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North Carolina

Nursing Home Staffing Profile — 2025Q3

406 facilities35,317 residents3.77 avg HPRD

vs National Average

-0.13 HPRD

National avg: 3.90 · North Carolina: 3.77

📋

North Carolina ranks among the lower-performing states for nursing home staffing, with an average of 3.77 HPRD — 0.13 hours below the national average. Only 58.9% of facilities meet the CMS staffing benchmark of 3.48 HPRD, compared to 65.8% nationally. RN staffing averages 0.58 HPRD, with 18.2% of facilities meeting the 0.75 research recommendation.

3.77

Average Total HPRD

All nursing staff combined

▼ 0.13 vs national

0.58

Average RN HPRD

Recommended: 0.75

▼ 0.10 vs national

58.9%

Meet CMS Benchmark

239 of 406 facilities

15.5%

Avg Weekend Drop-off

Staffing reduction on Sat/Sun

8.9%

Avg Agency Staff

Contractor/temp worker hours

—

Had Zero-RN Days

Data unavailable

3.56

Median HPRD

50th percentile (less skewed by outliers)

F-Rated Facilities

Under 2.5 HPRD — critically understaffed

Grade Distribution

How North Carolina's 406 facilities grade out

HPRD Distribution

Where facilities fall across the staffing spectrum

Staffing by Ownership Type

For-profit facilities consistently staff lower than non-profit and government-run homes

For-Profit

3.59

avg HPRD

345 facilities (85%)

Non-Profit

4.80

avg HPRD

56 facilities (14%)

Government

4.47

avg HPRD

5 facilities (1%)

💡 Non-profit facilities in North Carolina average 1.21 more HPRD than for-profit ones — about 34% higher staffing.

▲ Best Staffed in North Carolina

Top 5 by total nurse HPRD

A+

TRANSYLVANIA REGIONAL HOSPITAL

WILKES REGIONAL MEDICAL CTR SN

NOVANT HEALTH PRESBYTERIAN MEDICAL CENTER-SNU

CHARLOTTE

6.67 HPRD

RN: 2.02

▼ Most Understaffed in North Carolina

Bottom 5 by total nurse HPRD

406

Arbor Acres United Methodist Retirement Community

IREDELL MEMORIAL HOSPITAL INC

The Forest At Duke Inc

The Carrolton of Williamston

Laurel Park Rehabilitation and Healthcare Center

Elizabeth City

2.77 HPRD

RN: 0.33

⚖️

Compare Two Facilities Side by Side

Pick any two North Carolina nursing homes and see how they stack up across every metric

Open Comparison Tool →

County Breakdown

Staffing metrics by county in North Carolina — click a county to see individual facilities

Avg HPRD— total nurse hours per resident per day:≥ 3.48 meets federal benchmark,3.0–3.47 below benchmark,< 3.0 critically low

Meet Benchmark— share of facilities in the county at or above the 3.48 HPRD federal minimum:≥ 50%35–49%< 35%

County	Facilities ↓	Avg HPRD	RN HPRD	Meet Benchmark	Grades
▸Mecklenburg	26	3.81	0.59	57.7%	Mixed C/D
▸Guilford	20	3.93	0.54	80.0%	Mixed C/B
▸Wake	19	4.11	0.61	89.5%	Mostly C
▸Buncombe	18	3.74	0.78	50.0%	Mixed D/B
▸Forsyth	13	4.13	0.51	61.5%	Mixed B/D
▸Durham	12	3.85	0.55	75.0%	Mixed B/C
▸New Hanover	11	3.81	0.74	81.8%	Mixed B/C
▸Cumberland	10	3.57	0.40	40.0%	Mostly C
▸Gaston	10	3.87	0.64	70.0%	Mixed B/C
▸Henderson	9	3.83	0.80	55.6%	Mostly C
▸Davidson	9	3.82	0.50	55.6%	Mixed C/B
▸Rowan	9	3.88	0.61	55.6%	Mixed C/B
▸Moore	7	4.12	0.62	42.9%	Mixed C/D
▸Union	7	3.72	0.61	71.4%	Mostly C
▸Alamance	7	4.24	0.58	71.4%	Mixed C/D
▸Cabarrus	6	3.55	0.46	33.3%	Mostly C
▸Pitt	6	3.94	0.73	66.7%	Mixed B/C
▸Robeson	6	3.74	0.39	83.3%	Mostly C
▸Randolph	6	3.52	0.36	33.3%	Mixed D/B
▸Catawba	6	4.56	0.80	83.3%	Mixed A/C
▸Johnston	5	3.48	0.53	60.0%	Mostly C
▸Brunswick	5	3.71	0.64	100.0%	Mostly B
▸Burke	5	3.72	0.50	80.0%	Mostly C
▸Craven	5	3.55	0.51	40.0%	Mostly C
▸Harnett	5	3.63	0.48	40.0%	Mixed C/A
▸Haywood	5	3.58	0.62	60.0%	Mostly C
▸Iredell	5	3.25	0.53	20.0%	Mostly C
▸Rockingham	5	3.78	0.53	40.0%	Mixed C/D
▸Rutherford	5	3.58	0.39	60.0%	Mostly D
▸Surry	5	3.90	0.82	60.0%	Mixed B/A
▸Stokes	4	3.28	0.46	50.0%	Mostly D
▸Stanly	4	3.73	0.51	75.0%	Mixed B/D
▸Wilkes	4	4.66	1.40	50.0%	Mixed D/A+
▸Caldwell	4	3.56	0.50	50.0%	Mixed A/B
▸Cleveland	4	3.66	0.41	50.0%	Mixed C/D
▸Wilson	4	3.64	0.41	75.0%	Mixed D/B
▸Halifax	4	3.46	0.54	25.0%	Mixed C/B
▸Chatham	3	3.92	0.61	66.7%	Mixed A/C
▸Duplin	3	3.26	0.37	0.0%	Mostly D
▸Wayne	3	3.41	0.50	33.3%	Mixed B/C
▸Transylvania	3	5.11	1.71	66.7%	Mixed A+/B
▸Davie	3	3.72	0.32	33.3%	Mostly D
▸Carteret	3	3.32	0.66	33.3%	Mostly C
▸Lenoir	3	3.92	0.67	66.7%	Mostly C
▸Lee	3	3.47	0.33	66.7%	Mixed C/D
▸Lincoln	3	3.55	0.55	66.7%	Mostly C
▸Edgecombe	3	3.78	0.39	66.7%	Mostly D
▸Vance	3	3.79	0.34	66.7%	Mixed C/D
▸Polk	3	4.11	1.00	66.7%	Mixed A/B
▸Orange	3	4.45	1.16	100.0%	Mixed A+/B
▸Nash	3	3.73	0.52	100.0%	Mixed B/C
▸Scotland	2	4.58	0.52	100.0%	Mixed A/D
▸Franklin	2	3.23	0.42	0.0%	Mixed C/D
▸Cherokee	2	3.38	0.76	0.0%	Mostly C
▸Granville	2	3.19	0.38	0.0%	Mostly D
▸Watauga	2	3.57	0.42	50.0%	Mixed C/D
▸Jackson	2	3.67	0.63	100.0%	Mostly B
▸Mc Dowell	2	3.40	0.75	50.0%	Mixed B/C
▸Macon	2	3.98	0.91	100.0%	Mostly B
▸Madison	2	3.27	0.61	50.0%	Mixed B/C
▸Bladen	2	3.61	0.55	100.0%	Mixed B/C
▸Bertie	2	3.33	0.46	50.0%	Mostly C
▸Northampton	2	3.31	0.35	50.0%	Mostly D
▸Onslow	2	3.57	0.54	100.0%	Mostly C
▸Pasquotank	2	3.32	0.31	50.0%	Mostly D
▸Pender	2	4.27	0.69	100.0%	Mixed A/B
▸Person	2	3.17	0.52	0.0%	Mostly C
▸Beaufort	2	3.20	0.40	0.0%	Mixed C/D
▸Richmond	2	3.58	0.60	100.0%	Mostly B
▸Anson	2	3.53	0.59	50.0%	Mixed B/C
▸Yadkin	2	3.20	0.39	0.0%	Mixed C/D
▸Sampson	2	3.50	0.28	50.0%	Mixed D/F
▸Swain	2	4.71	0.88	50.0%	Mixed A+/C
▸Columbus	2	3.75	0.34	50.0%	Mostly D
▸Chowan	1	3.49	0.40	100.0%	Mostly C
▸Ashe	1	3.13	0.51	0.0%	Mostly C
▸Jones	1	3.53	0.55	100.0%	Mostly B
▸Currituck	1	3.39	0.45	0.0%	Mostly C
▸Dare	1	2.99	0.58	0.0%	Mostly D
▸Graham	1	3.22	0.63	0.0%	Mostly C
▸Clay	1	3.16	0.56	0.0%	Mostly C
▸Hoke	1	3.03	0.30	0.0%	Mostly D
▸Hertford	1	3.51	0.45	100.0%	Mostly C
▸Yancey	1	3.16	0.78	0.0%	Mostly C
▸Montgomery	1	3.28	0.38	0.0%	Mostly D
▸Gates	1	3.50	0.57	100.0%	Mostly B
▸Caswell	1	3.06	0.26	0.0%	Mostly D
▸Alleghany	1	2.98	0.30	0.0%	Mostly D
▸Mitchell	1	3.46	0.56	0.0%	Mostly C
▸Pamlico	1	3.21	0.75	0.0%	Mostly C
▸Greene	1	3.72	0.30	100.0%	Mostly D
▸Alexander	1	4.31	0.60	100.0%	Mostly B
▸Perquimans	1	3.15	0.47	0.0%	Mostly C
▸Warren	1	3.66	0.38	100.0%	Mostly D
▸Washington	1	3.01	0.33	0.0%	Mostly D
▸Martin	1	2.76	0.36	0.0%	Mostly D
▸Avery	1	3.04	0.41	0.0%	Mostly C

HPRD Range in North Carolina

The spread between best and worst staffed facilities

3.31

25th pctile

3.56

Median

3.93

75th pctile

Source: CMS Staffing & Quality Data — 2025Q3 · data.cms.gov

Staffing grades are based on CMS-published thresholds and research recommendations. CMS is not affiliated with and does not endorse this website.