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Nursing Homes, Adult-Care Facilities Regulated Differently

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RALEIGH, N.C. — An adult-care facility used to basically be a place for older folks to live, but today, many people view them as being the same as nursing homes, but the state does not.

Richard Carter's family learned a lot more than they expected about assisted living centers after his 97-year-old mother-in-law was injured in a fall from a chair at a facility.

"We needed a nursing home. They said they could do the job that a nursing home could do, but they obviously couldn't," he said.

Carter also learned about how injury cases are investigated. Adult-care facilities are not only run differently, but they are regulated differently.

"Adult-care homes take care of a group of people who don't need as much medical attention now as nursing homes," said James Upchurch Jr., of the North Carolina Department of Health and Human Services.

The state handles complaints at nursing homes directly while the individual counties handle incidents at adult-care facilities.

"County departments and Social Services have traditionally made the argument that they're located in the county and that they are local," he said.

The state still has a role as it assists in more serious matters like the

incident in Wendell at Oliver House

where an 85-year-old Alzheimer's patient was hit and killed by a car after wandering off. However, the state mostly reviews cases like the one in Cary where

an Alzheimer's patient

wandered off in a wheelchair and was found uninjured.

"Our rules and regulations are increasingly become more complex as the facilities become more complex," Upchurch said.

There are 1,300 adult care facilities in North Carolina compared to the state's 300 to 400 nursing homes. Carter, who was not satisfied with the county's investigation into his mother-in-law's accident, said his next step is to ask the state to step in.


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