North Carolina · 10A NCAC 13J · Updated October 20, 2026

North Carolina Home Care Agency Policies and Procedures

The eleven written policies 13J .1001(a) requires, what the rest of 13J and G.S. Chapter 131E add, and how the 2023 law changes things for companion-only agencies.

Short answer: 10A NCAC 13J .1001(a) requires every licensed North Carolina home care agency to have written policies, available to DHSR, on eleven specific topics. The rest of 13J and G.S. Chapter 131E add requirements those policies must carry out: personnel and TB screening, registry and criminal checks, aide competency, client rights, plans of care, supervision every 90 days and 5-year record retention.

The eleven policies 13J .1001(a) requires

Scope of services
Admission and discharge
Personnel supervision
Plan of care development and updates
Emergency care of clients in the home
Time frame for returning service records to the office
Personnel qualifications
Organizational chart
Program evaluation
Employee and client confidentiality
Referrals to and from community agencies

The governing body, or its designee, establishes and carries out these policies. A surveyor can ask for any of them.

What the rest of 13J adds to your policies and procedures

Agency director 13J .1001(b)–(e)

A qualified director with written responsibilities, a written order of authority when the director is away, and notice to DHSR within 5 working days if the job is vacant.

In our manual: Policies 1.01 and 1.02

Geographic service area 13J .1001(g) · .1107

A written policy naming the area you serve for each service, and 30 days’ written notice to DHSR before expanding. In-home aide services stay within your county, contiguous counties or 90 minutes’ driving time, whichever is greater.

In our manual: Policy 1.03

Personnel and infection control 13J .1003

Infection control policies, baseline TB testing for hands-on staff, in-service policies, job descriptions, and personnel records with the nine listed items, kept 1 year after termination.

In our manual: Policies 5.02 to 5.09, 5.13, 7.01 and 7.04

Registry and criminal checks G.S. 131E-256 · 131E-265

A Health Care Personnel Registry check before hire, and a criminal history check requested within 5 business days of a conditional offer, with a national fingerprint check for applicants with less than 5 years of NC residence.

In our manual: Policy 5.03 and Form F-17

Aide competency 13J .1003(g) · .1107

RN verification of the six required skills for aides not on the Nurse Aide Registry, and registry listing for extensive assistance.

In our manual: Policies 5.07 and 5.09

Client rights 13J .1007 · G.S. 131E-144.3, -144.4

Written notice of clients’ rights before care or at the initial evaluation, with a signed receipt.

In our manual: Policies 2.01 and 2.02

In-home aide services and plan of care 13J .1107 · .1202

A practitioner’s home assessment before the plan, a signed plan with a copy in the home, permitted aide duties, and review of the plan every 90 days.

In our manual: Policies 4.01, 4.02 and 4.06

Supervision 13J .1110 · .1501–.1504

In-home aides: a home visit every 90 days and annual supervision while giving care. Companion, sitter and respite: contact every 3 months, a home visit every 6 months and annual supervision.

In our manual: Policy 4.04 and Form F-08

Service records 13J .1401

Confidential, secure records on the licensed premises, kept 5 years from discharge (minors to age 21), with written notice to DHSR of storage if you close.

In our manual: Policies 14.01 to 14.03

Reporting G.S. 131E-256(g) · 108A-102

Notify DHSR of allegations against staff, investigate, protect the client and report results within 5 working days. Report a disabled adult who needs protective services to the county DSS.

In our manual: Policies 9.02 and 9.03

Companion-only agencies after the 2023 law

Session Law 2023-150 made companion, sitter, respite and homemaker services a separate category, “home assistance services”, which are not home care services (G.S. 131E-136). These providers still need a license. G.S. 131E-138(h)–(i) adds its own duties: liability insurance, telling clients you don’t provide hands-on care, 7-year multistate background checks, driver records, a yearly compliance attestation and no billing of health insurers. Confirm with DHSR which 13J rules still apply to you.

What 13J doesn’t set

In the rules we reviewed, 13J has no separate emergency-preparedness plan requirement beyond the policy on emergency care in the home, no client discharge-notice period and no annual training-hour minimum. Write agency standards for each anyway.

Applying for a license? See how DHSR reviews your home care policy and procedure manual. Filling in a ready-made manual? See how to fill in a North Carolina home care policy and procedure manual template.

Skip the blank page

North Carolina Home Care Policy Manual

All eleven .1001(a) policies plus the rest of 13J, already written: 108 pages, 17 forms and a 13J crosswalk. Editable Word plus PDF, $79.

See the NC manual

FAQ

Does North Carolina require a written policies and procedures manual?

Yes. 13J .1001(a) requires written policies on eleven topics, available to DHSR, and DHSR’s initial survey is a review of your policies, procedures and personnel documents.

How often are supervisory visits required?

For in-home aides, a home visit every 90 days (13J .1110). For companion, sitter and respite services, contact every 3 months and a home visit every 6 months (.1501–.1504).

How long do I keep client records?

At least 5 years from discharge, and minors’ records until age 21 (13J .1401).

Does the 2023 law change my policies?

If you provide only companion, sitter, respite or homemaker services, you may now be a home assistance services provider with different duties under G.S. 131E-138(h)–(i). Confirm your category with DHSR.

Sources

This page summarizes North Carolina rules, statutes and DHSR guidance as reviewed on October 19–20, 2026 and is not legal advice. Confirm current requirements with the NC Division of Health Service Regulation.