Understanding family care homes
What is a familycare home?
Most people have never heard the term until the week they need one. Here’s the plain answer.
- Two to six adults
- Licensed and inspected by the State of North Carolina
- A house, not an institution
The plain answer
The short version
A family care home is a licensed home where two to six adults live and get help with daily life around the clock. It’s a house — usually an ordinary house on an ordinary residential street. It’s licensed and inspected by the State of North Carolina.
It is not a nursing home, not a hospital, and not an institution.
The law
It’s legally a house
North Carolina doesn’t classify a family care home as an institution. State law treats it as a residential use of property — which means it belongs in a residential neighborhood.
What the state actually pays
That’s the whole idea.
A family community — the kind you only find in a smaller home.
- Older adults who need supervision but not skilled nursing care
- Adults living with serious mental illness — often people leaving a hospital with nowhere to go
- Adults with intellectual and developmental disabilities
- Adults living with a brain injury
- All ages with disabilities considered for staying in our homes
A family care home isn’t a home for old people.
It’s a home for people who need one.
Six people, not ninety
Ordinary weeks, in an ordinary house.
Being honest
Who can’t
Being honest about this matters as much as anything else on this page. A family care home can’t take someone who needs continuous licensed nursing care, or who is ventilator-dependent, or whose doctor says this isn’t the right setting for them.
If that’s your situation, we’d rather tell you on the phone than after you’ve driven out here.
Oversight
How it’s licensed and watched
- Licensed by the North Carolina Division of Health Service Regulation
- Monitored by the county department of social services at least four times a year
- Surveyed annually by the state
- Inspected by the fire marshal and the health department
Our license numbers are listed on each home’s page.
Our homesMoney
What it costs, and who pays
Two separate things get paid for, by two different programs. It confuses almost everybody, so here it is plainly.
Room and board — the room, the meals, the utilities, keeping the house running — is covered for eligible residents by State-County Special Assistance. In 2026 that rate is $1,397 a month. The resident puts most of their own income toward it and keeps $70 a month for themselves.
If someone doesn’t qualify for Special Assistance, private pay is $3,500–$5,600 a month. In many times its hard to get these hours.
The numbers are public. Almost nobody knows them.
What North Carolina pays for a person to have a home.
In 2026, Special Assistance pays a maximum of $1,397 a month for an eligible resident’s room and board. That covers the room, the utilities, three meals and snacks, the laundry, and a house with staff awake in it around the clock.
A budget motel room costs more than that. It doesn’t come with dinner.
SA rate from the NC DHHS Special Assistance Manual, January 2026. Assisted living and nursing home medians from 2025 CareScout survey data.
The wider picture
Three numbers behind that rate.
The Special Assistance rate is not a market price. It is a decision, and it has a history.
The Special Assistance rate did not increase once between 2008 and 2022 — not through the financial crisis, not through a decade of rising food and labor costs.
What the state’s own 2024 cost analysis concluded the monthly rate should be. It is $1,397 today — a gap of nearly four hundred dollars per resident, per month.
Licensed family care homes left in North Carolina. Every one is privately owned. The state licenses them and pays them. It does not run them.
- Age 65 or older, or 18–64 with a Social Security disability determination
- Countable income at or under about $1,467 a month (2026)
- Countable assets under about $2,000
- A doctor completes a form — an FL-2 — confirming they need this level of care
- Living in a licensed home approved to receive Special Assistance. Ours are.
The application goes through the county department of social services. We’ll walk you through all of it.
Nobody should have to figure this out alone at the worst week of their life.
Side by side
How it compares
| Measure | Family care home | Assisted living | Nursing home |
|---|---|---|---|
| How many people | 2–6 | Often 40–150 | Often 100+ |
| What it is | A house on a street | A building | A medical facility |
| Level of care | Personal care & 24-hr supervision | Personal care & 24-hr supervision | Skilled nursing |
| Typical NC cost | $1,397/mo if SA-eligible | ≈$6,496/mo private pay | ≈$9,733/mo semi-private |
Still not sure
The fastest way to understand one is to stand in one.
Call to schedule a visit. Walk through the whole house, meet whoever is on shift, and ask us anything you want.