Home / Virginia / Independence
400 South Independence Avenue, Independence, VA 24348 · Grayson County · (276) 773-0303
120 certified beds, about 113 residents a day · For profit - Corporation · Medicare and Medicaid since 1998
CMS Care Compare ratings, data as of September 1, 2026 · CCN 495331 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on December 14, 2023, inspectors cited 6 health deficiencies (the Virginia average is 14.3, the national average 9.2).
None of its 31 health citations since January 2019 was rated as actual harm or immediate jeopardy.
CMS lists no fines against this home in the last three years.
Nurses and nurse aides worked 2.72 hours per resident per day, against 3.76 across Virginia and 3.86 nationally. Registered nurses accounted for 0.57 of those hours.
45.2% of nursing staff left within the year CMS measured (Virginia average 48.1%).
CMS links it to Avardis Health, an affiliated group of 38 nursing homes.
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 31 health citations on file.
Inspectors wroteBased on staff interview, clinical record review and facility document review, the facility staff failed to immediately notify the resident representative of a significant change in resident condition for one of four residents in the survey sample, resident #1.
Inspectors wroteBased on staff interview and clinical record review, the facility staff failed to follow medical provider orders for 2 of 4 sampled residents (Resident #1 and Resident #4).
Inspectors wroteBased on staff interview and facility document review, the facility staff failed to ensure 2 of 4 sampled residents were free of significant medication errors (Resident #1 and Resident #4).
Inspectors wroteBased on staff interview and facility document review, the facility staff failed to complete reviews of nurse aides at least every 12 months and failed to provide in-service education based on the outcome of these reviews.
Inspectors wroteBased on staff interview, clinical record review, and facility document review, the facility staff failed to follow the providers order for 1 of 24 current residents, Residents #267.
Inspectors wroteBased on observation, resident interview, staff interview, and facility document review, the facility staff failed to ensure the resident environment was free of accident hazards for 1 of 24 current residents, Resident #96.
Inspectors wroteBased on staff interview, facility document review and clinical record review the facility staff failed to ensure medications were available for administration for one of 24 residents, Resident #93.
Inspectors wroteBased on staff interview, clinical record review and facility staff review the facility staff failed to ensure three of 24 residents was free of significant medication errors, Resident #82, Resident #215 and #267.
Inspectors wroteBased on observation and staff interview, the facility staff failed to dispose of expired laboratory (blood) tubes in 1 of 4 medication rooms. The 100-hall medication room.
Inspectors wroteBased on staff interview and clinical record review, the facility staff failed to consult with the physician the need to review current treatment due to possible adverse medication interactions for 2 of 23 residents in the survey sample, Residents #29 and #359. For Resident #29, the facility staff failed to consult the physician regarding drug protocol alerts for possible drug interactions between Xanax (a benzodiazepine used to treat anxiety) and Norco (a narcotic used to treat pain), Xanax and Nizoral Shampoo (a topical antifungal), and Xanax and Depakote Sprinkles (an antiepileptic used to treat seizures). [...]
Inspectors wroteBased on observations, staff interviews, clinical record review, and facility document review, the facility staff failed to complete a Significant Change Minimum Data (MDS) assessment for 1 of 23 sampled residents, Resident #160.
Inspectors wroteBased on staff interview, clinical record review, and facility document review, the facility staff failed to review and revise the comprehensive person-centered plan of care for 1 of 23 residents in the survey sample, Resident #29. Resident #29's comprehensive person-centered plan of care was not revised following discovery of the resident inappropriately touching another resident.
Inspectors wroteBased on observation, staff interview, and clinical record review the facility staff failed to provide ADL (activities of daily living) care for a dependent resident for 1 of 23 residents, Residents #69. The facility staff failed to provide nail care.
Inspectors wroteBased on staff interview, clinical record review, and facility document review, the facility staff failed to follow physician's orders for 2 of 23 residents in the survey sample, Resident #7 and #110. For Resident #7, the facility staff failed to perform weekly skin assessments as ordered by the physician. For Resident #110, the facility staff failed to transcribe a physician's order from the hospital discharge summary for wound care.
Inspectors wroteBased on staff interview, clinical record review and facility document review the facility staff failed to follow up on monthly drug regimen reviews for 2 of 23 residents, Resident #72 and Resident #74. For Resident #72, the facility staff failed to follow up on pharmacist recommendations for the months of September 2021 and December 2021. For Resident #74, the facility staff failed to follow up on a pharmacist recommendation for the month of September 2021.
Inspectors wroteBased on staff interview, clinical record review, facility document review, and during a medication pass and pour observation, the facility staff failed to ensure a medication error rate of less than 5% there were 3 errors in 30 opportunities for a medication error rate of 10%. These errors effected Residents #12 and #42.
Inspectors wroteBased on observations, interviews, and facility document reviews, the facility staff failed to correctly implement contingency plans for staff who were not fully vaccinated for COVID-19.
Inspectors wroteBased on staff interview and clinical record review, the facility staff failed to ensure a complete and accurate DDNR (Durable Do Not Resuscitate) for 2 of 26 residents in the survey sample (Resident #99 and Resident #95).
Inspectors wroteBased on staff interview and clinical record review, the facility staff failed to ensure an accurate MDS (Minimum Data Set) for 1 of 26 residents in the survey sample (Resident #43).
Inspectors wroteBased on facility document review, staff interview and clinical record review, the facility staff failed to notify the MD (medical doctor) of a significant change for 1 of 26 residents in the survey sample (Resident #43).
Inspectors wroteBased on staff interview and clinical record review the facility staff failed to develop a comprehensive care plan for 1 of 26 Residents, Resident #47. Resident #47 was admitted to the facility on [DATE] with diagnoses including schizophrenia, diabetes mellitus, hypertension, gastroesophageal reflux disease, anxiety, and dementia. On the admission minimum data set assessment (MDS) with assessment reference date 12/6/18, the resident scored 11/15 on the brief interview for mental status and was assessed as without symptoms of delirium, psychosis, or behaviors affecting care or others. During an interview on 1/29/19, the resident indicated that she smoked cigarettes. The resident was on the list of smokers living in the facility. The surveyor observed the resident smoking outside with a group of residents. [...]
Inspectors wroteBased on clinical record review and staff interview, the facility staff failed to review and revise the comprehensive care plan for 2 of 26 Residents in the survey sample, Resident # 25 and Resident # 86.
Inspectors wroteBased on staff interview, facility document review and clinical record review, the facility staff failed to follow professional standards of practice for 2 of 26 residents in the survey sample (Resident #13 and Resident #43).
Inspectors wroteBased on clinical record review, Resident interview, and staff interview, the facility staff failed to follow physician's orders for 2 of Residents in the survey sample, Resident # 40 and Resident # 86.
Inspectors wrote2. The facility staff failed to complete the smoking evaluation for Resident #99. Resident #99 was admitted to the facility on [DATE] with the following diagnoses, but not limited to atrial fibrillation, high blood pressure, diabetes and dementia. On the 5 day, admission MDS (Minimum Data Set) with an ARD (Assessment Reference Date) of 12/20/18, the resident was coded as having a BIMS (Brief Interview for Mental Status) score of 3 out of a possible score of 15. Resident #99 was coded as requiring extensive assistance of 2 staff members for dressing and personal hygiene. Resident #99 was also coded as being totally dependent on 2 staff members for bathing. The surveyor observed Resident #99 on 1/29/19 at 1:48 pm. The resident was outside smoking with a smoking apron over resident. One staff member was observed to be outside with the residents that were smoking. [...]
Inspectors wroteBased on observation, Resident interview, staff interview, and clinical record review the facility staff failed to obtain physicians orders for the use of oxygen for 1 of 26 Residents, Resident # 40.
Inspectors wroteBased on staff interview, facility document review and clinical record review, the facility staff failed to ensure that a physician ordered medication was available for administration for 1 of 26 residents in the survey sample (Resident #44).
Inspectors wroteBased on staff interview and clinical record review, the facility staff failed to monitor targeted behaviors for 1 of 26 residents in the survey sample. (Resident #44)
Inspectors wroteBased on staff interview, clinical record review, and facility document review, the facility staff failed to ensure that 2 of 26 Residents were free of unnecessary psychotropic medications, Resident # 95 and Resident #25.
Inspectors wroteBased on staff interview and clinical record review the facility staff failed to ensure a complete and accurate clinical record for 1 of 26 residents in the survey sample (Resident #43).
Inspectors wroteBased on observation, staff interview, clinical record review and facility document review the facility staff failed to follow established infection control procedures for 2 of 26 Residents, #49 and #159. 1. For Resident #49 the facility staff failed to post signage outside of the Resident's room, and staff failed to don proper PPE (personal protective equipment) prior to assisting with Resident care. Resident #49 was admitted to the facility on [DATE] and readmitted on [DATE]. Diagnoses included but not limited to anemia, atrial fibrillation, congestive heart failure, benign prostatic hyperplasia, diabetes mellitus, hypothyroidism, arthritis, Alzheimer's disease, dementia, anxiety, depression, schizophrenia, ataxia, dysphagia, and insomnia. [...]
8 fire safety citations on file: 2 on December 14, 2023, 6 on April 7, 2022.
CMS lists no fines or payment denials against this home in the last three years. The national average is 0.9 fines per home.
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Virginia | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 2.72 | 3.76 | 3.86 |
| Registered nurses | 0.57 | 0.69 | 0.69 |
| All nursing staff on weekends | 2.37 | 3.29 | 3.42 |
| Nurse aides | 1.53 | ||
| Licensed practical nurses | 0.62 | ||
| Nursing staff turnover (share who left in a year) | 45.2% | 48.1% | 45.8% |
| Registered nurse turnover | 33.3% | 48.2% | 42.9% |
| Administrators who left | 0 |
CMS expects 3.53 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 2.86 on weekdays and 2.37 on weekends, 17% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 0.0% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 2.55 in April to June 2025 to 2.72 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 2.72 | 0.57 | 2.86 | 2.37 | 0.0% | 0 of 90 | 113 |
| Oct to Dec 2025 | 2.66 | 0.62 | 2.77 | 2.37 | 0.0% | 0 of 92 | 108 |
| Jul to Sep 2025 | 2.69 | 0.60 | 2.82 | 2.37 | 0.0% | 0 of 92 | 109 |
| Apr to Jun 2025 | 2.55 | 0.57 | 2.70 | 2.15 | 0.0% | 0 of 91 | 113 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Virginia, Jan to Mar 2026 | 3.58 | 0.56 | 3.76 | 3.12 | 5.7% | 0.2% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Staff pay reports
No staff pay figure for this home has passed review yet. A figure appears only after at least 5 reports from at least 3 different people, sent over at least 60 days, have passed review. If you work here, your report helps start one.
| Job | Median | Middle half | Employed |
|---|---|---|---|
| Virginia, all employers | |||
| CNAs (nursing assistants) | $20.77 | $17.80 to $22.56 | 40,580 |
| LPNs and LVNs | $31.21 | $28.66 to $35.84 | 15,550 |
| Registered nurses | $45.00 | $38.51 to $49.53 | 77,490 |
| United States, nursing care facilities | |||
| CNAs (nursing assistants) | $20.67 | $17.91 to $22.55 | 534,270 |
| LPNs and LVNs | $33.86 | $30.05 to $37.40 | 188,210 |
| Registered nurses | $41.11 | $37.85 to $47.68 | 142,270 |
Hourly wages; the middle half runs from the 25th to the 75th percentile. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025. BLS has no separate estimate for medication aides. These are survey estimates for whole occupations, not figures for any one home.
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Virginia | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 11.4 | 14.8 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.0 | 0.4 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 1.0 | 1.6 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 3.1 | 3.6 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 1.6 | 1.3 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 12.2 | 15.6 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 6.1 | 4.7 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 20.6 | 14.2 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 17.9 | 22.3 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 10.1 | 11.5 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 0.9 | 1.5 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.4 | 1.5 | 1.8 |
For a stay to recover after a hospital visit, these are the results CMS publishes for Grayson Health and Rehabilitation's Medicare short-stay residents. On returning residents home or to the community, CMS rates it no different from the national rate (60.7% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.
60.7% this home
No different from the national rate
US median of homes 51.5% · Virginia: 101 better, 22 worse
Rate of successful return to home or community from a SNF (risk-standardized discharge to community rate). Higher is better. October 2022 to September 2024. 100 eligible stays.
9.8% this home
No different from the national rate
US median of homes 10.7% · Virginia: 1 better, 9 worse
Rate of potentially preventable hospital readmissions 30 days after discharge from a SNF (risk-standardized rate). Lower is better. October 2022 to September 2024. 117 eligible stays.
7.0% this home
No different from the national rate
US median of homes 7.1% · Virginia: 2 better, 8 worse
Percentage of infections residents got during their SNF stay that resulted in hospitalization (risk-standardized rate). Lower is better. October 2023 to September 2024. 68 eligible stays.
62.5% this home
Median of homes: Virginia60.0% · US 56.6%
Percentage of residents who are at or above an expected ability to care for themselves and move around at discharge. Higher is better. October 2024 to September 2025. 72 residents counted.
4.0% this home
Median of homes: Virginia0.7% · US 0.0%
Percentage of SNF residents who experience one or more falls with major injury during their SNF stay. Lower is better. October 2024 to September 2025. 99 residents counted.
4.7% this home
Median of homes: Virginia2.1% · US 1.7%
Percentage of residents with pressure ulcers or pressure injuries that are new or worsened (adjusted rate). Lower is better. October 2024 to September 2025. 99 residents counted.
Not reported
CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Median of homes: Virginia97.8% · US 98.7%
Percentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge. Higher is better. October 2024 to September 2025. 14 residents counted.
Source: CMS Skilled Nursing Facility Quality Reporting Program - Provider Data, released 2026-09-30. Better, no different and worse are CMS's own comparisons with the national rate, after adjusting for how sick residents were. Medians of homes and the state counts are worked out by us from the same file.
Legal business name: 400 SOUTH INDEPENDENCE AVENUE OPCO LLC. CMS links this home to Avardis Health, a group of 38 nursing homes averaging 2 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Independence Parentco LLC | 5% or greater direct ownership interest | Organization | 100% | 05/01/2025 |
| Grayson Holdco LLC | 5% or greater indirect ownership interest | Organization | 100% | 05/01/2025 |
| Clark, Alyssa | Managing control - governing body | Individual | 05/01/2025 | |
| Hoback, Tiffany | Managing control - governing body | Individual | 05/01/2025 | |
| SNF Mgr LLC | Operational/managerial control | Organization | 05/01/2025 | |
| Clark, Alyssa | Operational/managerial control | Individual | 05/01/2025 | |
| Hoback, Tiffany | Operational/managerial control | Individual | 05/01/2025 | |
| Jones, Tequilla | Operational/managerial control | Individual | 05/01/2025 | |
| Riggins, Bridget | Operational/managerial control | Individual | 05/01/2025 | |
| Sturgill Fant, Vanessa | Operational/managerial control | Individual | 05/01/2025 | |
| Sword, Robert | Operational/managerial control | Individual | 05/01/2025 | |
| SNF Mgr LLC | Adp of the SNF | Organization | 04/20/2025 | |
| Clark, Alyssa | Adp of the SNF | Individual | 05/01/2025 | |
| Hoback, Tiffany | Adp of the SNF | Individual | 05/01/2025 | |
| Jones, Tequilla | Adp of the SNF | Individual | 05/01/2025 | |
| Riggins, Bridget | Adp of the SNF | Individual | 05/01/2025 | |
| Sturgill Fant, Vanessa | Adp of the SNF | Individual | 05/01/2025 | |
| Sword, Robert | Adp of the SNF | Individual | 05/01/2025 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Chosen from this home's own inspection record.
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