North Carolina · Template guide · Updated October 20, 2026

North Carolina Home Care Policy and Procedure Manual Template: How to Fill It In

What an NC template should already contain under 10A NCAC 13J, the choices you make in the brackets, and how to get it ready before you apply.

Short answer: A North Carolina home care policy and procedure manual template should already contain the eleven written policies 13J .1001(a) requires, 90-day supervision and plan-of-care review, the 5-year record rule, Health Care Personnel Registry and criminal checks, and the 2023 home assistance services rules. What you fill in is your director and supervisors, your service area, your on-call setup and your agency’s own standards.

What our North Carolina template fills in for you

Already written in	NC rule or statute
All eleven policy topics .1001(a) requires	13J .1001(a)
Director qualifications, order of authority, 5-working-day vacancy notice	13J .1001(b)–(e)
30 days’ notice to DHSR before expanding the service area	13J .1001(g)
TB testing, infection control and the nine personnel record items	13J .1003
Registry check before hire; criminal check within 5 business days of a conditional offer	G.S. 131E-256; 131E-265
Aide supervision every 90 days; companion contact every 3 months and visits every 6 months	13J .1110; .1501–.1504
Plan of care reviewed every 90 days	13J .1202
Records kept 5 years from discharge, minors to 21; storage notice on closing	13J .1401
Home assistance services provider duties	G.S. 131E-138(h)–(i)

The choices you fill in

Bracket in the template	What to decide	NC note
[AGENCY NAME], license number	Your name and DHSR license	Every page and form
Director and supervisor names	Who runs the agency and supervises each service	13J .1001 requires a supervisor for each service type
Service area [LIST]	Counties for each service	In-home aide services: your county, contiguous counties or 90 minutes’ drive, whichever is greater (.1107)
On-call phone and hours	How clients and staff reach you after hours	Clients’ rights include being told about on-call service (G.S. 131E-144.3)
Visit cancellation [24] hours; payment within [__] days	Client-facing terms	Clients get a written account of services and charges (G.S. 131E-144.3)
Complaint and incident records [at least 6 years]	Retention for complaint files	Longer than the 5-year client record minimum; your choice
Discharge summary within [7] days	How fast you close out a discharge	13J sets no discharge-notice period in the rules we reviewed
Companion-only sections	Which path applies	Confirm with DHSR how S.L. 2023-150 applies to your license

Check these before you adopt it

How DHSR is applying S.L. 2023-150 to companion, sitter and respite-only providers, including where the annual attestation goes
Rules 13J .1002, .1004, .1101 and .1111, which are mapped in the crosswalk but marked VERIFY
The deadline for first notifying DHSR of an allegation against staff under G.S. 131E-256(g)
The current Initial Home Care Survey Checklist on DHSR’s site

Adopt it before you apply

Finish every bracket and delete services you don’t offer.
Compare it line by line with DHSR’s Initial Home Care Survey Checklist.
Have it reviewed, then have your governing body sign the adoption page.
Set up personnel files that follow the manual’s own hiring procedure. DHSR asks for personnel documents together with your policies.

Next: how DHSR reviews your manual at the initial survey, or the rule-by-rule list in North Carolina home care agency policies and procedures.

Template ready to fill in

North Carolina Home Care Policy Manual

The editable Word template described on this page: 108 pages, 15 sections, 17 forms and a 13J crosswalk. $79, instant download.

Get the NC template

FAQ

Is there a DHSR-approved NC template?

We didn’t find any process for DHSR to approve a template. DHSR reviews your agency’s own policies, procedures and personnel documents at the initial survey.

Does the template cover companion-only agencies?

Yes. It includes the 13J companion, sitter and respite rules and flags the 2023 home assistance services duties, so you can apply whichever fits your license.

Is it editable?

Yes. You get an editable Word document plus a PDF, and it also opens in Google Docs.

What should I compare the template against?

DHSR’s Initial Home Care Survey Checklist and 10A NCAC 13J. The template’s crosswalk maps each rule to a policy.

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.