Oak Forest Health and Rehabilitation
5680 Windy Hill Drive · Winston Salem, NC · 27105 · 3367765000
170 certified beds For profit - Corporation Chain: Liberty Senior Living
Why this verdict
- Federal penalties on record: $29,749 in fines in the last 24 months.
- 3 citations involved actual harm to residents.
- Inspection results have improved across recent cycles.
The complete Safety Report — $19
Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.
Red flags
1 immediate-jeopardy citation in prior inspection cycles
Serious past findings — check whether the underlying problems were fixed and stayed fixed.
60% of nursing staff left within a year
High turnover disrupts continuity of care; the national median is 45%.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 1 of 5 Inspections: 2 of 5 Staffing: 1 of 5 Quality measures: 1 of 5
| Total nurse hours / resident-day | 3.68 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.37 | 0.55–0.75 |
| Weekend hours / resident-day | 3.31 | ≈ weekday level |
| Nursing turnover / year | 60% | median 45% |
| Fines (3-yr window) | 4 · $43,002 |
Inspection citations (32 in the current record)
-
Actual harm · G June 12, 2025 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected June 27, 2025 · Quality of Life and Care
-
Potential for harm · D June 12, 2025
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected June 27, 2025 · Resident Assessment and Care Planning
-
Potential for harm · D June 12, 2025
Provide appropriate foot care.
Corrected June 24, 2025 · Quality of Life and Care
-
Potential for harm · D June 12, 2025
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected June 13, 2025 · Pharmacy Service
-
Potential for harm · D June 12, 2025
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Corrected June 13, 2025 · Pharmacy Service
-
Potential for harm · D June 12, 2025 · found via complaint
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Corrected June 27, 2025 · Resident Rights
-
Potential for harm · D June 12, 2025 · found via complaint
Protect each resident from the wrongful use of the resident's belongings or money.
Corrected June 13, 2025 · Freedom from Abuse, Neglect, and Exploitation
-
Potential for harm · D June 12, 2025 · found via complaint
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected June 27, 2025 · Quality of Life and Care
-
Potential for harm · D June 12, 2025 · found via complaint
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Corrected June 13, 2025 · Quality of Life and Care
-
Potential for harm · D February 12, 2025 · found via complaint
Ensure each resident receives an accurate assessment.
Corrected February 21, 2025 · Resident Assessment and Care Planning
-
Immediate jeopardy · J November 8, 2024 · found via complaint
Ensure that residents are free from significant medication errors.
Corrected October 23, 2024 · Pharmacy Service
-
Potential for harm · D November 8, 2024 · found via complaint
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected October 23, 2024 · Resident Assessment and Care Planning
-
Potential for harm · D February 15, 2024
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected March 1, 2024 · Resident Assessment and Care Planning
-
Potential for harm · F February 15, 2024
Dispose of garbage and refuse properly.
Corrected March 1, 2024 · Nutrition and Dietary
-
Potential for harm · F February 15, 2024
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Corrected March 1, 2024 · Administration
-
Potential for harm · D February 15, 2024
Provide and implement an infection prevention and control program.
Corrected March 1, 2024 · Infection Control
-
Potential for harm · D February 15, 2024 · found via complaint
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected March 1, 2024 · Quality of Life and Care
-
Potential for harm · E February 15, 2024 · found via complaint
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected March 1, 2024 · Nutrition and Dietary
-
No harm found · C February 15, 2024
Post nurse staffing information every day.
Corrected March 1, 2024 · Nursing and Physician Services
-
Actual harm · G December 18, 2023 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected November 24, 2023 · Quality of Life and Care
-
Potential for harm · D December 18, 2023 · found via complaint
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Corrected December 27, 2023 · Administration
-
Potential for harm · D July 26, 2023 · found via complaint
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Corrected August 9, 2023 · Resident Rights
-
Potential for harm · D July 7, 2023 · found via complaint
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Corrected August 9, 2023 · Resident Rights
-
Potential for harm · F July 7, 2023 · found via complaint
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected August 9, 2023 · Nutrition and Dietary
-
Actual harm · H November 15, 2022
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected November 16, 2022 · Quality of Life and Care
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| June 12, 2025 | Fine | $12,948 |
| November 8, 2024 | Fine | $16,801 |
| December 18, 2023 | Fine | $8,778 |
| July 7, 2023 | Fine | $4,475 |
Family & resident reviews — a separate signal, never mixed into the score
No approved reviews yet. If your family has experience with this facility, yours could be the review that helps the next family decide.
Sign in to share your family's experience — reviews are moderated and never affect the Safety Score.
Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 345443 · certified since July 28, 1993. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.