Federal inspection record · CMS data as of October 1, 2026
Holston Health & Rehabilitation
990 Holston Rd, Wytheville, VA · (276) 228-5595
- Certified beds
- 137
- Residents per day
- 96
- Ownership
- For-Profit
- Chain
- No chain reported
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- November 1, 2000
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.
-
Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Virginia.
-
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.
-
Overall
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Virginia homes
Holston Health & Rehabilitation carries 347.5 inspection points. That is fewer than 7% of Virginia's 287 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Virginia: 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★ 0–16 pts
- 4★ 16–45 pts
- 3★ 45–76.5 pts
- 2★ 76.5–168.75 pts
- 1★ over 168.75 pts
Bars show every rated home in Virginia 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
68 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 (2)
-
K
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
-
G
Provide safe, appropriate pain management for a resident who requires such services.
Everything else, by area of care
Quality of Life and Care15E
- D
Provide enough food/fluids to maintain a resident's health.
- D
Provide safe and appropriate respiratory care for a resident when needed.
- D
Provide care or services that was trauma informed and/or culturally competent.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide enough food/fluids to maintain a resident's health.
- D
Provide safe and appropriate respiratory care for a resident when needed.
- D
Provide medically-related social services to help each resident achieve the highest possible quality of life.
- E
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- D
Provide for the safe, appropriate administration of IV fluids for a resident when needed.
- D
Provide safe and appropriate respiratory care for a resident when needed.
- D
Provide safe, appropriate pain management for a resident who requires such services.
Resident Assessment and Care Planning13E
- E
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
- E
Ensure services provided by the nursing facility meet professional standards of quality.
- E
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Ensure each resident receives an accurate assessment.
- 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.
- D
Assess the resident when there is a significant change in condition
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Ensure each resident receives an accurate assessment.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Resident Rights11E
- E
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
- D
Allow residents to self-administer drugs if determined clinically appropriate.
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- D
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
- D
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
- D
Prepare residents for a safe transfer or discharge from the nursing home.
- D
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- D
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Pharmacy Service11E
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
- D
Ensure that residents are free from significant medication errors.
- 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 each resident’s drug regimen must be free from unnecessary drugs.
- D
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
- E
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
- E
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
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
Ensure medication error rates are not 5 percent or greater.
- D
Ensure that residents are free from significant medication errors.
Administration6E
- E
Provide behavior health training consistent with the requirements and as determined by a facility assessment.
- D
Provide timely, quality laboratory services/tests to meet the needs of residents.
- D
Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.
- D
Provide timely, approved x-ray services, or have an agreement with an approved provider to obtain them.
- D
Employ staff that are licensed, certified, or registered in accordance with state laws.
- D
Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.
Nursing and Physician Services4F
- E
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
- E
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
- D
Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.
- F
Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.
Infection Control4D
- D
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- D
Perform COVID19 testing on residents and staff.
- D
Provide and implement an infection prevention and control program.
Environmental1D
- D
Keep all essential equipment working safely.
Nutrition and Dietary1E
- E
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Inspection history
2025-05-07
31 health deficiencies · 7 fire-safety deficiencies
Top issue: Resident Rights (7 deficiencies)
2022-05-12
4 health deficiencies · 13 fire-safety deficiencies
Top issue: Administration (1 deficiency)
2019-06-07
33 health deficiencies · 4 fire-safety deficiencies
Top issue: Quality of Life and Care (12 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 2 h 56 min of nursing staff time a day, 29 min of it from a registered nurse.
This home
2 h 56 min
Virginia average
3 h 53 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 75% of nursing staff and 80% of registered nurses left in the past year, along with 2 administrators.
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
$111,911 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2025-05-07 | Fine | $111,911 |
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 daysAbout the same | 1.4 | 1.4 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days1.7 pts worse | 3.1 | 1.4 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine8.8 pts better | 100.0% | 91.2% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine6.7 pts better | 100.0% | 93.3% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury2.6 pts better | 0.9% | 3.5% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms13.1 pts better | 7.4% | 20.5% | 13.5% |
| Percentage of long-stay residents who lose too much weight3.5 pts worse | 8.8% | 5.3% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication14.8 pts worse | 35.5% | 20.7% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication2.8 pts better | 11.4% | 14.2% | 15.4% |
| Percentage of long-stay residents who were physically restrained0.1 pts better | 0.0% | 0.1% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened5 pts worse | 19.2% | 14.2% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased3.9 pts worse | 18.4% | 14.5% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.4 pts worse | 0.8% | 0.4% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection1.6 pts better | 0.0% | 1.6% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence1.7 pts worse | 23.0% | 21.3% | 18.3% |
| Percentage of long-stay residents with pressure ulcers1.7 pts better | 2.7% | 4.4% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine25.1 pts better | 99.3% | 74.2% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit3.8 pts worse | 15.3% | 11.5% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication1.3 pts better | 0.0% | 1.3% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine20.8 pts better | 94.1% | 73.3% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission11 pts better | 11.0% | 22.0% | 23.4% |
·
Fire safety
24 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke6F
- E
Meet other general requirements.
- E
Have approved installation, maintenance and testing program for fire alarm systems.
- E
Inspect, test, and maintain automatic sprinkler systems.
- E
Install corridor and hallway doors that block smoke.
- F
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- F
Install an approved automatic sprinkler system.
Emergency Preparedness5E
- E
Address subsistence needs for staff and patients.
- E
Establish policies and procedures for volunteers.
- E
Establish staff and initial training requirements.
- E
Conduct testing and exercise requirements.
- E
Address patient/client population and determine types of services needed.
Egress4E
- E
Provide rooms that can be unlocked from inside without a key.
- E
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.
- E
Have properly located and lighted "Exit" signs.
- E
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.
Miscellaneous3F
- E
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- F
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- D
Provide a written emergency evacuation plan.
Services3F
- F
Have properly installed electrical wiring and gas equipment.
- E
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
- D
Have properly installed electrical wiring and gas equipment.
Gas, Vacuum, and Electrical Systems2E
- E
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- E
Ensure proper usage of power strips and extension cords.
Construction1E
- E
Use approved construction type or materials.
·
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