North Carolina100 countiesEnrollment 2025Claims 2024Licensure Sep 2026
North Carolina Senior Care Atlas
Medicare demand, cost and licensed senior-housing supply for every county in North Carolina — built to show where independent living, assisted living and memory care have room to grow, and what Medicare actually spends where they don't. Every category is North Carolina's own.
CMS Monthly EnrollmentCMS Geographic Variation PUFCMS Care CompareNC DHSR Adult Care Licensure Section facility listings
Read this before you read the numbers
Medicare does not record where a beneficiary lives. Claims identify the service billed, never the residence. Someone in independent living, in assisted living, or in their own house is indistinguishable in this data, and no public CMS file splits spend by residential setting. So the residence measures here come from state licensure, and the spend measures are county-wide.
Independent living is invisible on purpose. North Carolina does not license IL — it is housing, not care, so there is no registry and no bed count. The closest honest proxy is the 75+ and 85+ enrollee counts (907,823 and 212,636 here) set against licensed capacity: that gap is your addressable population.
“Skilled nursing” here means post-acute SNF, not the nursing home. Medicare covers up to 100 days after a qualifying hospital stay. Long-term custodial care is paid by Medicaid and out of pocket and never appears in these dollars — which means most of the savings from keeping someone out of a nursing home accrue to Medicaid, not Medicare.
What Medicare savings do look like is on this page: fewer inpatient stays, lower readmission rates, fewer ER visits, fewer SNF days per 1,000, and a heavier tilt toward home health and hospice. Those five are the measurable case for aging in place, and they vary by more than two-fold across North Carolina counties.
Spend is Original Medicare only, and North Carolina is 57% Medicare Advantage. CMS publishes no county-level MA spending, so the $9.99B here covers only the 856,468 fee-for-service beneficiaries. Per-capita figures are per FFS beneficiary with full Part A and B — not per enrollee.
How this state counts memory care. North Carolina licenses one assisted living facility and certifies some of its beds for Alzheimer's care, so alzheimer-licensed beds is a subset of licensed capacity and is never added to it. Every figure on this page follows North Carolina's own definitions; nothing is converted to another state's categories.
County heat map
Every measure in the dataset can shade the map. Pick a category to narrow the list, or search it by name — inpatient stays, readmissions, SNF days, home health use, bed gap, growth in the 75+ cohort. Click any county on the map or in the ranking to open its profile below.
Not reported — the county has no beds or CMS suppressed the cell
Each mark is one county. The dashed rule is the '+CFG.name+' average.
All 67 counties, ranked
County profile
The selected county in full — demand, where its Medicare dollar goes, licensed capacity, and how heavily it leans on institutional care.
Every measure, side by side
The same data as a table. Rates and dollars are shaded against the '+CFG.name+' average; counts are shaded low to high. Click a column header to sort. The category chips above control which columns appear here too.
Supply against institutional intensity
Horizontal axis: licensed assisted-living and memory-care capacity per 1,000 enrollees aged 75 and over. Vertical axis: Medicare-covered SNF days per 1,000 fee-for-service beneficiaries — how heavily a county leans on institutional post-acute care. Circle size is total Medicare enrollment; dashed lines mark the '+CFG.name+' average. Counties in clay have no licensed assisted living or memory care at all.