Greensboro Senior AdvisorBy Greensboro Senior Advisor Care Team · August 20, 2026
DHSR rates 63 adult care and family care homes in Guilford, Randolph and Rockingham counties: 27 hold four stars and 31 three. The rating comes from state inspections, so read it together with the inspection documents posted beside it.
A state rating most families never hear about
Most states leave families to judge assisted living on tours and online reviews. North Carolina does something unusual: its Division of Health Service Regulation (DHSR) publishes a star rating for every licensed adult care home and family care home, along with the inspection documents behind it and any penalties from the last three years.
The scale runs from zero to four stars, with a numerical score underneath. It is built from what state inspectors found, not from surveys of residents or anything the operator submits. Nursing homes are not on this scale; they carry CMS's federal five-star ratings, which are calculated in an entirely different way.
How the Triad's homes are rated
This is how the current ratings spread across the three counties, taken from DHSR's Facility Inspections, Ratings and Penalties search:
| County | Rated homes | Four stars | Three stars | Two or fewer |
|---|---|---|---|---|
| Guilford County | 31 | 11 | 18 | 2 |
| Randolph County | 8 | 4 | 4 | 0 |
| Rockingham County | 24 | 12 | 9 | 3 |
Source: N.C. DHHS Division of Health Service Regulation listings and rating pages, retrieved November 6, 2026. A home appears as unrated when DHSR shows no current rating, which can happen with a new license.
What a four-star rating does and does not mean
Four stars means the home's recent inspection record is strong by the state's measure. Around Greensboro, the larger four-star adult care homes include Cross Road Retirement Community, Brookstone Haven, Brookstone Terrace of Greensboro, Westchester Harbour at Providence Place, Brookdale Reidsville. That is useful, but it does not tell you whether the home suits your parent, whether it has a special care unit, or what it costs.
A small home's rating is also more volatile. In a six-bed family care home, a single citation can move the score noticeably, while a large building absorbs it. That is why we list each home's inspection history on its own page rather than relying on the stars alone.
Reading the documents behind the stars
Each inspection document on DHSR's site is either a statement of deficiency, the same statement with the home's plan of correction attached, or a note that no deficiencies were cited. Annual surveys, follow-up visits, complaint investigations and building inspections by DHSR's construction section all appear in the same list.
Read the most recent annual survey first, then look for patterns: the same rule cited in consecutive years, or a complaint investigation followed by a penalty. Medication administration, supervision and residents' rights are the areas where findings matter most for day-to-day life.
Ratings in large homes versus family care homes
The same scale covers a 150-bed campus and a six-bed house, and that creates quirks worth knowing. A large home is surveyed across many residents and staff, so one finding rarely sinks its score. In a family care home, the inspector may review two or three residents' records, and a single medication error affects a big share of the sample.
That is not a reason to distrust family care home ratings, only to read them with the documents open. If a small home dropped a star after one citation that was corrected on the follow-up visit, the record tells a different story than a home with repeated findings.
When there is no rating
A home with a new license, or one whose rating DHSR has not yet posted, shows as unrated in our directory. Treat that as missing information rather than a bad sign. Ask the home when its first annual survey took place and request a copy of the result.
If an established home has no rating at all, ask DHSR's Adult Care Licensure Section why. It may reflect a change of ownership, which starts a new license and a new record.
Turning the rating into tour questions
Bring the documents with you. Asking an administrator what changed after a specific citation is the fastest way to learn how the home handles problems. A confident, specific answer is a good sign; vagueness is not.
Then ask what the rating cannot tell you: who works third shift, how many staff come from agencies, what happens when money runs low, and which changes in health would lead to a discharge notice. Those answers, together with the stars, make a sound short list.
Frequently asked questions
Does a higher star rating mean a better home?
It means a stronger recent inspection record by DHSR's measure. It does not measure fit, cost, activities or the staff your parent will see every day.
Are nursing homes rated on the same scale?
No. Nursing homes carry CMS's one-to-five star ratings, which combine inspections, staffing and quality measures. The two scales should not be compared.
How often do ratings change?
Ratings move as new inspection results come in, so check the date of the latest annual survey on the home's page.
Where can I see a specific home's rating?
On our facility page for that home, which also lists its inspection documents, or on DHSR's Facility Inspections, Ratings and Penalties search.
Can a home display its star rating in marketing?
Homes may mention their rating, but always confirm it on DHSR's own search or our facility page, which reproduce the current figure.
Do family care homes get the same star scale?
Yes. Adult care homes and family care homes are both rated zero to four stars by DHSR.
