Opening a Family Care Home

What is a Family Care Home?

A Family Care Home is an Adult Care Home that is licensed for two to six beds.   An Adult Care Home is a home for older adults that has at least seven beds.  The home must provide 24-hour personal care services (bathing, dressing, grooming, etc.) and supervision. However, this type home is not required to have nurses on duty within the home. Most offer private or semi-private rooms with private or shared baths. The homes are monitored by the local Department of Social Services.


What If I Just Want To Offer Board and Care In My Home Informally?

According to North Carolina General Statutes, if you provide care to only one, non-related person in your home, you do not have to be licensed as a Family Care Home.  If you provide care, termed "activities of daily living", to more than one non-related person in your home, you must be licensed as a Family Care Home.  Providing care means helping a person with their medications, transportation, getting dressed, mobility, personal care - or any combination of the these.

If you provide only boarding, i.e. a room and meals only, and provide no care as identified above, then you may house as many individuals as you can safely accommodate and as zoning allows.

If you are providing any type of mental health services, then you are considered a "supervised group home" and you must be licensed. This applies if there is more than one non-related person receiving the care.


What Does Licensing Mean?

Licensing is a process where a home owner who wants to provide board and services to non-relative individuals applies to the state for a "license to operate".  The state checks a variety of areas to help ensure that the residents will be safe and well cared for.  Monitoring is done at prescribed intervals to ensure that the rules and regulations continue to be met.

Some of the areas reviewed for compliance are:

  • ability to provide services
  • appropriate staffing
  • building inspections
  • criminal background checks
  • fire inspections
  • NC rules and regulations
  • policies and procedures
  • safety laws
  • tuberculosis screening
  • zoning laws

For the home administrator:

  • completion of high school or GED program
  • documentation of 30 day on-the-job training as an administrator
  • passing state administered rules exam
  • three letters of recommendation including one prior employer


Things to Consider Beforehand

Taking non-related individuals into your home can come with risks and unexpected consequences.  A few things to consider would be:

  • Is zoning an issue?
  • Does your homeowner's association allow non-relative boarding and/or care?
  • What type insurance do you need to protect yourself from personal liability?
  • What type of insurance is required for non-relative boarding and/or care?
  • How do you find suitable individuals?
  • How do you screen individuals?
  • What type of care can you and are you willing to provide?
  • What will happen if a resident's health needs change and they need more care?
  • What will happen if a resident's health needs change and they need more care than you can provide?
  • What if they don't work out? What are your rights as a landlord/care provider?
  • How much notice will they need to give to move out?
  • How much notice do you have to give them if you ask them to move out?
  • What do you need to do to make sure you provide a safe environment for yourcharges?
  • What is your legal responsibility related to providing a safe environment?
  • What if someone residing with you gets injured?
  • How much space is needed for each person?
  • What do you need in the way of income to make the effort work?
  • What sanitation rules will have to be followed to feed non-related individuals?
  • Will the individuals have access to your central living area?  If so, how much? If not, how will you handle that?
  • How will you handle inappropriate behavior if it happens?
  • How will you provide personal security for all your residents? (from outsiders and residents)
  • Can residents have pets?
  • Will a resident's space be furnished?
  • How will you feel if one of your residents dies while in your care (without fault)?
  • How does your family feel about having non-relatives in the home?

You may find it prudent to write out how things will work, who is responsible for what, and address many of the items listed above, into an agreement.  Both parties should understand the agreement and sign it, preferably with a witness.  If you can, have an attorney draft and/or review it.

To publicize what you have to offer, you can advertize in places where seniors may see it, like at a senior center, for example.  Be aware that most organizations of that type will not recommend you to anyone but they might let you post it somewhere in the center or include you on a list of potential places to live. Often, word of mouth through friends or your church or civic group is the best way to find someone appropriate. Online or newspaper ads can be done also, but be cautious in communicating or meeting with individuals you don’t know. You don’t want to put yourself or other family members at risk.


How Do I Start a Family Care Home?

To start the process of licensing your home or establishment as a Family Care Home, contact the local county Department of Social Services, Adult Services Section.  Ask to speak to an Adult Home Specialist and tell them what you would like to do.  They will provide you with information, the steps to take, and provide you with the necessary forms that will need to be completed and sent to the NC Division of Health Service Regulation for approval and to complete the licensure process.

Use the links below to find online information about how to open an Family Care Home in North Carolina.


Need more information or have a question?

NC Division of Health Service Regulation, Adult Care Licensure Section