Winston-Salem Senior AdvisorWho licenses nursing homes in Winston-Salem?
DHSR's Nursing Home Licensure and Certification Section licenses every nursing home in North Carolina under N.C.G.S. Chapter 131E, and for homes that take Medicare or Medicaid it also carries out the federal surveys on behalf of CMS.
the state lists 32 nursing homes in the five counties with 3,296 licensed beds; CMS rates 31 of them, and 14 hold four or five stars overall (Care Compare data dated October 1, 2026).
Almost every nursing home in the five counties is certified, which brings the federal requirements of 42 CFR Part 483 on top of the state license: resident assessments, care planning, staffing, infection control, residents' rights and much more.
How often are nursing homes inspected?
Each certified nursing home gets an unannounced standard health survey roughly once a year, with federal law requiring one at least every 15 months, plus complaint surveys and infection-control inspections whenever they are warranted.
The standard survey is a multi-day visit in which surveyors observe care, interview residents and staff, and review records. Every deficiency is graded by how serious it was and how many residents it affected. CMS publishes the survey dates, deficiency counts and the details on Care Compare, and our nursing home pages show the latest two cycles next to the local median.
What do the CMS star ratings for nursing homes measure?
CMS gives each certified nursing home one to five stars in three areas, health inspections, staffing and quality measures, and combines them into an overall rating; the inspection rating carries the most weight.
The staffing rating uses payroll data that homes submit to CMS, so it reflects hours actually worked rather than hours promised. Quality measures come from resident assessments and claims, covering things like falls, pressure ulcers and rehospitalization. Use the overall stars to build a shortlist, then open the inspection and staffing numbers behind them.
What penalties can a nursing home face?
CMS can impose civil money penalties and deny payment for new admissions when a certified home is out of compliance, and the state can impose its own penalties under Chapter 131E; CMS publishes three years of fines and payment denials for each home.
Homes with a persistent record of serious problems can be placed in CMS's Special Focus Facility program, which means more frequent surveys and public flagging until they improve or leave Medicare and Medicaid. CMS also marks homes cited for abuse with an icon on Care Compare. Our facility pages repeat both flags whenever CMS shows them.
How should Winston-Salem families use the federal data?
Start with the overall rating to narrow the field, then compare the latest inspection's deficiency count, nurse staffing hours and staff turnover against the local medians, and finish by reading the inspection narrative for any home you are seriously considering.
Numbers do not replace a visit, and a visit does not replace the numbers. A home can tour beautifully and have high turnover on nights; another can look tired and have the same nurses for a decade. Our nursing home list sorts all homes in the five counties by CMS rating, inspection date or deficiencies.
What it is, and what it is not
| Nursing home oversight in North Carolina is | Nursing home oversight in North Carolina is not | |
|---|---|---|
| License | A DHSR nursing home license under Chapter 131E | An adult care home license |
| Certification | CMS rules for homes taking Medicare or Medicaid | Optional for homes that bill Medicare |
| Ratings | CMS one-to-five stars on Care Compare | DHSR's zero-to-four adult care stars |
| Surveys | Unannounced, about yearly, plus complaints | Scheduled in advance with the home |
Based on N.C.G.S. Chapter 131D, 10A NCAC 13F and 13G, DHSR and NCDHHS documents, NC Medicaid, CMS, the VA, CareScout and the local agencies named above; see our editorial standards for how each is checked.
