Nursing Homes in North Carolina
North Carolina has 416 Medicare-certified nursing homes across 198 cities, with 43,633 total beds. 112 facilities (27%) earn a recommended rating for family consideration. The state performs 4.6% above the national average on quality metrics.
Compare 416 nursing homes · data
See all 112 recommended nursing homes in North CarolinaWorth Considering
112
facilities earn a recommended rating
State Average
+4.6% vs national
Coverage
198
cities with facilities
High Risk Facilities
128
55 with abuse citations
198 rated F grade
Cities with Best Care
416 facilities · Showing 1-10
Search above to find more facilities, or browse by city below.
Showing 1-10 of 416 facilities in North Carolina
Or Browse by City
Largest Cities
All 198 Cities
A-ZExplore Nearby States
About Nursing Home Care in North Carolina
North Carolina's 416 Medicare-certified nursing homes serve residents across 198 cities, offering a combined capacity of 43,633 beds. The state's nursing home landscape performs notably well compared to national benchmarks, with facilities averaging 4.6% higher on quality metrics than the national average.
Of the state's facilities, 112 (27%) earn our recommended rating, indicating they meet quality thresholds across CMS star ratings, inspection results, staffing levels, and penalty history. This includes 77 five-star facilities that represent the highest tier of care quality.
However, families should exercise caution with 128 high-risk facilities in the state, including 55 with abuse citations and 198 rated F grade on our scoring system. Charlotte is the state's largest market with 21 facilities. for families in the state's largest city.
North Carolina at a Glance
Good News
- 27% of facilities earn recommended status
- State averages 4.6% above national quality metrics
- 38% of facilities have no recent fines
- 77 five-star CMS-rated facilities available
- Mount Airy leads the state with 1 recommended facilities and an average trust score of 93.
Be Aware
- 128 facilities (31%) are high-risk
- 55 facilities have abuse citations
- $19,282,035 in total fines over 3 years
- However, the city averages only 48 trust score—research facilities carefully.
- 83% of facilities are for-profit
What's Changing
- CMS staffing mandates taking effect 2024-2026
- 26% of facilities currently meet staffing benchmarks
- Quality reporting requirements expanding
- Infection control standards strengthened post-COVID
- State inspection frequency increasing
Questions to Ask When Visiting
Based on North Carolina's nursing home data, we recommend asking these questions during facility tours:
About Staffing
- What is the RN-to-resident ratio on each shift?
- How do you handle staffing on weekends?
- What is your staff turnover rate?
- Are staff trained in dementia care?
About Quality
- Can I see your most recent inspection report?
- Have you had any abuse citations in the past 3 years?
- What is your fall prevention protocol?
- How do you handle medication management?
About Costs
- What services are included in the daily rate?
- Do you accept Medicaid? What's the waitlist?
- Are there additional fees for therapies?
- What happens if my loved one runs out of private funds?
About Daily Life
- What activities are available for residents?
- What are the visiting hours and policies?
- How do you handle dietary restrictions?
- Can residents personalize their rooms?
Fines & Penalties in North Carolina
Over the past 3 years, North Carolina nursing homes have been assessed $$19,282,035 in federal fines and penalties. Here's how that breaks down:
$$19.3M
Total Fines (3yr)
$$46,351
Avg per Facility
175
No Recent Fines
49
Facilities Fined
Note: Fines data is based on CMS enforcement actions over the past 3 years. A facility with no fines may still have deficiencies; conversely, a fined facility may have corrected issues.
Most Common Deficiencies
8,631 total deficiencies · 20.7 avg per facility
Ownership Breakdown in North Carolina
North Carolina's nursing home industry is predominantly for-profit, with 346 facilities (83%) operated by for-profit companies.
For-Profit
83%346 of 416 facilities
Non-Profit
15%61 of 416 facilities
Government
2%9 of 416 facilities
Research suggests ownership type can influence care quality, though many factors affect outcomes. Non-profit facilities may reinvest surplus into care improvements, while for-profit facilities face investor return pressures. However, excellent and poor facilities exist in all ownership categories.
Finding Quality Nursing Home Care in North Carolina
Finding the right nursing home in North Carolina requires careful research. With 416 facilities spread across 198 cities, families have options—but quality varies significantly. Our analysis shows that while North Carolina performs 4.6% above the national average, nearly one in four facilities (31%) carries a high-risk designation.
Understanding Our Trust Score System
The Trust Score is a 0-100 rating calculated from CMS's official nursing home database. The score combines five data categories:
- Health Inspection Results — Recent deficiencies, their severity, and patterns over time
- Staffing Levels — RN hours, total nursing hours, and weekend staffing
- Quality Measures — Clinical outcomes like falls, pressure ulcers, and rehospitalizations
- Penalties — Fines, payment denials, and enforcement actions
- Complaints — Substantiated complaints and their severity
In North Carolina, 112 facilities score a B grade or better, indicating they meet quality benchmarks across these categories. We recommend families prioritize these facilities and carefully research any facility rated C or below before visiting.
Regional Considerations
Quality varies significantly by region. Mount Airy, Cary, Chapel Hill lead the state in quality metrics, with higher percentages of recommended facilities and lower rates of citations.
Frequently Asked Questions
North Carolina has 416 Medicare-certified nursing homes across 198 cities, offering a total of 43,633 beds. Of these, 112 facilities (27%) earn our recommended rating based on quality metrics including CMS star ratings, inspection results, staffing levels, and penalty history.
The largest cities for nursing home care in North Carolina are Charlotte, Greensboro, Raleigh, Durham, Wilmington. These cities consistently score above the state average on quality metrics.
North Carolina nursing homes score 4.6% above the national average on our Trust Score metric, with an average score of 58 compared to the national average of 53. The state has 77 five-star facilities (19%) and 38% of facilities have no recent fines.
The average cost of nursing home care in North Carolina varies by facility type and level of care. Medicare covers skilled nursing care for qualifying stays up to 100 days. Medicaid covers long-term care for eligible residents. Contact individual facilities for private pay rates and payment options.
All Medicare-certified nursing homes in North Carolina are inspected annually by the North Carolina Department of Health and Human Services. Inspections evaluate quality of care, safety, and compliance with federal regulations. Results are reported to CMS and factor into our Trust Score calculations.
Ready to Find Care?
Use our search above to filter North Carolina's 416 nursing homes by quality rating, location, and features. Start with our 112 recommended facilities for the best care options.