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Choosing Between Two Communities

The questions that break a tie once the tours all start blurring together.

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Short answer

When two communities both seem workable, compare the all-in cost at your parent's actual care level, the three-year rate increase history, overnight staffing (not daytime), both facilities' state inspection records, and whether either holds a Medicaid waiver provider agreement your family might eventually need.

This decision comes up often enough that we cover it in full, with a step-by-step comparison process, on its own page in our situations section rather than repeating it here.

See the full comparison walkthrough →

What to ask on a tour. Ask to see the state inspection report, the memory-care disclosure/certification if marketed, the all-in cost at your parent's care level, the three-year rate increase history, and the overnight staffing ratio. Read the full explanation →

Questions families ask

Is a 'Special Care Unit' designation in a Cary memory care facility the same as a state quality certification?

No — a Special Care Unit designation under G.S. 131D-8 and 10A NCAC 13F .1300 is a disclosure and approval process layered onto a facility's existing adult care home license, requiring the facility to file specific information about its dementia-care program, not a separate quality certification or endorsement of care quality by the state. Families should treat the disclosure statement as required transparency, not a state seal of approval.

How do I confirm the CMS Five-Star rating for a Raleigh-area nursing home before touring it?

Search the facility by name or ZIP code on Medicare's Care Compare tool (medicare.gov/care-compare), which publishes the federal CMS Five-Star Quality Rating combining health inspection results, staffing data, and quality measures into an overall score and three component scores. This rating applies only to Medicare/Medicaid-certified nursing homes (skilled nursing facilities), not to assisted living or adult care homes.

What's the difference between reporting a licensing problem and reporting resident abuse at a facility in Clayton?

A licensing problem (unsafe conditions, inadequate staffing, rule violations) is reported to DHSR's Complaint Intake Unit at 1-800-624-3004 or 919-855-4500, which can investigate and cite the facility under Chapter 131D. Suspected abuse, neglect, or exploitation of a specific resident is reported to Johnston County's Adult Protective Services through the county Department of Social Services, since APS in NC is administered county-by-county, not through a single state hotline.

Does a Special Care Unit disclosure requirement apply to every dementia unit in the Triangle, or only some facilities?

The Special Care Unit disclosure requirement under G.S. 131D-8 applies to any licensed adult care home that operates, markets, or advertises a distinct unit or program for residents with Alzheimer's disease or a related dementia (or mental health/developmental disability population); a facility that simply serves individual residents with dementia within its general population without designating a special unit is not required to file the SCU disclosure. This distinction is why some Triangle memory-care marketing language should prompt families to specifically ask whether an SCU disclosure has been filed.

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