Jan272026
Guardianship Q&A Series

Can the nursing facility give me medical records and care plan documents if I’m the next of kin but don’t have power of attorney? – North Carolina

Short Answer

Usually not. In North Carolina, a skilled nursing facility generally cannot release a resident’s medical records or detailed care plan documents to a “next of kin” unless that person has legal authority (such as a valid health care power of attorney, a court-appointed guardianship, or the resident’s written authorization). If the resident still has capacity, the simplest path is a written HIPAA authorization or having the resident sign the facility’s release form.

Understanding the Problem

In North Carolina, can a family member who is the next of kin obtain an elderly relative’s nursing facility medical records and care plan documents when the relative may have dementia, but no one has been formally appointed to act for the relative? The decision point is whether “next of kin” status alone gives authority to receive private health information from the facility. This question often comes up when a family member suspects the resident is no longer able to manage personal affairs and needs help coordinating care.

Apply the Law

Medical records and care planning documents are generally treated as private health information. A nursing facility typically may share them only with the resident or with someone who has legal authority to act for the resident (or someone the resident has authorized in writing). In North Carolina, facilities also commonly look for formal authority documents before they will discuss care details or release records, especially when the resident’s capacity is in question.

When a resident cannot manage their own decisions and there is no valid power of attorney in place, the usual legal route to gain authority is a guardianship proceeding in front of the Clerk of Superior Court in the county where the resident lives. The clerk has original jurisdiction over adult guardianship appointments and related proceedings.

Key Requirements

  • Resident authorization (if capacity exists): If the resident can understand and sign, a written authorization (often a facility form or HIPAA authorization) typically allows release of records and care plan information to the named person.
  • Legal authority (if capacity is lacking): If the resident cannot validly authorize release, the facility generally requires a recognized decision-maker, such as a health care agent under a health care power of attorney or a court-appointed guardian.
  • Proper forum for guardianship: Guardianship is handled through the Clerk of Superior Court, and the clerk can appoint a guardian (including limited guardianship) based on the person’s needs and capacity.

What the Statutes Say

Analysis

Apply the Rule to the Facts: The facts describe a next of kin relationship and concerns about dementia and competence. Next of kin status by itself usually does not equal legal authority to receive medical records or care plan documents from a skilled nursing facility. If the relative can still understand and sign a release, the facility can typically provide records and care plan information to the person named in that written authorization. If the relative cannot validly authorize release, the practical path to authority is often seeking appointment as guardian through the Clerk of Superior Court.

Process & Timing

  1. Start with the least formal option: Who signs: the resident (if able). Where: at the skilled nursing facility. What: the facility’s medical records release form and/or a HIPAA authorization naming the next of kin. When: as soon as possible, especially if care decisions are time-sensitive.
  2. If capacity is doubtful or the facility refuses without formal authority: Who files: an interested person (often a family member). Where: the Office of the Clerk of Superior Court in the county where the resident resides. What: a petition/application to have the person adjudicated incompetent and to appoint a guardian (the clerk may also consider limited guardianship depending on the person’s needs).
  3. After appointment: the clerk issues letters/authority for the guardian. The guardian can then present those documents to the facility to request records and participate in care planning consistent with the scope of the guardianship.

Exceptions & Pitfalls

  • “Next of kin” is not the same as “legal decision-maker”: Facilities often cannot release records based only on family relationship, even when the request is well-intentioned.
  • Capacity can be “gray”: A person may have dementia but still be able to sign a valid release on a good day. Facilities may still hesitate if staff believe the resident does not understand what is being signed.
  • Wrong document for the job: A financial power of attorney (if one exists) may not satisfy a facility’s request for medical authority. A health care power of attorney or guardianship is often what the facility needs for medical records and care planning discussions.
  • Scope limits: Even with guardianship, the authority depends on what the clerk orders (for example, limited vs. general guardianship). A mismatch between the order and the request can cause delays.

Conclusion

In North Carolina, a skilled nursing facility usually cannot provide medical records or care plan documents to a next of kin without legal authority. The most common ways to get access are (1) the resident signing a written authorization if the resident still has capacity, or (2) obtaining court authority through a guardianship proceeding handled by the Clerk of Superior Court. The practical next step is to request the facility’s written release form and have the resident sign it, or file for guardianship if the resident cannot validly consent.

Talk to a Guardianship Attorney

If you’re dealing with a nursing facility that will not release records or care plan documents because there is no power of attorney, our firm has experienced attorneys who can help explain options and timelines, including whether a North Carolina guardianship filing is appropriate. 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.