Federal inspection record · CMS data as of October 1, 2026
Carter Nursing and Rehabilitation
250 McDavid Boulevard, Grayson, KY · (606) 474-7835
- Cited for abuse (CMS abuse icon)
- Certified beds
- 120
- Residents per day
- 111
- Ownership
- For-Profit
- Chain
- David Marx
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- February 21, 1991
1
How this home got 1 star
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Kentucky.
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Staffing
★★★★★no change (already 1)
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
-
Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
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Overall
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
This home carries CMS's abuse icon, which caps its inspection rating at 2 stars and so its overall rating at 4.
2
Where it sits among Kentucky homes
Carter Nursing and Rehabilitation carries 90.25 inspection points. That is fewer than 9% of Kentucky's 265 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Kentucky: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–2 pts
- 4★ 2–11 pts
- 3★ 11–22 pts
- 2★ 22–45 pts
- 1★ over 45 pts
Bars show every rated home in Kentucky by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
16 health citations on record since 2019. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
Harm and immediate-jeopardy citations (3)
-
G
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
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G
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
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K
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Everything else, by area of care
Nutrition and Dietary3F
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- D
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Resident Assessment and Care Planning3D
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Pharmacy Service3E
- E
Ensure medication error rates are not 5 percent or greater.
- D
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.
- D
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.
Infection Control2D
- D
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
Freedom from Abuse, Neglect, and Exploitation2D
- D
Protect each resident from the wrongful use of the resident's belongings or money.
- D
Not hire anyone with a finding of abuse, neglect, exploitation, or theft.
Inspection history
2025-08-29
5 health deficiencies · 3 fire-safety deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (2 deficiencies)
2023-07-17
10 health deficiencies · 8 fire-safety deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (2 deficiencies)
2019-11-07
1 health deficiencies · 6 fire-safety deficiencies
Top issue: Pharmacy Service (1 deficiency)
4
Nursing time per resident, per day
Each resident here gets about 3 h of nursing staff time a day, 23 min of it from a registered nurse.
This home
3 h
Kentucky average
3 h 59 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 64% of nursing staff and 58% of registered nurses left in the past year, along with 1 administrator.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Fines and payment denials
$11,700 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2025-08-29 | Fine | $5,200 |
| 2025-08-29 | Fine | $6,500 |
6
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.4 pts worse | 2.3 | 1.9 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.7 pts better | 1.3 | 2.0 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine3.1 pts better | 97.2% | 94.1% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine2.9 pts better | 99.1% | 96.2% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury1.5 pts better | 2.3% | 3.8% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms8 pts better | 10.9% | 18.9% | 13.5% |
| Percentage of long-stay residents who lose too much weight1.1 pts worse | 7.7% | 6.6% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication5.9 pts worse | 35.8% | 29.9% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication9.8 pts better | 6.4% | 16.2% | 15.4% |
| Percentage of long-stay residents who were physically restrained0.2 pts better | 0.0% | 0.2% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened8 pts better | 4.3% | 12.3% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased5.1 pts better | 8.1% | 13.2% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.3 pts better | 0.2% | 0.5% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection1.2 pts better | 0.3% | 1.5% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence0.6 pts worse | 18.9% | 18.3% | 18.3% |
| Percentage of long-stay residents with pressure ulcers1.6 pts worse | 6.3% | 4.7% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine0.3 pts worse | 84.2% | 84.5% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit0.4 pts worse | 13.6% | 13.2% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication1.2 pts better | 0.4% | 1.6% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine2.2 pts worse | 81.5% | 83.7% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission2.3 pts worse | 26.2% | 23.9% | 23.4% |
·
Who owns and runs it
29 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Carter Nursing And Rehabilitation Holdings LLC | 5% Or Greater Direct Ownership Interest · Organization | 100% | 1 facilities |
| 250 Mcdavid Blvd SNF Realty Holdings LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| 250 Mcdavid Blvd SNF Realty LLC | Operational/Managerial Control · Organization | 0% | 1 facilities |
| 250 Mcdavid Blvd SNF Realty LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Alexander, David | Operational/Managerial Control · Individual | 0% | 26 facilities |
| Alexander, David | Adp Of The SNF · Individual | 0% | 26 facilities |
| Bluegrass Consulting Group LLC | Operational/Managerial Control · Organization | 0% | 9 facilities |
| Bluegrass Consulting Group LLC | Adp Of The SNF · Organization | 0% | 9 facilities |
| Chamberlain, Margaret | Operational/Managerial Control · Individual | 0% | 32 facilities |
| Chamberlain, Margaret | Adp Of The SNF · Individual | 0% | 32 facilities |
| Gibbs, Sarah | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Gibbs, Sarah | Adp Of The SNF · Individual | 0% | 1 facilities |
| Kentucky SNF Realty Holdings LLC | Adp Of The SNF · Organization | 0% | 7 facilities |
| Marx, David | Operational/Managerial Control · Individual | 0% | 30 facilities |
| Marx, David | Adp Of The SNF · Individual | 0% | 30 facilities |
| Mdg Real Estate Global Limited | Adp Of The SNF · Organization | 0% | 22 facilities |
| Pruitt, Paul | Managing Control - Governing Body · Individual | 0% | 32 facilities |
| Pruitt, Paul | Operational/Managerial Control · Individual | 0% | 32 facilities |
| Pruitt, Paul | Adp Of The SNF · Individual | 0% | 32 facilities |
| Rewa, Angela | Operational/Managerial Control · Individual | 0% | 32 facilities |
| Rewa, Angela | Adp Of The SNF · Individual | 0% | 32 facilities |
| Russell, Robert | Operational/Managerial Control · Individual | 0% | 32 facilities |
| Russell, Robert | Adp Of The SNF · Individual | 0% | 32 facilities |
| Shatrov, Anzhelika | Operational/Managerial Control · Individual | 0% | 32 facilities |
| Shatrov, Anzhelika | Adp Of The SNF · Individual | 0% | 32 facilities |
| Shields, Kari | Operational/Managerial Control · Individual | 0% | 8 facilities |
| Shields, Kari | Adp Of The SNF · Individual | 0% | 8 facilities |
| Wolfe, Eric | Operational/Managerial Control · Individual | 0% | 32 facilities |
| Wolfe, Eric | Adp Of The SNF · Individual | 0% | 32 facilities |
·
Fire safety
17 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Miscellaneous5F
- D
Have simulated fire drills held at unexpected times.
- D
Have restrictions on the use of portable space heaters.
- F
Have simulated fire drills held at unexpected times.
- D
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
- D
Have restrictions on the use of portable space heaters.
Smoke5F
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- E
Install corridor and hallway doors that block smoke.
- E
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- F
Inspect, test, and maintain automatic sprinkler systems.
- D
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Gas, Vacuum, and Electrical Systems4F
- D
Ensure proper usage of power strips and extension cords.
- F
Have generator or other power source capable of supplying service within 10 seconds.
- F
Ensure proper usage of power strips and extension cords.
- E
Have proper medical gas storage and administration areas.
Egress3D
- D
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
- D
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
- D
Have corridors or aisles that are unobstructed and are at least 8 feet in width.
·
Other homes nearby
-
Boyd Nursing and Rehabilitation
Ashland, KY · David Marx
★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
- 3 h 15 min
- Fines
- $0
-
Kingsbrook Lifecare Center
Ashland, KY
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 4 h 48 min
- Fines
- $11,154
-
Wurtland Nursing and Rehabilitation
Wurtland, KY · David Marx
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 3 h 20 min
- Fines
- $69,908