Home / Virginia / Big Stone Gap
2045 Valley View Drive, Big Stone Gap, VA 24219 · Wise County · (276) 523-3000
180 certified beds, about 166 residents a day · For profit - Corporation · Medicare and Medicaid since 1983
CMS Care Compare ratings, data as of September 1, 2026 · CCN 495135 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on February 1, 2023, inspectors cited 5 health deficiencies (the Virginia average is 14.3, the national average 9.2).
Of 40 health citations since June 2019, 5 were rated as actual harm or immediate jeopardy to residents.
CMS lists 1 fine totaling $40,517 in the last three years; the largest was $40,517, and the latest is dated November 19, 2024.
Nurses and nurse aides worked 3.11 hours per resident per day, against 3.76 across Virginia and 3.86 nationally. Registered nurses accounted for 0.41 of those hours.
26.6% of nursing staff left within the year CMS measured (Virginia average 48.1%).
CMS links it to Heritage Hall, an affiliated group of 15 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 40 health citations on file.
Inspectors wroteBased on staff interviews, clinical record review, and facility document review, the facility staff failed to assess, monitor, and treat bilateral hand contractures resulting in skin breakdown with maggot infestation for (1) one of (7) seven sampled residents, Resident #2.
Inspectors wroteBased on staff interview, clinical record review, and facility document review, the facility staff failed to ensure residents receive treatment and care in accordance with the comprehensive care plan and medical provider orders for (2) two of (7) seven sampled residents, Resident #2 and Resident #7.
Inspectors wroteBased on resident interview, staff interview, clinical record review, and facility document review, the facility staff failed to ensure residents were free of significant medication errors for 1 of 7 sampled residents (Resident #1). Resident #1 received eight (8) separate medications in error placing the resident's health and safety in jeopardy resulting in transfer to a higher level of care.
Inspectors wroteBased on observation, staff interview, and facility document review, the facility staff failed to maintain an infection prevention and control program to provide a safe, sanitary, environment and help prevent the development and transmission of communicable disease and infection on 1 of 4 facility units (North Hall).
Inspectors wroteBased on staff interview and clinical record review the facility staff failed to develop a comprehensive care plan for 1 of 31 residents, Resident #43.
Inspectors wroteBased on staff interview and clinical record review the facility staff failed to review and revise a care plan for 1 of 31 residents, Resident #79.
Inspectors wroteBased on staff interview, clinical record review and facility document review the facility staff failed to provide care and services to meet the needs of the residents for 1 of 31 residents, Resident #43.
Inspectors wroteBased on staff interview, clinical record review and facility document review the facility staff failed to to obtain a diet order targeted to address the clinical condition of the resident for 1 of 31 current residents in the survey sample (Resident #32). Resident #32 was admitted to the facility with diagnoses including hepatorenal syndrome, type 2 diabetes mellitus with diabetic neuropathy, morbid obesity, spinal stenosis without neurogenic caudication, chronic obstructive pulmonary disease. The resident received hemodialysis three times per week. The resident had orders for insulin per sliding scale before meals and at hour of sleep. The surveyor was unable to interview the resident who was out of the facility for hemodialysis three days per week and attended group activities, scheduled smoking opportunities, and a leave of absence. [...]
Inspectors wroteBased on staff interview, clinical record review and facility document review the facility staff failed to provide ongoing assessment of the resident's condition and monitoring for complications before and after dialysis treatments received at a certified dialysis facility for 1 of 31 current residents in the survey sample (resident 32). Resident #32 was admitted to the facility with diagnoses including hepatorenal syndrome, type 2 diabetes mellitus wit diabetic neuropathy, morbid obesity, spinal stenosis without neurogenic caudication, chronic obstructive pulmonary disease. The surveyor was unable to interview the resident who was out of the facility for hemodialysis three days per week and attended group activities, scheduled smoking opportunities, and a leave of absence. On 1/26/23 the surveyor reviewed the clinical record. [...]
Inspectors wroteBased on resident interview, staff interview, clinical record review, and during the course of a complaint investigation, facility staff failed to ensure the resident environment remained as free of accident hazards related to call light cord availability for 1 of 27 residents, Resident #121 and failed to include investigation of an elopement with identifying how the resident was able to exit the building for one (1) of 27 sampled current residents (Resident #64).
Inspectors wroteBased on resident interview, staff interview, and clinical record review, the facility staff failed to coordinate necessary behavioral health care services to attain the highest practicable physical, mental, and psychological well-being for 1 of 27 residents, Resident #121.
Inspectors wroteBased on staff interview, employee record review and facility documentation review, the facility staff failed to obtain verification of licensure from the Department of Health Professions prior to hire for 1 (Employee # 8) of 8 Registered Nurses, for 1(Employee # 20) of 6 Certified Nursing Assistants and failed to re-verify licensure after expired dates on three (Employees # 6, # 17 and # 19) of 8 Registered Nurses and failed to re-verify the expired license of one (Employee # 24) of 6 Licensed Practical Nurses. And the facility staff failed to obtain a Criminal Background Check for one (Employee # 22) of 4 Unlicensed Nurses Aide and one (Employee # 24) of 6 Licensed Practical Nurses to obtain a Criminal Background Check prior to hire.
Inspectors wroteBased on interviews and the review of documents, it was determined the facility staff failed to ensure complete and/or accurate clinical documentation for six (6) out of 27 sampled current residents (Resident #13, Resident #90, Resident #101, Resident #121, Resident #124, and Resident #138).
Inspectors wroteBased on staff interview, clinical record review, and facility document review, the facility staff failed to conduct COVID-19 outbreak testing for asymptomatic staff and residents during an identified facility COVID-19 outbreak for 1 of 3 staff members (LPN #2) and 3 of 3 residents (Resident #92, #109, and #116).
Inspectors wroteBased on staff interview and clinical record review, facility staff failed to ensure the resident's right to formulate an advanced directive by failing to ensure the correct code status for 1 of 27 residents, Resident #116.
Inspectors wroteBased on staff interviews and clinical record review, the facility failed to notify providing and/or RP (responsible party) for medication not available and a weight loss for one of twenty-seven residents (#121). 1. For Resident #121, facility staff failed to notify the medical provider and the resident representative of a significant weight loss identified on 12/03/20, failed to notify the psychiatric nurse practitioner and psychologist of the resident's suicide attempt on 4/30/21, and failed to notify the physician of the ER's decision to send the resident back to the facility following suicide attempt on 4/30/21. [...]
Inspectors wroteBased on staff interview and clinical record review, facility document review and Adult Protective Service (APS) report, facility staff failed to notify Office of Licensure and Certification of possible misappropriation of property (narcotic pain medication) for 1of 27 residents in the survey sample (Resident #124). Resident #124 was admitted to the facility with diagnoses including hypertensive heart disease, paraplegia, cauda equina syndrome, spina bifida, back and wrist pain, and major depression. On the quarterly minimum data set assessment with assessment reference date 4/6/21, the resident scored 12/15 on the brief interview for mental status and was assessed as without signs of delirium, psychosis, or behaviors affecting care. [...]
Inspectors wroteBased on resident interview, staff interview and clinical record review, facility staff failed to notify the state mental health authority following a significant change in the mental condition of a resident who has mental illness for review for 1 of 27 residents, Resident #121.
Inspectors wroteBased on interviews and the review of documents, it was determined the facility staff failed to provide services to address maintaining desirable body weight range for one (1) of 27 sampled current residents (Resident #44).
Inspectors wroteBased on staff interview, employee record review, and facility documentation review, the facility staff failed to ensure that one (Employee # 27) of four unlicensed nurse aides was able to demonstrate competency in skills and techniques necessary to care for residents' needs.
Inspectors wroteBased on observation, staff interview. and clinical record review, facility staff administered expired medications for 1 of 27 ( Resident #13). Resident # 13 was admitted to the facility [9/17/17] with diagnoses including lymphedema, COPD, morbid obesity, type 2 diabetes mellitus, venous insufficiency, cellulitis of lower limb, major depressive disorder, and psychosis. On the quarterly minimum data set assessment (MDS) with assessment reference date 4/26/21, the resident scored 10/15 on the brief interview for mental status and was assessed as without signs of delirium, psychosis, or behaviors affecting care. On 5/06/21 at 2:38 PM, the surveyor examined the south front hall medication cart. The surveyor discovered a Lispro humalog insulin pen labeled for Resident #13 which was marked opened 3-22-21 expired 4-19-21. [...]
Inspectors wroteBased on observation and staff interview, facility failed to remove from storage expired medications from the resident's medical supplies for 2 of 27 residents in the survey sample ( Residents #13 and 78). The facility's Storage of Medications policy stated, under Unusable Drugs or Biologicals, The facility shall not use discontinued, outdated, or deteriorated drugs or biologicals. All such drugs shall be returned to the dispensing pharmacy or destroyed. 1. For Resident #13, facility staff failed to discard expired insulin. On 5/06/21 at 2:38 PM, the surveyor examined the south front hall medication cart. The surveyor discovered a Lispro humalog insulin pen labeled for Resident #13 which was marked opened 3-22-21 expired 4-19-21. The resident's nurse was with the surveyor when the expired pen was discovered. The resident did not have another Lispro pen in the medication cart. 2. [...]
Inspectors wroteBased on staff interview and facility document review, facility staff failed to ensure the quality assessment and assurance (QAA) committee met at least quarterly. The surveyor conducted the QAA review with the director of nursing on 6/27/19. There were QA sign in sheets 4/23/19, 1/28/19, 8/20/18. There was a 5 month interval between meetings. The administrator and director of nursing were notified of the concern during a summary meeting on 6/12/19.
Inspectors wroteBased on clinical record review, staff interview, and facility document review, the facility staff failed to provide appropriate notice of transfer or discharge for 5 of 39 Residents in the survey sample, Resident # 9, Resident # 65, Resident # 73, Resident # 115, and Resident # 151.
Inspectors wrote6. For Resident #153, the facility failed to offer a bed hold when they were transferred and admitted to an acute care hospital. The clinical record review revealed that Resident #153 had been originally admitted to the facility 11/03/14 and had been readmitted on [DATE]. Diagnoses included, but were not limited to, heart failure, muscle weakness, chronic obstructive pulmonary disease, dysphagia, hypertension, dementia, and chronic pain syndrome. Section C (cognitive patterns) of the Residents quarterly MDS (minimum data set) assessment with an ARD (assessment reference date) of 06/06/19 included a BIMS (brief interview for mental status) summary score of 4 out of a possible 15 points. The clinical record included information to indicate the Resident had been transferred and admitted to an acute care hospital on [DATE]. [...]
Inspectors wroteBased on staff interview and clinical record review, the facility staff failed to complete a DDNR (durable do not resuscitate) order form for 1 of 39 Residents, Resident #118.
Inspectors wroteBased on staff interview, clinical record review, facility document review, and during the course of a complaint investigation, the facility staff failed to implement their policy/procedure in regards to preadmission screening of admissions to determine if a potential Resident was a convicted sex offenders for 1 of 39 Residents, Resident #59.
Inspectors wroteBased on staff interview and clinical record review, the facility staff failed to ensure an accurate MDS (minimum data set) assessment for 1 of 39 Residents, Resident #169.
Inspectors wroteBased on clinical record review, staff interview, facility document review, and over the course of a complaint investigation, the facility staff failed to review and revise the comprehensive plan of care for 1 of 39 Residents in the survey sample, Resident # 368.
Inspectors wroteBased on clinical record review, staff interview, Resident representative interview, facility document review, and during the course of a complaint investigation, the facility staff failed to implement an effective discharge planning process for 1 of 39 residents in the survey sample, Resident # 368.
Inspectors wroteBased on staff interview and clinical record review the facility staff failed to follow physician's orders for 1 of 39 Residents, Resident #61.
Inspectors wroteBased on observation, clinical record review, staff interview, and facility document review, the facility staff failed to provide care to prevent urinary tract infections for 1 of 39 Residents in the survey sample, Resident # 73.
Inspectors wroteBased on observation, clinical record review, staff interview, and facility document review, the facility staff failed to provide appropriate gastrostomy care for 2 of 39 Residents in the survey sample, Resident # 73 and Resident # 115.
Inspectors wroteBased on observation, clinical record review, and staff interview, the facility staff failed to properly maintain respiratory care equipment, and failed to provide respiratory care services for 1 of 39 Residents in the survey sample, Resident # 73.
Inspectors wroteBased on clinical record review, Resident Representative interview, and facility document review, the facility staff failed to ensure that 1 of 39 Residents in the survey sample received dialysis services in accordance with professional standards of practice, Resident # 115.
Inspectors wroteBased on clinical record review, staff interview, facility document review, and over the course of a complaint investigation, the facility staff failed to ensure that 2 of 39 Residents in the survey sample were free of unnecessary psychotropic medications, Resident # 65 and Resident # 368.
Inspectors wroteBased on staff interview, clinical record review and in the course of a complaint survey the facility staff failed to ensure 2 of 39 Residents were free of significant medication errors, Resident #19 and Resident #117.
Inspectors wroteBased on observation, staff interview, and facility document review, the facility staff failed to store medications appropriately for 1 of 39 Residents (Resident #27), on 1 of 4 medication carts, and in 1 of 2 medication rooms.
Inspectors wroteBased on staff interview and clinical record review the facility staff failed to ensure a complete and accurate clinical record for 1 of 33 Residents, Resident #19.
Inspectors wroteBased on observation, staff interview, clinical record review, and facility document review, the facility staff failed to follow established infection control guidelines for 1 of 39 Residents, Resident #153.
12 fire safety citations on file: 5 on February 1, 2023, 7 on May 12, 2021.
| Date | Penalty | Amount or length |
|---|---|---|
| November 19, 2024 | Fine | $40,517 |
A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.
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) | 3.11 | 3.76 | 3.86 |
| Registered nurses | 0.41 | 0.69 | 0.69 |
| All nursing staff on weekends | 2.56 | 3.29 | 3.42 |
| Nurse aides | 1.97 | ||
| Licensed practical nurses | 0.73 | ||
| Nursing staff turnover (share who left in a year) | 26.6% | 48.1% | 45.8% |
| Registered nurse turnover | 6.3% | 48.2% | 42.9% |
| Administrators who left | 0 |
CMS expects 4.00 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 3.33 on weekdays and 2.56 on weekends, 23% 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 3.14 in April to June 2025 to 3.11 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 | 3.11 | 0.41 | 3.33 | 2.56 | 0.0% | 0 of 90 | 166 |
| Oct to Dec 2025 | 3.10 | 0.36 | 3.29 | 2.61 | 0.0% | 0 of 92 | 168 |
| Jul to Sep 2025 | 3.36 | 0.37 | 3.58 | 2.79 | 0.0% | 0 of 92 | 164 |
| Apr to Jun 2025 | 3.14 | 0.34 | 3.37 | 2.57 | 0.0% | 0 of 91 | 162 |
| 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 | 9.0 | 14.8 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.1 | 0.4 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 0.3 | 1.6 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 2.4 | 3.6 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 2.4 | 1.3 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 6.7 | 15.6 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 1.5 | 4.7 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 29.2 | 14.2 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 4.9 | 22.3 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 4.6 | 11.5 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.0 | 1.5 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 2.3 | 1.5 | 1.8 |
For a stay to recover after a hospital visit, these are the results CMS publishes for Heritage Hall Big Stone Gap's Medicare short-stay residents. On returning residents home or to the community, CMS rates it worse than the national rate (32.6% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.
32.6% this home
Worse than 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. 82 eligible stays.
10.4% 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. 101 eligible stays.
8.9% 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. 53 eligible stays.
65.8% 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. 41 residents counted.
3.9% 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. 51 residents counted.
0.0% 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. 51 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. 9 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: BIG STONE GAP LIFE CARE LLC. CMS links this home to Heritage Hall, a group of 15 nursing homes averaging 4.1 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| East, Thomas | Corporate director | Individual | 11/20/2012 | |
| Hopkins, William | Corporate director | Individual | 07/23/2010 | |
| Dalton, Brad | Corporate officer | Individual | 07/11/2024 | |
| Dalton, Robert | Corporate officer | Individual | 04/21/2014 | |
| East, Thomas | Corporate officer | Individual | 11/20/2012 | |
| Gallant, Cassandra | Corporate officer | Individual | 07/11/2024 | |
| Dalton, Brad | Operational/managerial control | Individual | 04/01/2024 | |
| Dalton, Robert | Operational/managerial control | Individual | 04/21/2014 | |
| Dalton, Brad | Adp of the SNF | Individual | 04/01/2024 | |
| Dalton, Robert | Adp of the SNF | Individual | 04/21/2014 | |
| East, Thomas | Adp of the SNF | Individual | 04/21/2014 | |
| Gallant, Cassandra | Adp of the SNF | Individual | 07/11/2024 | |
| Giles, Norelle | Adp of the SNF | Individual | 06/27/2025 | |
| Quinn, Donald | Adp of the SNF | Individual | 06/27/2025 |
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.
These are the official offices in Virginia. NursingHomeClear cannot take or act on complaints.