North Carolina HB 813: Enhanced Registration of Registered Residential Facilities.

Bill Text

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
H 1
HOUSE BILL 813

Short Title: Enhanced Reg. of Registered Res. Facilities. (Public)
Sponsors: Representatives Pittman, Clark, and Crawford (Primary Sponsors).
For a complete list of sponsors, refer to the North Carolina General Assembly web site.
Referred to: Appropriations, if favorable, Finance, if favorable, Rules, Calendar, and
Operations of the House
April 8, 2025
*H813-v-1*
A BILL TO BE ENTITLED 1
AN ACT REPLACING THE TERM "MULTIUNIT ASSISTED HOUSING WITH SERVICES" 2
WITH "REGISTERED RESIDENTIAL FACILITY" AND REDEFINING THE TERM 3
"ASSISTED LIVING RESIDENCE" TO EXCLUDE THESE FACILITIES TO MAKE IT 4
CLEARER TO THE PUBLIC THAT REGISTERED RESIDENTIAL FACILITIES ARE 5
NOT EQUIVALENT TO LICENSED ADULT CARE HOMES; UPDATING THE 6
REGISTRATION REQUIREMENTS FOR REGISTERED RESIDENTIAL FACILITIES; 7
EXPANDING THE LIST OF PERSONS NOT TO BE CARED FOR IN REGISTERED 8
RESIDENTIAL FACILITIES; AUTHORIZING THE DEPARTMENT OF HEALTH AND 9
HUMAN SERVICES TO SEEK AN INJUNCTION OR OTHER PROCESS AGAINST A 10
REGISTERED RESIDENTIAL FACILITY OPERATING WITHOUT APPROVED 11
REGISTRATION; AND DIRECTING THE MEDICAL CARE COMMISSION TO ADOPT 12
RULES ESTABLISHING STANDARDS FOR REGISTERING, INSPECTING, AND 13
TAKING ADVERSE ACTION AGAINST REGISTERED RESIDENTIAL FACILITIES. 14
The General Assembly of North Carolina enacts: 15
SECTION 1. Effective January 1, 2026, Part 1 of Article 1 of Chapter 131D of the 16
General Statutes reads as rewritten: 17
"Part 1. Licensing. 18
... 19
"§ 131D-2.1. Definitions. 20
As used in this Article: 21
... 22
(5) Assisted living residence. – Any group housing and services program for two 23
or more unrelated adults, by whatever name it is called, that makes available, 24
at a minimum, one meal a day and housekeeping services and provides 25
personal care services directly or through a formal written agreement with one 26
or more licensed home care or hospice agencies. The Department may allow 27
nursing service exceptions on a case-by-case basis. Settings in which services 28
are delivered may include self-contained apartment units or single or shared 29
room units with private or area baths. Assisted living residences are to be 30
distinguished from nursing homes subject to provisions of G.S. 131E-102. 31
There are three two types of assisted living residences: adult care homes, 32
homes and adult care homes that serve only elderly persons, and multiunit 33

General Assembly Of North Carolina Session 2025
Page 2 House Bill 813-First Edition
assisted housing with services. persons. As used in this section, "elderly 1
person" means: 2
a. Any person who has attained the age of 55 years or older and requires 3
assistance with activities of daily living, housing, and services, or 4
b. Any adult who has a primary diagnosis of Alzheimer's disease or other 5
form of dementia who requires assistance with activities of daily 6
living, housing, and services provided by a licensed Alzheimer's and 7
dementia care unit. 8
... 9
(10) Multiunit assisted housing with services. – An assisted living residence in 10
which hands-on personal care services and nursing services which are 11
arranged by housing management are provided by a licensed home care or 12
hospice agency through an individualized written care plan. The housing 13
management has a financial interest or financial affiliation or formal written 14
agreement which makes personal care services accessible and available 15
through at least one licensed home care or hospice agency. The resident has a 16
choice of any provider, and the housing management may not combine 17
charges for housing and personal care services. All residents, or their 18
compensatory agents, must be capable, through informed consent, of entering 19
into a contract and must not be in need of 24-hour supervision. Assistance 20
with self-administration of medications may be provided by appropriately 21
trained staff when delegated by a licensed nurse according to the home care 22
agency's established plan of care. Multiunit assisted housing with services 23
programs are required to register annually with the Division of Health Service 24
Regulation. Multiunit assisted housing with services programs are required to 25
provide a disclosure statement to the Division of Health Service Regulation. 26
The disclosure statement is required to be a part of the annual rental contract 27
that includes a description of the following requirements: 28
a. Emergency response system; 29
b. Charges for services offered; 30
c. Limitations of tenancy; 31
d. Limitations of services; 32
e. Resident responsibilities; 33
f. Financial/legal relationship between housing management and home 34
care or hospice agencies; 35
g. A listing of all home care or hospice agencies and other community 36
services in the area; 37
h. An appeals process; and 38
i. Procedures for required initial and annual resident screening and 39
referrals for services. 40
Continuing care retirem