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Adult Care Home Rule Waiver Alert and Reminders


The effects of Hurricane Florence have been devastating for many in North Carolina and have not yet subsided. It has impacted many of North Carolina’s most vulnerable citizens. To help facilitate the admission of new residents impacted by the recent hurricane, the North Carolina Division of Health Service Regulation, Adult Care Licensure Section (“ACLS”) just issued a waiver process for certain Adult Care Home (“ACH”) admission rules. The purpose of this waiver is to expedite the admission of new residents from emergency shelters and to help ensure a smooth and safe transition.

The Waiver Memorandum issued by the ACLS sets out the substantive and procedural requirements necessary for an ACH to request and obtain a waiver. These requirements include the resident documentation that the ACH must review, the physician’s orders the ACH must obtain, the information that must be included in the waiver request, and the manner to submit the waiver request. (Please review the Waiver Memorandum for the detailed process.) Approved waiver requests grant the ACH additional time, up to 30 days, to comply with certain admission rules regarding: the resident Tuberculosis test; the resident FL-2 requirement; and the resident PASRR requirement.

For ACHs that apply for and receive this waiver, there are several important points to remember:

  • The waiver applies only for the admission of new residents from Emergency Shelters.
  • The waiver is resident specific. You will need to request a waiver for each resident you are seeking to admit from an Emergency Shelter.
  • All other admission rules and requirements apply and remain in place.
  • Maintain a paper copy of the following in the resident record:
    • Your email waiver request; AND
    • The email approval from DHSR.
  • You must have a physician’s order confirming that the resident requires assisted living level of care prior to requesting the waiver. The approved waiver permits a 30 day extension to obtain a signed FL-2.
  • Even if DHSR approves your waiver request, you still must contact and notify NC Medicaid of a resident you are admitting under an approved waiver to ensure the PASRR extension.

This waiver will assist the admission of new residents from Emergency Shelters that have been impacted by Hurricane Florence. However, it is important that ACH’s are aware of the waiver requirements and process to help with a safe and orderly transition and to not encounter any issues with the admission and provision of care.

Iain Stauffer is a member of the Health Care team at Poyner Spruill. He can be reached at 919.783.2982 or by email at

Physical Address: 301 Fayetteville Street, Suite 1900, Raleigh, NC 27601 | © Poyner Spruill LLP. All rights reserved.

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