Regulations

State Operations Manual - This appendix to the State Operations Manual, issued by CMS, contains the directions to State Agencies, e.g. the North Carolina Division of Facility Services, on how to conduct a Nursing Home survey and what to survey.  The items to survey are citations from the Code of Federal Regulations and usually appear as:

• This refers to 42 CFR Part 483, Subpart B, and the various subsections.  The Federal Survey guidelines also cross reference to the actual survey document which is in tabular format.  Each of the form's sections have a 'federal tag number' or FTag. F385 is the FTag for §483.40 Physician Services.
• The following sections have significant applicability to Nursing Facility Medical Directors:
  • F329 - §483.25(I) Unnecessary Drugs
  • F385 - §483.40 Physician Services
  • F428 - §483.60(c) Drug Regimen Review
  • F501 - §483.75(i) Medical Director

Rules for the Licensing of Homes for the Aged and Infirm - NC Administrative Code Title 10 Chapter 13 Subchapter D - This link takes you to the State's Rules for the Licensing of Homes for the Aged and Infirm (aka Rest Homes or Assisted Living Facilities).

Rules for the Licensing of Nursing Homes - NC Administrative Code Title 10 Chapter 13 Subchapter D - This link takes you to the State's Rules for the Licensing and Operation of a Nursing Facility.  Note that if a Nursing Facility has a Home for the Aged facility operating under its Nursing Facility License, those HA beds are governed by the Nursing Facility Rules, not the HA Rules.

North Carolina General Statute §90-21.18. Medical directors; liability limitation - This statute, which became effective January 1st, 2005, limits the professional liability of a Nursing Facility Medical Director to the coverage held by the Facility. (note - Medical Malpractice does not extend coverage to acts of a Physician acting in his/her role as a 'Medical Director', because it is an administrative duty and unrelated to direct patient care)

Regulatory Focus Bulletin - Since its inception in July 1991, the Regulatory Focus Bulletin (RFB) has served as an important tool for both regulators and providers in North Carolina.  RFB is designed to provide clarification of state and federal law, and nursing home licensure and certification policy in matters relating to the state's nursing facilities.

NC Medicaid Nursing Facility – Clinical Coverage Policies - DMA manual describing Nursing Facility Coverage guidelines, mandatory services, policies, and procedures reltated to Patient Care.

NC Medicaid Geropsychiatric Units in Nursing Facilities – Clinical Coverage Policy - DMA manual describing additional criteria for facilities offering Psychiatric services in a Nursing Facility setting.