Adult Care Home Violations and Penalties


North Carolina's adult care home penalties are part of the Department of Health and Human Service's ongoing effort to provide information to citizens and family members faced with difficult health care decisions. A listing of adult care homes in North Carolina is available for download.

Difference in Adult Care Homes from Nursing Homes

The primary difference between adult care homes and nursing homes is as follows:

"Adult Care Homes" provide care and assistance to people with problems carrying out activities of daily living and supervision to people with cognitive impairments whose decisions, if made independently, may jeopardize the safety or well-being of themselves or others and therefore require supervision. Medication in an adult care home may be administered by designated, trained staff. Smaller adult care homes that provide care to two to six unrelated residents are commonly called family care homes.

"Nursing Homes" are for people who need chronic or rehabilitative care, who, on admission are not acutely ill and who do not usually require special facilities such as an operating room, X-ray facilities, laboratory facilities, and obstetrical facilities. A "nursing home" provides care for people who have remedial ailments or other ailments, for which medical and nursing care are indicated; who, however, are not sick enough to require general hospital care. Nursing care is their primary need, but they will require continuing medical supervision.

Information on This Site

There are necessary regulatory delays between when an adult care home is inspected and when findings from the inspection will appear on this Web site. Therefore, when visiting an adult care home, we encourage you to request copies of more recent inspection results.

Every effort is made to ensure accuracy of the information on this Web site; however, corrections, comments, and suggestions are welcome and can be made by e-mailing:


The goal of inspections is to assess how well the adult care home complies with applicable laws and regulations affecting the quality of care provided. Inspections are typically conducted on an annual basis and when the state receives complaints. All inspections are unannounced. Inspections conducted on an annual basis typically last one to four days. Complaint inspections may last one or more days depending upon the number of allegations and what inspectors find during the course of the inspection.

Regarding Adult Care Home Inspections

One possible result of an inspection is the imposition of fines due to a "Type A" violation, which is defined as a condition or conditions that have resulted in death or serious physical harm to a resident or are likely to result in death or serious physical harm. The range for a "Type A" violation is $500.00 to $10,000 for each Type A violation in homes licensed for six or fewer beds and $1,000 to $20,000 for each Type A violation in facilities licensed for seven or more beds.

Examples of a Type A violation include the following:

Another sanction that could result in the imposition of fines would be due to a "Type B" violation, which is an identified condition which impacts the quality of care of the residents in the adult care home but has not been corrected by the facility after the state has allowed the facility a reasonable period of time to correct. The range of the fine for a "Type B" violation is up to $400.00 for each day that the facility fails to correct the noncompliance past the date specified for compliance to be achieved.

Examples of a Type B violation include the following:

Please note that adult care homes have the right to appeal the imposition of fines by filing an appeal with the North Carolina Office of Administrative Hearings. If a fine is appealed, it may go to hearing or a settlement may be reached between the state and the facility.

Other Information

For adult care homes, months will typically pass between inspections and much could change for the better or worse in a facility between inspections. Therefore, it is advised that you inspect the facility yourself before making such an important decision.