How many deficiencies did Tug Valley Arh Skilled Nursing Facility get at its last inspection?

1 health deficiency at the standard inspection on June 18, 2025. The Kentucky average is 2.9.

Has Tug Valley Arh Skilled Nursing Facility been fined?

CMS lists no fines in the last three years.

Does Tug Valley Arh Skilled Nursing Facility accept Medicaid?

It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.

Who owns Tug Valley Arh Skilled Nursing Facility?

CMS lists 26 owners and managers. Legal business name: APPALACHIAN REGIONAL HEALTHCARE INC.

Tug Valley Arh Skilled Nursing Facility: Inspections

The record in brief

At its most recent standard inspection, on June 18, 2025, inspectors cited 1 health deficiency (the Kentucky average is 2.9, the national average 9.2).

None of its 12 health citations since October 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 6.45 hours per resident per day, against 3.95 across Kentucky and 3.86 nationally. Registered nurses accounted for 2.07 of those hours.

33.3% of nursing staff left within the year CMS measured (Kentucky average 46.4%).

Health inspections

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.

010/19

703/23

106/25

406/25

Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit

Where its citations fall on CMS's grid

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 12 health citations on file.

Severity

Isolated

Pattern

Widespread

Immediate jeopardy

Actual harm

Potential for more than minimal harm

Potential for minimal harm

June 27, 2025Complaint inspection · 4 citations

D

Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.

F568 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) July 30, 2025

Inspectors wroteBased on interview, record review, and review of the facility's policy, the facility failed to have a system in place to account for residents' funds or provide residents with a monthly statement of their funds for one of five sampled residents (R1). Based on interview, record review, and review of the facility's policy, the facility failed to have a system in place to account for residents' funds or provide residents with a monthly statement of their funds for one of five sampled residents (Resident 1 (R1).
D

Protect each resident from the wrongful use of the resident's belongings or money.

F602 · Freedom from Abuse, Neglect, and Exploitation · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) July 30, 2025

Inspectors wroteBased on interview, record review, and review of the facility's policy, the facility failed to ensure residents were free from misappropriation of resident's property for one of five sampled residents (Resident (R)1), who were investigated for misappropriation. As the representative payee for the resident, the facility failed to properly manage the resident's account. It was determined through a Kentucky State Police (KPS) and Adult Protective Services (APS) investigations that the former Administrator had stolen more than $8,300.00 from Resident (R) 1's personal funds.
D

Administer the facility in a manner that enables it to use its resources effectively and efficiently.

F835 · Administration · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) July 30, 2025

Inspectors wroteBased on interview, record review, review of the facility's Position Descriptions, and review of the facility's policies and procedures, the facility failed to be administered in a manner that enabled effective use of its resources to attain and maintain the highest practicable physical, mental, and psychosocial well-being of each resident. This practice affected one of five sampled residents (Resident 1 (R1)). Refer to F602.
D

Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility.

F837 · Administration · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) July 30, 2025

Inspectors wroteBased on interview, record review, and facility policy/document review, the facility's Governing Body failed to provide effective oversight to ensure the facility implemented policies to prevent the misappropriation of resident funds. This had the potential to affect all the facility's residents.

June 18, 2025Standard inspection · 1 citation

D

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

F656 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) July 3, 2025

Inspectors wroteBased on observation, interview, and record review, the facility failed to develop and implement a comprehensive, person-centered care plan for one (1) of eighteen (18) sampled residents (R)13. A review of R13's care plan for Potential for Injury Related to Non-Compliance with No Smoking Policy, dated 06/11/2025, indicated that R13 should smoke in an area visible to staff. However, as outlined in the care plan and facility policies, the facility failed to provide supervision.

March 3, 2023Standard inspection · 7 citations

F

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.

F727 · Nursing and Physician Services · No actual harm, potential for more than minimal harm, widespread · Corrected (the home has a date of correction) April 27, 2023

Inspectors wroteBased on interview, and document review, it was determined the facility failed to ensure a Registered Nurse (RN) was designated to serve as the Director of Nursing (DON) on a full-time basis, which had the potential to affect all eighteen (18) residents currently residing in the facility. Per interview, the Administrator was also the facility's Director of Nursing (DON) and the facility had no Assistant Director of Nursing (ADON) in order to devote full time supervision of nursing services.
E

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

F656 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) April 27, 2023

Inspectors wroteBased on observation, interview, record review, and facility policy review, it was determined the facility failed to ensure the Comprehensive Care Plan interventions related to side rail use were consistently implemented to maintain safety for eight (8) out of nine (9) sampled residents reviewed for use of side rails, Residents #1, #2, #3, #4, #5, #7, #8, and #15. Observations conducted throughout the survey revealed the side rails for the residents in question were raised while the residents were in bed. Use of the side rails was not reflected in the respective residents' care plans to direct staff regarding the type of side rails to be utilized or their expected and safe deployment.
E

Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.

F700 · Quality of Life and Care · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) April 27, 2023

Inspectors wroteBased on observation, interview, record review, and review of the facility's policies and documents, it was determined the facility failed to ensure: (a) resident-appropriate alternatives were attempted prior to installing side rails on residents' beds: side rail assessments were consistently conducted and documented; (b) resident-specific risks and benefits of side rail use were evaluated and discussed with the residents and/or their responsible parties; (c) and informed consents were obtained for nine (9) of nine (9) sampled residents (Residents #1, #2, #3, #4, #5, #7, #8, #14, and #15) reviewed for the use of side rails.
D

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

F657 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) April 27, 2023

Inspectors wroteBased on observation, interview, record review, and review of facility policy it was determined the facility failed to revise the Comprehensive Care Plan for one (1) of eight (8) sampled resident, Resident #16. The facility failed to review Resident #16's care plan to address the resident's safety and smoking needs.
D

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

F689 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) April 27, 2023

Inspectors wroteBased on observation, interview, record review, and facility policy review, it was determined, the facility failed to ensure residents received adequate supervision and remained as free of accident hazards as possible for one (1) of ten (10), Resident #16. Resident #16 was observed sitting in a wheelchair with a blanket covering his/her legs outside the facility smoking without staff's supervision. Interview revealed the facility failed to develop and implement policies to ensure the assessment and safety of residents who smoked.
D

Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame.

F909 · Environmental · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) April 27, 2023

Inspectors wroteBased on observation, interview, record review, and facility policy review, it was determined the facility failed to conduct regular inspections of all resident bed frames, mattresses, and bed rails, to identify any risk of entrapment for three (3) of nine (9) sampled residents reviewed for accidents (Residents #2, #3, and #8).
D

Have policies on smoking.

F926 · Environmental · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) April 27, 2023

Inspectors wroteBased on observation, interview, and record review, it was determined the facility failed to establish smoking policies as required to ensure the safety of one (1) out of ten (10) residents sampled for smoking, Resident #16. Interview on 02/28/2023 at 3:02 PM, with the Administrator (also the facility's Director of Nursing) revealed the facility had no policy regarding resident smoking, smoking areas, or smoking safety.

October 17, 2019Standard inspection · 0 citations

Fire safety inspections

7 fire safety citations on file: 6 on June 18, 2025, 1 on March 3, 2023.

Every fire safety citation7 citations

F
Provide properly protected cooking facilities.

K 324 · June 18, 2025 · Corrected (the home has a date of correction)
F
Have approved installation, maintenance and testing program for fire alarm systems.

K 345 · June 18, 2025 · Corrected (the home has a date of correction)
E
Have simulated fire drills held at unexpected times.

K 712 · June 18, 2025 · Corrected (the home has a date of correction)
E
Ensure proper usage of power strips and extension cords.

K 920 · June 18, 2025 · Corrected (the home has a date of correction)
D
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

K 321 · June 18, 2025 · Corrected (the home has a date of correction)
D
Inspect, test, and maintain automatic sprinkler systems.

K 353 · June 18, 2025 · Corrected (the home has a date of correction)
E
Install proper backup exit lighting.

K 281 · March 3, 2023 · Corrected (the home has a date of correction)

Fines and payment denials

CMS lists no fines or payment denials against this home in the last three years. The national average is 0.9 fines per home.

Staffing

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	Kentucky	United States
All nursing staff (RN, LPN and aides)	6.45	3.95	3.86
Registered nurses	2.07	0.79	0.69
All nursing staff on weekends	5.89	3.49	3.42
Nurse aides	2.21
Licensed practical nurses	2.17
Nursing staff turnover (share who left in a year)	33.3%	46.4%	45.8%
Registered nurse turnover	10.0%	41.8%	42.9%
Administrators who left	1

CMS expects 3.59 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.

Staffing by quarter, from daily payroll records

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 6.68 on weekdays and 5.89 on weekends, 12% 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 6.57 in April to June 2025 to 6.45 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	6.45	2.07	6.68	5.89	0.0%	0 of 90	21
Oct to Dec 2025	6.95	2.24	7.21	6.29	0.0%	0 of 92	19
Jul to Sep 2025	6.34	1.94	6.56	5.79	0.0%	0 of 92	20
Apr to Jun 2025	6.57	1.76	6.84	5.86	0.0%	0 of 91	20
United States, Jan to Mar 2026	3.75	0.62	3.92	3.33	5.3%	0.5% of days
Kentucky, Jan to Mar 2026	3.85	0.71	4.04	3.40	3.2%	0.1% 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

Staff pay at this home

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.

Official wage estimates for Kentucky

Job	Median	Middle half	Employed
Kentucky, all employers
CNAs (nursing assistants)	$18.45	$17.38 to $21.21	23,410
LPNs and LVNs	$29.07	$26.10 to $31.29	8,570
Registered nurses	$38.96	$36.38 to $46.73	50,300
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.

How staff pay reports work · CNA pay by state

Quality measures

The measures CMS uses for the quality star. Lower is better for every one of them.

Measure	This home	Kentucky	US
Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1	12.2	13.8	13.9
Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1	6.5	0.5	0.8
Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1	15.9	1.6	1.6
Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1	0.0	3.9	3.2
Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1	0.0	1.7	1.6
Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1	7.4	4.8	4.6
Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1	10.5	16.1	15.4

Short-term rehab results

For a stay to recover after a hospital visit, these are the results CMS publishes for Tug Valley Arh Skilled Nursing Facility's Medicare short-stay residents. On returning residents home or to the community, CMS rates it no different from the national rate (45.5% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.

Went home or back to the community

45.5% this home

No different from the national rate

US median of homes 51.5% · Kentucky: 38 better, 49 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. 47 eligible stays.

Potentially preventable readmissions

11.7% this home

No different from the national rate

US median of homes 10.7% · Kentucky: 0 better, 12 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. 42 eligible stays.

Infections that led to a hospital stay

Not reported

CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.

US median of homes 7.1% · Kentucky: 0 better, 6 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. 19 eligible stays.

Self-care and mobility at discharge

11.1% this home

Median of homes: Kentucky49.5% · 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. 27 residents counted.

Falls with major injury

2.3% this home

Median of homes: Kentucky0.0% · 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. 43 residents counted.

New or worsened pressure ulcers

3.8% this home

Median of homes: Kentucky2.6% · 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. 43 residents counted.

Medication list given at discharge

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: Kentucky98.1% · 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. 5 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.

Owners and operators

Legal business name: APPALACHIAN REGIONAL HEALTHCARE INC.

Name	Role	Type	Since
Allman, Ken	Corporate director	Individual	11/08/2019
Anderson, Joann	Corporate director	Individual	11/02/2017
Campbell, Dustin	Corporate director	Individual	11/11/2022
Couch, Gregory	Corporate director	Individual	11/08/2013
Dunn, Samuel	Corporate director	Individual	11/05/2021
Ellis, Martha	Corporate director	Individual	11/08/2024
Evans, Randall	Corporate director	Individual	11/08/2013
Hollon, Jeffrey	Corporate director	Individual	11/02/2012
Massey, Andrea	Corporate director	Individual	11/08/2019
Newman, Karen	Corporate director	Individual	11/08/2019
Rust, Michael	Corporate director	Individual	11/08/2019
Sizemore, Onzie	Corporate director	Individual	11/05/2014
Bergman, Sonya	Corporate officer	Individual	11/05/2021
Braman, Maria	Corporate officer	Individual	03/07/2016
Gabbard, Byron	Corporate officer	Individual	11/02/2023
Harris, Hollie	Corporate officer	Individual	05/10/2021
Lee, Christi	Corporate officer	Individual	11/05/2021
Coley, Jennifer	Operational/managerial control	Individual	07/01/2025
Francis, Garett	Operational/managerial control	Individual	08/01/2025
Harris, Hollie	Operational/managerial control	Individual	05/10/2021
Johnson, Vanessa	Operational/managerial control	Individual	11/05/2021
Lee, Christi	Operational/managerial control	Individual	11/05/2021
Vaughn, Paula	Operational/managerial control	Individual	09/12/2022
Coley, Jennifer	Adp of the SNF	Individual	12/24/2025
Francis, Garett	Adp of the SNF	Individual	12/24/2025
Vaughn, Paula	Adp of the SNF	Individual	12/04/2025

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.

Questions to ask on a visit

Chosen from this home's own inspection record.

When is the care plan meeting, and can family attend it?Inspectors cited 3 problems in this area, most recently on June 18, 2025: "Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured."
Who is the administrator and director of nursing, and how long have they been in the job?Inspectors cited 2 problems in this area, most recently on June 27, 2025: "Administer the facility in a manner that enables it to use its resources effectively and efficiently."
How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 2 problems in this area, most recently on March 3, 2023: "Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail."
Can we see a resident room, a shower room and the dining room on this visit?Inspectors cited 2 problems in this area, most recently on March 3, 2023: "Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame."
How long has the current administrator been here?CMS counts 1 administrator who left in the period it measured.

Other nursing homes nearby

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Good Shepherd Health and Rehabilitation
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Martin County Health Care Facility
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Pikeville Nursing and Rehab Center, LLC
Pikeville, 19.3 mi · 3 of 5 stars · 14 citations
Logan Center
Logan, 21.4 mi · 3 of 5 stars · 31 citations
Trinity Health Care of Logan
Logan, 22.4 mi · 1 of 5 stars · 43 citations
Riverview Health Care Center
Prestonsburg, 24.6 mi · 3 of 5 stars · 5 citations

Kentucky contacts for a concern about a nursing home

These are the official offices in Kentucky. NursingHomeClear cannot take or act on complaints.

Inspections and complaints: Kentucky Office of Inspector General, Division of Health Care, the state agency that inspects nursing homes for CMS and takes complaints about care.
Resident advocate: Kentucky State Long-Term Care Ombudsman Program, Nursing Home Ombudsman Agency of the Bluegrass, (800) 372-2991. The long-term care ombudsman is a free, confidential advocate for residents and families, set up under the federal Older Americans Act.
State inspection reports: Kentucky OIG Nursing Home Inspection Findings, where Kentucky publishes its own records on licensed homes.

Common questions

What is Tug Valley Arh Skilled Nursing Facility's Medicare star rating?: CMS rates Tug Valley Arh Skilled Nursing Facility 4 out of 5 stars overall, with 3 for health inspections, 5 for staffing and 2 for quality measures (CMS data as of September 1, 2026).
How many deficiencies did Tug Valley Arh Skilled Nursing Facility get at its last inspection?: 1 health deficiency at the standard inspection on June 18, 2025. The Kentucky average is 2.9.
Has Tug Valley Arh Skilled Nursing Facility been fined?: CMS lists no fines in the last three years.
Does Tug Valley Arh Skilled Nursing Facility accept Medicaid?: It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
Who owns Tug Valley Arh Skilled Nursing Facility?: CMS lists 26 owners and managers. Legal business name: APPALACHIAN REGIONAL HEALTHCARE INC.

Sources

Ratings, staffing and fines: CMS Provider Information, released September 30, 2026, data as of September 1, 2026.
Citations: CMS Health Deficiencies and Fire Safety Deficiencies.
Owners: CMS Ownership. Penalties: CMS Penalties.
Staffing by quarter: CMS Payroll Based Journal Daily Nurse Staffing, April 2025 to March 2026, summed by NursingHomeClear.
Inspector summaries: CMS Full Statement of Deficiencies (CMS-2567 text), data as of September 1, 2026. Each quote is the part of the statement before the detailed findings.
Inspection reports with the inspectors' full notes are on this home's Medicare.gov page.
Something wrong on this page? Ask for a correction. We fix errors in our copy of the data; findings themselves can only be changed by CMS and the state.
NursingHomeClear is independent and not affiliated with CMS, Medicare or any state agency. This page reports federal records; it does not rate, recommend or endorse any home, and it is not medical or legal advice.