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.














