Nursing Homes in North Carolina
418 Medicare- and Medicaid-certified facilities · NC · ranked on CMS Five-Star ratings, staffing, and penalties
North Carolina's 418 Medicare- and Medicaid-certified nursing homes average 2.9 of 5 CMS overall stars, in line with the 3.0-star national average; 81 hold the top 5-star rating while 87 sit at the 1-star floor (CMS Nursing Home Compare, March 2026).
Ratings are force-curved within each state, so North Carolina's averages are best read against its own facilities and the national mean, not used to rank one state's 3-star home against another's.
- 2.9 / 5
- About average · nat'l 3.0
- 418
- Certified facilities
- 81
- Five-star homes (81)
- $17.7M
- Federal fines, statewide
How North Carolina's nursing homes are rated
Where North Carolina's 416 rated facilities fall across the CMS 1-to-5 overall star scale. Because ratings are force-curved within each state, the curve below is North Carolina's own - 81 sit at the 5-star ceiling and 87 at the 1-star floor.
North Carolina vs the national average
How North Carolina's averages compare with the U.S. mean across the four most outcome-correlated CMS metrics. North Carolina beats the national average on 0 of 4.
National average: 2.98 ★
National average: 0.68
National average: 3.89
National average: 46.4%
Bar = North Carolina average · vertical marker = U.S. average. Source: CMS Nursing Home Compare · March 2026.
What the North Carolina Nursing Home Record Reveals
North Carolina hosts 418 Medicare- and Medicaid-certified nursing facilities operating 43,796 total certified beds, with a statewide average CMS overall rating of 2.9 out of 5 stars. Rating distribution in North Carolina skews toward the lower end, 1-star facilities outnumber 5-star providers, a pattern typically driven by heavier urban concentrations of chain-owned facilities: 81 facilities (19%) hold the top 5-star mark, while 87 (21%) sit at the 1-star floor. The star distribution is a forced curve, CMS ratings are state-normalized, so the same absolute inspection record may place differently in North Carolina than in a state with a different facility mix.
Statewide staffing reports an average of 0.59 registered-nurse hours per resident day across North Carolina facilities, the single most outcome-correlated metric in the CMS staffing file. Nursing staff turnover statewide averages 50.4% - a level where continuity of care, medication accuracy, and resident-staff familiarity typically begin to erode measurably. Staffing levels and turnover are upstream drivers of the inspection and quality-measure scores that feed the overall star rating; states with structurally higher wages, stronger collective-bargaining coverage, and tighter state-level minimum-staffing rules tend to post better composite numbers. The North Carolina figures above should be read against the federal CMS 2024 minimum-staffing rule, which phases in HPRD floors over several years and will reshape this distribution for facilities currently operating below the thresholds.
For families evaluating nursing home options in North Carolina, the statewide averages above set the backdrop, but placement decisions ultimately turn on facility-level records: the specific deficiencies cited at the most recent inspection, the staffing hours actually logged (as opposed to budgeted), the enforcement history of fines and payment denials, and direct observation through in-person visits. Every facility listed below links to its full CMS record on this site. Data is sourced from CMS Nursing Home Compare and Provider Data; figures reflect the most recent refresh and should be verified with each facility and the North Carolina state survey agency before any placement decision is finalized.
Top-rated nursing homes in North Carolina
The 100 highest-rated of North Carolina's 418 certified facilities, ordered by CMS overall star rating. Search all 418 North Carolina facilities →
Choosing a nursing home in North Carolina
North Carolina averages 2.9 of 5 CMS stars - in line with the 3.0-star national mean, but the statewide number is only the backdrop to a facility-level decision.
- Open any home above for its health-inspection, staffing, and quality sub-ratings, a strong overall star can still hide a weaker sub-score. See a top-rated home
- Weigh enforcement history too: North Carolina's most-penalized facility carries $418K in federal fines. See its record
- Ratings are curved within each state, so read North Carolina against the national picture before deciding. States by rating
CMS ratings are state-normalized and refreshed quarterly; confirm current status with each facility and the North Carolina state survey agency before any placement decision.
Read our methodology - how this data is sourced, computed, and verified.
Related
How North Carolina compares on federal nursing-home metrics
The CMS Five-Star Quality Rating program scores every Medicare- and Medicaid-certified nursing facility on three independent axes: health inspections, total nurse staffing hours per resident day, and a basket of quality measures drawn from MDS (Minimum Data Set) clinical assessments. Each axis is normalized against same-state peers to produce a 1-to-5 rating, then combined into the overall star count visible on each facility's record. Because the overall star is forced into a curve, the median facility in North Carolina sits at 3 stars by construction, but the underlying inspection-deficiency counts, registered-nurse hours, and rehospitalization rates are not curve-adjusted and remain directly comparable across states.
State-level patterns in North Carolina reflect labor market conditions (registered-nurse wages, certified-nursing-assistant turnover), regulatory posture (state surveyor strictness, mandatory minimum-staffing thresholds), payer mix (Medicaid reimbursement rates set the floor for skilled nursing margins), and ownership concentration (chain-owned versus independent operators show consistently different staffing and inspection profiles in published academic work). When using North Carolina averages as a benchmark, treat them as the backdrop against which an individual facility's record stands, not as a substitute for reading that record in detail.
The Provider Information File (PIF), Health Deficiencies File, MDS Quality Measures File, and Penalties File are all published on a quarterly cadence at data.cms.gov; PlainNursing refreshes the North Carolina record within 30 days of each release. State survey agencies enforce federal certification requirements on CMS's behalf - North Carolina families with concerns about a specific facility should file complaints through the state's long-term-care ombudsman channel as well as through the federal CMS reporting portal. Cross-reference the figures shown here against the upstream provider record on the official Medicare Care Compare tool before drawing any individual-facility conclusion, since small differences in monthly refresh timing can shift specific star ratings between data snapshots, and the federal record carries the definitive deficiency, staffing, and penalty history for each Medicare-certified nursing home.
Source: Centers for Medicare & Medicaid Services (CMS) Nursing Home Compare 5-Star Quality Rating, North Carolina · 2026 Star ratings combine health inspections, staffing, and quality measures. Updated quarterly by CMS.
