Titles the act as “The G.U.A.R.D. Act” or “The Guaranteeing Uninterrupted Access to Resident Dignity Act.”

Enacts new GS 131E-112.10 (applicable to nursing homes or combination homes) and new GS 131D-7.10 (applicable to adult care homes), providing as follows. Requires the home to allow a resident (defined as a person residing in the home or that person’s responsible party or legal representative) to monitor their room with an electronic monitoring device. Residents who do must post a notice on their door stating that the room is being monitored. Requires that the monitoring: (1) be noncompulsory and at the resident’s election; (2) be paid for by the resident; and (3) to the greatest extent possible, the resident must protect the privacy of other residents and visitors. Requires the following of the home: (1) not refuse to admit an individual as a resident, nor discharge a resident, because they request to install an electronic monitoring device in their room; (2) make reasonable physical accommodations for a resident's electronic monitoring device by providing access to power sources, access to the internet if readily available, and a reasonably secure place to mount the device; (3) shall inform a resident or prospective resident of their right to install or arrange for the installation of an electronic monitoring device; (4) may require a resident who requests to install an electronic monitoring device to make the request in writing; (5) not include in any contract between a resident and home a provision that purports to waive or modify the resident's rights under this statute. Allows a recording created through the use of such an electronic monitoring device to be admissible in a civil or criminal action. Operating a home in violation of the statutes is a Class A1 misdemeanor, subject to a fine of up to $2,000 or imprisonment of up to one year, or both. Makes it a Class A1 misdemeanor to willfully and without consent hamper, obstruct, tamper with, or destroy a device, subject to a fine of up to $2,000 or imprisonment of up to 90 days, or both.

Makes conforming changes to GS 131E-117 and GS 131D-21 by adding installing, or having installed, at their own expense an electronic monitoring device in their room to ensure their health and safety, to the declaration of patient’s/resident’s rights.

Effective October 1, 2025.