Nursing Homes and Senior Care in North Carolina

Nursing Homes by City in North Carolina

The North Carolina cities with the most CMS-certified nursing homes. All 199 cities are listed below the table. Homes in North Carolina average 3.8 hours of nursing care per resident per day; the national median is 3.7 hours.

5-Star Nursing Homes in North Carolina

Homes with CMS's top overall rating, ordered by inspection rating. See all highest-rated nursing homes in North Carolina.

Assisted Living in North Carolina

NC Division of Health Service Regulation, Adult Care Licensure Section licenses assisted living in North Carolina. License types: Adult Care Home and Family Care Home. Use the state's search to check a community's license and inspection history.

• North Carolina assisted living facility search
• North Carolina assisted living rules
• North Carolina assisted living licensing (NC Division of Health Service Regulation, Adult Care Licensure Section)

Memory Care Rules in North Carolina

North Carolina's term is "Special Care Unit for Alzheimer's Disease or Related Disorders", a separate license or certification. Facilities must give families a written disclosure of their dementia care services.

• A facility that advertises, markets or otherwise promotes itself as having a special care unit for residents with Alzheimer's Disease or related disorders shall be licensed as an adult care home with a special care unit, and the license shall indicate that a special care unit is provided (10A NCAC 13F .1303).
• Only facilities with units that meet the special care unit rules may advertise, market or otherwise promote themselves as providing special care units for persons with Alzheimer's Disease or related disorders (10A NCAC 13F .1302).
• Written disclosure under G.S. 131D-8 to the Department, to each person seeking placement before an agreement is signed, and to the Office of State Long-Term Care Ombudsman annually. It must cover philosophy and mission, placement, transfer and discharge criteria, assessment and care planning, staffing ratios, dementia-specific staff training, physical environment and design features, frequency and type of programs and activities, family involvement and support programs, and additional costs and fees.
• For units licensed on or after April 1, 2025: unit exit doors locked with devices meeting the North Carolina State Building Code for special locking arrangements, a sounding device on exit doors, window openings limited to four to six inches, and direct access to a secured outside area enclosed by a fence at least six feet high (10A NCAC 13F .1304).
• Staffing: at least one staff person for up to eight residents on first and second shifts plus 1 hour of staff time for each additional resident, and one staff person for up to 10 residents on third shift plus .8 hours of staff time for each additional resident; a care coordinator on duty in the unit at least eight hours a day, five days a week (10A NCAC 13F .1308).
• Training: the administrator documents at least 20 hours of training specific to the population served before opening a unit; each employee assigned to the unit completes six hours of orientation within the first week; personal care staff complete 20 hours of population-specific training within six months; and at least 12 hours of continuing education annually, of which six hours shall be dementia specific (10A NCAC 13F .1309).
• Admission: a physician shall specify a diagnosis on the resident's FL-2 that meets the conditions of the unit, and the facility screens for appropriateness of placement (10A NCAC 13F .1306).
• A written resident profile within 30 days of admission to the unit and quarterly thereafter (10A NCAC 13F .1307).

• North Carolina memory care rules

Medicaid Long-Term Care in North Carolina

North Carolina's Medicaid program is NC Medicaid. For nursing home Medicaid (2026), the state lists an asset limit of $2,000 (individual); $3,000 (couple). Residents keep a personal needs allowance of $70 for an institutionalized individual, or $140 for a married couple who share a room.

• Community Alternatives Program for Disabled Adults (CAP/DA): in-home care. For adults age 18 and older who meet a level of care and need at least one CAP/DA home and community-based service. The person must qualify for long-term care NC Medicaid (MAA, MAB, MAD or HCWD) and be enrolled in NC Medicaid Direct. Some participants may owe a deductible based on income.
• Personal Care Services (PCS): in-home care and assisted living. PCS can be provided in a person's own home or in a place where they live with help, like an adult care home.
• Program of All-Inclusive Care for the Elderly (PACE): in-home care. Age 55 or older, needs nursing home level of care, lives in a PACE service area and can live safely at home. 11 PACE organizations operate in 14 locations in North Carolina.

• NC Medicaid nursing facility coverage
• North Carolina Medicaid long-term care limits

Nursing Home Inspections and Complaints in North Carolina

NC Division of Health Service Regulation, Nursing Home Licensure and Certification Section inspects nursing homes in North Carolina for CMS. To file a complaint, call 1-800-624-3004 (within N.C.); 919-855-4500 or use the state's complaint page.

• North Carolina nursing home inspection lookup
• File a nursing home complaint in North Carolina

North Carolina Long-Term Care Ombudsman

The Long-Term Care Ombudsman Program is a free, confidential advocate for residents of nursing homes and assisted living. Ombudsmen help with complaints, residents' rights and problems with care. Call 1-800-662-7030.

• Contact the Long-Term Care Ombudsman Program

Aging Services and Caregiver Support in North Carolina

NC Division of Aging runs North Carolina's aging services, delivered through local Area Agencies on Aging. Family caregivers can get help through Family Caregiver Support Program. Adult day services are overseen by NC Division of Aging (certification).

• North Carolina aging services: NC Division of Aging
• Caregiver support in North Carolina: Family Caregiver Support Program
• North Carolina adult day services

Guides for Your Next Step

See how to choose a nursing home, what memory care is, how Medicaid pays for nursing home care and what Medicare covers. For local help, call the Eldercare Locator at 1-800-677-1116.

Frequently Asked Questions