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residents. She painted out that the biggest change in nursing homes over the last five years is the acuity of <br />residents. <br />Jack Vogt, Chair of the NHCAC, distributed a list of the five nursing homes in the County. The mast <br />important responsibility of the committee is to make quarterly visits to facilities. The committee also handles <br />complaints from nursing home residents or family members. These complaints are sent to the State for <br />action. The committee did a survey of nursing home administrators this past year to find out the challenges. <br />A friendly visitor program has been initiated in two of the nursing homes in the County, and there are 10 <br />visitors that are visiting different residents in the home. <br />III. Current State of Facilities in Orange County <br />a. Quality of CarelG2uality of Life <br />Becky Bradley, Co-Chair of the NHCAC, spoke about the quality of care and quality of life in long- <br />term care facilities. She said that both committees see the same problems. One of the first issues that is <br />addressed is hygiene. She said that the Alzheimer's units in the County homes ware clearly understaffed. <br />She said that the staff ratio in adult care homes has been increased due to Senate Bill 10. She pointed out <br />that in one of the facilities in the County, not one of the residents had a chance to vote in the primary <br />election. Other issues that need to be addressed are food quality and choices, meaningful activities, <br />restraints, privacy, mental health care, and access to medical care. She said that chemical and physical <br />restraints are not to be used far the convenience of the staff. <br />b. Staffing and Management <br />Cherie Rosemond described the typical staff member of an adult care home. She described the <br />training involved for the staff. The training only gives five hours to the interpersonal aspect. She said that <br />the training was not sufficient for the nursing homes. Employee turnover in nursing homes is 100 to 140 <br />percent per year. She described the operator turnover in the facilities in Orange County. One facility has <br />had four administrators each year and another has had three. There is a lack of corporate support for local <br />facilities. She spoke about a personal story of when she spent the night in a nursing home to be with a <br />friend and how the staff acted inappropriately in many ways. <br />c. Access <br />Tracy Diefenderfer, a social worker on the ACHCAC, said that she has a unique perspective <br />because she works at UNC Hospitals and has worked in a nursing home in Chapel Hill. She described a <br />nursing home resident, Mr. Jones. She said that hospitals become bed-locked with patients that cannot get <br />into nursing homes because of lack of availability of affordable rooms, quality facilities, and limiting <br />regulations. <br />IV. Legislation 200012001 <br />Jill AI-Hafez, the Regional Ombudsman, said that they were in charge of providing training and <br />technical assistance to the committees. She said that three of the five facilities in the County were <br />substandard. She said that this was a systems problem and that she did not fault the State. <br />Carol Teal, from the Friends of Long Term Care, said that an Ombudsman in Winston-Salem started <br />this group 15 years ago. She said that the staffing issue, in her opinion, was the biggest issue for the <br />quality of care in adult care homes. She spoke about a Wage Pass Through bill, which will give an extra <br />number of dollars per hour to the front line workers. The proposed increase in North Carolina is only 50 <br />cents an hour, which is very inadequate. She said that Medicaid was in serious trouble in North Carolina. <br />The Friends of Long Term Care is also supporting legislation to require facilities to post the capacity so that <br />people would know how many staff should be on duty. She painted out that there was no minimum ratio of <br />staff to residents in adult care homes. <br />Gwen Phillips, from the Orange County Department of Social Services, said that every month they <br />monitor, visit, and advocate for adult care homes. She said that there was a need for legislation to look at <br />reimbursement rates. She said that the rates should be based an the resident's need. The second issue is <br />the need to require supervisors in homes licensed from 21 to 30 for third shift. The third issue is the need to <br />restructure the state reimbursement plan for adult care homes. The current plan does not establish any <br />fixed profit margins for adult care homes and encourages the homes to cut corners in order to increase <br />profits. The fourth issue is the need to have a cap on indirect casts in facilities. Many of the facilities lease <br />