Frequently Asked Questions

A Continuing Care Retirement Community (CCRC) is a residential community that offers independent living and provides access to assisted living, nursing care, or other health-related services under a continuing care contract. CCRCs operating in North Carolina are regulated under Article 64A of Chapter 58 of the North Carolina General Statutes.

Continuing Care at Home is a program that allows an individual to receive certain long-term care benefits while remaining in their private residence. These programs require a separate license and are subject to specific statutory and regulatory requirements

The North Carolina Department of Insurance regulates CCRCs and Continuing Care at Home programs, including:

• Licensing and approvals
• Disclosure Statements and public filings
• Financial solvency and reserve requirements
• Certain governance and resident-protection provisions

The Department does not regulate daily operations, medical decision-making, healthcare or resolve private contractual disputes.

The new law, Article 64A of Chapter 58 of the North Carolina General Statutes, became effective December 1, 2025.

North Carolina’s prior CCRC statutes had remained largely unchanged for decades while the industry evolved significantly. Article 64A modernizes the regulatory framework by strengthening financial safeguards, improving transparency, enhancing enforcement authority, and clarifying licensing and governance requirements.

Key changes include:

• A structured, multi-stage licensing process
• Expanded Disclosure Statement content and public posting requirements
• Updated operating reserve standards
• New provisions governing expansions and Continuing Care at Home programs
• Enhanced governance and resident-engagement requirements
• Increased reporting, filing, and electronic submission requirements

Yes. A continuing care provider must obtain appropriate licensure before operating in North Carolina. The licensing process depends on the provider’s stage of development and operations.

Before marketing and collecting deposits, a provider must obtain a Permit to Accept Deposits from the Department.

Depending on circumstances, licensure may include:

• Permit to Accept Deposits
• Start-Up Certificate
• Preliminary Certificate
• Permanent or Restricted Permanent License

Each stage has specific statutory requirements

An expansion generally involves an increase in the number of independent living units at an existing CCRC. Expansions meeting statutory thresholds require prior notification to and approval from the Commissioner and written notice to residents.

A Disclosure Statement is a required regulatory document that provides information about a provider’s organization, governance, financial condition, contractual terms, and resident protections. It is not a marketing document.

Disclosure Statements must be provided to prospective residents before execution of a continuing care contract and must also be made available to existing residents.

Yes. Disclosure Statements are posted on the Department’s website.

Providers are required to file audited financial statements and other financial information as specified by statute, including prospective financial information and actuarial opinions, when applicable.

An actuarial study evaluates whether a provider’s anticipated revenues are sufficient to meet its long-term contractual obligations. Actuarial studies must be prepared and submitted in accordance with statutory requirements and applicable actuarial standards.

Article 64A includes governance-related requirements designed to promote transparency, oversight, and resident engagement, including board-level obligations and reporting requirements.

Yes. Providers are required to hold meetings with residents at least semiannually. Certain meetings must include participation by an independent board member, as required by statute.

Article 64A does not create a single document titled “Residents’ Bill of Rights,” but it does enumerate specific resident rights, including rights related to self-organization, resident councils, access to information, and engagement with provider governance.

An operating reserve is a minimum amount of funds that a provider must maintain to help ensure the ability to meet ongoing obligations and protect residents.

The required operating reserve depends on a provider’s occupancy level. Once a provider achieves sustained high occupancy, the minimum reserve equals a percentage of total operating costs, as specified by statute.

If the Department determines that a provider is in a hazardous condition, the Commissioner may take action under state law to protect residents, which may include increased monitoring, corrective measures, restrictions, supervision, or receivership.

A Binding Reservation Agreement is an agreement entered into before execution of a continuing care contract. Such agreements are regulated and must meet statutory requirements regarding disclosures, limitations, and refundability.

Entrance fee refunds are governed by the terms of the continuing care contract and applicable statutory provisions. The Department does not determine individual refund outcomes but may review refund practices for compliance with the law.

The Department reviews contracts for statutory compliance but does not negotiate or approve individual contract terms on behalf of residents.

Complaints must be submitted through the Department’s formal consumer assistance and complaint process using the online complaint form.

Complaints are reviewed to determine whether they raise issues within the Department’s regulatory authority. The Department may request additional information as part of its review.

No. The Department cannot provide legal advice or intervene in private contractual disputes. Filing a complaint does not guarantee enforcement action or a specific outcome.

Most regulatory questions should be directed to the Department’s general CCRC inbox, which is monitored by the Financial Oversight and Special Entities Division and used to route inquiries internally.

If you are raising concerns about a specific provider’s compliance or conduct, you should use the formal complaint process rather than a general inquiry email.

The Continuing Care Advisory Committee is a statutorily established advisory body that provides input to the Department on matters related to continuing care regulation.

Yes. Information regarding meeting schedules, materials, and public attendance is posted by the Department.

Public records requests must be submitted through the Department’s public records request process.

No. The Department cannot provide legal advice. Individuals with legal questions should consult private counsel.