NBHA®National Boarding Home Association
Regulations / North CarolinaReviewed September 2026

North Carolina

An 'adult care home' is an assisted living residence giving 24-hour scheduled and unscheduled personal care to two or more residents. Homes with 2-6 residents are licensed as family care homes (10A NCAC 13G) and homes with 7 or more as adult care homes (10A NCAC 13F). County departments of social services are the first point of contact for applications and handle adult care home complaints. Batches of amended/readopted 13F/13G rules took effect March 1, June 1 and August 1, 2025.

License categories

Family care homes (2-6 residents)Adult care homes (7+ residents)

Key laws

N.C.G.S. Chapter 131D
Inspection and Licensing of Facilities (adult care homes) — official text
10A NCAC 13F
Licensing of Adult Care Homes of Seven or More Beds
10A NCAC 13G
Licensing of Family Care Homes
2024-2025 rule readoption (13F/13G)
Adult Care Home and Family Care Home Rules (DHSR rulemaking page) — official text

Key requirements

  1. Family care home applications start at the county DSS adult services section and need zoning approval, then construction plan review and an onsite visit by the Adult Care Licensure Section (DHSR).
  2. Administrators must be certified: high school diploma/GED, an approved 120-hour administrator-in-training program, the administrator exam, and a background check with fingerprints (DHSR).
  3. Family care home staff who provide or supervise personal care must finish an 80-hour personal care training and competency program within six months of hire (applies to staff hired after Sept. 30, 2022) (10A NCAC 13G .0501).
  4. Staff who administer medications must pass a medication administration competency evaluation (10A NCAC 13G .0503).
  5. Family care homes are limited to two stories and have restrictions on housing aged or physically disabled residents upstairs (G.S. 131D-2.1).

Sources

  1. https://info.ncdhhs.gov/dhsr/acls/licenseinfo.html
  2. https://info.ncdhhs.gov/dhsr/acls/flofch.html
  3. https://info.ncdhhs.gov/dhsr/rules/achfch2024.html
  4. https://info.ncdhhs.gov/dhsr/ciu/complaintintake.html
  5. https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/ByChapter/Chapter_131D.html
  6. https://www.law.cornell.edu/regulations/north-carolina/10A-N-C-Admin-Code-13G-0501
  7. https://regulations.justia.com/states/north-carolina/title-10a/chapter-13/subchapter-g/section-0500
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