Long Term Care (LTC) is a range of services that help people with chronic illnesses or disabilities who can not care for themselves for long periods of time. Long Term Care services are designed to help these individuals perform and complete everyday activities with as much support as needed that is available. These services involve a wide variety of support services to help people live as independently and safely as possible. It is provided in different places by different caregivers, depending on a person’s needs. The care ranges from Home-based or Community to Residential Facility Care.
Long-Term Care Ombudsman Program
The Kerr-Tar Regional Long-Term Care Ombudsman coordinates activities that:
• Advocate for residents of long-term care facilities
• Investigate and resolve complaints made by residents of care facilities
• Train and assist community advisory committee members as advocates
• Promote community involvement in long-term care
• Promote awareness of elder abuse, neglect and exploitation.
Who may need an Ombudsman:
• Residents of nursing homes, assisted living/adult care homes and family care homes
• Family and friends of residents in long-term care facilities
• Long-term care facility staff
• Government agencies and community groups
• Anyone seeking information and education related to long-term care or placement issues.
What to do before calling the Ombudsman:
Be prepared. Be organized and have your concerns written down to help you be more effective and ask the right questions.
• Keep your own records. Take notes or keep a journal. Remember to record dates, times, and people you spoke with regarding your concerns.
• Be pleasant. Being angry or rude never helps to solve the problem.
• Utilize the facility complaint or grievance procedure system. If possible, try and solve complaints through the facility first.
To locate a long term care facility in North Carolina, please click here.
Community Advisory Committees (CAC)
Community Advisory Committee (CAC) members for Nursing Homes and Adult Care Homes are trained volunteers. They are local citizens appointed by their county Board of Commissioners. These committees were established by the North Carolina State Legislature (G.S. 131D-31 and G.S. 131E-128) to be a volunteer, grassroots advocates for residents in long-term care facilities. The committees cover Nursing Homes, Adult Care Homes, and Family Care Homes within their county.
Roles and Responsibilities
The very presence of informed, concerned citizens in and around facilities can make a critical difference and provide a force to ensure quality care for long-term care residents.
The Community Advisory Committees have the responsibility to:
- Work to maintain the intent of the Resident’s Bill of Rights.
- Make official visits to assigned facilities to apprise themselves of the general conditions under which residents are living and to establish rapport with residents, families, staff, and administrators.
- Serve as the nucleus for increased community interaction with facilities.
- Assist residents and their families with grievance resolution regarding residents’ rights issues.
- Promote community education and awareness of the needs of residents in long-term care facilities.
- Work toward keeping the public informed about long-term care issues in their county.
Typically, CAC members spend an average of 8–24 hours per quarter fulfilling their primary responsibilities, which include visiting long-term care facility residents and completing visitation worksheets. Additionally, attendance is required at quarterly committee meetings.
Minimum Requirements for Appointment
Initial appointment to the CAC is for a one-year term. At the discretion of the Board of Commissioners, members are eligible for a subsequent three year term. Appointees must be 18 years or older and must reside in the county that they serve. They cannot have an immediate family member residing in or employed by the type of home that their committee covers, nor can they have a financial interest in a long-term care facility served by the committee. After appointment by the Board of County Commissioners, members must be able to visit long-term care facilities with fellow committee members. An interest in advocacy for disabled and senior adults is desirable.
Training Requirements
CAC Members are required to complete 36 hours of initial orientation and training prior to appointment on the committee. This required orientation and training is outlined as follows:
- Classroom/Virtual Training (20 hours)
- Independent study/online modules (6 hours).
- Facility orientation on-site (10 hours)
After initial training and orientation, CAC members are required to complete a minimum of 18 hours continuing education relative to long-term care annually.
To apply to be a CAC Member, Click Here
General Statute that governs your Board(s)
• Nursing Home Community Advisory Committee
• Adult Care Home Community Advisory Committee:
• Regional Information/Facilities
Elder Abuse Awareness
Families and friends of disabled adults can help prevent abuse, neglect and exploitation of these individuals by looking out for some tell-tale signs and taking action.
The North Carolina Adult Protective Services Law applies to any disabled adult or emancipated minor who might be abused, neglected or exploited and might be in need of protection. The law prohibits:
• Abuse – willful infliction of physical pain, injury, mental anguish, unreasonable confinement or willful deprivation by a caregiver of services necessary to maintain mental or physical health.
• Self-neglect – disabled adults who live alone and have no caregiver and are unable to provide necessary services to maintain mental or physical health.
• Caretaker neglect – failure of a caregiver to provide services necessary to avoid physical harm or mental anguish and to maintain mental health of the disabled adult.
• Exploitation – illegal or improper use of a disabled adult or his or her resources for another’s profit or advantage.
Reporting Abuse and Neglect
Anyone who suspects abuse, neglect or exploitation of a disabled adult is required by law to report it to the county Department of Social Services (DSS). Confidentiality is guaranteed.
County DSS representatives may be reached at these numbers:
Franklin County – (919) 496–5721
Granville County – (919) 693–1511
Person County – (919) 599–8361
Vance County – (252) 492-5001
Warren County – (252) 257–5000 Ext#6
In any county, call 911 to reach local public safety emergency services after 5 p.m. or on holidays and weekends, and ask for the on call social worker.
Be prepared to provide as much of this information as possible about the disabled adult:
• Name and address
• Age or birthdate
• Caregiver/caretaker’s name (if any)
• Explain the situation and why you feel the person needs protection
• Mental or physical condition of the adult (Is this individual disabled?)
• Names of others who may help provide information regarding the situation (if available)
Links: http://www.ncdhhs.gov/assistance/adult-services/adult-protective-services
Residents’ Rights
New residents of nursing and assisted living facilities may go through a difficult adjustment period, even if the staff are doing all that they can. The adjustment can be made easier with the support of family and friends, and by knowing about their resident rights and some special protections under the law.
Resident rights essentially are the same for all types of homes and in all states. They include:
Respect
As a resident, you have the right to be treated with dignity and respect. As long as it fits your plan of care, you have the right to make your own schedule, including when you go to bed, rise in the morning, and eat your meals. You have the right to select the activities you would like to attend. You also may have the right to leave the facility with relatives or friends after notifying the staff.
Restraints
It is against the law for a nursing home to use physical and chemical restraints, except when necessary, to treat medical symptoms. Restraints may not be used for discipline or for the convenience of the home’s staff.
Restrained residents may have decreased functional ability, lower self-esteem, and feel depressed or angry. Restraints do not provide security or safety. Residents also are likely to be seriously injured if they fall with a restraint on. A physician must provide medical orders for any use of restraints and give the reason why they are needed except in certain emergency circumstances.
Managing Money
You have the right to manage your own money or to pick someone you trust to do so. If you request the home to manage your personal funds, you must sign a written statement that authorizes the home to do this for you. However, the home must allow you access to your bank accounts, cash, and other financial records. The home must protect your funds from any loss by purchasing a bond or providing other similar assurances.
Privacy, Property and Living Arrangements
You have the right to privacy. In addition, you have the right to keep and use your personal property, as long as it does not interfere with the rights, health or safety of others. Your mail should never be opened by the home unless you allow it. The home must have a system in place to keep you safe from neglect and abuse, and to protect your property from theft. See if there is a safe in the facility or cupboards with locked doors in resident rooms. If you and your spouse live in the same home, you are entitled to share a room (if you both agree to do so).
Guardianship and Advance Directives
As a home resident, you are responsible for making your own decisions (unless you are mentally unable or have made legal arrangements for help). You may also draw up a document called an Advance Directive. This sometimes is called a living will because it becomes effective while you are still alive. It is a legal document that says what type of treatment you want or don’t want in case you cannot speak for yourself.
If you wish, you may designate someone else to make health care decisions for you. This document is called a Durable Power of Attorney for health care. The person you name may become your legal guardian if you ever become incapable of making your own decisions. (In N.C., an attorney is not needed to draw up these legal documents. There is help available if you need it.)”
Visitors
You have the right to spend private time with visitors at any reasonable hour. You have the right to make and receive telephone calls in privacy. The home must permit your family to visit you at any time, as long as you wish to see them. You do not have to see any visitor you do not wish to see. Any person who provides you with health or legal services may see you at any reasonable time.
Medical Care
You have the right to be informed about your medical condition, medications, and to participate in developing your Plan of Care. You have the right to examine your medical records and reports upon request. You have the right to refuse medications or treatments, and to see your own doctor.
Social Services
The home must provide each resident with any needed social services, including counseling, mediation of disputes with other residents, assistance in contacting legal and financial professionals, and discharge planning.
Moving Out
Living in a home is voluntary. You are free to move to another place. However, admission policies usually require that you give proper notice that you are leaving. If you do not give proper notice, you may owe the home money based on the home’s proper notice rules. If you are going to another home, make sure the home has a bed for you.
Discharge and Transfer
Whether leaving a room or the home, change can be very traumatic for residents.
Homes cannot discharge you unless:
• It is necessary for the welfare, health, or safety of you or others;
• Your health has declined to the point that the home cannot meet your care needs;
• Your health has improved to the point that home care is no longer necessary;
• The home has not been paid for services you received; or
• The home closes.
Except in emergencies, the facility must give a 30-day written notice of discharge or transfer. Residents have the right to appeal a transfer to another facility. (The Ombudsman can help you with this process.)
Rights of Family and Friends
Relatives and friends have rights too. Family members and legal guardians have the right to privacy when visiting the home when the resident asks. They also have the right to meet with the families of other residents and to join or address family councils.
By law, homes must develop a plan of care for every resident. Family members are allowed to participate in the development of the care plan with the resident’s permission. Relatives who have legal guardianship of residents have the right to examine all medical records concerning their loved one and the right to make important decisions on his or her behalf.
Family and friends can make sure the resident receives good care. They visit often, know the home’s staff and procedures, express concerns to the right staff member, and are active in the home’s family council(where available).
Learn more about North Carolina’s efforts to promote quality, independent living for disabled and senior citizens at the NC Division of Aging and Adult Services Web site.