Average — CMS composite of the measures below.
The next survey window likely opens around December 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 Main Street Care during CMS and state inspections, most recent first.
The facility failed to have an RN on duty for 8 hours per day, 7 days a week. Review of staffing records showed no RN coverage for eight consecutive hours daily during the review period. Although the facility had a DON, ADON, and two part-time RNs, one part-time RN did not work at all and the other worked only 7.3 hours total. The Administrator could not confirm that the DON or ADON provided resident care, and acknowledged the need for additional RNs.
The facility failed to maintain required RN coverage for eight consecutive hours daily and did not have a current RN waiver in place. Review of staffing records showed one RN did not work during the review period and another worked only 7.3 hours over 14 days, while the DON and ADON usually worked weekdays but documentation of resident care was not available. The Administrator acknowledged the facility needed to hire additional RNs or apply and renew the waiver.
Missing Required CNA Abuse/Neglect Training: The facility failed to ensure nurse aides received required annual education, including dementia management and abuse/neglect prevention training. CNA records for several nurse aides were missing abuse/neglect training documentation, and the DON and Administrator stated they believed an ethics course covered it, although the course description did not show abuse/neglect training.
PASRRs were not updated for three residents after newly documented psychiatric diagnoses were added to their records. One resident developed major depressive disorder, another had psychosis and was receiving Seroquel, and a third had depression and was receiving Remeron; the SS Director said he did not resubmit the PASRR because he was unaware it was required, and the DON and Administrator agreed the PASRRs should have been resubmitted.
Failure to provide hand hygiene before meals was observed during lunch tray pass and in the dining room. A CNA stated she usually gives residents a wipe or wet washcloth but did not do it for the observed residents, and an LPN said hand hygiene is usually done before meals but had not been done that day. The Administrator confirmed the residents should have been provided hand hygiene.
A resident’s PASRR was not accurate when the resident was admitted with an evident psychiatric disorder. The PASRR listed anxiety and visual hallucinations, but the resident also had delusional disorders present on admission and was receiving Depakote and Seroquel for that diagnosis; the DON and Administrator agreed the PASRR was incorrect.
Insulin Used Beyond Manufacturer-Recommended Timeframe: The facility failed to maintain medication in accordance with accepted standards of practice when two Lantus products were kept in use longer than the manufacturer recommended. An LPN confirmed that a multiple-dose vial for one resident and a multiple-dose prefilled pen for another resident had been opened and used beyond the 28-day timeframe listed in the package inserts.
Personal hygiene products, including shaving cream and body wash, were found unlabeled and improperly stored on the safety bar and floor of a shared shower. When questioned, a resident and a nurse aide could not identify the owner of the items, and the DON confirmed that labeling was required.
The facility did not have an RN on duty for at least eight hours on weekends, as required. The DON and ADON were on call but did not work on weekends, and the facility relied on an agreement with a hospital for emergency RN coverage. This affected all 31 residents.
A facility failed to protect a resident from potential hazards by leaving five medicine cups of Triamcinolone acetonide cream 0.1% at the bedside. The ADON confirmed the cream was for the resident's face, but the DON stated there was no order for self-administration or bedside storage.
The facility failed to document side effect monitoring for psychotropic medications for five residents, despite administering drugs like Alprazolam, Seroquel, and Risperdal. Interviews with the DON and ADON confirmed that while behaviors were monitored daily, side effect monitoring was not documented, indicating a systemic issue in medication management.
The facility failed to document side effect monitoring for psychotropic medications for five residents, despite administering these medications for conditions like anxiety and dementia. Interviews with the DON and ADON confirmed that while behaviors were monitored daily, side effect monitoring was not documented, revealing a systemic issue in medication management.
The facility failed to maintain cleanliness in the kitchen, as observed during a tour where seven air conditioning vents were found covered in dust and a black substance. These vents, located in the window and blowing over the sink and food preparation area, were confirmed to be dirty by the Food and Nutrition Contact, who stated that the maintenance department is responsible for their cleaning.
The facility failed to maintain proper infection control for clean linen storage. A linen cart with clean linen was found uncovered during a unit tour. The ADON was informed and acknowledged the issue.
A facility failed to provide a transfer form and notify the State Ombudsman when a resident was transferred to an acute care hospital after an unwitnessed fall, resulting in a head injury. The resident was found on the floor with a hematoma and bruising, and was transferred to the emergency room for evaluation. The ADON stated that note summaries are sent to the acute care facility, and the Ombudsman is not notified unless the resident is admitted.
A resident was transferred to a hospital after an unwitnessed fall, resulting in a large knot and bruising on the head. Despite the transfer, the facility failed to provide a current bed hold notice, as the existing notice was outdated. The ADON confirmed that the facility relies on a bed hold notice signed upon admission, but did not issue a new one for this incident.
A facility failed to accurately document a fall in the MDS for a resident who was transferred to a hospital after an unwitnessed fall, resulting in a head injury. Despite the incident being documented in progress notes, the MDS inaccurately indicated no falls, revealing a deficiency in the resident's assessment documentation.
RN Staffing Deficiency
Penalty
Summary
The facility failed to have a Registered Nurse on duty for eight hours per day, seven days a week as required. Review of the Daily Staffing Report for the 14-day period from 12/23/25 through 01/05/26 showed that there was not an RN on duty for eight consecutive hours each day. The facility had four RNs on staff, including the DON, the ADON, and two part-time RNs, but RN #19 did not work during the review period and RN #18 worked only 7.3 hours total over the 14 days. The Administrator stated that the DON and ADON usually work Monday through Friday but could not provide documentation or state for sure that they performed resident care. The review showed one RN on duty on eight of the fourteen days, which the Administrator acknowledged may have been the DON or ADON.
Failure to Maintain RN Coverage and Renew Waiver
Penalty
Summary
The facility failed to ensure a current RN waiver was completed when it did not have an RN on duty for eight consecutive hours daily during the 14-day review period from 12/23/25 through 01/05/26. Review of the Daily Staffing Report showed no RN coverage for the required daily eight-hour period, and the facility’s four RNs included the DON, the ADON, and two part-time RNs. Employee records showed RN #19 did not work at all during the review period, and RN #18 worked only 7.3 hours over the 14 days. The Administrator stated that the DON and ADON usually work Monday through Friday but could not provide documentation or state for sure that they performed resident care. The Administrator also stated the facility may apply for a waiver if it cannot meet RN staffing requirements due to difficulty hiring in a rural area, but the facility failed to re-apply for the waiver.
Missing Required CNA Abuse/Neglect Training
Penalty
Summary
The facility failed to ensure the continuing competence of nurse aides by not providing the required annual education, including at least 12 hours per year with dementia management training and resident abuse/neglect prevention training. During record review, CNA training documentation for Nurse Aides #4, #9, #11, #15, and #33 was missing required abuse/neglect training documentation. In interview, the Administrator and DON stated there was no training for abuse/neglect and believed it was covered under Ethics in Healthcare in Medline University. The course description reviewed by surveyors addressed ethics in healthcare, patient-centered care, autonomy, justice, and human dignity, and did not document abuse/neglect training. The Administrator later confirmed that the abuse/neglect training had not been completed as required by staff members.
PASRR Not Updated for New Psychiatric Diagnoses
Penalty
Summary
The facility failed to ensure a new Preadmission Screening and Resident Review (PASRR) was completed when residents developed newly evident psychiatric diagnoses while residing at the facility. Resident #24 had a PASRR completed on 03/22/22 with no mental illness diagnoses documented, but later received a diagnosis of major depressive disorder, recurrent, moderate on 10/01/24, and the DON confirmed on 01/07/2026 that a new PASRR had not been completed after that diagnosis was made. Resident #3 had a PASRR dated 05/12/21, but the record review found a new diagnosis of psychosis and use of Seroquel that was absent from the PASRR. Resident #5 had a PASRR dated 10/17/23, but the record review found a new diagnosis of depression and use of Remeron that was absent from the PASRR. The Social Services Director stated he did not resubmit the PASRR because he was not aware he had to do so, and the DON and Administrator agreed the PASRR should have been resubmitted.
Failure to Provide Hand Hygiene Before Meals
Penalty
Summary
The facility failed to ensure resident hand hygiene was performed before meals as part of its infection prevention and control program. During lunch tray pass observation on 01/05/26 at 12:05 PM, hand hygiene was not provided to residents on the [NAME] Hall, specifically in room [ROOM NUMBER] and room #338. At 12:10 PM, CNA #4 stated that she usually gives residents a wipe or wet washcloth before meals, but when asked about the observed residents she said, "I didn't do it." Later, at 12:25 PM, observation in the dining room found hand hygiene had not been performed before residents ate lunch. When asked whether hand hygiene was provided to all residents prior to meals, LPN #42 stated, "We usually do but haven't today." The observations were confirmed with the Administrator #29 at 1:01 PM, who agreed the residents should have been provided hand hygiene.
Inaccurate PASRR for Resident with Psychiatric Diagnosis
Penalty
Summary
The facility failed to ensure that a PASRR was completed and accurate for Resident #5 when the resident was admitted with an evident psychiatric disorder. Record review showed the resident had a PASRR dated 10/17/23 listing anxiety and visual hallucinations, which the Social Services Director confirmed was the latest PASRR. The resident’s current medical diagnoses also included delusional disorders, present on admission, and the resident received Depakote and Seroquel for those diagnoses. The PASRR did not list the delusional disorders diagnosis, and the DON and Administrator later agreed that the PASRR was incorrect.
Insulin Used Beyond Manufacturer-Recommended Timeframe
Penalty
Summary
The facility failed to maintain medication in accordance with accepted standards of practice when multi-dose insulin products were kept in use longer than the manufacturer recommended. During an inspection of the medication preparation room on 01/06/26 at 9:15 AM, surveyors observed a multiple-dose vial of Lantus insulin for Resident #6 with an opening date of 12/05/25 and a multiple-dose prefilled pen of Lantus insulin for Resident #3 with the same opening date. Both opening dates had been written on the medications in pen by the nurse who first accessed them. The package insert for the vial stated it could be used for 28 days refrigerated or at room temperature, and the package insert for the prefilled pen stated it could be used for 28 days at room temperature. LPN #39 confirmed that both Lantus insulins had been in use longer than recommended by the manufacturer.
Failure to Label and Store Personal Hygiene Items in Shared Bathroom
Penalty
Summary
Surveyors observed personal hygiene items, including two cans of shaving cream, a bottle of shampoo/conditioner/body wash, a container of eczema soothing lotion, and a stick, stored improperly on the safety bar and floor of a shared shower. These items were not labeled with resident names. When asked, one resident was unsure if the items belonged to another resident, and a nurse aide was also unable to identify the owner, stating they would throw the items away. The Director of Nursing confirmed that the items should have been labeled. This failure to properly label and store personal hygiene products in a shared bathroom demonstrates a lapse in the facility's infection prevention and control program, as required for the safe management of residents' personal items.
Failure to Provide RN Coverage on Weekends
Penalty
Summary
The facility failed to have a Registered Nurse (RN) on duty for at least eight hours on weekends, as required. During a record review, it was found that there was no RN coverage on several weekends, specifically on 07/06/24, 07/07/24, 07/13/24, 07/14/24, 07/20/24, 07/21/24, 07/27/24, 07/28/24, 08/03/24, 08/04/24, and 08/11/24. The Director of Nursing (DON) and the Assistant Director of Nursing (ADON) were on call and could arrive at the facility within seven to fifteen minutes, but they did not work on weekends. The facility had an agreement with a hospital to have an emergency room RN come to the unit if the on-call staff were unavailable. This practice had the potential to affect all 31 residents residing in the facility.
Medication Hazard at Bedside
Penalty
Summary
The facility failed to protect residents from potential hazards by leaving five medicine cups containing Triamcinolone acetonide cream 0.1% at the bedside of a resident. This was observed during an interview with the resident, where the surveyor noted the presence of the medication cups on the bedside table. The Assistant Director of Nursing confirmed that the cream was intended for the resident's face. However, the Director of Nursing later stated that there was no order for the resident to self-administer the medication or to have it by the bedside.
Failure to Monitor Side Effects of Psychotropic Medications
Penalty
Summary
The facility failed to provide side effect monitoring for psychotropic medications for five residents during the Long-Term Care Survey Process. The residents involved were prescribed various psychotropic medications, including Alprazolam, Depakote, Effexor XR, Seroquel, Xanax, Zoloft, Risperdal, Donepezil hydrochloride, DULoxetine HCl, Mirtazapine, Trazodone, and Paxil. Despite the administration of these medications, there was no documentation of side effect monitoring in the Medication Administration Records (MAR) and Treatment Administration Records (TAR) for the months of June, July, and August 2024. Interviews with the Director of Nursing (DON) and the Assistant Director of Nursing (ADON) revealed that while the facility monitored for behaviors daily, they did not document the monitoring of side effects for these medications. This lack of documentation was consistent across all five residents reviewed, indicating a systemic issue in the facility's medication management practices. The facility's census at the time was 31 residents.
Failure to Monitor Side Effects of Psychotropic Medications
Penalty
Summary
The facility failed to provide side effect monitoring for psychotropic medications for five residents during the Long-Term Care Survey Process. The residents involved were prescribed various psychotropic medications for conditions such as anxiety disorder, delirium, generalized anxiety disorder, depressive disorder, and vascular dementia with behavioral disturbance. Despite the administration of these medications, there was no documentation of side effect monitoring in the Medication Administration Records (MAR) and Treatment Administration Records (TAR) for the months of June, July, and August 2024. Interviews with the Director of Nursing (DON) and the Assistant Director of Nursing (ADON) revealed that while the facility monitored for behaviors daily, they did not document the monitoring of side effects for the psychotropic medications. This lack of documentation was consistent across all five residents reviewed, indicating a systemic issue in the facility's medication management practices.
Unclean Air Conditioning Vents in Kitchen
Penalty
Summary
The facility failed to maintain cleanliness in the kitchen, specifically regarding the air conditioning vents. During an initial tour of the kitchen, it was observed that seven vents located in the window, which blow over the three-compartment sink and into the open area where food is prepared and served, were covered in dust and a black substance. This condition was confirmed by the Food and Nutrition Contact (FNC), who acknowledged that the maintenance department is responsible for taking down the vents for cleaning and agreed that it was time for this task to be completed.
Infection Control Deficiency: Uncovered Clean Linen Cart
Penalty
Summary
The facility failed to maintain an appropriate infection control program for the storage of clean linen. During a tour of the unit, a linen cart with clean linen was observed to be uncovered on the top and sides. This observation was made at 10:42 AM on 08/20/24. The Assistant Director of Nursing (ADON) was notified and observed the uncovered linen cart at 10:46 AM, acknowledging the issue by stating, 'I'll take care of this.'
Failure to Notify Ombudsman and Provide Transfer Form
Penalty
Summary
The facility failed to provide a transfer form and notify the State Ombudsman of a transfer to an acute care facility for a resident. The resident was transferred to an acute care hospital following an unwitnessed fall, which resulted in a large knot and bruising to the back of the head. A progress note indicated that the resident was found lying on the floor beside her bed and had stated she fell on her head. A full body assessment was completed, and neurological checks were initiated. The facility physician and the resident's power of attorney were notified via phone, and the resident was transferred to the emergency room for evaluation. However, the review found no transfer form in the medical record, and the State Ombudsman was not notified of the transfer. The Assistant Director of Nursing stated that note summaries are sent to the acute care facility, and the State Ombudsman is not notified unless the resident is admitted.
Failure to Provide Bed Hold Notice After Hospital Transfer
Penalty
Summary
The facility failed to provide a bed hold notice for a resident after a transfer to an acute care hospital following an unwitnessed fall. The resident was found on the floor beside her bed with a large knot and bruising on the back of her head. A full body assessment was conducted, and neurological checks were initiated. The facility physician and the resident's power of attorney were notified, and the resident was transferred to the emergency room for evaluation. However, the review revealed that the bed hold notice provided by the facility was dated for a previous year, and no new notice was issued for this specific transfer. The Assistant Director of Nursing acknowledged that the facility uses a bed hold notice signed upon admission, but a specific notice for this incident was not completed.
Inaccurate MDS Documentation for Resident Fall
Penalty
Summary
The facility failed to complete an accurate Minimum Data Set (MDS) for a resident regarding a fall incident. The resident was transferred to an acute care hospital following an unwitnessed fall, which resulted in a large knot and bruising to the back of the head. A progress note documented the fall and subsequent medical actions, including a full body assessment and neurological checks. However, the MDS inaccurately noted that the resident had no falls, despite the documented incident. This discrepancy was identified during a record review and staff interview, highlighting the inaccuracy in the resident's assessment documentation.
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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.
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Nursing homes near Hinton
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Summers Healthcare Center | 5.7 mi | ★★★★★ | 27 | 1 |
| Raleigh Center | 13.5 mi | ★★★★★ | 13 | 0 |
| Majestic Care Of Beckley | 17.4 mi | ★★★★★ | 7 | 0 |
| Lindside Healthcare Center | 18 mi | ★★★★★ | 24 | 0 |
| Pine Lodge | 18 mi | ★★★★★ | 17 | 0 |
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