Jan182026
Guardianship Q&A Series

Can a care facility refuse to share medical updates with me just because there is a guardian appointed? – North Carolina

Short Answer

Often, yes. In North Carolina, once an adult is under guardianship, the person with legal authority to make (and receive information about) medical decisions is usually the guardian of the person (or a general guardian), unless a valid health care power of attorney is in place and still controls. A care facility may limit medical updates to the legally authorized decision-maker and anyone the ward (or the authorized decision-maker) has approved in writing.

Understanding the Problem

In North Carolina guardianship cases, can a care facility share medical updates with a family member when a court has already appointed a guardian? If a public agency is acting as guardian for finances and another guardian is involved for estate-related matters, can a family member still be recognized to receive medical information or take the adult out for short visits? The decision point is whether the family member has legal authority (or written permission from the right person) to receive medical information and participate in medical and placement decisions.

Apply the Law

Under North Carolina law, medical information is generally confidential and is typically released only to the patient or someone with legal authority to act for the patient. In an adult guardianship, the guardian of the person (or a general guardian) usually has authority over the ward’s care and can consent to medical treatment and related decisions, subject to any limits in the clerk’s order. If a valid health care power of attorney exists, the health care agent may keep that authority unless the clerk suspends it.

Key Requirements

  • Who has decision-making authority: The facility will usually look to the guardian of the person (or general guardian) for medical decisions and communications, not to family members without legal authority.
  • What the court order says: The guardianship letters/order may limit or define what the guardian can do and who can receive information.
  • Proper written authorization: If the ward can sign a valid release, or if the legally authorized decision-maker signs a HIPAA-compliant release, the facility can usually share updates within the scope of that authorization.

What the Statutes Say

Analysis

Apply the Rule to the Facts: Here, the adult is under guardianship and a care facility is deferring to “guardianship restrictions.” If the family member is not currently appointed as guardian of the person (and does not have a written authorization signed by the ward or the legally authorized decision-maker), the facility will often refuse to provide medical updates because it risks violating confidentiality rules. If the existing guardianship structure does not include a guardian of the person with authority over medical decisions, the facility may still require proof of who has that authority before sharing information or approving outings.

Process & Timing

  1. Who files: An interested person (often a family member) may file to be appointed guardian of the person, or to modify the existing guardianship to clarify authority. Where: The Clerk of Superior Court (Estates/Guardianship) in the county where the guardianship is pending in North Carolina. What: A motion/petition in the guardianship file requesting appointment, substitution, or modification, along with proposed orders and supporting information. When: As soon as access to medical information or placement/visitation decisions becomes urgent; timing depends on the clerk’s calendar and local practice.
  2. Interim step: If the immediate goal is medical updates (not a full change in guardianship), the legally authorized decision-maker can often sign a written release allowing the facility to speak with specific family members. Facilities commonly require their own release form or a HIPAA-compliant authorization.
  3. Resolution: The clerk may enter an order clarifying who has authority over medical and placement decisions and may appoint a guardian of the person if appropriate. The facility typically relies on the letters/order and the signed releases going forward.

Exceptions & Pitfalls

  • Existing health care power of attorney: If the ward signed a valid health care power of attorney before being found incompetent, the health care agent may still control medical decisions and access to information unless the clerk suspends that authority. Confusion between “guardian” and “health care agent” is a common reason facilities refuse to talk.
  • Guardianship type mismatch: A guardian of the estate (finances) generally is not the same as a guardian of the person (care/medical). If the facility only sees paperwork about finances, it may refuse to share medical updates until it sees documentation for the person/medical decision-maker.
  • No written release on file: Even when a guardian is willing to share information, facilities often require a signed authorization naming the family member and describing what can be disclosed. Verbal permission is commonly not enough for staff to feel comfortable.
  • Outings and short visits: Taking the ward out for visits can be treated as a placement/safety decision. Facilities often require approval from the guardian of the person (or a court order) and may require a written plan to address supervision, medications, and return time.

Conclusion

In North Carolina, a care facility can often refuse to share medical updates with a family member when a guardian has been appointed, because the facility generally must communicate with the person who has legal authority to make and receive medical decisions (usually the guardian of the person or a valid health care agent). The most practical next step is to file a motion or petition with the Clerk of Superior Court in the existing guardianship case to appoint or substitute a guardian of the person (or to clarify authority) and then provide the facility with the updated letters/order and a written release.

Talk to a Guardianship Attorney

If a care facility is refusing to share medical updates because a guardian is appointed, our firm has experienced attorneys who can help clarify who has legal authority, request the right court order, and put proper releases in place so communication can move forward. 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: Pierce Law

Pierce Law Group is a North Carolina law firm focused on probate administration, real estate partition matters, and surplus funds claims across North Carolina. We know these situations often come with stress, family dynamics, and time-sensitive decisions—so we prioritize clear communication, steady guidance, and a practical plan from day one. Our goal is to make a complicated process feel manageable, while protecting what matters most to you.