Orange County NC Website
Browse       Search
2 <br /> FACTS - <br /> Related to Critical Issues <br /> Concerning Domiciliary Homes <br /> 1. North Carolina depends heavily on domiciliary care as a prindpal means of long term care. <br /> There are approximately 1,339 free-standing domiciliary homes with some 24,945 beds. These <br /> numbers exceed the bed count in nursing homes. An additional 3,336 domiciliary care beds <br /> are licensed in units affiliated with nursing homes. <br /> 2. North Carolina has the second highest domiciliary bed to older adult population ratio in the <br /> nation and provides the fourth highest domiciliary care payment rate in the country. It has <br /> the fourth highest average payment of all state supplements. <br /> 3. It is estimated that 66% of domiciliary residents have physical disabilities; over 50% have <br /> mental disabilities,and less than 7% have no physical or mental disability. <br /> 4. There are no specific formal training regulations for personal care staff(aides)who provide <br /> approximately 80% of resident care. <br /> 5. Staff turnover is high;among aides it reaches more than 200%per year. <br /> 6. North Carolina domiciliary regulations require no medical assessment of residents beyond <br /> occasional and incidental medical are. <br /> 7. Most domiciliary residents have multiple prescription/medical needs and they do not man- <br /> age their own medications or self medicate. There are no requirements for formal training in <br /> drug management for staff. This is in contrast to nursing homes where only licensed profes- <br /> sional staff may manage drugs and administer them. <br /> 8. Domiciliary hakes_remain asssnpt hum registration under the North Carolina Controlled <br /> Substance Act j <br /> 9. Except for r e:for developmentally disabled adults,no mental health training is <br /> required rest homes and family care homes where the number and variety of men- <br /> tal health are increasing. Some homes have a population entirely of younger <br /> mental health residents;others have significant numbers,alongside frail older persons. There <br /> is very limited access to mental health services by domiciliary home residents. <br /> 10. Rules and regulations governing Medicare/Medicaid in acute care hospitals result in patients <br /> being discharged to domiciliary homes in fragile medical conditions. <br /> 11. A resident on a state/county assistance program receive only$34 a month for all personal <br /> needs -from tissues to shoes. Medicare/Medicaid does not fund domiciliary care. <br />