Greensboro Senior AdvisorWhat is a family care home in North Carolina?
A family care home is a licensed assisted living residence for two to six adults, usually in a house, regulated under 10A NCAC 13G; an adult care home serves seven or more under 13F, and both are licensed and rated by DHSR.
DHSR's October 2026 listings show 35 adult care homes (2,625 beds) and 29 family care homes (171 beds) in Guilford, Randolph and Rockingham counties; 22 of the adult care homes are in Guilford County, while Rockingham County holds 18 of the family care homes. The small homes look like ordinary houses, often in residential neighborhoods, and many are run by an owner who lives nearby or works shifts in the home.
Who does well in a family care home?
Residents who want a quiet, household-sized setting with the same few caregivers, who need help with daily care but not a dementia unit, and who do not depend on the activities, dining choices and amenities of a larger building.
Families often like that staff know every resident well. The trade-offs are fewer activities, less privacy in some houses, and more dependence on a small number of people; if one caregiver leaves, the whole home feels it. Ask how the home covers staff vacations and sick days.
How do the ratings and inspections compare?
Both are rated on DHSR's zero-to-four star scale and inspected under the same system, so a family care home's stars and inspection documents can be read exactly like a large home's.
Of the 63 rated homes in the three counties, 27 hold four stars, 31 three, 3 two, 0 one and 2 none. Because a small home has few residents, a single citation can move its score noticeably, so read the documents rather than relying on the number alone. Every family care home in the three counties has its own page in our directory with that history.
Do family care homes cost less?
Often, but not always: there is no published median for either size, and the price depends on the room, the care needed and the home's acceptance of Special Assistance, which pays the same Basic Rate in either type.
Many family care homes in Rockingham and Guilford counties serve residents on Special Assistance, which caps what the home receives at $1,397 a month in 2026 plus the resident's $70 allowance. For private payers, ask for written rates and what they include.
What should we check before choosing a family care home?
The DHSR license and expiration, the star rating and recent inspections, who lives in the home now and whether their needs resemble your parent's, the night staffing arrangement, and the plan if your parent's needs increase.
Some family care homes serve mainly younger adults with mental illness or disabilities, others mainly older adults; the license does not distinguish, so ask. Visit at mealtime and in the evening, and ask how medications are handled when the owner is away.
Side by side
| A family care home (2-6 beds) | An adult care home (7+ beds) | |
|---|---|---|
| Rules | 10A NCAC 13G | 10A NCAC 13F |
| Setting | A house with a handful of residents | A larger building, often with apartments |
| Dementia units | Not offered as special care units on this list | Special care units possible |
| Ratings | DHSR zero-to-four stars | DHSR zero-to-four stars |
Drawn from G.S. Chapter 131D, 10A NCAC 13F and 13G, DHSR and NCDHHS publications, NC Medicaid, CareScout, CMS, the VA and the Piedmont Triad aging agency cited in the text; our editorial standards explain how we check them.
