Below average — CMS composite of the measures below.
The next survey window likely opens around June 2027
Estimate from public CMS data, current as of October 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Homestead Hills during CMS and state inspections, most recent first.
Medication Error Caused Severe Bradycardia and Hospital Transfer: A severely cognitively impaired resident with sinus bradycardia received his scheduled AM meds and then was mistakenly given another resident's meds, including metoprolol succinate ER, amlodipine, tamsulosin, and donepezil. He became lethargic with HR in the 30s to 40s and BP 90/60, was sent to the hospital, and was diagnosed with severe symptomatic bradycardia, hypotension, and progression to complete heart block requiring epinephrine, atropine, and a dual-chamber pacemaker.
The facility failed to keep the dumpster area free of trash and debris and failed to keep both dumpster doors fully closed. Surveyors observed cardboard, used gloves, and trash bags on the ground and partially under a dumpster, with repeated findings of open or partially open sliding doors. The DSD and DFD acknowledged the trash on the ground was not acceptable, and a Dietary Aide confirmed a trash bag on the ground should not have been there.
Expired meds were found stored with current stock in the med room refrigerator and on a med cart, several inhaled and nebulized meds were opened without open dates and loose vials were stored outside their original packaging, and prescription blister packs were left unsecured on top of an unattended med cart. The DON, an RN, and the dispensing pharmacist all confirmed the meds should have been properly labeled, stored, and locked when the cart was unattended.
Failure to Use Beard Covers During Food Prep: The DON and Sous Chef were observed preparing and serving food with facial hair but without beard covers. The DON had a full beard and mustache and handled food items on the steam table, while the Sous Chef had a goatee-style beard and prepared pork chops, seasoned food, and placed food in the oven without a beard cover. Interviews showed differing expectations about when beard covers were required, and the Administrator stated staff were expected to follow beard-cover regulations.
Inaccurate Advance Directive Documentation: A resident’s code status was documented inconsistently across the chart, with some notes listing DNR and others listing full code, while the MOST showed DNR and the care plan listed full code. The resident stated she wanted DNR, and the DON, SW, NPs, and Administrator all confirmed the care plan and record should match the resident’s current advance directive and MOST.
A medication aide gave one resident his scheduled meds and then, after returning to the cart, administered another resident's meds to the same resident because identity was not properly verified. The affected resident had Alzheimer's disease, severe cognitive impairment, DM, HTN, and sinus bradycardia, and the error involved meds including Eliquis, memantine, and omeprazole. The error was later reported to the nurse, and the resident was found to be bradycardic and hypotensive, with hospital records showing progression to complete heart block.
A nurse aide failed to follow EBP for a resident with a urinary catheter and wound care needs by changing a fecal-soiled brief while wearing gloves but no gown, despite an EBP sign outside the room requiring gloves and gowns for brief changes and other high-contact care. The DON, NP, and Administrator all confirmed that staff were expected to follow the posted EBP precautions.
The facility failed to obtain laboratory blood work as ordered for two residents with severe cognitive impairments and multiple diagnoses, despite the orders being marked as completed by a nurse. The Nurse Practitioner and DON were unaware of the lapses in the process.
Medication Error Resulted in Severe Bradycardia and Hospitalization
Penalty
Summary
The facility failed to prevent a significant medication error involving a severely cognitively impaired resident with diagnoses including Alzheimer's disease, sinus bradycardia, hypertension, diabetes, depression, and psychotic disorder with hallucinations. On the morning of the event, a Medication Aide administered the resident's scheduled medications, which included propranolol ER, quetiapine, donepezil, metformin ER, and citalopram. The aide then returned to the medication cart, prepared another resident's medications, and later gave those medications to the same resident in error. The medications mistakenly given to the resident included metoprolol succinate ER, tamsulosin, amlodipine, and donepezil, which were prescribed for another resident. Approximately 30 minutes later, the Medication Aide realized the error and reported it to the nurse. The resident was assessed and found to be lethargic with a heart rate in the 40s that dropped into the high 30s and a blood pressure of 90/60. EMS was contacted and transported the resident to the hospital for evaluation. Hospital records documented severe symptomatic bradycardia and hypotension secondary to an unintentional medication overdose with beta blockers and amlodipine. The resident's ECG progressed from sinus bradycardia with second-degree AV block to complete heart block, and he required epinephrine infusion and atropine with limited response. He later underwent implantation of a dual-chamber pacemaker and returned to the facility after hospitalization. Interviews with the Medication Aide, nurse, NP, pharmacist, and Medical Director confirmed that the resident received both his own morning medications and another resident's medications, and that the medication error was associated with the resident's decline in heart rate and blood pressure.
Dumpster Area Not Kept Clean and Dumpster Doors Left Open
Penalty
Summary
The facility failed to keep the dumpster area free of trash and debris and failed to ensure the dumpster doors remained closed for 2 of 2 dumpsters. During an observation of the dumpster area outside the kitchen, multiple pieces of trash and debris were seen, including cardboard pieces, multiple used plastic gloves, and a bag of trash pushed into the back corner with part of the bag under one of the dumpsters. Both dumpsters’ sliding doors were not fully closed. The Director of Dining Services stated the trash on the ground was not acceptable and could attract rodents. On a later observation, a new trash bag was present on the ground along with a bag halfway out of the dumpster, and the dumpsters’ sliding doors were again not fully closed. A Dietary Aide confirmed the trash bag on the ground should not have been there and then threw a trash bag directly into the dumpster and closed the door. The Director of Dining Services later observed the new trash on the ground, picked it up, and placed it into the dumpster, then closed the sliding doors. Another observation later that day found a trash bag on the ground below an open dumpster door. The dumpster service company confirmed it emptied the dumpsters 3 times per week in the early morning and could provide additional service if scheduled.
Expired, Unlabeled, and Unsecured Medications Found on Medication Cart and in Medication Room
Penalty
Summary
Drugs and biologicals were not properly labeled, stored, or secured in the facility’s medication room and medication carts. During observation of the medication refrigerator with Nurse #3, expired medications were found stored with non-expired medications, including Flucelvax flu immunizations and multiple daptomycin IV bags with expiration dates ranging from 6/13/2026 through 6/24/2026. Nurse #3 confirmed expired medications should not be kept in the refrigerator with current stock, and the DON later removed the expired items and placed them with other expired medications awaiting return. On the lower 500 hall medication cart, several inhaled and nebulized medications were not labeled with an open date after being opened. These included fluticasone furoate/vilanterol, Stiolto, and levalbuterol nebulizing solution. In addition, four loose ipratropium bromide nebulizing vials were found in the bottom drawer instead of being stored in their foil package. Nurse #3 confirmed the opened medications should have been dated and the loose vials should have been discarded, and the DON stated medications opened from a pouch or inhaler should be labeled with the opened date and not stored loose in the drawer. The lower 500 hall medication cart was also observed unattended with prescription blister packs left unsecured on top of the cart. Two separate observations showed the medications remained exposed while no staff or residents were in sight. The unsecured medications included amlodipine 2.5 mg and rifampin 300 mg. Nurse #3 stated she had removed the medications from the cart but had not returned them before being interrupted, and both the DON and the dispensing pharmacist confirmed medications should be secured inside a locked cart when unattended.
Failure to Use Beard Covers During Food Preparation
Penalty
Summary
The facility failed to ensure dietary staff with facial hair wore beard covers during food preparation and service. During a kitchen observation, the Director of Dining Services was seen with a full dark beard and mustache, approximately 1/2 to 1 inch in length, preparing and serving food without a beard cover. He was observed placing plastic wrap over individual peach bowls, assisting a dietary aide with removing pork chops from a tray on the steam table, placing tongs into pork chops on the steam table, placing a lid over sweet potatoes, handling salads from the refrigerator off the steam table, and performing temperature checks of hot food on the steam table. During the same observation, the Sous Chef was seen with a chin beard/goatee-style facial hair, approximately 2 to 3 inches in length, preparing food without a beard cover. He was observed moving pork chops from storage bags onto a cooking tray, entering the steam table area to get seasoning and season pork chops, and placing the pork chop tray into the oven. In interviews, the Director of Dining Services stated his expectation was that beard covers were required only if facial hair was longer than an individual's eyelashes and said he did not think he needed to wear one, though he believed the Sous Chef should have worn one. The Sous Chef stated the Director of Dining Services told him to wear a beard cover, that he thought 2 to 3 inches required one, and that he had simply forgotten. The Administrator stated she expected staff to follow the regulations for beard covers.
Inaccurate Advance Directive Documentation
Penalty
Summary
The facility failed to keep Resident #9’s advance directive and code status accurate throughout the medical record. Record review showed conflicting documentation over time, including encounter notes that listed the resident as DNR on some dates and full code on others, while the MOST form dated 5/7/2026 showed DNR status. The quarterly MDS assessment completed on 6/18/2026 found the resident cognitively intact, and the comprehensive care plan revised the same day listed the resident as full code, which did not match the MOST or several other notes in the record. Interviews confirmed the inconsistency. Resident #9 stated she wanted DNR. Nurse #2 confirmed the resident was currently DNR. The DON stated the care plan was expected to match the most recent MOST sheet and the resident’s wishes, but was unsure why the care plan was not updated and said it probably slipped through the cracks. The Social Worker and both NPs stated the encounter notes and care plan should match the MOST and the resident’s current code status, and the Administrator confirmed the care plan should have been updated if changes occurred.
Medication given to the wrong resident after identity verification failure
Penalty
Summary
Nursing staff failed to meet professional standards of care when a medication aide administered medications intended for one resident to another resident. Resident #4, who was admitted with diagnoses including Alzheimer's disease, type II diabetes mellitus, depression, hypertension, sinus bradycardia, and psychotic disorder with hallucinations, was documented on the quarterly MDS as severely cognitively impaired. On the morning of the incident, the medication aide gave Resident #4 his scheduled morning medications in the common area, then returned to the medication cart and prepared Resident #47's medications, and without realizing it, administered those medications to Resident #4. The medication aide later stated he realized the error about 30 minutes afterward and immediately informed Nurse #1. The MAR for Resident #4 documented that his morning medications were administered at 8:27 AM by the medication aide. Nurse #1 later documented that Resident #4 received his scheduled medications and also received his roommate's scheduled medications, including Eliquis 5 mg and Omeprazole 20 mg. Nurse #1 stated the medication aide reported the error to her between 8:30 AM and 9:00 AM. Resident #47's active orders included Eliquis 5 mg twice daily, Memantine 10 mg twice daily, and Omeprazole 20 mg daily. The administrator identified the root cause as a medication administration error related to the medication aide's failure to properly verify Resident #4's identity according to established protocols. The report also states that Resident #4 was assessed after the error and was found to have bradycardia and hypotension, and hospital records later showed severe bradycardia and progression to complete heart block.
Failure to Follow EBP During Brief Change
Penalty
Summary
The facility failed to follow Enhanced Barrier Precautions for a resident who had an indwelling urinary catheter and an unstageable pressure ulcer requiring wound care. A facility policy stated that EBP applied to residents with indwelling medical devices, including urinary catheters, and required gloves and gowns for high-contact care activities such as changing briefs, toileting assistance, and wound care. An EBP sign was posted outside the resident’s room directing staff to clean hands and wear gloves and gowns for those activities. During an observation, a nurse aide entered the resident’s room, donned gloves, and changed the resident’s fecal-soiled incontinent brief without wearing a gown. Another nurse aide entered the room but did not provide direct care. The first nurse aide confirmed the resident required EBP because of the catheter and acknowledged that a gown was required when changing the brief, stating that gowns were located just inside the room. The DON, who was also the Infection Preventionist, confirmed the resident had EBP because of the catheter and wound and stated staff should follow the sign on the door. The NP and Administrator also stated they expected staff to follow the EBP sign.
Failure to Obtain Ordered Laboratory Blood Work
Penalty
Summary
The facility failed to obtain laboratory blood work as ordered for two residents, leading to a deficiency in providing timely and quality laboratory services. Resident #4, who was admitted with diagnoses of type 2 diabetes mellitus, cognitive impairment, and lymphoma, had an order for a routine Complete Metabolic Panel (CMP), a Complete Blood Count (CBC) with differential, a Lipid Panel, and a Hemoglobin A1C on admission. Despite the order being marked as completed by Nurse #5, there were no lab results in the medical record. The Nurse Practitioner was unaware of the facility's process for communicating lab orders and expected the staff to ensure the lab work was done. The Director of Nursing (DON) confirmed that the current process involved submitting paper requisitions, but was unaware that the lab work had not been completed for Resident #4 and could not explain why the order was marked completed. Similarly, Resident #7, admitted with diagnoses of dementia, type 2 diabetes mellitus, vitamin D deficiency, and chronic kidney disease, had an order for a routine Hemoglobin A1C, Vitamin D level, and TSH (Thyroid Stimulating Hormone) test. This order was also marked as completed by Nurse #5, but there was no evidence of the lab work being drawn. The Nurse Practitioner again stated her expectation that the staff would ensure the lab work was done and was unaware that it had not been completed. The DON reiterated the process of submitting paper requisitions and was again unaware that the lab work had not been completed for Resident #7, unable to explain why the order was marked completed.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Winston-salem
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Silas Creek Rehabilitation Center | 1.3 mi | ★★★★★ | 6 | 0 |
| The Oaks | 1.5 mi | ★★★★★ | 0 | 0 |
| Willow Valley Center For Nursing And Rehabilitatio | 3.2 mi | ★★★★★ | 3 | 0 |
| Arbor Acres United Methodist Retirement Community | 3.7 mi | ★★★★★ | 2 | 0 |
| Cedar Hills Center For Nursing And Rehabilitation | 5.6 mi | ★★★★★ | 41 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release October 2026) and official state health department websites.