Feb182026
Guardianship Q&A Series

Why isn’t my healthcare power of attorney enough to get information from treatment facilities when my adult child is inpatient? – North Carolina

Short Answer

In North Carolina, a healthcare power of attorney often allows an agent to make healthcare decisions only when the adult child lacks capacity under the document’s terms. If the facility believes the adult child can still make decisions (or has not been found incompetent), the facility may treat the adult child as the only person who can authorize releases.

In addition, inpatient mental health and substance use treatment records can have stricter confidentiality rules, and facilities may limit what they can share without a specific written release or a court order.

Understanding the Problem

In North Carolina guardianship cases, a parent may ask: can a healthcare power of attorney require an inpatient treatment facility to share information about an adult child’s diagnosis, medications, discharge plan, or safety concerns? The key decision point is whether the adult child is still treated as the decision-maker for privacy and consent purposes during the admission, or whether the parent has legal authority to act as the adult child’s decision-maker for healthcare and information releases.

Apply the Law

North Carolina generally treats an adult as the person in control of their own medical information unless a valid legal authority shifts decision-making to someone else. A healthcare power of attorney can be powerful, but it is not always “on” for every situation, and it may not override special confidentiality rules that apply to mental health treatment records. When a family is pursuing general guardianship, the main forum is the Clerk of Superior Court in the county where the adult resides or is present, because Chapter 35A sets the procedure for an incompetency adjudication and guardian appointment.

Key Requirements

  • The adult child is still the legal decision-maker unless authority has shifted: If the facility believes the adult child can understand and communicate choices, the facility may require the adult child’s own written permission to release information.
  • The healthcare power of attorney must apply to the situation: Many healthcare powers of attorney are triggered by incapacity (often confirmed by clinicians as described in the document). If the trigger is not met (or not documented the way the facility requires), staff may refuse to treat the agent as authorized.
  • Mental health facility confidentiality rules can be stricter: Even when a family member is involved, North Carolina’s mental health confidentiality statutes can limit disclosure unless an exception applies, a proper written consent exists, or a court order compels disclosure.

What the Statutes Say

Analysis

Apply the Rule to the Facts: Here, a parent is trying to pursue general guardianship for an adult family member with multiple inpatient admissions and diagnoses that include bipolar disorder. Even with a healthcare power of attorney, a facility may refuse to share information if it does not believe the document is currently triggered by incapacity, if staff have not received the documentation they require to confirm activation, or if the adult child is refusing to sign a release. If the admission involves mental health treatment, the facility may also rely on North Carolina’s mental health confidentiality rules to limit what it can disclose without written consent, a legally responsible person, or a court order.

Process & Timing

  1. Who files: a parent or other interested person. Where: the Clerk of Superior Court in the appropriate North Carolina county. What: a verified petition to adjudicate incompetence and request appointment of a guardian. When: as soon as practical when repeated admissions and inability to manage care create ongoing risk or instability.
  2. Evaluation and hearing preparation: the clerk may require evidence about functioning and may involve an evaluation process and/or an agency review of a proposed guardian’s suitability, depending on local practice and what information is already available.
  3. Decision and authority: if the clerk adjudicates incompetence and appoints a guardian, the guardian generally has clearer authority to communicate with providers and request information needed to carry out the guardian’s duties (subject to any limits in the order and confidentiality rules).

Exceptions & Pitfalls

  • “Healthcare decision-making” is not always the same as “information access”: some facilities will not release records without a separate, HIPAA-compliant authorization signed by the adult child (or by someone the facility recognizes as legally authorized to sign).
  • POA activation problems: a healthcare power of attorney may require specific findings or certifications of incapacity. If the document is old, incomplete, not properly executed, or not clearly activated, the facility may refuse to rely on it.
  • Mental health confidentiality limits: even family members acting in good faith can be denied details about diagnosis, medications, therapy, or progress notes. In some situations, the facility may only share limited facts (for example, admission/discharge information) when the statute allows it and the responsible professional believes it is in the client’s best interest.
  • Guardianship is not automatic: filing does not immediately create authority. Until a court appoints a guardian (or another court order applies), the facility may still treat the adult child as the only person who can authorize disclosure.

For a broader discussion of next steps when records are hard to obtain during a guardianship case, see become a legal guardian for an adult relative when records are not accessible. For what to expect if the case proceeds, see what happens at an incompetency hearing.

Conclusion

In North Carolina, a healthcare power of attorney may not be enough to obtain inpatient treatment information because the adult child is still the legal decision-maker unless the document is properly triggered by incapacity, and mental health facilities must follow strict confidentiality rules. When a facility will not share information without the adult child’s written release, the practical legal path is often to file a verified incompetency petition with the Clerk of Superior Court and request appointment of an appropriate guardian as soon as possible, ideally before discharge.

Talk to a Guardianship Attorney

If a family is dealing with repeated inpatient admissions and treatment facilities will not share information despite a healthcare power of attorney, our firm has experienced attorneys who can help explain options, likely timelines, and what to file with 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: 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.