What North Carolina's Adult Care Penalty List Shows for the Winston-Salem Area

What the penalty list is

North Carolina fines adult care homes only for its most serious violations. Under N.C.G.S. 131D-34, a Type A1 violation is one that resulted in death or serious physical harm, abuse, neglect or exploitation, and a Type A2 violation is one that created a substantial risk of those outcomes. When a home fails to correct a violation by the deadline, the state can add an unabated-violation penalty on top.

The Division of Health Service Regulation publishes every penalty imposed in the past 36 months, with the facility, the inspection date, the rule, the level, the amount and whether it has been paid or appealed. Lesser deficiencies never reach this list; they are closed with a plan of correction.

Which homes are on it

These are the homes in Forsyth, Davidson, Davie, Stokes and Yadkin counties with at least one penalty in the current 36-month window:

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

By level, the list holds 8 Type A1 penalties, 10 Type A2 penalties and 4 unabated-violation penalties. The largest totals come from unabated penalties, which grow daily until a problem is corrected.

Which rules are cited most

Most penalties here cite 10A NCAC 13F .0901, personal care and supervision, followed by medication administration under 13F .1004, health care under 13F .0902 and residents' rights under 13F .0909. Those are the rules closest to a resident's daily life: whether staff noticed a change in condition, gave the right medication at the right time and called the doctor when they should have.

When you read a home's penalty, open the inspection report linked beside it. The narrative explains what happened, to how many residents, and what staff said. Two penalties under the same rule can describe very different events.

How to use the list without overreacting

A fine records what went wrong at one point in time, sometimes more than two years ago. Since then a home may have changed administrators, retrained staff and passed clean surveys. The facility pages on this site list each home's later surveys under the penalty, so you can see whether the record has improved.

Ask the administrator directly: what happened, what changed, who checks that it stays fixed and whether the people involved still work there. A frank answer backed by a clean recent survey is reassuring. A defensive answer or a repeat citation is not.

How fines are decided and appealed

When inspectors find a serious violation, the state reviews the evidence and decides the level and the amount. Homes can contest a penalty through an informal review and then a formal appeal, which is why some entries on the list show a status other than paid. A penalty under appeal is still a finding the state stood behind enough to impose.

Penalty amounts depend on the level of the violation, the facility's history and, for unabated violations, how long the problem continued after the correction deadline. That is why a single unabated penalty can be larger than several A1 and A2 fines combined.

For families, the amount matters less than the facts behind it. A modest fine for a medication error that harmed a resident deserves as much attention as a large one, and reading the inspection narrative is the only way to know which you are looking at.

What an empty record does and does not mean

53 homes in the five counties have no penalty in the window, which is good news but not the whole story. Deficiencies that did not reach a fine still appear in survey documents, and they can tell you more about ordinary care than the penalty list does. Read both, and use our assisted living roster, which sorts by fines as well as by stars.