Rules For the Licensing of Nursing Homes
Pursuant to GS 150B-21.3A, Periodic Review and Expiration of Existing Rules, all rules are reviewed at least every 10 years, or they shall expire. As a result of the periodic review of Subchapters 10A NCAC 13D, Licensing of Nursing Homes, 64 rules determined as “Necessary,” requiring readoption. With input from advisory committees, working groups of the N.C. Medical Care Commission and stakeholders, there are 4 repeals, 10 amendments, and 50 readoptions. The Nursing Home Licensure and Certification Section’s goal is to have rules that are clear, meaningful, up-to-date, and consistent with federal long-term care regulations for providers who do and do not participate in Medicare and Medicaid. The aim is to create a regulatory environment that supports high standards of care while being adaptable to the evolving needs of the population
Notification of proposed readoption rules
- Proposed Effective Date: August 1, 2026
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Public Comment Period: December 15, 2025 – February 13, 2026
Comments may be submitted by:- Email: [email protected]
- Mail: Shanah Black, Division of Health Service Regulation, 2701 Mail Service Center, Raleigh, NC 27699-2701
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Public Hearing:
- Date: January 14, 2026
- Time: 10:00 a.m.
- Location: NC DHHS Headquarters, Conference Room 02210, 1915 Health Service Ways, Raleigh, NC 27607
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The fiscal note was approved by:
- OSBM on October 17, 2025
- N.C. Medical Care Commission
- Rule Fiscal Note
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Federal Certification required by GS 150B-19.1(g)
- Not applicable for these rules
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The notice of text as approved by the N.C. Medical Care Commission on November 7, 2025:
- 10A NCAC 13D .2001
- 10A NCAC 13D .2101
- 10A NCAC 13D .2102
- 10A NCAC 13D .2103
- 10A NCAC 13D .2104
- 10A NCAC 13D .2105
- 10A NCAC 13D .2106
- 10A NCAC 13D .2107
- 10A NCAC 13D .2108
- 10A NCAC 13D .2109
- 10A NCAC 13D .2201
- 10A NCAC 13D .2202
- 10A NCAC 13D .2203
- 10A NCAC 13D .2204
- 10A NCAC 13D .2205
- 10A NCAC 13D .2206
- 10A NCAC 13D .2207
- 10A NCAC 13D .2208
- 10A NCAC 13D .2209
- 10A NCAC 13D .2210
- 10A NCAC 13D .2211
- 10A NCAC 13D .2212
- 10A NCAC 13D .2301
- 10A NCAC 13D .2302
- 10A NCAC 13D .2303
- 10A NCAC 13D .2304
- 10A NCAC 13D .2305
- 10A NCAC 13D .2306
- 10A NCAC 13D .2307
- 10A NCAC 13D .2308
- 10A NCAC 13D .2309
- 10A NCAC 13D .2401
- 10A NCAC 13D .2402
- 10A NCAC 13D .2501
- 10A NCAC 13D .2502
- 10A NCAC 13D .2503
- 10A NCAC 13D .2504
- 10A NCAC 13D .2505
- 10A NCAC 13D .2601
- 10A NCAC 13D .2602
- 10A NCAC 13D .2603
- 10A NCAC 13D .2604
- 10A NCAC 13D .2605
- 10A NCAC 13D .2606
- 10A NCAC 13D .2607
- 10A NCAC 13D .2701
- 10A NCAC 13D .2801
- 10A NCAC 13D .2802
- 10A NCAC 13D .2901
- 10A NCAC 13D .2902
- 10A NCAC 13D .3003
- 10A NCAC 13D .3004
- 10A NCAC 13D .3005
- 10A NCAC 13D .3031
- 10A NCAC 13D .3101
- 10A NCAC 13D .3102
- 10A NCAC 13D .3103
- 10A NCAC 13D .3104
- 10A NCAC 13D .3201
- 10A NCAC 13D .3202
- 10A NCAC 13D .3401
- 10A NCAC 13D .3402
- 10A NCAC 13D .3403
- 10A NCAC 13D .3404
- Public Comments:
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These rules were approved by the Medical Care Commission on February 20, 2026, to go to the Rules Review Commission:
- 10A NCAC 13D .2001
- 10A NCAC 13D .2101
- 10A NCAC 13D .2102
- 10A NCAC 13D .2103
- 10A NCAC 13D .2104
- 10A NCAC 13D .2105
- 10A NCAC 13D .2106
- 10A NCAC 13D .2107
- 10A NCAC 13D .2108
- 10A NCAC 13D .2109
- 10A NCAC 13D .2201
- 10A NCAC 13D .2202
- 10A NCAC 13D .2203
- 10A NCAC 13D .2204
- 10A NCAC 13D .2205
- 10A NCAC 13D .2206
- 10A NCAC 13D .2207
- 10A NCAC 13D .2208
- 10A NCAC 13D .2209
- 10A NCAC 13D .2210
- 10A NCAC 13D .2211
- 10A NCAC 13D .2212
- 10A NCAC 13D .2301
- 10A NCAC 13D .2302
- 10A NCAC 13D .2303
- 10A NCAC 13D .2304
- 10A NCAC 13D .2305
- 10A NCAC 13D .2306
- 10A NCAC 13D .2307
- 10A NCAC 13D .2308
- 10A NCAC 13D .2309
- 10A NCAC 13D .2401
- 10A NCAC 13D .2402
- 10A NCAC 13D .2501
- 10A NCAC 13D .2502
- 10A NCAC 13D .2503
- 10A NCAC 13D .2504
- 10A NCAC 13D .2505
- 10A NCAC 13D .2601
- 10A NCAC 13D .2602
- 10A NCAC 13D .2603
- 10A NCAC 13D .2604
- 10A NCAC 13D .2605
- 10A NCAC 13D .2606
- 10A NCAC 13D .2607
- 10A NCAC 13D .2701
- 10A NCAC 13D .2801
- 10A NCAC 13D .2901
- 10A NCAC 13D .2902
- 10A NCAC 13D. 3003
- 10A NCAC 13D .3004
- 10A NCAC 13D .3005
- 10A NCAC 13D .3031
- 10A NCAC 13D .3101
- 10A NCAC 13D .3102
- 10A NCAC 13D .3202
- 10A NCAC 13D .3401
- 10A NCAC 13D .3402
- 10A NCAC 13D .3403
- 10A NCAC 13D .3404
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These are the final version of the rules approved by the Rules Review Commission on April 28, 2026:
- 10A NCAC 13D .2001
- 10A NCAC 13D .2101
- 10A NCAC 13D .2102
- 10A NCAC 13D .2103
- 10A NCAC 13D .2104
- 10A NCAC 13D .2105
- 10A NCAC 13D .2106
- 10A NCAC 13D .2107
- 10A NCAC 13D .2108
- 10A NCAC 13D .2109
- 10A NCAC 13D .2201
- 10A NCAC 13D .2202
- 10A NCAC 13D .2203
- 10A NCAC 13D .2204
- 10A NCAC 13D .2205
- 10A NCAC 13D .2206
- 10A NCAC 13D .2207
- 10A NCAC 13D .2208
- 10A NCAC 13D .2209
- 10A NCAC 13D .2210
- 10A NCAC 13D .2211
- 10A NCAC 13D .2212
- 10A NCAC 13D .2301
- 10A NCAC 13D .2302
- 10A NCAC 13D .2303
- 10A NCAC 13D .2304
- 10A NCAC 13D .2305
- 10A NCAC 13D .2306
- 10A NCAC 13D .2307
- 10A NCAC 13D .2308
- 10A NCAC 13D .2309
- 10A NCAC 13D .2401
- 10A NCAC 13D .2402
- 10A NCAC 13D .2501
- 10A NCAC 13D .2502
- 10A NCAC 13D .2503
- 10A NCAC 13D .2504
- 10A NCAC 13D .2505
- 10A NCAC 13D .2601
- 10A NCAC 13D .2602
- 10A NCAC 13D .2603
- 10A NCAC 13D .2604
- 10A NCAC 13D .2605
- 10A NCAC 13D .2606
- 10A NCAC 13D .2607
- 10A NCAC 13D .2701
- 10A NCAC 13D .2801
- 10A NCAC 13D .2901
- 10A NCAC 13D .2902
- 10A NCAC 13D. 3003
- 10A NCAC 13D .3004
- 10A NCAC 13D .3005
- 10A NCAC 13D .3031
- 10A NCAC 13D .3101
- 10A NCAC 13D .3102
- 10A NCAC 13D .3202
- 10A NCAC 13D .3401
- 10A NCAC 13D .3402
- 10A NCAC 13D .3403
- 10A NCAC 13D .3404
- Procedure for subjecting a proposed rule to Legislative Review: If an objection is not resolved prior to the adoption of the rule, a person may also submit written objections to the Rules Review Commission. If the Rules Review Commission receives written and signed objections in accordance with G.S. 150B-21.3(b2) from 10 or more persons clearly requesting review by the legislature and the Rules Review Commission approves the rule, the rule will become effective as provided in G.S. 150B-21.3(b1) . The Commission will receive written objections until 5:00 p.m. on the day following the day the Commission approves the rule. The Commission will receive those objections by mail, delivery service, hand delivery, or facsimile transmission.