Above average — CMS composite of the measures below.
The next survey window likely opens around November 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Valley Rehabilitation And Nursing Center during CMS and state inspections, most recent first.
Residents on the second-floor unit reported ongoing cold or fluctuating shower water for weeks, with one resident receiving bed baths because the shower water was too cold. Surveyor testing found shower water only lukewarm or cold in the bathing rooms, while sink water was hot, and staff acknowledged the issue had been ongoing and not fully resolved.
A facility failed to accurately code MDS assessments for four residents. One resident’s quarterly MDS incorrectly listed multiple high-risk drug classes when the record showed only a short course of ceftriaxone, another resident’s significant change MDS coded antianxiety medication after clonazepam had been discontinued, a third resident’s admission MDS failed to code hemodialysis despite ongoing dialysis treatment, and a fourth resident’s quarterly MDS misclassified Trulicity as insulin. Staff acknowledged the coding errors during survey interviews.
Incomplete Person-Centered Activity Care Plans: Multiple residents with severe cognitive impairment and significant medical diagnoses had activity assessments that identified specific preferences such as music, Bible reading, animals, news, fresh air, religious services, and 1:1 or self-directed activities, but the CCPs did not reflect those documented interests and needs. Staff interviews and record review showed the activity plans were centered on general TV or group activity language, lacked individualized detail, and in one case did not include PACE services that were being provided to the resident.
Failure to Provide Person-Centered Activity Programming: Multiple residents with severe cognitive impairment and other medical conditions had documented activity preferences and care plan goals for individualized or self-directed activities, but the AD and admin could not produce evidence of ongoing activity participation. Observations found residents in bed with TVs off or no meaningful engagement documented, and one resident stated unopened mail had not been read to her despite her request.
A resident with COPD and severe cognitive impairment was found on observation with oxygen set above the provider-ordered 2 L/min on two occasions. The resident said it is usually at 2 L/min but was unsure who changed it, and an LPN later confirmed the oxygen was set at 5 L/min before checking the order and adjusting it. The care plan directed staff to administer oxygen as ordered and did not indicate the resident would change the settings.
A resident with dementia, severe cognitive impairment, visual impairment, weakness, and a fall history was observed in bed with bilateral 1/2 side rails in place. The chart included an order and care plan for the rails for bed mobility and self-support, but the Bed Side Rail Tool showed no evidence that alternatives were tried before the rails were installed. The RDCS acknowledged that no alternatives were documented prior to use.
A resident with type 2 DM, dementia, CKD stage 3, and severe cognitive impairment received Humalog even when BG was below the provider’s hold parameter of 120. MAR review showed multiple insulin administrations outside the ordered threshold, despite the care plan directing meds be given as ordered.
Surveyors found multiple PTAC units in resident rooms that were loose, crooked, or not properly sealed, with daylight visible through one unit and outdoors visible around another. A resident reported prior rain intrusion, ongoing cool air coming through a hole near the unit, and that the wall area needed patching and painting. Facility leadership reviewed the concerns, and the facility policy required routine inspection and immediate repair of HVAC wall units.
Cold shower water on second-floor bathing unit
Penalty
Summary
The facility failed to provide a safe, clean, comfortable environment for residents on the second-floor Summit unit because shower water temperatures were repeatedly cold or only lukewarm for approximately two months. During the initial tour, several residents complained of cold showers, and resident interviews confirmed the issue had been ongoing for a long time. One resident stated showers were sometimes cold and the water fluctuated from hot to very cold, another said they had been getting bed baths because the shower water was too cold, and a third described the water as cold or tepid and said it still was not hot like it should be. Surveyor testing of the second-floor shower room showed the water remained cold after several minutes, and an LPN stated the knob in the housekeeping closet may have been left turned, causing the water not to get hot. When the surveyor returned later, the water was still not hot. A CNA stated the water was only about as warm as it gets and said they would not take a shower in that temperature. Maintenance staff then stated there had been an ongoing problem and they had been working through the process of elimination, believing it had been fixed until residents continued to complain. Further testing on the second floor showed shower water temperatures of 78.1 degrees and 75 degrees in two bathing rooms, while sink water in those same areas was hot. Maintenance staff stated they were unsure of the thermometer accuracy and had been checking and adjusting parts such as spindles, the solenoid, and the mixing valve. The administrator acknowledged the issue remained unresolved and stated the facility was showering residents on the first floor as needed until the problem was resolved.
Inaccurate MDS Coding for Medications and Dialysis
Penalty
Summary
The facility failed to ensure accurate MDS assessments for four residents by incorrectly coding medications and treatments in Section N and Section O of the assessments. Resident #18’s quarterly MDS, with an ARD of 09/12/25, coded multiple high-risk drug classes as being received without indications for use, including hypnotic, anticoagulant, antibiotic, diuretic, opioid, antiplatelet, hypoglycemic, and anticonvulsant medications. Review of the physician order summary identified only ceftriaxone 1 gram IM every 24 hours for pharyngitis for 5 days, ordered on 09/01/25 and discontinued on 09/06/25, and the surveyor could not locate medications in the other coded classes. The MDS coordinator stated the medications were coded in error and would be corrected. Resident #2’s significant change MDS with an ARD of 9/30/25 coded antianxiety medication during the 7-day look-back period, even though the order for clonazepam 0.5 tablet by mouth in the afternoon for anxiety had a discontinuation date of 9/3/25. The September 2025 MAR showed the resident received the medication from 9/1/25 through 9/3/25, and RN #1 agreed the medication should not have been coded on the MDS because it was discontinued on 9/3/25. Resident #61’s admission MDS, ARD 11/26/25, did not code dialysis in Section O even though the resident was receiving hemodialysis three times a week, had diagnoses including end stage renal disease and dependence on renal dialysis, and the care plan and medication summary both reflected dialysis every Tuesday, Thursday, and Saturday. Resident interview also confirmed dialysis three days a week. Resident #69’s quarterly MDS, ARD 10/24/25, coded insulin once in the last 7 days even though the clinical record showed an order for Trulicity 1.5 mg subcutaneously every Wednesday for diabetes mellitus. LPN #1 stated the MDS was coded incorrectly and would be modified. Across these four residents, surveyors identified inaccurate coding of medications and dialysis status on the MDS assessments, and the facility staff acknowledged the errors during interviews.
Incomplete Person-Centered Activity Care Plans
Penalty
Summary
The facility failed to develop and/or implement person-centered comprehensive activity care plans for four residents. Resident #2 had diagnoses including difficulty walking, dementia, depression, anxiety disorder, bilateral macular degeneration, and legal blindness, and a significant change MDS showed a BIMS score of 3, indicating severe cognitive impairment. The activity admission assessment identified preferences such as reading the Bible and true stories, listening to gospel music, watching the news, doing things with groups of people, Bible quizzes, being around dogs, and going outside in nice weather, but the most recent activity assessment did not reflect those interests and instead coded several of them as not very important, no response, or non-responsive. The comprehensive care plan focused on music, TV, and encouraging group activities, with interventions to assist with group activities and review preferences as needed. Resident #15 had diagnoses including early-onset Alzheimer's disease, anxiety disorder, depression, bipolar disorder, and a tracheostomy, and a quarterly MDS showed a BIMS score of 0, indicating severe cognitive impairment. The activity assessment documented that the resident wished to participate in activities in the center, wanted one-to-one and self-directed activities, needed activities modified for cognitive deficits, and required assistance with mobility and daily routine. The care plan focused on watching TV, individual activities, activity calendars, assistance to and from activities, and respecting limited or no participation, but the assessment and plan did not reflect the resident’s documented needs and preferences in a person-centered way. The AD stated the resident could not communicate effectively and that the activity care plan needed to be updated. Resident #75 had diagnoses including dementia, chronic pain, anxiety disorder, depression, muscle wasting and atrophy, and difficulty walking, and the quarterly MDS showed the resident was rarely/never understood, had memory problems, and was severely impaired in daily decision making. The activity assessment identified interests including reading, being around dogs, keeping up with the news, listening to country/gospel music, and participating in Presbyterian religious services, and noted the resident wished to participate in activities and self-directed activities with physical and mental impairments. The most recent activity assessment did not list prior or current interests and instead focused on self-directed activities such as watching TV in the room, with assistance as needed, while the care plan similarly centered on TV and self-directed activities rather than the documented preferences. Resident #13 had diagnoses including respiratory failure, altered mental status, hypotension, and muscle weakness, and an admission MDS showed a BIMS score of 3, indicating severe cognitive impairment. The care plan focused on impaired vision, self-directed TV activities, limited group participation, and listening to TV in the room, while the activity assessment identified music, animals, news, fresh air, and religious services as very important. The resident was observed in the room with the TV off, the Activities Director stated no 1:1 activity participation record was available and that no activities had been done because the resident was usually lethargic, and when asked, the resident said a radio would be nice. The record also showed the resident was receiving Medicaid PACE services, but there was no reference to PACE on the care plan, and RN #1 stated she was not aware of those services until the issue was discussed.
Failure to Provide Person-Centered Activity Programming
Penalty
Summary
The facility failed to provide an ongoing, person-centered activity program that supported resident choice, interests, and physical, mental, and psychosocial well-being for four sampled residents. The report identified deficiencies for residents with significant cognitive impairment and multiple diagnoses, including dementia, Alzheimer’s disease, depression, anxiety, respiratory failure, altered mental status, hypotension, muscle weakness, impaired vision, and difficulty walking. Facility records and observations showed that the residents had documented preferences for individualized or meaningful activities, but the documented activity participation was absent or incomplete. For one resident with severe cognitive impairment and legal blindness, the record showed preferences for Bible reading, gospel music, news, group activities, Bible quizzes, dogs, and going outside in nice weather. The care plan called for encouragement to participate in group activities and noted independent activities such as music and TV, but the activity director stated there was no evidence of activity engagement, and the administrator said only activity assessments could be located with no evidence of participation since July 2025. The resident was observed lying in bed with a radio playing in the room. For another resident with Alzheimer’s disease and severe cognitive impairment, the assessment indicated a need for 1:1 room visits, self-directed activities, and assistance with mobility and daily routine. The care plan stated the resident was most at ease watching TV and should be encouraged to participate in individual activities, but the activity director could not produce documentation of activity participation for October, November, or December 2025 and agreed there were no activity participation records since April 2025. The resident was observed in bed in a dark, quiet room with the TV off, and the activity director acknowledged the resident could not turn the TV on independently. A third resident with dementia, chronic pain, anxiety, depression, muscle wasting, and difficulty walking had activity preferences documented for reading, dogs, news, country/gospel music, and Presbyterian services, and the care plan referenced self-directed activities such as watching TV in the room. However, the activity director stated there was no evidence of activity engagement and the administrator agreed no documentation of activity participation could be located since 6/30/24. A fourth resident with respiratory failure, altered mental status, hypotension, and muscle weakness had a care plan for self-directed activities and limited/no group participation, but the activity director stated no 1:1 activity record existed and that no activities had been done because the resident was usually lethargic. During observation, the resident’s TV was off, unopened mail was on the over-bed table, and the resident stated no one had read it to her and that she would like someone to read it to her.
Oxygen set above ordered rate
Penalty
Summary
Facility staff failed to ensure Resident #61 received the provider-ordered amount of oxygen. Resident #61 had a diagnosis of chronic obstructive pulmonary disease (COPD) and a provider order for oxygen at 2 liters per minute via nasal cannula as tolerated every shift for COPD/hypoxia. The resident’s MDS assessment showed a BIMS score of 7, indicating severe impairment in cognitive skills for daily decision making. The resident’s care plan identified risk for respiratory complications and included administering oxygen as ordered. During observation, the resident’s oxygen was found set above the ordered rate on two occasions. On 02/10/25 at 8:25 a.m., the surveyor observed the oxygen set at 4 1/2 liters per minute, and the resident stated it is usually at 2 liters per minute but was not sure who changed it. On 12/10/25 at 1:10 p.m., the surveyor again observed the oxygen set at 5 liters per minute, which was confirmed by LPN #7, who checked the order and adjusted the oxygen level. LPN #7 stated the resident would change it, and the care plan did not indicate the resident would change oxygen settings.
Failure to Document Alternatives Before Using Bed Rails
Penalty
Summary
Facility staff failed to provide evidence of appropriate alternatives before installing bilateral half-side rails for Resident #2. The resident had diagnoses including muscle weakness, difficulty walking, dementia, macular degeneration, legal blindness, restless leg syndrome, and a history of falling. The most recent significant change MDS dated 9/30/25 showed a BIMS score of 3 out of 15, indicating severe cognitive impairment. Section GG coded the resident as dependent on staff for rolling from side to side and returning to a back-lying position. On 12/9/25, the resident was observed lying in bed sleeping with bilateral 1/2 side rails upright. The medical provider order dated 10/17/25 directed 1/2 side rails for bed mobility, self-positioning, and self-support, and the care plan dated 9/23/25 included 1/2 upper side rails x 2 for bed mobility, self-repositioning, and self-support related to pressure ulcer risk from impaired mobility. A Bed Side Rail Tool dated 9/30/25 showed no evidence that alternatives were attempted before the side rails were used. The RDCS stated that the resident's BIMS was higher when the rails were implemented and the resident may have requested them, and agreed the assessment showed no alternatives were attempted prior to installation.
Significant Medication Error: Humalog Given Below Ordered Blood Glucose Threshold
Penalty
Summary
Resident #2 was found to have received Humalog insulin despite a provider order to hold the medication when blood glucose was less than 120. The resident had diagnoses including type 2 diabetes mellitus with diabetic polyneuropathy, hypertension, dementia, chronic kidney disease stage 3, and muscle weakness. The most recent significant change MDS dated 9/30/25 showed a BIMS score of 3 out of 15, indicating severe cognitive impairment. A review of the provider order showed Humalog 2 units subcutaneously before meals for diabetes, with instructions not to give if glucose was below 120. Review of the November and December 2025 MARs showed Humalog was administered when blood sugars were 114, 102, 106, 118, and 98, all below the ordered threshold. The resident’s care plan included an intervention to administer medications as ordered. The concern was discussed with the administrator, DON, and regional director of clinical services at the end of day meeting on 12/11/25, and no further information was provided before exit conference.
PTAC Units Not Securely Installed in Multiple Resident Rooms
Penalty
Summary
The facility staff failed to ensure a safe and functional environment for 4 of 85 resident rooms because multiple package terminal air conditioners (PTACs) on the second floor were not properly secured or sealed. During the initial tour, surveyors observed one PTAC hanging crooked and loose from the wall, another with daylight visible through the unit, and another with outdoors visible around the unit and crumbling wall material around it. In one room, the surveyor also noted cold air coming in through and around the PTAC unit. Resident #3 was interviewed and stated that the wall area above the PTAC needed painting and that the wall had previously allowed rain to blow in. The resident pointed to a hole on the right side of the unit and said cool air could still be felt coming in there, although no rain was coming in anymore. On a later observation, the PTAC in another room was again noted to be crooked and pulled away from the wall, with an approximate 4-inch gap between the wall and the left edge of the unit. Facility leadership, including the Administrator, DON, and RDCS, reviewed the concerns, and the facility policy stated that through-the-wall HVAC units are to be inspected and serviced as scheduled and that needed repairs or corrections are to be initiated immediately.
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Illustrative
What surveyors actually found near you
We read the 5 citations issued within 25 miles in the last 12 months — and tell you exactly what happened, in plain English, matched to your record.
Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
Illustrative
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Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Chilhowie
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Sw Va M H Inst Geri Trt Ctr | 9.4 mi | ★★★★★ | 3 | 0 |
| Francis Marion Manor Health & Rehabilitation | 9.9 mi | ★★★★★ | 0 | 0 |
| Abingdon Health & Rehab Center | 13.8 mi | ★★★★★ | 0 | 0 |
| Deer Meadows Rehabilitation And Nursing | 16.7 mi | ★★★★★ | 0 | 0 |
| Clinch Valley Medical Center | 21.3 mi | ★★★★★ | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.