Best places to open an assisted living home in North Carolina

Name: North Carolina assisted living market data
Creator: RAL Market Scout

The top markets for residential assisted living in North Carolina, ranked by demand versus supply — plus the cities where the homes are.

Updated July 2026

The top markets for assisted living in North Carolina right now are Johnston, Brunswick, Robeson counties — ranked by RAL Market Scout's opportunity score, which weighs 75+ demand and projected senior growth against current bed supply. Statewide there are 1,085 licensed assisted living homes serving 737,440 residents aged 75+, at a median cost of about $6,496/mo.

Licensed homes

1,085

state roster

Population 75+

737,440

ACS

Median AL cost

$6,496/mo

near the national median

Bed supply

54.1/1k

saturated supply

Top 10 markets for assisted living in North Carolina

RAL Market Scout's opportunity score blends 75+ demand and projected senior growth against current bed supply — a saturated market is scored down even when demand is high. Higher means more room for a new small home.

Johnston County — opportunity 7.2/10 (Strong); 11,851 seniors 75+, growing 27.2%, with 38 licensed homes.
Brunswick County — opportunity 7.2/10 (Strong); 17,841 seniors 75+, growing 39.1%, with 6 licensed homes.
Robeson County — opportunity 7.1/10 (Strong); 7,229 seniors 75+, growing -1.7%, with 20 licensed homes.
Nash County — opportunity 7.0/10 (Strong); 7,170 seniors 75+, growing 9.3%, with 14 licensed homes.
Rowan County — opportunity 6.9/10 (Moderate); 10,447 seniors 75+, growing 4.3%, with 11 licensed homes.
Union County — opportunity 6.9/10 (Moderate); 13,396 seniors 75+, growing 25.9%, with 13 licensed homes.
Pitt County — opportunity 6.9/10 (Moderate); 9,922 seniors 75+, growing 8.3%, with 13 licensed homes.
Orange County — opportunity 6.7/10 (Moderate); 9,249 seniors 75+, growing 32.3%, with 15 licensed homes.
Carteret County — opportunity 6.7/10 (Moderate); 7,310 seniors 75+, growing 12.4%, with 11 licensed homes.
Lincoln County — opportunity 6.7/10 (Moderate); 7,068 seniors 75+, growing 32.8%, with 8 licensed homes.

All North Carolina counties by market opportunity

County	Pop 75+	Demand	Homes	Market	Band
Johnston	11,851	6.8	38	7.2	Strong
Brunswick	17,841	7.2	6	7.2	Strong
Robeson	7,229	3.3	20	7.1	Strong
Nash	7,170	3.7	14	7.0	Strong
Rowan	10,447	3.7	11	6.9	Moderate
Union	13,396	6.5	13	6.9	Moderate
Pitt	9,922	4.3	13	6.9	Moderate
Orange	9,249	6.1	15	6.7	Moderate
Carteret	7,310	5.4	11	6.7	Moderate
Lincoln	7,068	5.9	8	6.7	Moderate
Catawba	12,611	6.3	11	6.7	Moderate
Mecklenburg	53,017	6.1	68	6.6	Moderate
Cabarrus	12,738	5.9	20	6.6	Moderate
Durham	18,261	6.4	42	6.6	Moderate
Wayne	7,979	2.7	14	6.6	Moderate
Caldwell	6,857	4.3	5	6.6	Moderate
Buncombe	23,968	6.4	56	6.6	Moderate
Forsyth	26,541	5.0	34	6.6	Moderate
Wake	58,786	6.7	112	6.6	Moderate
Beaufort	4,557	3.8	4	6.6	Moderate
Guilford	35,457	5.1	33	6.6	Moderate
Pender	4,427	4.3	4	6.6	Moderate
Franklin	5,015	5.8	14	6.6	Moderate
New Hanover	18,056	6.1	8	6.5	Moderate
Iredell	13,004	6.4	16	6.5	Moderate
Cleveland	7,535	4.3	19	6.5	Moderate
Rutherford	5,934	4.4	15	6.5	Moderate
Gaston	15,493	5.3	11	6.5	Moderate
Wilson	5,989	3.4	8	6.5	Moderate
Cumberland	17,369	5.3	17	6.4	Moderate
Henderson	13,582	5.6	30	6.4	Moderate
Harnett	7,554	6.1	13	6.4	Moderate
Jackson	3,546	4.9	2	6.4	Moderate
Randolph	11,107	5.1	8	6.4	Moderate
Craven	8,991	5.1	12	6.3	Moderate
Davidson	13,438	5.0	8	6.3	Moderate
Dare	3,283	5.3	1	6.3	Moderate
Chatham	8,952	7.4	16	6.3	Moderate
Rockingham	7,980	3.3	27	6.3	Moderate
Burke	8,106	5.3	17	6.2	Moderate
Alamance	12,584	5.1	47	6.2	Moderate
Cherokee	3,717	5.3	3	6.2	Moderate
Columbus	4,361	3.1	2	6.2	Moderate
Duplin	4,066	2.4	10	6.2	Moderate
Surry	6,318	3.8	7	6.2	Moderate
Onslow	8,019	4.5	5	6.1	Moderate
Wilkes	6,495	4.3	2	6.1	Moderate
Macon	4,787	5.8	3	6.1	Moderate
Haywood	6,914	5.6	8	6.0	Moderate
Stanly	5,177	5.9	6	6.0	Moderate
Granville	4,228	3.3	6	6.0	Moderate
Sampson	4,369	2.9	6	6.0	Moderate
Lee	4,485	4.5	5	5.9	Moderate
Moore	11,641	5.0	11	5.9	Moderate
McDowell	3,767	3.4	10	5.8	Moderate
Hoke	2,078	5.1	4	5.8	Moderate
Transylvania	4,844	4.8	4	5.8	Moderate
Stokes	4,452	5.3	6	5.7	Moderate
Avery	1,716	5.0	1	5.7	Moderate
Madison	2,036	4.7	3	5.7	Moderate
Lenoir	4,909	3.7	9	5.7	Moderate
Halifax	4,243	3.1	3	5.7	Moderate
Edgecombe	4,007	2.9	7	5.6	Moderate
Caswell	2,038	4.3	10	5.6	Moderate
Yancey	2,138	4.9	1	5.5	Moderate
Bertie	1,752	2.8	12	5.5	Moderate
Watauga	3,696	4.3	1	5.5	Moderate
Vance	3,262	3.4	3	5.5	Moderate
Davie	4,269	6.3	4	5.5	Moderate
Alexander	3,366	3.7	4	5.4	Moderate
Ashe	3,060	5.4	5	5.4	Moderate
Person	3,463	4.9	8	5.4	Moderate
Richmond	2,996	2.1	3	5.3	Moderate
Bladen	2,772	3.4	7	5.3	Moderate
Greene	1,352	3.3	3	5.2	Moderate
Chowan	1,254	3.4	3	5.2	Moderate
Pasquotank	3,155	6.7	5	5.1	Moderate
Clay	1,541	5.9	1	5.1	Moderate
Yadkin	3,398	4.1	3	5.1	Moderate
Scotland	2,501	3.1	1	5.1	Moderate
Montgomery	2,369	5.6	3	5.1	Moderate
Pamlico	1,599	4.0	1	5.0	Moderate
Hertford	1,880	3.3	10	4.9	Moderate
Martin	2,223	4.3	4	4.9	Moderate
Washington	1,099	2.4	1	4.8	Moderate
Polk	3,095	5.4	3	4.8	Moderate
Warren	2,201	4.9	3	4.6	Moderate
Northampton	2,155	3.3	4	4.6	Moderate
Currituck	1,913	5.5	1	4.5	Moderate
Anson	1,840	2.9	1	4.5	Moderate
Mitchell	1,676	4.8	1	4.4	Thin
Alleghany	1,361	5.6	1	4.4	Thin
Perquimans	1,704	6.4	2	4.2	Thin
Swain	1,193	4.6	1	4.2	Thin
Jones	874	3.2	0	—	—
Graham	910	5.2	0	—	—
Tyrrell	532	6.7	1	—	—
Camden	750	2.7	1	—	—
Hyde	247	1.4	0	—	—
Gates	977	5.2	1	—	—

Top cities for assisted living in North Carolina

Where the homes actually are. Each linked city has its own page with local supply and market context.

City	County	Homes	Avg size
Raleigh	Wake	56	—
Charlotte	Mecklenburg	53	—
Durham	Durham	42	—
Burlington	Alamance	36	—
Asheville	Buncombe	30	—
Greensboro	Guilford	22	—
Cary	Wake	20	—
Reidsville	Rockingham	20	—
Fayetteville	Cumberland	15	—
Rocky Mount	Nash	15	—
Winston-Salem	Forsyth	15	—
Chapel Hill	Orange	14	—
Leicester	Buncombe	13	—
Flat Rock	Henderson	13	—
Morganton	Burke	12	—
Hendersonville	Henderson	12	—
Clayton	Johnston	11	—
Smithfield	Johnston	10	—
Goldsboro	Wayne	10	—
New Bern	Craven	9	—

Frequently asked questions

What are the top markets for assisted living in North Carolina?

The strongest North Carolina markets on RAL Market Scout's opportunity scoring are Johnston, Brunswick, Robeson, Nash, Rowan counties — based on 75+ demand and projected senior growth versus current bed supply.

Which North Carolina city has the most assisted living homes?

Raleigh has the most, with 56 licensed assisted living homes (about 0 beds).

How much does assisted living cost in North Carolina?

The median assisted living cost in North Carolina is about $6,496 per month — near the national median.

How many assisted living homes are in North Carolina?

North Carolina has approximately 1,085 licensed assisted living homes serving 737,440 residents aged 75 and older.

See the full North Carolina picture

RAL Market Scout scores every county and ZIP in North Carolina on demand, supply gaps, and referral capacity — and builds a site-level report for any address you're evaluating.

Run a Market Report Site Intelligence report

Sources: Licensed-home and city counts from North Carolina state licensing rosters (RAL Market Scout data pipeline). 75+ population and growth from U.S. Census ACS. Bed supply from NIC MAP / state surveys. Cost figures are market medians. Data snapshot: 2026-07. Informational only — not legal, financial, or investment advice.