Three Years of Adult Care Home Penalties in the Triad

What a penalty means in North Carolina

North Carolina's adult care home statute sorts violations by seriousness. Under G.S. 131D-34 a Type A1 violation is one that resulted in death, serious physical harm, abuse, neglect or exploitation; a Type A2 violation created a substantial risk of that harm. Both carry fines. Lesser findings are corrected through a plan of correction without a penalty.

DHSR publishes every penalty from the last 36 months with the rule cited, the level, the amount and whether it was paid, appealed or settled.

The record for our three counties

Source: N.C. DHHS Division of Health Service Regulation listings and rating pages, retrieved November 6, 2026. Levels: A1 5, A2 5.

What the rules cited tell you

Look at the rule column. Citations under medication administration, health care, personal care and supervision, and residents' rights point to day-to-day care. Findings about outside entrances or housekeeping concern the building and routines, still important but different in kind.

A single penalty years ago, followed by clean annual surveys, tells a different story from repeated findings under the same rule. Each home's page lists its inspections after the penalty, so you can see whether the problem recurred.

Most homes have no penalties

Of the 64 licensed adult care and family care homes in the three counties, 59 have no penalty on DHSR's 36-month list. That does not mean they have never been cited; routine deficiencies are corrected without fines and appear only in the inspection documents.

So a clean penalty record is a starting point, not a verdict. The latest annual survey, the star rating and a visit complete the picture.

How settlements and appeals appear

Most penalties on the list are marked paid in full. A few are resolved through settlement agreements, which may change the amount or terms. An appealed penalty shows its status until the appeal ends.

Settlement does not mean the violation did not happen; it means the home and the state agreed on how to resolve it. Read the inspection document behind the penalty to understand what was found.

Penalties and the county's role

Many adult care home complaints in North Carolina are investigated by adult home specialists at the county department of social services, and their findings can lead DHSR to impose penalties. That is why some penalty records trace back to a DSS complaint investigation rather than an annual survey.

If you have a concern about a home in Guilford, Randolph or Rockingham County, you can contact DHSR's Complaint Intake Unit or the county department of social services directly. Either route can trigger an investigation, and the results join the home's public record.

Using the record on a tour

If a home on your list has a penalty, ask about it directly: what happened, what changed, who checks it now, and whether the staff involved are still there. A good administrator answers plainly.

If you see something on a visit that worries you, report it to DHSR's Complaint Intake Unit at 1-800-624-3004. For a resident's rights or a discharge dispute, call the Piedmont Triad regional ombudsman at 336-904-0300.