Nursing homes in North Carolina

North Carolina has 419 Medicare- or Medicaid-certified nursing homes in 97 counties, with 43,850 certified beds in total. The state average CMS overall rating is 2.9 of 5 against a national average of 3.0, and homes report 3.85 nurse staffing hours per resident per day against 3.86 nationally.

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North Carolina against the national average

Measure	North Carolina	United States
Overall rating (1 to 5)	2.9	3.0
Health inspection rating	2.9	2.8
Staffing rating	2.7	2.9
Nurse staffing hours per resident per day	3.85	3.86
Registered nurse hours per resident per day	0.62	0.69
Nursing staff turnover	49.0%	45.8%
Health deficiencies in the latest inspection	4.7	9.2
Fines per home, past three years	1.2	0.9

Averages are published by CMS. Health inspection ratings are set within each state, so compare them across states with care.

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Cities with at least 3 homes, by the city in each home's CMS address. Every home is also listed by county below.

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Nursing home rules and contacts in North Carolina

Federal rules on residents' rights, discharge notices and Medicare coverage are the same in every state. These are the offices to call in North Carolina, and the rules the state sets for itself.

Long-term care ombudsman North Carolina Long-Term Care Ombudsman Program NCDHHS Division of Aging (Office of the State Long-Term Care Ombudsman)919-855-3400 (Office of the State Long-Term Care Ombudsman, Raleigh. Regional ombudsmen (16 offices in Area Agencies on Aging) are listed by county in a document linked from the program page.) The program page itself gives no phone number; the number comes from the Division of Aging's ombudsman roster linked from that page (updated 2026) and the NCDHHS Division Contacts page.
File a complaint about a nursing home Complaint Intake Unit (Complaint Hotline) NCDHHS Division of Health Service Regulation, Complaint Intake and Health Care Personnel Investigations Section1-800-624-3004 (Within N.C.; or 919-855-4500. Hours: 9 a.m.-12 p.m. and 1-4 p.m. weekdays, except holidays. Also by fax (919-715-7724), mail (Complaint Intake Unit, 2711 Mail Service Center, Raleigh, NC 27699-2711) or email; a printable complaint form is on the page.) DHSR says it can investigate only incidents in the past year that are covered by federal regulations or state statutes; investigations are unannounced and complainant identifying information is not shared with the facility.
Apply for Medicaid nursing home coverage NC Medicaid application (local Department of Social Services / ePASS) NCDHHS Division of Health Benefits (NC Medicaid) and county Departments of Social Services1-888-245-0179 (NC Medicaid Contact Center (TTY 711), which helps find the local DSS. Phone applications are taken by the local DSS.) Apply online through ePASS (an NCID account is needed; Medicaid is called 'Medical Assistance' on the application), in person, by phone, or by mail, email, fax or drop-off at the county DSS.

Minimum staffing: North Carolina's licensing rules require every licensed nursing home to have at least one licensed nurse on duty for direct patient care at all times, and a registered nurse for at least eight consecutive hours a day, seven days a week. In homes with 60 or fewer nursing beds, the director of nursing may count toward that requirement. A multi-story home must have at least one nurse aide on duty on each patient care floor at all times. The rules do not set a general hours-per-resident-day minimum; units for residents on invasive mechanical ventilation must have at least 5.5 direct care nursing hours per patient day. Source: 10A NCAC 13D .2303 and .3003(e) (N.C. Medical Care Commission rules, authority G.S. 131E-104)
Personal needs allowance (Medicaid): North Carolina Medicaid lets a nursing home resident keep $70 a month as a personal needs allowance, or $140 for a married couple who share a room and are both on Medicaid. The amount rose from $30 ($60 for a couple) effective January 1, 2024. Source: NC Medicaid Aged, Blind and Disabled Medicaid Manual MA-2270 (revised 06/16/2026); NC State Plan Amendment 23-0048 (approved by CMS February 9, 2024)
Holding a bed during a hospital stay or leave: North Carolina Medicaid does not pay to hold a bed during a hospital stay; any bed hold is a private agreement between the resident and the home, and the admission contract must state the charge. Medicaid does keep paying the home's full daily rate for therapeutic leave ordered by the resident's physician: up to 60 days a calendar year for a resident of a skilled nursing facility, with no more than 15 consecutive days without approval. State law also says that if a resident is in a hospital (other than a State mental hospital) for no more than 15 days, counted from hospital admission until the home receives written notice of the discharge date, the home must give the resident the first bed available after it gets that notice and priority over new applicants, unless the home can no longer provide the needed treatment. Source: G.S. 108A-62; G.S. 131E-130; NC Medicaid Clinical Coverage Policy 2B-1, Nursing Facility Services, sections 5.8 and 7.4 (amended August 1, 2024)
Visiting: North Carolina law requires licensed nursing homes to let residents receive visitors to the fullest extent allowed by federal CMS or CDC rules and guidance. If a federal agency finds a visitation violation, the state may warn the home and give it no more than 24 hours to allow visits; if visits are still not allowed, the state must fine the home at least $500 for each instance on each day. Homes must allow compassionate care visits, such as at the end of life, to the fullest extent federal rules allow; homes may require these visitors to pass a health screening. During a declared disaster or emergency that limits visiting, each resident may name a preapproved visitor and an alternate, who must be allowed to visit at least twice a month, subject to CMS directives and the home's normal visitation conditions. Residents may also communicate privately with visitors at any reasonable hour. Source: G.S. 131E-112.7; G.S. 131E-112.5 and 131E-112.6; G.S. 131E-117(8)
Discharge notice: North Carolina requires nursing homes to use the state's Notice of Transfer or Discharge form; a notice without the completed form is invalid. The resident must be handed the form on the day it is dated, a copy must be mailed the same day to a family member or legal representative if contact information is available, and a Nursing Home Hearing Request Form must be given with it. The appeal goes to the DHHS Hearing Unit and must be received within 11 calendar days of the notice date. Hearings are by telephone unless an in-person hearing in Raleigh is requested. NC Medicaid policy says the home may not discharge while an appeal is pending unless that would endanger health or safety. Source: 10A NCAC 22H .0201-.0205; 10A NCAC 14A .0302-.0303; NC Medicaid Clinical Coverage Policy 2B-1 (amended August 1, 2024), section 5.6

Checked against North Carolina state sources on Oct 11, 2026. Rules and phone numbers change, so confirm with the office listed. For the rules that apply in every state, see residents' rights, how to file a complaint and how Medicaid pays for a nursing home.