Best Assisted Living in North Carolina

Overview of The Gardens of Rose Hill

The Gardens of Rose Hill is a 45-bed assisted living and secured living community at 571 S. Sycamore Street, Rose Hill, Duplin County, North Carolina. It accepts Medicaid, offers rehabilitation services and respite care with 24-hour staffing, and holds a 3-star state rating tied for 40th of 138 North Carolina facilities. The community provides restaurant-style dining, library, entertainment room, outdoor common areas, housekeeping, transportation, and structured daily activities.

Physical plant maintenance and medication management deficiencies define The Gardens of Rose Hill’s regulatory history. Over eight years and ten inspections, the facility averaged 5.3 deficiencies annually, 2 percent above North Carolina’s 5.2-deficiency benchmark. The most recent August 7, 2025 follow-up survey found one deficiency: five heat pumps remain non-operational with corridor temperatures at 78 to 79 degrees Fahrenheit, approaching egress limits. This deficiency had not been corrected from May 2025.

Building systems failures span electrical, fire safety, and HVAC infrastructure. May 2025 construction survey identified five deficiencies uncorrected from prior years: electrical outlets in wet locations lacked ground fault interrupters and proper in-use covers; fire safety components including rusted sprinkler escutcheons and a non-operational fire alarm air compressor; a non-functional left hot water heater in the 200 hall mechanical room; five non-operational heat pumps; and a non-functional soiled utility room exhaust fan. August 2023 documented additional building maintenance gaps including missing tiles and stained grout in the SPA shower, unprotected GFCI outlets throughout laundry areas and behind water heaters, improper ice machine drain configuration, and non-functional spa and housekeeping closet exhaust fans. April 2019 cited 11 major deficiencies: unsecured cleaning agents in janitor closets, deteriorating exterior fascia, ceiling stains and mildew, broken concrete benches, missing fire rehearsal documentation, compromised fire-rated ceiling penetrations in attic smoke barrier walls and mechanical rooms, propped fire doors, malfunctioning GFCI receptacles, items stored to ceiling height restricting sprinkler clearances, and non-operational exhaust ventilation.

June 2015 revealed that an NFPA 13 wet sprinkler system had been non-operational since January 2014, requiring continuous fire watch; fire-rated walls and ceilings throughout the facility contained unsealed penetrations; cross-corridor doors failed to latch; kitchen range hood fire suppression was not inspected monthly; and ice machine drain lacked proper air gap.

Medication administration and health professional support gaps appear consistently. August 2024 found one resident without required quarterly licensed health professional evaluations; three of five sampled residents did not receive ordered medications and vital sign checks were not documented. June 2022 documented medication aide failures to observe residents taking medications and errors with topical pain medications. January 2020 annual and complaint investigation found one resident did not receive six ordered medications and a steroid cream was left unattended in another resident’s room; the kitchen failed contamination protection standards with rusty shelves, undated items, and grease accumulation.

No substantiated complaint investigations appear in the record. No fines or license suspensions have been imposed.

Families should ask about corrections implemented following the August 2025 HVAC deficiency, the sprinkler system maintenance deficiency from June 2015, and medication administration monitoring protocols.

Overview of Morning Star Special Care Unit

Morning Star Special Care Unit is a 44-bed nursing home at 3017 Dunn Road, Fayetteville, Cumberland County, North Carolina. It specializes in weight management, direct medical care, and testing services through telemedicine and holds a 3-star state rating tied for 40th of 138 North Carolina facilities. Current occupancy is 75 percent (33 of 44 beds), comparable to the state average of 76.4 percent. The facility is not currently Medicare or Medicaid certified.

A substantiated abuse incident in March 2024 represents the facility’s most serious regulatory finding. Staff dragged a resident backwards down the hallway by her arms; the staff member was terminated and charged with a felony. That same survey found food safety violations with contaminated walk-in cooler and freezer ice buildup, and failure to complete pre-admission screenings for five Special Care Unit residents.

Physical plant and fire safety deficiencies persist across eight years of inspections, though the August 2025 follow-up survey found all previously cited issues corrected. March 2025 construction survey identified 12 deficiencies centering on emergency egress and fire safety infrastructure. Two emergency override switches failed to operate properly, one without staff having a key; another was unlabeled and magnetic locks did not release when activated. Current fire and building safety inspection reports were missing; the facility’s dry pendant sprinkler system had not been inspected since February 2024 and exceeded its 20-year service life requiring testing.

Bathrooms lacked privacy with no curtains or partitions at showers and water closets. Exterior grounds showed fallen siding, missing cleanout covers, and a sheet of glass on the ground. Interior conditions included broken flooring, rusted door frames, cracked ceilings, missing tiles, and dust accumulation on exhaust fan grilles. Three toilet seats were loose or unsecured.

Clothes racks blocked electrical panels. Fire safety rehearsal documentation was absent for the second quarter of 2024. Multiple emergency lights and exit signs failed to illuminate when tested. Fire safety systems contained unsealed cable penetrations, missing fire caulk, holes in ceilings, overdue fire extinguisher inspections, obstructed sprinkler heads with plumbing leaks, and non-closing fire doors.

Exhaust fans in bathrooms and shower areas were non-operational.

Medication administration and staff training deficiencies appear across 2019 to 2020 surveys. December 2019 documented nine deficiencies: one medication aide lacked required diabetic care training prior to insulin administration; a supervisor had not completed required continuing education; one resident experienced three falls in less than 30 days due to inadequate supervision; physicians were not notified of wound care issues for two residents; activity programming was not implemented; insulin pens and vials were not properly labeled; medications were administered without orders or were missed for days; one resident received expired insulin; and special care unit staff had not completed required orientation within required timeframes. March 2020 follow-up found continued medication administration failures, specifically failure to obtain heart rate documentation before administering metoprolol as ordered.

April 2017 construction survey revealed 16 deficiencies encompassing missing annual fire inspection reports, ceiling openings and water damage with mold and peeling finish, damaged furniture and walls with chipped and fallen finishes, malfunctioning door hardware, non-functional bathroom grab bars, fire alarm system failures with panel indicating trouble and improper maglock reengagement, non-working emergency lighting throughout, sprinkler obstructions, cracked windows, out-of-service water heaters and coolers, broken fixtures, hot water at 94 degrees Fahrenheit (below the 100-degree minimum), and unsafe exterior premises with damaged fence, exposed rusty nails, broken chairs, and debris stacked around the dumpster.

Over eight years, Morning Star averaged 13.8 deficiencies annually, 165 percent above North Carolina’s 5.2-deficiency benchmark. The August 2025 follow-up survey confirms all deficiencies have been corrected. Most complaint investigations were unsubstantiated except for the March 2024 abuse finding. No fines or license suspensions appear in the record.

The substantiated abuse incident in March 2024 and the facility’s extensive prior deficiency history warrant careful review.

Families should verify corrective action documentation for the 12 deficiencies from March 2025, request current fire safety inspection reports, and confirm all staff training requirements.

Overview of Dayspring of Wallace

Dayspring of Wallace is an 80-bed assisted living and secured living facility at 4026 S NC 11, Wallace, Duplin County, North Carolina. It provides 24-hour staffing, accepts Medicaid, and holds a 3-star state rating tied for 40th of 138 North Carolina facilities. Current occupancy is 59 percent (47 of 80 beds), below the state average of 76.4 percent. The facility offers restaurant-style dining, housekeeping, transportation, library, entertainment, outdoor common areas, therapy services, pharmacy services, and structured daily activities.

Infection control failures during acute illness and medication management gaps define DaySpring’s recent regulatory challenges. The April 24, 2025 follow-up survey found one critical deficiency: the facility failed to follow CDC recommendations and its own infection control policies during a COVID-19 outbreak. Nine residents and one staff member tested positive; four residents remained positive at the time of inspection. The facility failed to quarantine COVID-19 positive residents, notify the local health department, and ensure staff wore required PPE including masks.

This deficiency reflects fundamental infection control protocol breaches during a communicable disease outbreak.

January 2025 annual survey documented four deficiencies consolidating maintenance and medication management failures. A resident toilet clogged on January 3 and overflowed; the facility did not repair it until January 6, creating unsanitary conditions. A medication aide lacked required competency validation for Licensed Health Professional Support tasks, indicating inadequate staff onboarding oversight. The facility failed to notify the primary care provider of multiple medication refusals spanning 13 and 17 days for one resident, placing the resident at risk of unmonitored health changes.

A resident received cold pureed food instead of hot food. June 2022 annual survey documented medication administration failures when a medication aide did not perform hand hygiene before and after administering oral medications to three residents; the facility also failed to administer ten medication doses to one resident due to family refusal without physician orders to hold treatment.

Physical plant deficiencies spanning 2018 surveys included obstructed corridors, improperly maintained plumbing with algae growth, wall holes, non-functioning equipment, incomplete fire rehearsals, missing ground fault interrupters on electrical outlets in wet locations, compromised fire-resistant barriers, fire sprinkler system issues, blocked self-closing doors, corridor doors failing to resist smoke passage, and electrical hazards. October 2018 follow-up found four uncorrected deficiencies including sharp mounting brackets, improperly posted evacuation maps, electrical outlet deficiencies, and propped open self-closing doors. Over five years, DaySpring averaged 8 deficiencies annually, 54 percent above North Carolina’s 5.2-deficiency benchmark. Occupancy has declined over time.

No fines or license suspensions appear in the record.

Families should ask about corrections following the April 2025 COVID-19 infection control deficiency, medication aide competency, and protocols for notifying physicians of medication refusals.

Brookstone Retirement Center is a 115-bed, home for the aged licensed facility at 2968 Old Salisbury Road, Lexington, Davidson County, North Carolina. It provides 24-hour staffing with on-site registered nurse and physician, rehabilitation services, home health care, Alzheimer’s special care unit, activities, and on-site beauty salon with a 3-star state rating.

Nutrition, medication administration, and environmental control failures characterize Brookstone’s seven-year regulatory history. Over seven years, the facility averaged 7.9 deficiencies annually, 52 percent above North Carolina’s 5.2-deficiency benchmark. October 2025 annual survey found one deficiency: hot water temperatures at two of seven resident bathroom sinks exceeded the maximum allowed 116 degrees Fahrenheit, with readings reaching 122 degrees despite monthly maintenance checks and thermostat adjustments. July 2024 documented one deficiency when six of 28 Special Care Unit residents did not receive required eight ounces of milk three times daily, with milk available in 17 unopened and 2 opened gallons plus six crates of individual milk cartons.

December 2022 annual survey identified three critical deficiencies in resident care. One resident lacked follow-up for portable oxygen, resulting in no portable oxygen available despite physician orders, potentially compromising respiratory support. Special Care Unit residents requiring feeding assistance were not consistently assisted in unhurried manner; staff frequently stood rather than sat while feeding residents, raising dignity and proper nutrition concerns. One resident received duplicate diabetic medications due to pharmacy and facility communication errors.

Earlier inspections reveal recurring medication administration, resident supervision, and physical plant safety maintenance gaps across years with no clear improvement trajectory. No fines or license suspensions appear in the record.

Families should ask about corrective actions for hot water temperature management, protocols for special care unit meal service and feeding assistance, and medication error preventions.

Overview of Somerset Court of Mocksville

Somerset Court of Mocksville is a 60-bed assisted living and secured living facility at 150 Ken Dwiggins Drive, Mocksville, Davie County, North Carolina. It provides 24-hour staffing, accepts Medicaid, offers respite care, restaurant-style dining, housekeeping, transportation, emergency alert system, library, entertainment room, and outdoor common area. Current occupancy is 88 percent (53 of 60 beds), above North Carolina’s 76.4 percent average, with Walk Score 54 indicating moderate walkability. The facility holds a 3-star state rating, tied for 40th of 138 North Carolina facilities.

Resident supervision gaps and fall prevention failures have marked Somerset’s regulatory history, with significant improvement demonstrated by recent corrective actions. Over nine years, the facility averaged 4.8 deficiencies annually, 8 percent better than North Carolina’s 5.2-deficiency baseline. April 2025 follow-up construction survey confirmed all previously cited deficiencies had been corrected.

December 2016 annual survey identified critical safety failures. Two residents with documented fall histories (experiencing 13 and 5 falls respectively) lacked adequate supervision aligned with their assessed needs and symptom patterns, resulting in injuries and substantial risk of serious injury or death. Four of five sampled residents missed required quarterly Licensed Health Professional Support evaluations including physical assessment and care planning. Residents failed to receive three snacks daily as required.

October 2022 annual survey documented eight deficiencies reflecting medication administration and infection control lapses. Two residents lacked follow-up toenail care; kitchen and food storage areas were not clean and free of contamination; one resident did not receive ordered supplement twice daily; medication orders and diet orders conflicted for one resident; medications were not administered as ordered for six residents with missed doses including seizure medication, anti-nausea, topical pain medication, diuretic, steroid, and corticosteroid cream; medication aides failed to observe two residents taking medications; one medication aide administered eye drops without proper hand hygiene; one resident lacked physician order for self-administered eye drops and topical cream.

January 2023 follow-up documented one resident with documented fall history experiencing unwitnessed falls December 29, 2022 and January 3, 2023 without fall risk signage or consistent supervision. Fire safety infrastructure failures emerged across multiple inspection cycles. February 2018 complaint investigation substantiated that the facility’s sprinkler system was out of service since November 2017 due to rust-through holes with zero pressure. No repair or replacement date was determined despite fire watch protocols.

January 2019 construction survey identified 16 deficiencies including failure to maintain current fire and building inspection reports, obstructed corridors reducing required widths, unsecured oxygen cylinders, broken towel bars, outdated fire extinguisher inspection tags, inadequate fire safety rehearsal documentation, electrical outlets lacking ground fault interrupters, non-functional fire alarm systems, obstructed sprinkler heads, compromised fire-resistant wall and ceiling integrity, missing kitchen hood fire suppression documentation, blocked electrical panels, wedged corridor doors, and non-latching smoke-tight doors. Additional deficiencies spanned tuberculosis screening gaps and medication administration errors with inadequate staff training. No fines or license suspensions appear in the record.

The facility’s April 2025 clean follow-up survey and high current occupancy suggest sustained correction efforts.

Before placement, families should verify current fall prevention protocols, resident supervision staffing levels, and medication administration observation procedures with direct questions during tours.

Overview of The Gardens of Trent

The Gardens of Trent is a 60-bed assisted living facility at 2915 Brunswick Avenue, New Bern, Craven County, North Carolina. It provides 24-hour staffing, accepts Medicaid, and holds a 3-star state rating with Walk Score 76 indicating high walkability.

Medication administration failures and serious resident supervision breaches define The Gardens’ regulatory record, with substantiated Type A1 violations indicating systemic care failures. Over eight years, the facility averaged 8.4 deficiencies annually, 62 percent above North Carolina’s 5.2-deficiency benchmark. April 2025 complaint investigation substantiated critical findings. The facility failed to administer seizure medication (Depakote) as ordered for Resident #1, resulting in multiple hospitalizations and seizures.

The facility failed to notify Craven County Department of Social Services of incidents resulting in emergency medical evaluation or hospitalization within the required 48 hours.

Resident elopement incidents with supervision failures appear repeatedly across the record. June 2023 complaint investigation substantiated Type A1 violation when a resident with dementia eloped from the facility, with staff failing to respond to audible sounding device for the mag lock switch. The facility failed to provide supervision with dignity and respect to a resident and failed to report abuse allegations within 48 hours for two residents (census 52 of 60 beds). January 2023 complaint investigation documented October 25, 2022 elopement when Resident #1 with dementia reached a restaurant 704 yards away within 10-15 minutes, with doors unlocked for 13-15 hours due to malfunctioning mag locks and failure to hear and respond to audible sounding device (Type B violation).

Physical plant deficiencies spanning multiple inspection cycles reflect deferred maintenance and safety system failures. November 2024 follow-up construction survey found three uncorrected deficiencies: exterior egress paths improperly lit, electrical outlets in East Laundry room lacking ground fault circuit interrupters, and exhaust fans in rooms 45 and 49 non-operational. March 2019 construction survey identified 10 deficiencies including bathroom renovations non-compliant with North Carolina Building Code (shower heads over toilets, non-waterproof walls, missing floor drains), corridor obstructions, seven unsecured portable oxygen cylinders, incomplete fire safety rehearsal records, non-functional emergency lighting and exit signage, portable electric heater, hot water temperatures of 94-96 degrees (below 100-degree minimum), and missing exhaust ventilation.

Clinical care deficiencies span medication administration and nutrition. May 2019 annual survey found detachable shower head fixtures with looped hoses dangling over toilets in Special Care Unit, expired and unlabeled foods, therapeutic diets not served as ordered, incomplete medication administration records, and lack of physician contact for medication clarification. March 2017 annual survey documented medication administration errors with insulin, antipsychotic, pain reliever, laxative, antibiotic, and heart medications; two of three medication aides lacked annual infection control training; two of five staff lacked required 80-hour personal care training; resident neglect resulted in second-degree burns from bed placement near heater. May 2024 annual survey identified one deficiency when four deceased residents’ Estate Administrators failed to receive refunds within 30 days due to corporate accounting staff turnover and lost refund requests.

May 2017 and February 2017 construction surveys documented delayed egress exit door failures with missing signage and non-functional alarms, magnetic locks failing to unlock within 15 seconds or upon fire alarm activation, heat detectors improperly mounted or missing, and fire alarm pull station detached. April 2025 follow-up survey confirmed all previous deficiencies had been corrected. No fines or license suspensions appear in the record.

Families should ask about corrections following the April 2025 seizure medication administration failure, resident supervision, mag lock and alarm systems, and medication administration procedures.

Overview of Hope Mills Retirement Center

Hope Mills Retirement Center is a 64-bed assisted living facility at 4217 Elk Road, Hope Mills, Cumberland County, North Carolina. It provides 24-hour staffing and accepts Medicaid.

Fire safety system failures and medication administration errors define Hope Mills’ limited regulatory record. Over two years (2016-2018), the facility averaged 6 deficiencies annually, 15 percent above North Carolina’s 5.2-deficiency benchmark. The most recent inspection on February 28, 2018 identified five deficiencies reflecting maintenance and safety infrastructure gaps. An exterior light at south hall exit was non-functional.

Six small and seven large oxygen cylinders were improperly stored in cardboard carriers in Room 8; inoperable call systems were present in each resident room. Fire rehearsals were not conducted per North Carolina Fire Prevention Code; no evacuations or audible alarms occurred on shifts, and fire drill logs lacked required descriptions. Building equipment was not maintained safely with windows potentially failing to stay open creating injury risk, exit signs failing to illuminate on battery backup, non-secure GFCI outlet, and unapproved door-propping devices. Exhaust ventilation was not provided at required rates; a storage room used for housekeeping items lacked ventilation.

December 2016 annual survey documented medication administration and physician communication failures. One resident’s out-of-range blood pressure readings were not reported to the physician per ordered parameters. Two residents experienced medication administration errors including improper fast-acting insulin administration (no air shot before administration and incorrect timing relative to meals) and medication error with cholesterol treatment.

Fire detection system gaps persisted across inspection cycles. March 2016 construction survey cited four deficiencies: the facility lacked fire detection coverage in all habitable rooms affecting smoke and fire detection and fire alarm activation; emergency illumination was not maintained in safe manner affecting paths of egress during emergencies; no heat detection was present in the Linen Closet in North Wing; and emergency illumination was absent in TV Room North Wing, TV Room South Wing, and Hall outside Room 33. April 2016 follow-up survey confirmed one uncorrected deficiency when the facility still lacked fire detection coverage in all habitable rooms, specifically missing heat detection in Linen Closets in North Wing. No fines, immediate jeopardy findings, or enforcement actions appear in the record.

No complaint investigations documented. The inspection record spans 2016-2018 only with no recent survey activity listed.

Families should ask about fire detection systems, emergency lighting, oxygen cylinder storage, call system operability, fire drills, medication administration, and protocols for vital sign abnormalities.

Overview of Homestead Hills Assisted Living

Homestead Hills Assisted Living is a 66-bed community at 2101 Homestead Hills Drive, Winston-Salem, Forsyth County, North Carolina. It provides independent living, assisted living, memory care, and skilled nursing services; operates 24/7; and holds a 3-star state rating tied for 40th of 138 North Carolina facilities. A 6X National Award winner designation reflects prior operational achievements. Current occupancy is 30 percent (20 of 66 beds) significantly below the state average of 76.4 percent.

Staff training, medication management, and building safety represent Homestead Hills’ persistent compliance challenges. Over five years and across seven inspections, the facility averaged 9.6 deficiencies annually, 85 percent above North Carolina’s 5.2-deficiency benchmark. The October 26, 2023 annual survey identified five deficiencies consolidating longstanding gaps in medication aide preparation and health professional competency. Five of six medication aides failed to complete required medication clinical skills checklists or medication aide training verification; four of six staff lacked competency validation for licensed health professional support tasks spanning fingerstick blood sugar checks, insulin injections, inhalation medications, and oxygen administration.

Two residents were not tested for tuberculosis upon admission; one resident’s required licensed health professional evaluation was not completed within 30 days. Three residents did not receive ordered medications for blood pressure regulation, antipsychotic therapy, and heart-rate management.

Medication aide deficiencies recur across the facility’s history. August 2015 substantiated complaint investigation documented seven deficiencies that parallel current findings: five of six staff lacked competency validation for blood glucose checks, insulin injections, oxygen administration, and nebulizer use; four of six had not received diabetic care training before administering insulin; three of five medication aides hired after October 2013 had not completed required 15-hour medication administration training or clinical skills validation. Additional deficiencies in that investigation included two residents not receiving ordered therapeutic diets (no concentrated sweets, mechanical soft), inadequate infection control for shared glucometers affecting three residents, inadequate restraint documentation for one resident, and absent annual infection control training for three staff.

Building and fire safety deficiencies span July 2015 through August 2019. July 2015 construction survey documented nine deficiencies including failed fire alarm components, unsecured oxygen cylinders (projectile hazards), wedged fire doors, breached fire-rated construction, unsealed gas and electrical ceiling penetrations, dragging or difficult-to-open exit doors, non-latching interior doors, and inadequate mechanical ventilation. September 2015 follow-up found five uncorrected deficiencies: continued oxygen cylinder storage hazards, fire-rated construction breaches, missing sprinkler escutcheon plates, unsealed ceiling penetrations, and non-functional laundry ventilation. July 2017 cited 13 violations spanning missing fire inspection reports, bathrooms used for storage, poor furniture and plumbing maintenance, unsecured oxygen cylinders, non-functional emergency lighting, improperly propped doors, fire-resistant ceiling breaches, difficult egress doors, misaligned kitchen hood suppression heads, missing ansul system documentation, and absent bathroom exhaust ventilation.

August 2019 identified eight deficiencies: particulate buildup on return-air grilles, non-illuminated exit signs, non-functional emergency lights, missing sprinkler escutcheons, wedged fire doors, non-latching doors, stored items blocking sprinkler coverage, and non-operational janitorial exhaust.

September 2021 documented one capacity violation: 20 residents occupied a Special Care Unit licensed for 18 beds. The facility offers wellness programs, full-time activity coordination, fine dining with flexible menus, concierge and salon services, housekeeping, transportation, and 24-hour emergency call systems. No fines or license suspensions appear in the record.

Families should ask about corrective actions taken following the October 2023 medication administration and staff competency deficiencies.