How to Switch from an Assisted Living Facility to Independent Living

How to Move From Assisted Living to Independent Living in North Carolina

To move from assisted living to independent living in North Carolina, confirm the person’s readiness and goals, review the resident contract and its notice terms, line up Medicaid-funded supports through the LME/MCO, secure a home and a way to pay for it, and plan check-ins for the first 90 days.

What Does Moving From Assisted Living to Independent Living Mean in North Carolina?

In North Carolina, assisted living usually means a licensed adult care home or family care home, where staff provide meals, personal care, and medication support. Independent living, for adults with intellectual and developmental disabilities (IDD) or traumatic brain injury (TBI), usually means a home of one’s own, such as an apartment or house, with personalized supports that come to the person.

Independent living communities marketed to older adults are a different product. This guide is for adults with IDD or TBI who rent or own a home and use Medicaid-funded or private supports.

The person’s own goals lead this decision. Family members, guardians, and case managers help plan the move, but the plan starts with what the individual wants. Our page on adults with IDD seeking more independence has more on that topic.

Signs of Readiness for Independent Living

Readiness is a pattern of skills and supports, not a pass or fail test. Many people move while still building some skills, with supports in place for the gaps. The table shows what readiness often looks like and what can help.

Questions to talk through together:

• Has health and mobility stayed stable or improved over the past six to twelve months?
• Does the person want more privacy and more control over the daily schedule?
• Can they say what help they want, and from whom?
• Is there a plan for what happens if needs change?

How to Plan the Move: Four Steps

Step 1: Review the Resident Contract

Start with the contract. A licensed adult care home in North Carolina may require up to 14 days’ written notice, and the notice term must be written in the resident contract. Confirm:

• The notice period and how to deliver it
• Any charges if notice is shorter than the contract requires
• How the remaining prepaid balance will be refunded. NC rules call for a refund within 14 days of the notice date (10A NCAC 13F .1106)
• How medications, personal belongings, and records will move with the person

Get the answers in writing before you set a move date.

Step 2: Line Up Supports Before Move-Out

Independent living does not mean living without a safety net, and supports do not start on their own. Ask your LME/MCO care coordinator or case manager which services the person qualifies for and how long authorization takes. 1915(i) services have no waitlist, while the Innovations Waiver has a long one. Ask about 1915(i) services while you wait for an Innovations Waiver slot.

Step 3: Secure a Home and a Way to Pay for It

Look for a lease that fits the person’s budget and the supports they will use. Plan for rent, utilities, food, and transportation, because Medicaid-funded services pay for supports, not rent. Ask about the NC Targeting Program and local housing authority rental assistance before you give notice, since timelines vary.

Step 4: Prepare the Person and the Home, Then Plan the First 90 Days

Help the person personalize the new space from day one with familiar bedding, photos, and a favorite chair. Walk the neighborhood together before move-in: the nearest grocery, pharmacy, bus stop, and a place to meet people. Keep routines that already work, such as wake times and meals, and add new activities gradually. Schedule community activities in the first month instead of leaving them to chance. Set check-ins at 30, 60, and 90 days with the case manager to adjust supports.

What to Have Ready

• A copy of the resident contract and the written notice
• A current medication list and prescriber contact details
• The Medicaid card and the LME/MCO care coordinator’s contact information
• The current person-centered plan or Individual Support Plan, if one exists
• Diagnosis records and recent evaluations
• The lease or housing application and proof of income for the rental
• Emergency contacts and a list of preferred providers

North Carolina Supports That Can Help After the Move

Access to each support depends on Medicaid eligibility, the person’s plan, and the LME/MCO’s authorization. Ask a care coordinator or case manager which of these fit before you set a move date.

What About Cost and Housing?

There is no single price comparison, because the two settings pay for different things. Assisted living bills one monthly fee that bundles housing, meals, and care. Independent living splits those costs into rent and utilities, food and transportation, and supports that Medicaid or other funding may cover. Medicaid home and community-based services pay for supports, not rent.

To compare fairly, ask each option for an itemized monthly budget and line it up against the current assisted living bill. Our guides on how to pay for independent living and how to find affordable independent living cover related questions.

Rental help exists. The NC Targeting Program, run by NCDHHS with the NC Housing Finance Agency, connects adults with disabilities who receive supportive services to affordable rentals, and Key Rental Assistance lowers rent for people with extremely low incomes. Ask your local housing authority about its rental assistance process too, and learn the timelines before you give notice.

Frequently Asked Questions

How much notice do I have to give before leaving an assisted living facility in North Carolina?

It depends on your resident contract. A licensed adult care home in North Carolina may require up to 14 days’ written notice, and the contract must state the requirement. If you give proper notice, the home must refund any remaining advance payment within 14 days of the notice date. Read the contract first, give notice in writing, and keep a copy.

What if they need occasional help after the move?

This is the most common concern families raise — and the most solvable one. Arranging a Community Living and Support program or respite care plan before the move ensures support is available without committing to a higher level of daily care. Think of it as a flexible layer you can dial up or down based on need.

How do I know if someone is ready to move from assisted living to independent living?

Readiness is a pattern, not a pass or fail test. Look for steady skills in personal care, meals, medications, home safety, and getting around the community, or a clear plan for the supports that fill any gaps. The person’s own goals matter most. A case manager can help the team review readiness and build a plan.

What support is available after the move?

Community Living and Support, Supported Living, respite, and case management can all help, depending on eligibility. 1915(i) services have no waitlist but require a Tailored Plan. The Innovations Waiver has a long waitlist. Ask your LME/MCO care coordinator which services you qualify for before you set a move date.

How does the cost of independent living compare with assisted living?

There is no single answer. Assisted living bundles housing, meals, and care into one fee. Independent living splits those costs into rent, utilities, food, transportation, and supports. Medicaid services pay for supports, not rent. Request an itemized budget and compare it line by line with the current assisted living bill. Ask about NC rental assistance programs.

How long does it take to adjust to independent living?

It varies from person to person. A planned move, a familiar home before move-in day, and early community connections usually help. Set check-ins at 30, 60, and 90 days with the case manager and adjust supports as needs change.

What if independent living does not work out?

Moving back to a higher level of care is often possible, but it depends on openings, assessments, and funding. Keep records and provider relationships in place, ask the former facility about its re-admission policy, and talk with the case manager early if needs increase.

Related Guides

For a deeper look at creating a supportive, well-planned independent living environment, download our Supported Living Guide. It covers housing options, funding pathways, and what families in North Carolina should know before making this move.

• Independent living and assisted living
• How to qualify for Medicaid home care
• How to manage daily routines with limited assistance
• The Independence Toolkit

Download the Supported Living Guide

For a closer look at housing options, funding pathways, and what North Carolina families should know before a move, download our Supported Living Guide.

About Covenant Case Management Services

Covenant Case Management Services (CCMS) is a CARF-accredited provider of case management and supports for individuals with intellectual and developmental disabilities (IDD) and traumatic brain injury (TBI) across 56 North Carolina counties. We help individuals and families plan transitions, connect with Medicaid-funded services, and build supports that fit the person’s goals.

Ready to plan the move? Call (704) 780-4552 or contact our team.