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Medicaid Waiver vs. Nursing Home Medicaid

North Carolina's CAP/DA waiver and nursing facility Medicaid use similar financial eligibility tests but pay for completely different settings -- home versus a facility bed.

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Short answer

NC nursing facility Medicaid uses asset limits of $2,000 (per NC DHHS 2026 Basic Medicaid Eligibility Requirements, Aged/Blind/Disabled resource limit) (single) and $3,000 (per NC DHHS 2026 Basic Medicaid Eligibility Requirements, Aged/Blind/Disabled resource limit for a couple) (couple), and is an entitlement -- anyone who qualifies financially and medically gets it, no waitlist. CAP/DA, NC's in-home waiver, pays for community-based services only and, like most HCBS waivers nationally, can carry capacity limits.

The practical difference

Nursing home Medicaid pays for a facility bed once a resident qualifies. CAP/DA keeps someone at home with services like personal care, home modifications, and case management -- but does not pay for assisted-living-style room and board anywhere.

How families pay for care. NC's CAP/DA waiver pays for in-home services only; State/County Special Assistance (not a Medicaid waiver) helps with adult care home room and board. Read the full explanation →

Questions families ask

What number do I call to report problems with conditions inside a licensed nursing home or adult care home in North Carolina?

Call NC DHSR's Complaint Intake Unit at 1-800-624-3004 (in-state) or 919-855-4500 to report complaints about conditions, safety, or regulatory violations inside a licensed adult care home, family care home, or nursing home. The complaint line operates 9:00 a.m.-12:00 p.m. and 1:00 p.m.-4:00 p.m. on weekdays, excluding holidays.

What are common signs of financial exploitation of a senior that families in the Triangle should watch for?

Warning signs of financial exploitation can include sudden changes to a will, power of attorney, or bank account beneficiaries; unexplained withdrawals or missing funds; a new 'friend' or caregiver who becomes unusually involved in financial matters; unpaid bills despite adequate income; and the senior seeming confused, secretive, or fearful about money. If financial exploitation is suspected, report it to the county DSS Adult Protective Services office where the adult lives.

What should I do if I think my elderly parent is in immediate physical danger right now?

Call 911 immediately if a senior is in immediate danger. Adult Protective Services and the DHSR facility complaint line are important resources for investigating and addressing abuse, neglect, or facility conditions, but they are not emergency response services and should not be used in place of 911 when someone's safety is at risk right now.

Does Adult Protective Services get involved if my mother is being neglected by a family caregiver at home, not in a facility?

Yes. County Adult Protective Services investigates suspected abuse, neglect, or exploitation of vulnerable adults regardless of setting, including situations where a family member or informal caregiver is providing inadequate or harmful care in a private home. Reports go to the county DSS where the older adult lives -- for Wake County, that's Wake County Human Services at 919-212-7264.

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