Nursing homes across Buncombe County, North Carolina, graded on the federal inspection
record, nurse staffing and staff turnover. County rank is shown on each home's profile.
Highland Farms runs on a nonprofit model with 60 certified beds in Black Mountain, and the staffing numbers are the first thing worth noticing. At 4.92 nurse hours per resident day, it sits roughly 27% above the national average, and weekend coverage only dips about 12% below its own weekday level, a smaller drop than many homes show. Staff turnover lands at 28.1%, well under the national 45.8%, which matters because consistent caregivers tend to know residents' routines. The inspection record backs this up: 14 deficiencies, none at harm or jeopardy level and none abuse-related, with one fine totaling $4,271. State surveyors visited recently, in August 2025, so the picture is current.
Givens Health Center in Asheville runs on 5.26 nurse staffing hours per resident day, roughly a third more than the national average, and that shows up in its staffing rating. Weekend coverage dips about 18% below its own weekday level, so care may look thinner on Saturdays and Sundays. Staff turnover sits at 31.6%, well under the national 45.8%, a real advantage in a field where constant retraining erodes familiarity with residents. The nonprofit's inspection record carries 19 deficiencies, none at harm or jeopardy level and none abuse-related, with a 4/5 inspection rating and a March 2026 survey. The quality measure score of 3/5 is the softer spot.
Deerfield Episcopal runs a lean, well-staffed operation: 5.44 nurse hours per resident day against a national average of 3.86, and turnover at 28.7% is far below the 45.8% norm, which matters because consistent caregivers know the residents. Inspections back that up, a five-star health inspection rating, three total deficiencies, none causing harm, none abuse-related. The soft spot is quality measures, where the home scores just two stars, and weekend staffing dips about 14% below weekday levels, so ask specifically who's on the floor on Saturdays and Sundays. It's a nonprofit with 62 beds and a recent inspection, and the numbers suggest solid care with one area worth a direct question.
The Laurels of Summit Ridge runs on better-than-average nurse hours, 4.17 per resident day, roughly 8 percent above the national figure, and its staff turnover of 38.2 percent actually beats the national rate instead of trailing it. That's not nothing in a for-profit building where aides cycling out the door is the usual problem.
What tempers the picture is a 2-out-of-5 inspection history: 18 deficiencies on the current record, one serious enough to reach harm or jeopardy level, though none involved abuse. Weekend staffing drops about 18 percent below weekday levels, so the coverage your family sees on a Tuesday isn't what shows up on a Sunday. The inspection from May 2025 is recent, at least, so those findings reflect how the place runs now.
Nc State Veterans Home - Black Mountain runs a 100-bed for-profit operation where the nursing hours look strong on paper, 5.43 per resident day, well clear of the 3.86 national figure, but weekends drop roughly 20% below the home's own weekday coverage, so the care your family member gets depends heavily on which day it is. Turnover sits at 45.3%, essentially the national rate. What troubles me is the inspection record: 20 deficiencies, three at harm or jeopardy level, two tied to abuse, and a single $12,759 fine. The most recent inspection was December 2025. Ask directly what changed since then.
Aston Park runs a tight ship on the things that usually cause trouble: five deficiencies on its current record, none of them serious enough to count as harm or jeopardy, and nothing abuse-related. The last inspection was recent, in April 2026. Staffing sits at 3.67 nurse hours per resident day, roughly 5% under the national average, and weekends dip about 4% below the home's own weekday level, worth asking about if your family member needs more help on Saturdays and Sundays. The good news is turnover: 39.5% versus 45.8% nationally, meaning caregivers here tend to stick around longer than at the typical home. That stability, plus a clean inspection history as a nonprofit, is the real story behind the numbers.
The Laurels of Greentree Ridge runs 90 beds in Asheville under corporate for-profit ownership, and its strongest signals come from inspections and quality measures, a recent May 2025 survey, no deficiencies at the harm or jeopardy level, and quality scores near the top of the federal scale. The staffing picture is weaker: 3.72 nurse hours per resident day sits about 4% under the national average, and weekends drop roughly 13% below the home's own weekday level, which matters most when families visit. Fifteen deficiencies appear on the current record, four tied to abuse, so ask specifically how those were resolved. Turnover at 40.8% is better than the 45.8% national figure, a modest point in its favor.
Black Mountain Neuro-Medical Treatment Center is state-run, with 163 certified beds, and the federal inspection picture looks strong on paper: five stars for health inspections, five for quality measures. But the deficiency record tells a more complicated story. Five deficiencies on the current record, including one at the harm or jeopardy level and one abuse-related, are the kind of findings that matter more than a star rating. Inspections were recent, last dated September 25, 2025. State ownership can mean stable funding and oversight, but it can also mean slower fixes when something goes wrong. Ask directly about those two serious deficiencies and what changed afterward.
The Greens At Weaverville runs 122 beds under for-profit LLC ownership, and its inspection record is the strong point here: 11 deficiencies on file, none rising to harm or jeopardy, none abuse-related, and a survey completed as recently as July 2025. The staffing picture is weaker. At 3.59 nurse hours per resident day, it sits about 7% under the national average of 3.86, and weekends drop roughly another 9% below its own weekday coverage. Turnover is the number worth sitting with, 66.9% against a 45.8% national average means most of the aides and nurses caring for your family member are relatively new to the building. Ask how they hold weekday staffing steady into Saturday and Sunday.
Mountain Ridge runs on 3.47 nurse staffing hours per resident day, roughly 10% under the national average, and weekends drop about 16% below what the home staffs on weekdays. The inspection record shows 11 deficiencies, including 2 at the harm or jeopardy level and 1 tied to abuse, with two fines totaling $16,152; the most recent inspection was May 30, 2025. Staff turnover sits at 42%, a bit better than the 45.8% national figure, and the quality measure rating is strong at 4 out of 5. But a 1-out-of-5 inspection rating and 2-out-of-5 staffing rating carry more weight when you're choosing care.
Fleshers Fairview Health Care runs 106 certified beds in Buncombe County under corporate for-profit ownership, and the staffing numbers look strong on paper, 3.96 nurse hours per resident day, slightly above the national average. But weekends drop about 15% below the home's own weekday coverage, and staff turnover sits at 46.2%, essentially matching the national rate. The real concern is the inspection record: 38 deficiencies, six of them serious enough to put residents in harm's way, plus two abuse-related findings and $61,321 in fines. The most recent inspection was in September 2025, so the record is current, not stale. Strong staffing and a difficult regulatory history are both true here.
Bear Mountain runs 77 certified beds under for-profit LLC ownership, and the staffing numbers are the first thing worth noticing. At 3.28 nurse hours per resident day, it sits about 15% under the national average of 3.86, and weekends drop roughly 14% below its own weekday levels, so the thinnest coverage lands when families tend to visit. Turnover is the other flag: 60.5% annually against a national 45.8%, meaning most of the people caring for your relative are relatively new. The inspection history shows 31 deficiencies, three at harm or jeopardy level and one abuse-related, with a single fine of $11,170 and a survey completed in May 2025. Ownership is for-profit, and the record reflects it.
Stonecreek runs on 3.30 nurse hours per resident per day, about 14% under the national average, and weekends drop another 13% below its own weekday pace. That staffing pattern matters because the home's last inspection in April 2025 left 15 deficiencies on record, two of them serious enough to involve harm or jeopardy, along with a $38,431 fine; the 47.6% turnover rate sits slightly above the national figure, so the aides and nurses cycling through aren't staying long. The five-star quality measure score looks reassuring, but it's built from self-reported resident data, while the one-star inspection result reflects what surveyors actually found on site.
Swannanoa Valley Health and Rehabilitation runs 106 beds under for-profit LLC ownership, and its staffing is the number that stands out: 3.22 nurse hours per resident day, about 16 percent under the national average of 3.86. Weekends dip roughly 8 percent below the home's own weekday coverage, and annual turnover sits at 57.8 percent against a national 45.8 percent, meaning the aides and nurses your family member sees are cycling through faster than average. The inspection record is comparatively solid: 12 deficiencies, none at harm or jeopardy level, though one is abuse-related, and the most recent inspection was October 2025. Quality and staffing measures each land mid-range.
Emerald Ridge runs 3.06 nurse hours per resident per day, about 21% under the national average of 3.86, and weekends dip roughly 15% below its own weekday coverage. Staff turnover sits at 35.8%, better than the 45.8% national figure, but the inspection record is where things get harder to explain: 32 deficiencies, including two at the harm or jeopardy level and three tied to abuse, with two fines totaling $73,475. The most recent inspection was April 9, 2026. A for-profit limited liability company owns the 100-bed home, and federal inspectors rated its health inspection record 1 out of 5 stars, worth asking about directly before you decide.
Elevate Health and Rehabilitation runs 3.25 nursing hours per resident per day, roughly 16% under the national average, and weekends drop about 10% below its own weekday levels. Turnover sits at 72.8% against a national 45.8%, so the people providing care keep changing. Inspection history is the harder problem: 30 deficiencies on the current record, six at harm or jeopardy level and one abuse-related, plus three fines totaling $174,346. The September 2025 inspection is recent, and the one-star inspection and staffing ratings reflect what surveyors found. Quality measures score well, but that's a narrow slice of the picture.
Pisgah Manor runs on 2.86 nurse hours per resident per day, roughly a quarter below the national average of 3.86, and weekend coverage dips about 6% below its own weekday level, so the thinnest shifts come when families tend to visit. Staff turnover sits at 59.1% against a national 45.8%, which means CNAs and nurses are cycling out faster than residents can get used to them. The inspection record shows 12 deficiencies, one serious enough to put a resident in harm's way, plus a $59,391 fine. A 2/5 on health inspections and 2/5 on staffing tell you the same story the numbers do.
Biltmore Haven runs about 2.93 nursing hours per resident per day, roughly a quarter below the national average, and weekends drop further from there. That thin coverage sits alongside a 71.4% annual turnover rate, well above the 45.8% national figure, so the staff who are there are often new. The inspection record is the harder problem: 50 deficiencies, 7 of them at harm or jeopardy level, 2 tied to abuse, and $189,174 in fines across three penalties. CMS placed this for-profit LLC home in its Special Focus Facility program, which is reserved for homes with a persistent pattern of poor care. The last inspection was May 1, 2025.
River Bend runs on 3.13 nurse hours per resident day, roughly 19 percent under the national average, and weekends drop about 9 percent below what it manages on weekdays. The bigger warning sign is turnover: 86.4 percent of staff left over the past year, nearly double the national rate, which means the people caring for your relative are likely new to the building and still learning it. On the current record are 52 deficiencies, seven serious enough to involve harm or jeopardy, 11 tied to abuse, and six fines totaling $147,579. Ownership is a for-profit limited liability company, which tells you where the margin pressure comes from.