How to Read a North Carolina Star Rating for a Winston-Salem Adult Care Home

What is the North Carolina star rating?

North Carolina is one of a small number of states that rates assisted living. The Division of Health Service Regulation gives every adult care home and family care home a rating of zero to four stars, and it publishes the rating together with a numerical score, the home's inspection documents and any fines from the past 36 months on its Facility Inspections, Ratings and Penalties search.

The rating is built from inspection results. It is not a satisfaction survey and it does not reward chandeliers. A home with a dated lobby can hold four stars, and a new building with a busy marketing team can hold one, if its last survey found serious problems. That is exactly why the rating is useful: it measures the thing a brochure cannot, which is how the home did when state inspectors read its records and watched its staff.

How do the five counties' homes score?

Across Forsyth, Davidson, Davie, Stokes and Yadkin counties, most rated homes sit at three or four stars. The table below counts every licensed adult care home and family care home by county and rating. A few homes show no rating, usually because they are new or have not yet completed the survey cycle that produces one.

Source: N.C. DHSR adult care rosters, star ratings and 36-month penalty list, pulled November 6, 2026.

The lower end deserves attention rather than alarm. 6 homes in the five counties currently sit at two stars or fewer. For each of them, the facility page on this site lists the survey documents in date order, so you can see whether the low rating comes from one bad survey or from a pattern.

What does the score next to the stars tell you?

Each rating comes with a score, and the score tells you how close a home is to the line. Two homes with three stars can be in quite different places: one comfortably in the middle of the band, another one point from dropping. In the five counties the median score among rated homes is 100.5. When you compare two homes with the same stars, the score is a fair tie-breaker.

Do not over-read small differences. A home's score moves when it is surveyed, and a single citation can shift it. What matters more is direction: whether recent surveys have been getting cleaner or worse.

How should you read the survey behind the rating?

Open the most recent annual survey first. A document titled with no deficiencies cited is the best result a home can get. A statement of deficiencies lists each rule the inspectors found unmet, with the evidence. Look at which rules were cited: personal care and supervision, medication administration and residents' rights are the citations that touch daily life most directly.

Then open the version with the plan of correction. That is the home's written answer: what it will change, who is responsible and by when. A specific, dated plan is a good sign. A vague one that promises to re-educate staff without saying how is worth a question on your tour.

Finally, check for repeats. A medication finding in two consecutive surveys tells you the fix did not hold.

Where does the rating fall short?

The rating covers adult care homes and family care homes only. Nursing homes are rated by CMS on a one-to-five scale, and the two cannot be compared. The state rating also says nothing about price, food, activities or whether a home accepts Special Assistance. And because surveys happen roughly once a year, a rating can lag behind a change of administrator or ownership by months.

Treat it as the first filter, not the last word. Our assisted living roster sorts every licensed home in the five counties by stars, beds or fines, and each row links to a page with the full survey list.