Dec192025
Guardianship Q&A Series

What are my rights to receive rehab or therapy in a facility if I’m not getting it and my health is declining? – North Carolina

Short Answer

In North Carolina, when a court has appointed a guardian, the guardian of the person has a duty to arrange appropriate care, which can include rehabilitation services, based on the ward’s needs and the court’s order. If rehab or therapy is not happening and health is declining, the situation can be raised quickly with the guardian and, if needed, with the Clerk of Superior Court overseeing the guardianship. Depending on the facts, it may also be possible to ask the court to review the guardianship, limit the guardian’s powers, or seek restoration to competency.

Understanding the Problem

In North Carolina, when a person is placed in a residential care facility after a medical event and a court later appoints a guardian, the question often becomes: can the person require that rehab or therapy be provided when the facility is not providing it and health is getting worse? This question focuses on what duties a guardian has about arranging care (including rehab) and what options exist to prompt action when the current plan is not meeting the person’s needs. Timing matters because declining mobility and missed services can make returning home harder as weeks pass.

Apply the Law

North Carolina guardianship law separates decision-making into roles. A “guardian of the person” generally handles placement and care decisions, including coordinating medical care and services. The Clerk of Superior Court supervises the guardianship case and can resolve disputes about what the guardian should do, and the ward can ask the court to review or change things. If the ward’s capacity has improved (or was incorrectly found lacking), North Carolina law also provides a process to ask the clerk to restore competency.

Key Requirements

  • Guardian authority over care decisions: A guardian of the person typically has the power to consent to treatment and the duty to make reasonable arrangements for care and rehabilitation, consistent with the court order.
  • Appropriateness and need: Rehab or therapy usually turns on medical need and what treating providers order or recommend; the guardian’s job is to arrange services appropriate to the ward’s needs, not to ignore a declining condition.
  • Court oversight and review: The ward or another interested person can bring issues back to the Clerk of Superior Court, including asking for restoration to competency when facts support it.

What the Statutes Say

Analysis

Apply the Rule to the Facts: The facts describe a court-appointed guardian after a missed hearing and placement in a residential care facility where rehab has not been provided and mobility is declining. Under North Carolina law, if the appointed guardian is the guardian of the person (or a general guardian), that guardian has a legal duty to make reasonable arrangements for care and, when appropriate, rehabilitation services. When the current plan is not meeting those needs, the guardianship court (through the Clerk of Superior Court) is the main forum to ask for review, changes to the guardian’s authority, or restoration to competency if capacity exists.

Process & Timing

  1. Who files: The ward (through counsel), the guardian, or another interested person. Where: The Office of the Clerk of Superior Court that has the guardianship file in North Carolina. What: A written motion in the guardianship “cause” (often paired with a request for an expedited hearing) asking the clerk to address the lack of rehab/therapy and/or to modify the guardianship arrangement; if seeking restoration, a verified motion for restoration to competency. When: As soon as the decline and lack of services are documented; for restoration motions, the hearing is generally set not less than 10 days and not more than 30 days after service unless the clerk orders otherwise.
  2. Support the request: Gather recent provider notes, discharge summaries, therapy evaluations (or lack of referrals), and a clear plan describing what services are needed (for example, PT/OT frequency) and what outcome is being sought (such as improving mobility to return home). If the issue is also placement-related, include why a different setting would better support rehab.
  3. Hearing and order: The clerk can hear evidence about needs and services and enter an order within the clerk’s authority in the guardianship case. If restoration to competency is granted, the ward regains the right to manage personal and property decisions and the guardianship ends after required wrap-up steps.

Exceptions & Pitfalls

  • Type of guardian matters: A guardian of the estate controls finances, not care decisions; a guardian of the person (or general guardian) typically drives rehab/therapy arrangements. Misidentifying the guardian’s role can slow relief.
  • Facility vs. guardian responsibility: A facility may only provide therapy if ordered and scheduled through appropriate providers and payer rules; the legal pressure point in a guardianship case is often whether the guardian is arranging appropriate services and advocating for them.
  • Documentation gaps: Without written medical recommendations, it becomes harder to show the rehab request is “appropriate to the ward’s needs.” Asking the treating physician to document therapy needs and safety goals can be critical.
  • Notice and service errors: Motions in guardianship matters require proper service and notice; mistakes can delay an urgent hearing.
  • Property fears do not automatically change care rights: Concerns about a paid-off home and belongings may require separate court oversight (and sometimes a different guardian role). Mixing those issues into an emergency rehab request without a clear plan can dilute the message.

Conclusion

In North Carolina, when a guardian has been appointed, the guardian of the person has a duty to arrange appropriate care and, when appropriate, rehabilitation services, consistent with the court’s order. If rehab or therapy is not being provided and health is declining, the dispute can be brought to the Clerk of Superior Court supervising the guardianship. A clear next step is to file a motion in the guardianship case with the Clerk of Superior Court requesting court review and an expedited hearing, and if restoration is sought, file the verified restoration motion and serve it so a hearing can be set within 10 to 30 days.

Talk to a Guardianship Attorney

If a court-appointed guardian and a facility are not arranging needed rehab or therapy and health is declining, an attorney can help identify the right guardian role, assemble medical documentation, and present an urgent request to the Clerk of Superior Court. Call us today at (919) 341-7055.

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.

Category: Guardianship Q&A Series

Author: jpierce

Attorney Jared Pierce is the founder of Pierce Law Group in Raleigh, North Carolina, a firm he established with a dedicated focus on probate administration and estate planning across North Carolina. Born and raised in the Republic of South Africa, Jared moved to Durham with his family in 2001, bringing with him a rich cultural background and a distinctive accent that often serves as a conversation starter.