How North Carolina licenses assisted living
North Carolina uses a single license category called an adult care home, issued under N.C. General Statutes Chapter 131D and 10A NCAC 13F. There is no Type A/B/C acuity tiering like some other states use.
North Carolina's Division of Health Service Regulation (DHSR), through its Adult Care Licensure Section, licenses adult care homes statewide. Family care homes — small residences serving 2 to 6 unrelated residents — are licensed as a subset of the same adult care home category rather than a separate license class, though they carry a different fee schedule and penalty tier by bed count. Larger communities, sometimes called multi-unit assisted housing, fall under the same statutory framework.
What this single-license model means in practice: North Carolina does not sort assisted living by evacuation capability the way states like Texas do with their Type A/B system. Instead, whether a specific community can serve a specific resident depends on the community's own admission and retention policy layered on top of the base adult care home license — ask directly what a community's policy allows and what triggers a required move to a higher level of care.
Source: N.C.G.S. Chapter 131D and 10A NCAC 13F, NC DHSR Adult Care Licensure Section.
What the single-tier model changes for families
Because North Carolina does not tier adult care home licenses by acuity the way Texas does with Type A/B, the practical limit on whether a specific community can serve a specific resident comes down to that community's own admission and retention policy, not a state-assigned tier. Ask directly what triggers a required move to a nursing facility, and get the answer in writing.
