights, resident behavior and facility practices, quality of life, quality of care, nursing services, dietary services, pharmacy services, physician services, infection control, physical environment and administration.
Surveyors investigate complaints filed against a facility according to the severity level of the nature of the complaint. This Section receives approximately 2,000 nursing home complaints per year. Complaints are investigated timely and complainants receive feedback on the outcomes of the complaint investigation.
If a nursing home is cited for regulation non-compliance, it receives a document called a Statement of Deficiency. The home is required to provide a plan of correction for each deficiency cited and may be subject to other penalties. Surveyors follow up with the home to assure the deficiencies have been corrected.
In addition to inspection activities, the Section is responds to public record requests, provides training, and encourages improvements in care through a voluntary special licensure program. The Section offers a variety of training on subjects such as resident assessments, new regulations and the inspection process to nursing home staff, professional organizations, and other interested parties. Grants are awarded for eligible nursing home enhancement projects, and the Section awards the North Carolina New Organizational Vision Award (NC NOVA) special license to homes that participate in a program that requires them to exceed basic licensure requirements.
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