Stacy Wright, 29, a certified nursing assistant at Hillside Nursing Center of Wake Forest, was charged with assault on a handicapped person.
Police said on Saturday, Wright struck Alma Williams, 85, on the head with her fist and pinched her nose until it left a mark.
Bill Burroughs, Hillside's administrator, said the center performs all the necessary background checks on employees.
"Like any employer, I guess I'm at the mercy of the individuals that work for me, as to how they conduct themselves and their actions," he said.
State records indicate inspectors have received 73 allegations of poor care about Hillside over the past three years; 19 of those have been substantiated.
Burroughs said with hundreds of regulations, it is hard for any nursing home to have no deficiencies.
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