North Carolina Nursing Home Camera Laws: The G.U.A.R.D. Act (HB 591)

North Carolina has no law giving a nursing home or adult care home resident a right to install a monitoring camera. House Bill 591, the G.U.A.R.D. Act, would create one, but it has sat in a House committee without further action since April 2025.

Information last verified on 2026-08-14. This article has not yet been reviewed by a licensed lawyer.

This article covers North Carolina law as it stands for a nursing home or adult care home resident considering a monitoring camera: the absence of a facility-specific statute, the state's one-party consent recording law, and the pending G.U.A.R.D. Act's real status and terms. It does not address North Carolina's general recording law outside a care facility in full; see North Carolina Recording Laws for that framework.

Does North Carolina Have a Nursing Home Camera Law?

No. N.C. Gen. Stat. section 131E-117, the nursing home Patients' Bill of Rights, which HB 591 would amend to add a monitoring right, contains no reference to cameras, video, surveillance, or electronic monitoring anywhere in its current text. Section 131D-4.3, which governs adult care home staffing and supervision rules, uses the word "monitoring" only to mean staff oversight of resident care needs, not video surveillance, a distinction worth noting since a keyword search alone can mislead. North Carolina's adult care home administrative rules, 10A NCAC 13G, are silent on cameras as well.

Because no statute exists, a North Carolina resident or family has no state-mandated consent form, no required notice signage, and no statutory anti-retaliation protection specific to installing a monitoring device. The decision runs on the facility's own policy, layered on North Carolina's general one-party consent recording law.

North Carolina's One-Party Consent Law

North Carolina Gen. Stat. section 15A-287 makes it a Class H felony to intercept a wire, oral, or electronic communication without the consent of at least one party to the communication, meaning a participant in a conversation, such as a resident present in their own room, may record it without every other party's separate consent. This is a materially more permissive starting point than the all-party consent states covered elsewhere in this cluster, though it does not resolve every question a shared room raises, particularly a roommate's own privacy interest in conversations the resident is not part of. For the general framework governing recorded conversations anywhere in North Carolina, not just a care facility, see North Carolina Recording Laws.

The Pending Bill: The G.U.A.R.D. Act (HB 591)

House Bill 591, officially titled "Elec. Monitoring in Nursing/Adult Care Homes" and commonly called the G.U.A.R.D. Act, was filed March 31, 2025 by a bipartisan group of sponsors led by Reps. Willis, Loftis, and Brody. It passed a first reading and was referred to committee on April 1, 2025, and its last recorded action remains a re-referral to the House Rules, Calendar, and Operations Committee that same day. No committee substitute or amendment has been filed since, and the bill has been dormant for more than 16 months as of this writing.

The bill would create parallel new statutes for nursing and combination homes (new section 131E-112.10) and adult care homes (new section 131D-7.10), and amend both facilities' residents'-rights lists to add the new right. Under it, electronic monitoring would be resident-funded and entirely voluntary; a facility could not refuse admission or discharge a resident over a monitoring request; the facility would have to provide reasonable accommodations like power access and mounting; the resident would have to post a notice on their own door stating the room is monitored; and recordings would be admissible in civil or criminal proceedings, subject to the state's Rules of Evidence. The bill sets two separate penalties: operating a facility in violation of the section is a Class A1 misdemeanor with up to a year in prison, while a person who tampers with or destroys a device without the resident's consent commits a separate Class A1 misdemeanor capped at 90 days, both carrying a 2,000-dollar fine ceiling.

The bill's own effective-date clause specified October 1, 2025. That date has already passed while HB 591 remains stuck in committee, which means the bill's own timeline is now stale even if it eventually advances; any future enactment would need a new effective date. Nothing in HB 591 is current law, and it should not be described to a reader as close to taking effect.

Practical Guidance Under the No-Statute Reality

Without an enacted statute, a North Carolina family's options run through the facility's own policy rather than a state-mandated procedure.

• Check the admission agreement and ask the facility in writing before installing anything, mirroring the notice and disclosure approach HB 591 would eventually formalize.
• A camera capturing the resident's own activity and interactions generally fits within North Carolina's one-party consent framework, more permissive ground than the all-party consent states in this cluster.
• Get a roommate's consent in a shared room anyway, even though no statute currently requires it, since a roommate's own privacy interest in a shared room remains a live, unresolved issue.
• Understand that North Carolina's one-party consent rule protects a participant recording their own conversation, not necessarily a device that captures a private conversation between other people, such as staff or a roommate, that the resident is not part of.

Hidden Cameras: The Practical and Legal Risk

A hidden camera in a resident's own room, capturing the resident's own interactions, sits on comparatively firmer legal ground in North Carolina than in an all-party consent state, given the one-party consent rule described above. That does not eliminate risk. A device that primarily or exclusively captures a roommate's private conversations or a roommate's visitors, situations the resident is not a party to, raises a separate privacy question that North Carolina's one-party consent rule does not clearly resolve, since it depends on whether the resident (or the family acting for them) can be considered a party to what is being recorded.

There is also a practical risk separate from the legal one: a facility that discovers an undisclosed camera can treat it as a violation of the admission agreement, and North Carolina has no statute today barring a facility from responding with discharge or non-renewal the way HB 591 would if it were enacted. Families should weigh both the comparatively favorable one-party consent position and the facility-relations risk before relying on a hidden device.

Using Camera Footage as Evidence of Abuse or Neglect

Camera footage that appears to show abuse or neglect can support a report to the North Carolina Long-Term Care Ombudsman Program or the Department of Health and Human Services, and it can support a civil claim. Footage generally works alongside the resident's medical records, staffing records, and care plan rather than establishing a claim on its own. For a broader look at how a nursing home abuse or neglect claim works, see Nursing Home Abuse & Neglect.

North Carolina's Long-Term Care Ombudsman Program

The North Carolina Long-Term Care Ombudsman Program, with a State Office and 16 regional offices housed in Area Agencies on Aging, assists residents of long-term care facilities with rights and grievance resolution. It is the state's established channel for residents and families to raise care concerns, including anything a camera reveals, reachable at 1-800-662-7030.

Related Resources

• Nursing Home Camera Laws by State covers which states have an enacted electronic monitoring statute and how North Carolina compares.
• North Carolina Recording Laws covers the state's general one-party consent framework for conversations outside a nursing facility.
• Nursing Home Abuse & Neglect covers how an abuse or neglect claim works once evidence, including camera footage, is in hand.

---

Last updated: 2026-08-14.