North Carolina's adult care home and family care home facilities are inspected annually by the Division of Health Service Regulation (DHSR), Adult Care Licensure Section. The goal of inspections is to assess the facility's compliance with applicable laws and regulations affecting the quality of care provided. Follow-up inspections to the annual survey are conducted if a facility has demonstrated significant non-compliance during the annual inspection. All inspections are unannounced.
During annual inspections, the focus of the survey is on various rule areas that are vital to ensuring the health, safety and welfare of the residents. These are known as the "Fundamental Rule Areas." Although the focus of the survey begins with the fundamental rule areas, any rule area can be cited if non-compliance is identified. The fundamental rule areas are:
If non-compliance with state rules and regulations for adult care homes and family care homes is identified during an inspection, the survey team must determine the level of the facility's non-compliance. There are 3 levels of non-compliance:
1. Type A Violation:
A facility is cited for a Type A violation when its failure to follow the regulations, standards or requirements governing its licensure results in death or serious physical harm, or results in substantial risk that death or serious physical harm will occur. Civil monetary penalties will be imposed for Type A violations.
2. Type B Violation:
A facility is cited for a Type B violation when its failure to follow the regulations, standards or requirements governing its licensure 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 harm will occur. If a facility fails to correct a Type B violation by a specified timeframe, a civil monetary penalty will be imposed.
3. Citation (or 'Standard Deficiency')
A facility receives a citation when it fails to comply with licensure rules. A citation will be issued if the survey team determines there is sufficient scope (there are a number of residents potentially or actually affected by the non-compliance) and severity (the effect on resident outcomes).