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North Carolina's In-Home Medicaid Waiver (CAP/DA), Explained

CAP/DA is North Carolina's Medicaid HCBS waiver for adults who need a nursing-facility level of care but want to stay in their own home.

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Short answer

Community Alternatives Program for Disabled Adults (CAP/DA) is NC's Medicaid HCBS waiver (1915(c)) for adults 18+ who need a nursing-facility level of care but wish to remain in their own home/community.

What CAP/DA covers

18 in-home and community-based services including adult day health, in-home aide services, home modifications/equipment, meal preparation, respite care, personal emergency response systems, specialized medical supplies, case management, and consumer-directed care allowing beneficiaries to hire/supervise their own caregivers.

What it does not cover

Not applicable — CAP/DA serves people living in their own home, not a facility, so it does not pay room and board.

Who administers it locally

Administered by the NC Division of Health Benefits / NC Medicaid (NCDHHS), with local CAP/DA case management entities coordinating services and referrals by county.

Source: CAP/DA program

Questions families ask

Is the same state agency in charge of licensing both nursing homes and assisted living communities in Raleigh?

Yes, both fall under the NC Department of Health and Human Services' Division of Health Service Regulation (DHSR), but two different sections handle them: the Adult Care Licensure Section (ACLS) licenses adult care homes and family care homes (what most people call assisted living), while the Nursing Home Licensure and Certification Section (NHLCS) licenses and federally certifies nursing homes (skilled nursing facilities). They operate under different statutory and rule frameworks and use different inspection/rating tools.

Where do I file a complaint about care quality at an adult care home in Apex?

Complaints about a licensed adult care home or family care home anywhere in North Carolina, including Apex, go to DHSR's Complaint Intake Unit at 1-800-624-3004 (in-state) or 919-855-4500, staffed weekdays 9:00 a.m.–12:00 p.m. and 1:00 p.m.–4:00 p.m. except holidays. DHSR's Complaint Intake Unit often forwards complaints about specific resident conditions to the local county Department of Social Services for investigation, since Adult Protective Services in NC is county-administered.

What are DHSR's complaint line hours, and does it cover a facility in Fuquay-Varina?

DHSR's Complaint Intake and Health Care Personnel Investigations Section can be reached at 1-800-624-3004 (in North Carolina) or 919-855-4500, weekdays from 9:00 a.m. to 12:00 p.m. and 1:00 p.m. to 4:00 p.m., excluding state holidays. This line covers complaints about any DHSR-regulated facility statewide, including licensed adult care homes, family care homes, and nursing homes in southern Wake County towns like Fuquay-Varina.

Is there a five-star rating system for assisted living communities in North Carolina like there is for nursing homes?

No. The federal CMS Five-Star Quality Rating System (via Medicare Care Compare) only applies to nursing homes, not to adult care homes or family care homes. Instead, DHSR's Adult Care Licensure Section maintains its own 'Facility Inspections, Ratings and Penalties' search tool (info.ncdhhs.gov/dhsr/acls/star/search.asp), which provides a state-specific, compliance-history-based star rating along with raw inspection reports and penalty records, but it is not standardized against other states.

How do I look up whether an assisted living community in Chapel Hill has had recent violations or fines?

DHSR's Adult Care Home Facility Inspections, Ratings and Penalties search (info.ncdhhs.gov/dhsr/acls/star/search.asp) lets you search by facility name or county (Orange County, for Chapel Hill) to view a compliance-based star rating, inspection reports and corrective action plans, and any penalties assessed within the last 36 months. This is a different, NC-specific tool from the DHSR Regulated Facilities search, which only confirms basic licensing and contact information.

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