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Types of senior care in your area

Six categories, and your state's specific licensing approach changes how families should compare them.

Quick answer

Senior care in North Carolina spans six categories, with assisted living and memory care both licensed as adult care homes by the state's Division of Health Service Regulation.

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Short answer

Senior care in North Carolina spans six categories: independent living (unlicensed housing), assisted living and memory care (both licensed as adult care homes by DHSR), nursing homes (licensed separately, with 24-hour skilled nursing), in-home care, and hospice.

Assisted Living

Help with daily activities in an NC-licensed adult care home, with meals, housekeeping and medication assistance included.

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Memory Care

Secured, dementia-specific care under North Carolina's Special Care Unit disclosure requirement -- not a separate license or certification.

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Nursing Homes

Skilled nursing facilities, licensed separately from adult care homes under NC rules, providing 24-hour licensed nursing care and short-term rehabilitation.

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In-Home Care

Caregivers and skilled clinicians who come to the home, from a few hours a week to around-the-clock support.

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Independent Living

Age-restricted apartments and campuses with dining, activities and light services, for adults who do not need daily hands-on care.

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Hospice Care

Comfort-focused care for a life-limiting illness, delivered at home, in a facility, or in a dedicated inpatient unit.

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How North Carolina licenses assisted living. NC uses one license type -- 'adult care home' -- under Chapter 131D, with no Type A/B/C tiering. Read the full explanation →
Memory care regulation in North Carolina. NC requires a Special Care Unit disclosure statement, not a separate certification, before a community can market secured memory care. Read the full explanation →

Questions families ask

How do I check if an assisted living community in Cary is actually licensed?

Use the NC Department of Health and Human Services' Division of Health Service Regulation (DHSR) Regulated Facilities search at info.ncdhhs.gov/dhsr/facilities/search.asp, which lets you search by county (Wake) or facility name and confirms the current license status, address, and bed capacity for any licensed adult care home. Every community operating as assisted living in Cary must be licensed under N.C.G.S. Chapter 131D and 10A NCAC 13F, regardless of how it markets itself.

Does North Carolina license assisted living facilities as Type A, B, or C like some other states?

No. North Carolina uses a single licensure category called 'adult care home' under N.C.G.S. Chapter 131D and 10A NCAC 13F, adopted by the N.C. Medical Care Commission, rather than an acuity-tiered Type A/B/C system some other states use. A facility can add a Special Care Unit designation to that same license for memory care, but this is not a separate license class.

What's the difference between a 'family care home' and a regular adult care home in Durham?

A family care home is licensed to serve 2 to 6 unrelated residents in a residential-style setting, while a larger adult care home (7 or more beds) operates under the same statute and rules but with a different fee and penalty schedule based on bed count. Both are licensed by DHSR's Adult Care Licensure Section under the identical Chapter 131D / 10A NCAC 13F framework — a family care home is a subset of the adult care home category, not a separate license type.

What has to be disclosed if a memory care unit in Wake Forest calls itself a 'Special Care Unit'?

Under G.S. 131D-8 and 10A NCAC 13F .1300 (the Special Care Unit rules), a facility operating a dementia/Alzheimer's unit must file a disclosure statement with DHSR describing the unit's philosophy of care, staffing and training specific to dementia care, physical environment, admission and discharge criteria, and programming — this disclosure must also be made available to prospective residents and families. The required content and format are published on DHSR's Special Care Unit disclosure page (ncdhhs.gov, ACLS).

How do I find inspection reports and violation history for a nursing home in Durham?

Nursing homes (skilled nursing facilities) are licensed and certified by DHSR's Nursing Home Licensure and Certification Section and are also surveyed under federal Medicare/Medicaid rules, so their inspection results, deficiencies, and CMS Five-Star Quality Rating are published on Medicare's Care Compare website (medicare.gov/care-compare) alongside the underlying survey (Form 2567) reports. You can cross-reference the same facility's NC license status through DHSR's Regulated Facilities search at info.ncdhhs.gov/dhsr/facilities/search.asp.

Is the same state agency in charge of licensing both nursing homes and assisted living communities in Raleigh?

Yes, both fall under the NC Department of Health and Human Services' Division of Health Service Regulation (DHSR), but two different sections handle them: the Adult Care Licensure Section (ACLS) licenses adult care homes and family care homes (what most people call assisted living), while the Nursing Home Licensure and Certification Section (NHLCS) licenses and federally certifies nursing homes (skilled nursing facilities). They operate under different statutory and rule frameworks and use different inspection/rating tools.

Where do I file a complaint about care quality at an adult care home in Apex?

Complaints about a licensed adult care home or family care home anywhere in North Carolina, including Apex, go to DHSR's Complaint Intake Unit at 1-800-624-3004 (in-state) or 919-855-4500, staffed weekdays 9:00 a.m.–12:00 p.m. and 1:00 p.m.–4:00 p.m. except holidays. DHSR's Complaint Intake Unit often forwards complaints about specific resident conditions to the local county Department of Social Services for investigation, since Adult Protective Services in NC is county-administered.

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