Adult Protective Services in North Carolina

North Carolina Adult Protective Services (APS) operates through each of the state's 100 county Departments of Social Services (DSS), with oversight from the NC Department of Health and Human Services Division of Social Services. Unlike states with a single statewide hotline, APS reports in North Carolina must be made to the county DSS where the person lives. All county DSS offices are required by law to accept APS reports 24 hours a day, 7 days a week. North Carolina has a universal mandatory reporting requirement — any person with reasonable cause to believe a disabled adult is being abused, neglected, or exploited is legally required to report under G.S. Section 108A-102.

How to Report Elder Abuse in North Carolina

Because North Carolina uses a county-based system, reports go to the county DSS office in the county where the disabled adult resides. A directory of all 100 county DSS offices, including phone numbers and addresses, is available at ncdhhs.gov/divisions/dss/local-county-social-services-offices.

Report by Phone

Contact your local county Department of Social Services to make an APS report. All county DSS offices are required to provide 24-hour, 7-day-a-week coverage through an on-call social worker. To find your county DSS phone number, visit the North Carolina DSS county directory at ncdhhs.gov/divisions/dss/local-county-social-services-offices, or call the NCDHHS main line at 1-800-662-7030 for assistance.

Report Online

North Carolina does not have a statewide online reporting portal for APS. Reports must be made directly to the county DSS where the disabled adult lives. Some counties may accept reports by fax or email — contact your local DSS office for their specific reporting options. The state fax number for NCDHHS Aging programs is 919-334-1018, though county DSS offices handle all individual APS investigations.

Emergency Situations

If a disabled adult is in immediate danger, call 911 first. After emergency services have been summoned, contact the local county DSS to file an APS report. The county DSS is required to initiate an investigation immediately upon receiving a report with a risk of death, within 24 hours for situations involving irreparable harm, and within 72 hours for non-emergency situations.

What Information to Have Ready Before You Call

When you contact your county DSS to make an APS report, you do not need proof of abuse — reasonable cause to believe abuse is occurring is sufficient. Having the following information ready will help the intake social worker conduct an effective screening:

• Full name, approximate age, and complete address (including county) of the person at risk
• A description of the suspected abuse, neglect, or financial exploitation — including what you observed
• The name and relationship of the suspected abuser, if known
• Information about the person's disability or medical conditions that affect their ability to protect themselves
• Names of witnesses, family members, or neighbors with relevant information
• Your own contact information (reports can be made without identifying yourself in most circumstances)

Types of Elder Abuse APS Investigates in North Carolina

Under G.S. Chapter 108A, Article 6 — the Protection of the Abused, Neglected, or Exploited Disabled Adult Act — North Carolina APS investigates the following types of harm to disabled adults:

• Abuse — Willful infliction of physical pain or injury, unreasonable confinement, intimidation, or cruel punishment
• Neglect — Failure to provide adequate supervision, medical care, food, clothing, shelter, or other basic necessities
• Financial exploitation — Illegal or improper use of a disabled adult's funds, property, or resources
• Self-neglect — A disabled adult's inability to provide for their own basic needs due to their disability or incapacity

Warning Signs of Elder Abuse

Recognizing the signs of abuse or neglect in a disabled adult can be difficult — abusers often isolate victims from friends and family. Report your concerns to your local county DSS if you observe any of the following.

Physical Signs

• Unexplained bruises, cuts, burns, abrasions, or broken bones
• Injuries that are inconsistent with the explanation provided by the caregiver
• Signs of malnutrition or dehydration: significant weight loss, dry skin, or sunken eyes
• Pressure sores or bedsores suggesting prolonged immobility or inadequate care

Behavioral Signs

• Sudden changes in behavior, mood, or personality — especially new depression or fearfulness
• Withdrawal from social activities or relationships previously enjoyed
• Fearfulness or anxiety that increases in the presence of a particular caregiver
• Appearing disoriented or confused beyond their baseline cognitive state

Financial Signs

• Unexplained bank withdrawals, transfers, or changes to financial accounts
• New persons gaining control over the person's finances or assets
• Sudden changes to wills, trusts, or powers of attorney
• Bills going unpaid or utilities being shut off despite adequate income

Who Can (and Must) Report Abuse in North Carolina

North Carolina has a universal mandatory reporting requirement under G.S. Section 108A-102. Any person — regardless of profession, relationship, or circumstances — who has reasonable cause to believe a disabled adult is being abused, neglected, or exploited is legally required to report the concern to the county DSS. Financial institutions are specifically required to report suspected financial exploitation under G.S. Section 108A-115.

All reports to county DSS are confidential under G.S. Section 108A-102 and 10A NCAC 71A .0802. Reporters acting in good faith are immune from civil and criminal liability under G.S. Section 108A-102(c). For licensed facility staff, failure to report is a Class A1 misdemeanor under G.S. 122C-66.

What Happens After You Report to APS in North Carolina

After you contact your county DSS with an APS report, the county follows a structured process governed by G.S. Section 108A-103 and the North Carolina Adult Protective Services Manual.

Step 1 — Intake and Screening

The county DSS intake social worker screens the report to determine whether the person qualifies as a disabled adult under G.S. Section 108A-101(d) and whether the alleged harm meets the threshold for investigation. Reports that qualify are assigned a response priority based on the level of immediate risk.

Step 2 — Response Timeline

North Carolina law establishes three response tiers: immediate response for reports involving risk of death; response within 24 hours for irreparable harm; and response within 72 hours for non-emergency situations. Investigations must be completed within 30 days for abuse and neglect cases, and within 45 days for exploitation cases under G.S. Section 108A-103.

Step 3 — Investigation

The county DSS social worker conducts an in-person evaluation of the disabled adult, interviews witnesses, family members, and the suspected abuser as appropriate, and reviews medical and financial records if relevant. If criminal activity is suspected, the county DSS coordinates with local law enforcement. The social worker assesses the person's safety, disability status, and service needs.

Step 4 — Service Plan and Outcome

If the investigation substantiates abuse, neglect, or exploitation, the county DSS develops a service plan in collaboration with the disabled adult. Services may include emergency placement, home health care, medical and mental health referrals, financial counseling, legal assistance, and coordination with the local Area Agency on Aging. Disabled adults with decision-making capacity retain the right to refuse services. If a person lacks capacity and faces ongoing serious harm, the county DSS may petition the court for a guardian or other protective measures.

APS vs. Long-Term Care Ombudsman — Who Handles Nursing Home Abuse in North Carolina?

North Carolina county DSS handles abuse, neglect, and exploitation of disabled adults in all settings. However, the primary advocacy and complaint resource for residents of nursing homes and adult care facilities is the North Carolina Long-Term Care Ombudsman Program.

For residents of licensed nursing homes and adult care homes in North Carolina, contact the North Carolina State Long-Term Care Ombudsman at 1-855-227-3640. The Ombudsman program has regional staff throughout the state who advocate for residents' rights, investigate complaints, and work to resolve problems in licensed facilities. For regulatory violations and licensure complaints, contact the NC Division of Health Service Regulation.

For a complete guide to filing a nursing home complaint in North Carolina, see our North Carolina Nursing Home Complaint Guide.

Additional Resources in North Carolina

• NC County DSS Directory (find your county APS office): ncdhhs.gov/divisions/dss/local-county-social-services-offices
• North Carolina Long-Term Care Ombudsman: 1-855-227-3640
• NC Division of Aging and Adult Services: ncdhhs.gov/divisions/division-aging
• Eldercare Locator: 1-800-677-1116
• National Elder Fraud Hotline: 1-833-FRAUD-11 (1-833-372-8311)
• National Center on Elder Abuse

All reports to your county DSS are confidential. Any person who has reasonable cause to believe a disabled adult is being abused, neglected, or exploited has a legal duty to report in North Carolina. Contact your county DSS 24 hours a day, 7 days a week.