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The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
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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.
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.
This home is ranked 18th out of 90 homes in North Carolina. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
| Staff type | Hours / Day / Resident | vs state avg |
|---|---|---|
|
Weekend Total Nursing
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
| 4h 57m per day | ▲ 48% State avg: 3h 21m per day · National avg: 3h 25m per day |
Lower than the North Carolina average: 76.4%In North Carolina, the Department of Health and Human Services, Division of Health Service Regulation conducts unannounced surveys to ensure nursing and adult care homes meet safety standards.
This scorecard compares key inspection, citation, and complaint metrics at this facility against the North Carolina state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.
Deficiencies
| This Facility | NC Average | vs. NC Avg |
|---|---|---|---|
|
Total deficiencies
Formal regulatory issues recorded by inspectors across all inspection types.
| 48 | 46 | This facility has 4% more total deficiencies than a typical North Carolina nursing home (48 vs. NC avg 46).↑ 4% worse |
|
Deficiencies per year
Average deficiencies per year since 2015.
| 4.4 | 4.2 | This facility has 5% more deficiencies per year than a typical North Carolina nursing home (4.4 vs. NC avg 4.2).↑ 5% worse |
|
Deficiencies per inspection
Average deficiencies per inspection.
| 2.5 | 2.2 | This facility has 14% more deficiencies per inspection than a typical North Carolina nursing home (2.5 vs. NC avg 2.2).↑ 14% worse |
Inspections
| This Facility | NC Average | vs. NC Avg |
|---|---|---|---|
|
Total inspections
Combined count of all routine and focused inspections. Excludes complaint investigations.
| 19 | 21 | This facility has 10% fewer total inspections than a typical North Carolina nursing home (19 vs. NC avg 21).↓ 10% better |
|
Inspections with deficiencies
Inspections that resulted in at least one regulatory deficiency.
| 14 | 19 | This facility has 26% fewer inspections with deficiencies than a typical North Carolina nursing home (14 vs. NC avg 19).↓ 26% better |
|
Inspection deficiency rate
Percentage of inspections that resulted in at least one deficiency.
| 74% | 90% | This facility has 16 percentage points lower inspection deficiency rate than a typical North Carolina nursing home (74% vs. NC avg 90%).↓ 16% better |
An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.
The most recent inspection on October 26, 2023, identified deficiencies related to medication aide training and competency validation, tuberculosis testing, timely evaluations, and medication administration. Earlier inspections showed a pattern of issues with staff training and competency, as well as building maintenance and fire safety concerns. Prior reports also noted problems with fire-rated construction breaches, unsecured oxygen cylinders, and mechanical ventilation. Complaint investigations in 2015 substantiated deficiencies in medication administration, infection control, restraint use, and diabetic care, but enforcement actions such as fines or license suspensions were not listed in the available reports. The facility’s record shows ongoing challenges with staff training and medication management, while building safety issues were more prominent in earlier years.
Read the full inspection reports for this facility, including detailed findings and corrective actions.
Show Inspection ReportsState average 4
Last Health inspection on Apr 2024
State average 20.9
State average 4.99
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
All 6 citations resulted from standard inspections.
100% better than State averageState average: 1.3
100% better than State averageState average: 0.9
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
185% better than North Carolina average
6% worse than North Carolina average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.8 hoursThis role is partially covered by contractors.
Assists with medical care and medications.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.4 hoursThis role is partially covered by contractors.
Helps with daily care and mobility.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.5 hoursThis role is partially covered by contractors.
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
4,569 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 33 | 45 | 78 | 9,462 | 92 | 100% | 7.5 |
| Licensed Practical Nurse | 7 | 25 | 32 | 2,382 | 92 | 100% | 8.4 |
| Medication Aide/Technician | 4 | 0 | 4 | 1,938 | 87 | 95% | 10 |
| Other Dietary Services Staff | 3 | 0 | 3 | 1,614 | 91 | 99% | 8.7 |
| Registered Nurse | 6 | 15 | 21 | 1,090 | 79 | 86% | 8.8 |
| Dental Services Staff | 1 | 0 | 1 | 488 | 61 | 66% | 8 |
| Nurse Practitioner | 1 | 0 | 1 | 479 | 63 | 68% | 7.6 |
| RN Director of Nursing | 1 | 0 | 1 | 476 | 66 | 72% | 7.2 |
| Speech Language Pathologist | 0 | 3 | 3 | 471 | 68 | 74% | 4.1 |
| Administrator | 1 | 0 | 1 | 460 | 58 | 63% | 7.9 |
| Physical Therapy Assistant | 0 | 7 | 7 | 430 | 67 | 73% | 5.5 |
| Clinical Nurse Specialist | 1 | 0 | 1 | 428 | 54 | 59% | 7.9 |
| Qualified Social Worker | 0 | 4 | 4 | 317 | 63 | 68% | 5 |
| Respiratory Therapy Technician | 0 | 8 | 8 | 271 | 77 | 84% | 2.5 |
| Physical Therapy Aide | 0 | 5 | 5 | 139 | 29 | 32% | 4.8 |
| Occupational Therapy Aide | 1 | 0 | 1 | 64 | 8 | 9% | 8 |
| Therapeutic Recreation Specialist | 0 | 1 | 1 | 30 | 12 | 13% | 2.5 |
| Medical Director | 0 | 1 | 1 | 26 | 13 | 14% | 2 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 18 | 5 | 5% | 3.6 |
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database
No penalties in the past 3 years
No civil money penalties or payment denials were reported in the last 3 years.
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
7.8
32% better than North Carolina averageNorth Carolina average: 11.5
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
18.0
13% better than North Carolina averageNorth Carolina average: 20.6
Percent of long-stay residents whose need for help with daily activities has increased
22.6%
29% worse than North Carolina averageNorth Carolina average: 17.5%
Percent of low risk long-stay residents who lose control of their bowels or bladder
13.4%
37% better than North Carolina averageNorth Carolina average: 21.4%
Percent of long-stay residents experiencing one or more falls with major injury
1.6%
57% better than North Carolina averageNorth Carolina average: 3.6%
Percent of long-stay high risk residents with pressure ulcers
2.4%
62% better than North Carolina averageNorth Carolina average: 6.3%
Percent of long-stay residents with a urinary tract infection
3.1%
19% worse than North Carolina averageNorth Carolina average: 2.6%
Percent of long-stay residents who lose too much weight
4.7%
37% better than North Carolina averageNorth Carolina average: 7.4%
Percent of long-stay residents who have depressive symptoms
0.0%
100% better than North Carolina averageNorth Carolina average: 4.4%
Percent of long-stay residents who received an antipsychotic medication
4.7%
65% better than North Carolina averageNorth Carolina average: 13.4%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
67.2%
27% worse than North Carolina averageNorth Carolina average: 91.6%
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
50.7%
37% worse than North Carolina averageNorth Carolina average: 79.9%
Percent of short-stay residents who newly received an antipsychotic medication
0.0%
100% better than North Carolina averageNorth Carolina average: 1.5%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
50.0%
36% worse than North Carolina averageNorth Carolina average: 78.1%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
26% of new residents, usually for short-term rehab.
74% of new residents, often for short stays.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
34Residents meet regularly to discuss policies, care quality, and activities
Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.
Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
Historical financial and operational data for Homestead Hills Assisted Living based on CMS SNF Cost Reports.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #43 / 97Payroll — State benchmarkedThis home is ranked 43rd out of 97 homes in North Carolina. Shows total annual staff payroll benchmarked to the North Carolina average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Residents typically stay for brief periods, with frequent admissions and discharges throughout the year.
5.6 miles from city center
Estimated distance in miles from Winston-Salem's city center to Homestead Hills Assisted Living's address, calculated via Google Maps.
Add your location
Homestead Hills Assisted Living is located in Winston-Salem, North Carolina.
Here are the financial assistance programs available to residents in North Carolina.
The information below is reported by the North Carolina Department of Health and Human Services, Division of Health Service Regulation.
| Homestead Hills Assisted Living |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Winston-Salem | 66 | 30.3% | -60% | 5.28 | +32% | +33% | $0 | 6 | 3.0 | - | 20 | 20 | Kapson Gp, LLC | $22.0M | $7.4M | 33.7% | 345559 | ||||
| Oak Forest Health and Rehabilitation Center |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk.
RC Respite Care Short-term temporary care — days to weeks — to give family caregivers a break. Full care provided during the stay. Often used after hospitalization or to trial a facility before a permanent placement decision. | Winston-Salem | 170 | 78.6% | +3% | 3.44 | +8% | -13% | $30.1k | 34 | 3.8 | 4 | 157 | 5 | - | $21.2M | $12.1M | 57.2% | 345443 | ||||
| Willow Valley Center for Nursing and Rehabilitation |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
N Nursing | Winston-Salem (West Highlands) | 230 | 87.6% | +15% | 3.71 | -32% | -7% | $286.5k | 51 | 6.4 | 7 | 215 | 62 | Citadel At Winston Salem LLC | $22.4M | $12.3M | 54.7% | 345092 | ||||
| Mill Creek Center for Nursing & Rehabilitation |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
N Nursing | Winston-Salem (Oldtown) | 80 | 74.2% | -3% | 3.64 | -45% | -8% | $29.9k | 45 | 7.5 | 3 | 62 | 24 | Brittany Bailey | $8.9M | $4.4M | 49.2% | 345149 |
Homestead Hills Assisted Living has a walk score of 20. Car-dependent. Most errands require a car, with limited nearby walkable options.
According to NC state health department records, Homestead Hills Assisted Living's license number is HAL-034-023.
Homestead Hills Assisted Living's occupancy is 30%.
Homestead Hills Assisted Living received a 3-star overall rating from the CMS (Centers for Medicare and Medicaid Services). This score combines results from staffing levels, quality measures, and health inspections.
Homestead Hills Assisted Living has 66 beds.
Yes — there are 16 photos of Homestead Hills Assisted Living in the photo gallery on this page.
Homestead Hills Assisted Living is located at 2101 Homestead Hills Drive Winston-Salem, NC 27103.
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