Best Assisted Living in North Carolina

Overview of Southfork

Southfork is a 78-bed nursing home at 1345 Jonestown Road, Winston-Salem, Forsyth County, North Carolina. The facility provides 24-hour skilled nursing and secured living services; accepts Medicaid and respite care. A 3-star state rating places it tied for 40th of 138 North Carolina homes. Current occupancy is 60 percent (47 of 78 beds) which is below the state average of 76.4 percent.

Systemic failures in staffing, housekeeping, medication management, and resident care define Southfork’s regulatory record. The August 1, 2025 annual inspection found seven deficiencies that consolidate longstanding operational gaps. Aided residents in the Assisted Living unit experienced staffing shortages in 7 of 9 sampled shifts, with documented gaps ranging from 1 to 11.5 hours per shift; inadequate staffing led to delayed call bell responses and insufficient assistance for three sampled residents, violating their right to dignity and respect. Kitchen housekeeping was substandard: brown and black grease buildup contaminated floors; ice for resident consumption was stored uncovered.

Water was not served with meals to 31 of 37 assisted living residents, which is a violation of nutrition standards. Medication management failed for two residents: one did not receive ordered sertraline (six scheduled doses were not given), and documentation of insulin aspart administration proved inaccurate for another resident, with doses recorded as given but held.

Physical plant and fire safety deficiencies cluster across seven years, reflecting systemic maintenance failures. July 2023’s eleven citations encompassed automatic door closers removed from smoke barrier walls, emergency release switch covers screwed shut, absent fire and building inspection documentation, a bathroom converted to storage with 30 cardboard boxes, non-functional wanderer alarms, unsafe exterior premises (water damage, trip hazards), deteriorated furnishings and peeling ceilings, improper oxygen bottle storage, missing quarterly fire rehearsal records, compromised fire-resistant ceiling assemblies with bent sprinkler deflectors and electrical hazards, and absent exhaust ventilation. September 2017 and November 2019 surveys documented overlapping violations: improper corridor door latching, obstructed egress, dust and odor accumulation, inadequate grab bars in resident bathrooms, failed emergency lighting, missing fire extinguisher documentation, and gaps in fire-resistant construction. July 2015 identified eight deficiencies including code non-compliance on special locking arrangements with staff unaware of emergency override procedures; missing sanitation and fire safety reports; poor housekeeping with spider webs in 12 percent of bedroom closets; uncovered oxygen cylinders; improperly maintained fire doors; and non-functional exhaust in designated areas.

November 2023 and June 2024 follow-up surveys identified bent sprinkler deflectors impairing fire suppression capability. December 2022 and October 2019 annual inspections documented failure to implement physician orders (blood pressure, weight, and laboratory monitoring) and failure to serve mandated milk quantities to Special Care Unit residents.

Over seven years and across ten inspections, Southfork averaged 7.9 deficiencies annually, 52 percent above North Carolina’s 5.2-deficiency benchmark. The facility operates restaurant-style dining, entertainment and library rooms, outdoor common areas, transportation, housekeeping, and 24-hour staffing. No fines or license suspensions appear in the record.

Families should verify corrective actions taken following the August 2025 medication documentation, staffing hours, kitchen sanitation, and resident dignity deficiencies.

Overview of Terrace Ridge Assisted Living

Terrace Ridge Assisted Living is a 74-bed memory care center at 1251 East Hudson Boulevard, Gastonia, Gaston County, North Carolina, 2.0 miles from downtown. the facility offers memory care with events, activities, and family resources. CMS Overall Rating is 2 out of 5 stars. The facility does not accept Medicaid or Medicare.

The regulatory record spans ten years with serious deficiencies in resident safety, medication management, therapeutic diet compliance, and facility maintenance. Over six years, Terrace Ridge logged 39 deficiencies, averaging 6.5 annually, 25 percent worse than North Carolina’s 5.2-deficiency benchmark. An October 14, 2015, construction survey cited eight deficiencies in water supply, HVAC, sprinkler maintenance, fire-resistant construction, corridor doors, exit signage, emergency lighting, and ventilation. An October 18, 2017, construction survey cited nine deficiencies in closet fire protection, ceiling gaps, escutcheon plates, pipe caulking, smoke walls, cable penetrations, smoke doors, and exhaust.

A November 14, 2019, construction survey cited ten deficiencies in fire-resistant construction, grab bars, fire rehearsals, emergency lighting, kitchen hood system, electrical outlets, gaps, smoke doors, sprinkler escutcheon plates, and blocked doors. A September 16, 2022, annual survey cited three deficiencies in therapeutic diet documentation, diet service, and medication observation. A March 13, 2024, annual survey and complaint investigation substantiated serious resident safety failures: failure to ensure exit doors had audible alarms for residents with wandering behaviors resulting in elopements, failure to properly supervise two residents with exit-seeking behaviors resulting in elopements and substantial risk of harm, failure to provide therapeutic diet menus for consistent carbohydrate diets, failure to serve ordered therapeutic diets, failure to administer medications as ordered with unapproved medication and improper preparation and borrowing. An October 15, 2025, annual survey cited two deficiencies in failure to implement physician discontinuation orders for two medications.

No fines or license suspensions are records.

The facility’s 2-star CMS rating and 25 percent worse-than-average deficiency rate reflect serious operational failures. The March 2024 substantiated elopement incidents involving residents with dementia and failure to provide audible alarms on exit doors represent critical patient safety breaches with documented substantial harm risk.

Before placement, families must ask directly about the March 2024 elopements and current exit door alarm systems, resident supervision protocols, and medication administration safeguards.

Vienna Village is a 90-bed assisted living community at 6601 Yadkinville Road, Pfafftown, Forsyth County, North Carolina. Family-owned since 1965, it provides assisted living and independent living services, operates 24/7, and received the Winston-Salem Journal Reader’s Choice Award for Best Assisted Living. A 4-star state rating places it tied for 9th of 138 North Carolina facilities.

Medication management and building safety represent Vienna Village’s compliance challenges. The March 14, 2024 annual survey found one deficiency: a medication aide crushed extended-release medications (metoprolol succinate ER and potassium chloride ER) that should not have been altered, resulting in a 7 percent medication error rate for one resident. The resident care coordinator had failed to include “do not crush” instructions on the medication list; the medication aide supervisor did not audit to verify crushing protocols. The primary care provider confirmed that crushing extended-release medications compromises their therapeutic effectiveness and may increase adverse effects.

Fire safety and building code violations cluster across two construction survey cycles. December 2019 identified seven deficiencies: missing hand grip at a toilet, corridor and fire doors that did not close or latch properly (near exit S-7, West Dining room, utility room F53, and rooms F40 and F65), one-hour fire-rated walls and ceilings compromised by unsealed holes and electrical room penetrations, an improperly mounted light fixture, an ice machine drain line not maintained properly, non-approved electrical outlet expanders in institutional use, and storage too close to fire sprinkler heads (corrected during survey). September 2017 cited three deficiencies: resident room and cross-corridor smoke partition doors with quarter-inch or larger gaps that could allow smoke passage, and a multi-plug adapter replacing fixed electrical equipment in the salon area (corrected during survey).

A substantiated complaint investigation in March 2018 followed resident elopement on February 19, 2018. The facility failed to provide adequate supervision for a resident with exit-seeking behaviors admitted January 22, and did not initially use a body alarm despite known risks. Two deficiencies were cited for inadequate supervision and failure to assure appropriate care under applicable regulations. July 2015’s construction survey documented seven deficiencies: fire doors held open with permanent magnets in the laundry and soiled utility rooms, missing lever handles on the medication preparation sink, unsealed fire-rated wall and ceiling penetrations in the sprinkler riser room and linen closet F23, a compromised corridor smoke-resisting condition, disconnected ice machine exhaust ductwork, a prohibited portable electric heater, and an exit door requiring two hand motions to unlock.

Over five years Vienna Village averaged 4 deficiencies annually, 23 percent better than the state average of 5.2. The facility offers 24-hour staffing, clinical support, activities, dining, and grounds services. No fines or license suspensions appear in the record.

Families should ask about medication administration auditing protocols and corrective actions following the March 2024 crushing error.

Overview of Brookstone Terrace of Thomasville

Brookstone Terrace of Thomasville is a 62-bed assisted living and memory care facility at 915 West Cooksey Drive, Thomasville, Davidson County, North Carolina. It provides 24-hour staffing, dietitian-approved meals, activities, and dining services with a 3-star state rating. The facility is highly walkable (Walk Score 71).

Fire safety system maintenance failures and medication administration errors characterize Brookstone’s regulatory history. Over eight years, the facility averaged 8.8 deficiencies annually, 69 percent above North Carolina’s 5.2-deficiency benchmark. October 2024 follow-up survey found two deficiencies: the facility made unapproved modifications to safety systems on five exit doors without submitting required construction documents to DHSR, and fire-resistant ceiling gaps around sprinkler heads remained uncorrected where caps were removed. June 2024 construction survey identified six deficiencies reflecting systemic physical plant maintenance gaps: no quarterly fire rehearsal documentation on each shift, electrical receptacles lacking ground fault protection behind washing machines, kitchen door closer removed, fire safety equipment gaps and covered exit signs, ice machine drain without required 2-inch air gap, non-functional emergency lighting in multiple locations, and missing fire extinguisher monthly inspection records.

Clinical care deficiencies span medication administration and physician communication. December 2023 found one resident without required tuberculosis screening, one resident experiencing nine days of abnormal heart rate (outside ordered parameters) without physician notification, and one resident never receiving ordered Ozempic despite four documented administrations. June 2022 documented failure to notify physician of medication refusals, lorazepam administered more than once daily contrary to orders, warfarin doses missed, and medication aides failing to observe residents taking medications before documenting administration. No fines or license suspensions appear in the record.

Families should ask about corrections for the October 2024 exit door modifications and fire safety gaps, medication aide supervision, and physician notification procedures.

Overview of Caremoor Retirement Center

Caremoor Retirement Center is a 30-bed assisted living and memory care community at 4876 Caremoor Place, Kannapolis, Cabarrus County, North Carolina,, rated 2 out of 5 overall by the North Carolina Department of Health and Human Services, Division of Health Service Regulation, and ranked 106th (tied) among 138 homes statewide. Set within a broader campus that includes independent apartments and a fully licensed family care home, the facility accepts neither Medicaid nor Medicare. Walk Score is 3.

Atrium Health Cabarrus in Concord is the primary nearby acute-care resource.

Ten inspections from October 2015 through October 2024 average 11.8 deficiencies per year, 127 percent above the North Carolina benchmark of 5.2. Physical plant failures run through the middle of the record; clinical care deficiencies bracket both ends.

Starting with the most recent: the October 22 through 23, 2024, annual inspection found 5 deficiencies, all clinical, spanning unsigned care plans for 2 of 3 sampled residents, failure to notify the prescriber of low blood pressure and pulse readings for one resident, food storage past the 72-hour discard threshold, a chest pain medication not administered as ordered, and wound care supplies found unsecured on a resident’s bedside table.

The March 2024 biennial construction follow-up is the one bright spot in the record, confirming all previously cited deficiencies corrected with nothing new. That came after the December 2023 biennial survey, which produced 13 deficiencies: a missing quarterly fire safety rehearsal on the second-night shift, cross-corridor fire doors failing to release on alarm activation, multiple resident room doors not closing or latching, corroded sprinkler escutcheon rings in the kitchen, a non-functional emergency light in the medication prep room, unsealed cable penetrations, blocked electrical panels, and exhaust fans not working in staff and guest bathrooms, laundry, and community baths.

The January 2018 biennial survey found 14 deficiencies, including required exit signs absent from egress routes, fire alarm hold-open door failures, 27 oxygen cylinders stored without containers or restraints, fire extinguishers without monthly inspection documentation, and exhaust ventilation non-functional across multiple areas, deficiencies that persisted into two biennial follow-up surveys in June and August of the same year.

Back in October 2015, the annual inspection found criminal background check and Health Care Personnel Registry failures for 3 of 4 sampled staff, a competency validation failure, and a Prozac underdosing error. No fines, immediate jeopardy findings, or enforcement actions appear in the available record.

Families considering Caremoor should ask about corrections for the October 2024 medication and care plan findings, and fire door and exhaust ventilation compliance.

Overview of Tabor Commons

Tabor Commons is an 80-bed assisted living and respite care facility at 703 Elizabeth Street, Tabor City, Columbus County, North Carolina. It provides 24-hour staffing, accepts Medicaid, and focuses on providing a home-like environment.

Physical plant and fire safety deficiencies characterize Tabor Commons’ regulatory record, with recurring infrastructure maintenance failures across inspection cycles. Over seven years, the facility averaged 7.6 deficiencies annually, 46 percent above North Carolina’s 5.2-deficiency benchmark. February 2024 construction survey identified 11 critical deficiencies reflecting systemic facility maintenance and safety protocol gaps. The facility lacked current sanitation and fire and building safety inspection reports maintained in the home.

Remodeling including new fire alarm control panel installation occurred without submitting plans to DHSR/Construction. Exit doors lacked required sounding devices; exterior door alarm did not sound when opened. Walls and ceilings showed bubbled peeling paint and cracked separating finishes; furnishings showed damage including cracked glass in back door. Unsecured oxygen bottles were present in resident rooms.

Fire doors failed to close and latch properly; fire extinguishers and hood suppression system inspections were overdue. Fire-resistant-rated ceilings had unsealed cable and conduit penetrations and holes allowing potential fire and smoke spread. Electrical equipment showed missing outlet covers, non-functioning outlets, and exterior outlets without protective covers. Exit signs failed to illuminate on emergency backup test.

Emergency fire alarm system heat detectors were not secure to bases. Multiple exhaust fans were non-operational in guest toilets, women’s toilet, room bath, and housekeeping areas.

Medication administration and medication aide competency failures appear across clinical inspections. October 2016 annual survey documented one resident receiving 24 missed doses of Lantus insulin out of 57 opportunities despite physician orders, and failure to ensure infection prevention during medication administration. February 2017 follow-up found unclear sliding scale insulin orders for one resident without documented Primary Care Provider contact, and failure to administer ordered diabetes medication, vitamin D supplement, and blood pressure medication for two residents. January 2015 annual survey documented medication administration error for one resident (7% error rate with inhaler administration) and one medication aide staff member performing medication aide duties without meeting state training and competency requirements.

Food service and facility cleanliness deficiencies span multiple cycles. February 2023 annual survey found residents not provided non-disposable place settings (forks, knives, spoons, cups) at meal service. February 2020 annual survey identified unlabeled and undated opened food packages, a cracked container lid, and improper meat thawing without cold running water. October 2016 identified two of four common showers containing black substance resembling mold, and tuberculosis testing compliance gaps for one of three staff upon hire and one of five residents upon admission.

Fire safety infrastructure failures recur across 2015 and 2018 construction surveys. November 2015 construction survey cited 16 deficiencies. February 2018 construction survey documented 15 deficiencies. No fines or license suspensions appear in the record.

No complaint investigations documented.

Families should verify fire alarm system functionality, sanitation reports, oxygen cylinder storage, medication aide training, medication administration, and food service protocols.

The Shaire Center is an 82-bed memory care and rehabilitation facility at 1450 Shaire Center Drive, Lenoir, Caldwell County, North Carolina. It accepts Medicaid and provides memory care unit, rehabilitation services, hospice services, discharge planning, and care planning. Voted Best Nursing Home 2025. 3-star state rating.

A substantiated complaint investigation in July 2025 revealed failure to report physical abuse. Staff A slapped Resident #2 after the resident pinched staff. The facility investigated and deemed the incident unsubstantiated but failed to complete required 24-hour initial allegation report and 5-day investigation report to the Health Care Personnel Registry. Medication order clarification also failed for two of five residents involving multivitamin starts, inhaler changes, incomplete insulin orders, and antifungal cream.

Therapeutic diet and medication management failures characterize The Shaire Center’s regulatory record. Over four years, the facility averaged 8.5 deficiencies annually, 63 percent above North Carolina’s 5.2-deficiency baseline. February 2024 annual survey documented failure to provide matching therapeutic diet menus for physician-ordered pureed diets and failure to ensure proper consistency; pureed foods contained small pieces and were not smooth, with staff using mechanical soft menu as guidance. March 2018 documented inaccurate medication administration records for controlled substances (Xanax, Ativan, Oxycodone, Tramadol, Guaifenesin cough syrup with codeine) showing significant discrepancies between controlled drug logs and MAR, and missing physician order for assist bed rails used as restraints for a resident with fall history.

Fire safety infrastructure failures recur across construction surveys. July 2018 construction survey identified 19 deficiencies spanning special magnetic locking exits failing to unlock on emergency release activation, missing bathroom hand grips, corridor obstructions, improperly stored oxygen cylinders, missing fire suppression and extinguisher inspection documentation, non-functional emergency lights and exit signs, compromised fire-rated walls and ceilings, non-latching corridor doors, exposed sharp edges on hold-open devices, and non-functioning exhaust ventilation. August 2016 construction survey documented missing current sanitation and fire safety inspection reports, unsecured oxygen cylinders, algae growth in ice machine drain, missing fire rehearsal records, special locking doors not unlocking on fire alarm, and compromised fire-resistant construction. February 2024 follow-up construction survey confirmed all prior corrections completed with no further action required.

No fines or license suspensions appear in the record.

Families should ask about corrections for the July 2025 failure to report physical abuse, medication order and physician communication protocols, therapeutic diets, and fire safety.

Marjorie Mccune Memorial Center is a 64-bed assisted living and memory care community at 101 Lions Way, Black Mountain, Buncombe County, North Carolina,, rated 4 out of 5 overall by the North Carolina Department of Health and Human Services, Division of Health Service Regulation, and ranked 9th (tied) among 138 homes statewide. Care types include assisted living, memory care, and respite care, with 24-hour staffing and rehabilitation services confirmed. Medicaid is accepted; Medicare is not. Starting price is reported at $3,000 per month.

Medication management is where the compliance picture gets complicated. The April 25 through 26, 2023, annual inspection found 2 deficiencies, both clinical in nature: Resident 2 received insulin incorrectly across 13 documented instances, administered when blood sugar was below 80 and withheld when it exceeded 80; Resident 1 went without antihypertensive (amlodipine, 15 missed doses), blood thinner (clopidogrel, 13 missed doses), antacid (famotidine, 30 missed doses), and a second antihypertensive (lisinopril, 10 missed doses) because of medication availability failures. Both findings carried documented risk of serious health complications.

Before that, physical plant deficiencies dominated the record. The November 2019 biennial construction survey produced 13 deficiencies, the largest cluster in the period, covering corridor obstructions, unsecured oxygen cylinders, repeated fire door and fire-wall failures, malfunctioning emergency lighting and exhaust ventilation, and an unprotected electrical receptacle beside the medication room sink. The September 2017 biennial survey found 7 deficiencies, including persistent failures on oxygen storage, shower hose vacuum breakers, smoke barrier door latching, and emergency lighting. A March 2016 follow-up found 1 uncorrected deficiency: the dining room corridor doors still not closing against fire and smoke.

The December 2015 biennial survey produced 10 deficiencies across corridor clearance, fire-rated wall integrity, kitchen suppression system lapses, and detector mounting failures.

Across five inspections, the facility averages 6.6 deficiencies per year, 27 percent above the North Carolina average of 5.2. No fines, immediate jeopardy findings, enforcement actions, or complaint investigations appear in the available record.

Confirmed amenities include walking grounds, cozy meeting areas, large dining and socializing rooms, three meals and three daily snacks, housekeeping and laundry, transportation, and organized outings. Black Mountain sits roughly 15 miles east of Asheville in eastern Buncombe County; Mission Hospital is the primary nearby acute-care resource.

Families considering placement should ask administrators directly about current medication auditing protocols and the status of fire door and corridor compliance since the 2019 findings.

Overview of Cleveland House

Cleveland House is a 72-bed home for the aged facility at 950 Hardin Drive, Shelby, Cleveland County, North Carolina. It provides 24-hour staffing and accepts Medicaid, focusing on residential senior care.

Serious resident care failures and systemic fire safety infrastructure deficiencies characterize Cleveland House’s regulatory record. Over six years, the facility averaged 10 deficiencies annually, 92 percent above North Carolina’s 5.2-deficiency benchmark. A substantiated January 2020 complaint investigation documented critical care failures during a norovirus outbreak. The facility failed to maintain temperature at 75°F in resident rooms and dining area during winter.

One of five staff members sampled had substantiated findings on the North Carolina Health Care Personnel Registry upon hire. Personal care failures resulted in untreated genital and buttock rash and dried soiled incontinent brief adhered to skin for two of five residents. Timely referral and follow-up failed for residents with untreated rash and psychotropic medication not administered for up to 28 days. Medications were improperly labeled for two residents; four residents did not receive medications as ordered (9.5 percent medication error rate).

Medication administration records were inaccurate for two residents. The facility failed to notify Cleveland County Department of Social Services of incidents resulting in injury or emergency medical evaluation for six of 26 residents involving falls. Residents were denied showers and personal care during outbreak. Infection control policy was not implemented per CDC guidelines.

A substantiated November 2019 complaint investigation identified four resident care deficiencies. The facility failed to provide adequate supervision for five sampled residents related to falls. Failed to assure timely referral and follow-up for acute health care needs. Failed to treat residents with dignity and respect.

Failed to notify local law enforcement of a resident’s unexpected death.

Physical plant and fire safety failures appear across inspection cycles.

June 2019 construction survey identified 10 deficiencies. Earlier inspections spanning 2015-2017 document persistent fire safety infrastructure failures including unprotected penetrations in smoke barriers, missing or damaged sprinkler heads, non-functioning emergency lighting, improperly stored portable oxygen cylinders, inadequate fire safety rehearsal documentation, electrical hazards, and non-functioning exhaust fans in multiple locations. Follow-up surveys in 2015 and 2017 confirmed some deficiencies remained uncorrected.

Medication administration deficiencies appear across clinical inspections. November 2022 annual survey documented failure to ensure physician contact for unclear medication order for one resident and inaccurate electronic medication administration records for wound care documentation. No fines or license suspensions appear in the record.

The pattern of serious resident care failures during the 2020 norovirus outbreak, combined with persistent fire safety and physical plant deficiencies, warrants careful family inquiry.

Families should ask about corrections following the January 2020 outbreak, fire safety, fall-risk supervision, and medication administration oversight and electronic record accuracy procedures.