Dec32025
Guardianship Q&A Series

If I become guardian, will I be personally responsible for paying the facility or medical costs, and what duties would I take on? – North Carolina

Short Answer

Under North Carolina law, a guardian is generally not personally responsible for a ward’s facility bills or medical costs; those are paid from the ward’s own income, benefits, or assets unless the guardian separately agrees in writing to be personally liable. A guardian of the person must arrange for the ward’s care, living situation, and medical decisions, while a guardian of the estate or general guardian manages money and pays bills from the ward’s funds. The clerk of superior court can tailor and modify an existing guardianship order so that decision-making authority matches what the ward needs without requiring the guardian to provide full-time hands-on care.

Understanding the Problem

The narrow question is whether a person who becomes a guardian under North Carolina guardianship law must personally pay a ward’s care facility and medical expenses, and what legal duties that guardian takes on. In many adult guardianship cases, one sibling already serves as guardian, and another family member wants authority to participate in medical decisions, receive health updates, and arrange outings from a care facility, while being unable to assume full-time care or pay facility charges. North Carolina law allows the clerk of superior court to define and modify the type and scope of guardianship so that decision-making authority and financial responsibility are separated when appropriate.

Apply the Law

North Carolina separates guardianship into two main roles: guardian of the person (care and decisions) and guardian of the estate (money and property). A general guardian combines both. The clerk of superior court creates a court order that defines what the guardian may do and any limits. Facility and medical costs are usually paid from the ward’s estate, Social Security, veterans’ benefits, or other income, not from the guardian’s own pocket, unless the guardian signs a separate agreement making the guardian personally responsible.

Key Requirements

  • Duties of a guardian of the person: Arrange for the ward’s care, comfort, maintenance, residence, and services, and give consent for medical and other professional treatment, all consistent with the guardianship order.
  • Duties of a guardian of the estate or general guardian: Safeguard the ward’s money and property, pay lawful bills (including facility and medical expenses) from the ward’s funds when available, and follow court and reporting requirements.
  • Limits on personal liability: Use the ward’s estate and benefits to pay for care; avoid signing admission or medical forms that make the guardian a personal guarantor, and act in good faith within the court order to reduce personal risk.

What the Statutes Say

Analysis

Apply the Rule to the Facts: In the described situation, the primary interest is medical and care decision-making for a sibling already in a facility. Under North Carolina law, a guardian of the person could be appointed or added with powers focused on health care consent, receiving medical information, and decisions about outings and residence, without taking over the estate. The guardian of the estate or general guardian would remain responsible for using the ward’s funds, insurance, and veterans’ benefits to pay the facility and medical bills, so personal payment from the new guardian would not be required unless a separate contract is signed.

Process & Timing

  1. Who files: An interested person, such as a sibling, files. Where: With the Clerk of Superior Court in the North Carolina county where the ward resides or is domiciled. What: A motion or petition to modify the existing guardianship (often using local clerk forms available on the North Carolina Judicial Branch website) explaining the requested change in powers. When: Any time after the original guardianship order, preferably before disputes arise with the facility or family.
  2. The clerk schedules a hearing, gives notice to the current guardian and other interested parties, and may require updated medical or functional evidence about the ward’s needs. This process can take several weeks to a few months, depending on the county’s calendar and whether anyone objects.
  3. After the hearing, the clerk enters a modified guardianship order and issues updated Letters of Appointment describing the guardian’s authority. Facilities and medical providers then rely on these letters to share information and accept decisions.

Exceptions & Pitfalls

  • Guardians who sign admission contracts or financial guaranty language in their individual capacity, rather than “as guardian of” the ward, may unintentionally agree to pay bills personally.
  • If the guardianship order grants only limited powers, acting beyond those powers (for example, making financial decisions without authority) may create personal exposure or lead to removal.
  • Failure to file required status reports or updates with the clerk can result in court orders, possible contempt findings, or removal as guardian, and the guardian may be ordered to pay costs of those enforcement proceedings.
  • When the ward is a veteran, federal privacy rules and agency procedures can delay access to medical records; guardians often need to provide certified Letters of Appointment and may need to work through specific VA release processes.
  • Disagreements among family members about care decisions can lead the clerk to narrow or condition guardianship powers or to appoint a neutral guardian instead of a family member.

Conclusion

Under North Carolina law, becoming a guardian generally does not require personal payment of a ward’s facility or medical expenses; those obligations are handled from the ward’s own resources by a guardian of the estate or general guardian, unless the guardian separately agrees to be individually liable. A guardian of the person focuses on arranging safe housing, consenting to treatment, and monitoring care. Anyone seeking more authority over an adult’s medical and care decisions should file a request with the clerk of superior court to modify the existing guardianship order so that responsibilities match the ward’s needs and the guardian’s limits.

Talk to a Guardianship Attorney

If a family member is under a North Carolina guardianship and another relative wants decision-making authority without taking on personal liability for care costs, our firm has experienced attorneys who can help clarify options and court procedures. 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 any specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If there is 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.