Jan22026
Guardianship Q&A Series

Once guardianship is granted, what ongoing duties, reporting, and accounting are required, and to what extent can guardians make medical decisions and manage finances? – North Carolina

Short Answer

In North Carolina, once a guardian is appointed, the guardian must follow the clerk of superior court’s orders and keep the ward’s personal care and finances properly managed and documented. A guardian of the person can generally consent to medical and other professional care for the ward, while a guardian of the estate (or general guardian) must take control of the ward’s assets, use prudent financial judgment, and file required inventories and annual accounts with the clerk. Missing required reports or accounts can lead to court orders, removal, or contempt proceedings.

Understanding the Problem

In North Carolina adult guardianship, the key question is what happens after the clerk of superior court appoints a guardian: what ongoing duties continue each year, what reports and accountings must be filed, and what authority the guardian has to make medical decisions and manage money. This issue often comes up when parents have long handled an adult child’s care informally, but hospitals, banks, and other institutions require clear legal authority. The answer depends on the type of guardianship appointed (guardian of the person, guardian of the estate, or general guardian) and the terms of the clerk’s order.

Apply the Law

North Carolina guardianship is supervised by the clerk of superior court. After appointment, a guardian’s authority and responsibilities come from (1) the clerk’s order and (2) the statutes that define the guardian’s powers, duties, and reporting obligations. In general, a guardian of the person handles personal and medical decisions; a guardian of the estate handles property and money; and a general guardian handles both. Ongoing reporting and accounting are not optional—guardianship is a court-supervised fiduciary role, and the clerk can require proof of how decisions and funds are handled.

Key Requirements

  • Follow the appointment order and court supervision: The guardian must obey lawful orders from the clerk of superior court and operate within the limits of the guardianship granted.
  • Medical and personal decision-making authority (guardian of the person): The guardian generally may arrange care and living arrangements and may consent to medical and other professional services for the ward, subject to statutory limits and any existing health care agent’s authority unless suspended by the clerk.
  • Financial management and recordkeeping (guardian of the estate/general guardian): The guardian must take possession of the ward’s assets, manage them with prudent care, pay required taxes from the ward’s funds as required by law, keep documentation of receipts and payments, and file inventories/accounts with the clerk on the required schedule.

What the Statutes Say

Analysis

Apply the Rule to the Facts: The parents’ goal is ongoing authority to communicate with providers, consent to treatment during emergencies, and manage finances for an adult child with lifelong disabilities. Under North Carolina law, that typically means seeking appointment as guardian of the person for medical and care decisions and guardian of the estate (or a general guardian) for money and property decisions. Once appointed, the guardians must follow the clerk’s order, keep records, and complete required reporting—especially annual inventories and accounts if any assets are under the guardian’s control.

Process & Timing

  1. Who files: The appointed guardian. Where: Office of the Clerk of Superior Court in the county where the guardianship is administered in North Carolina. What: Required reports and accountings (often on local forms or formats required by the clerk). When: For a guardian of the estate or general guardian, an annual inventory and account is due within 30 days after the close of the fiscal year selected by the guardian, and annually thereafter, for as long as any estate remains under the guardian’s control.
  2. Ongoing supervision: The clerk reviews and audits filed accounts and can require supporting proof for payments. If a required status report is missing or unsatisfactory, the clerk can order a corrected report to be filed within 20 days after service of the order.
  3. Enforcement: If reporting or accounting does not happen after the clerk’s order, the clerk can remove the guardian and may pursue contempt proceedings, depending on the circumstances.

Exceptions & Pitfalls

  • Mixing funds or informal recordkeeping: A guardian of the estate must be able to show, with documentation, what came in and what went out. Missing receipts, unclear spending categories, or combining the ward’s money with someone else’s money can create serious problems in the clerk’s audit.
  • Assuming “medical guardianship” automatically covers finances (or vice versa): A guardian of the person generally handles medical and care decisions, but that does not automatically grant authority to access or manage bank accounts, benefits funds, or other property unless the guardian is also appointed over the estate (or as a general guardian).
  • Overlooking limits on medical authority: Even when a guardian can consent to treatment, certain actions can require additional court involvement. Also, if the ward has a valid health care power of attorney, the health care agent’s authority generally controls unless the clerk suspends it.
  • Missing deadlines after a clerk’s order: If the clerk orders a status report to be corrected or completed, the statute sets a short turnaround (20 days after service). Noncompliance can lead to removal or contempt proceedings.

Conclusion

In North Carolina, after guardianship is granted, the guardian must follow the clerk of superior court’s order and continue meeting court-supervised duties. A guardian of the person can generally consent to medical and other professional care and arrange living and support services, while a guardian of the estate (or general guardian) must take control of assets, manage them prudently, keep proof of transactions, and file an annual inventory and account. The key ongoing deadline is filing the annual account within 30 days after the guardianship fiscal year ends.

Talk to a Guardianship Attorney

If a family needs court authority to make medical decisions, access information during emergencies, and manage an adult child’s finances under North Carolina guardianship rules, an attorney can help clarify the type of guardianship needed and the ongoing reporting and accounting requirements. Call 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.