250 McDavid Boulevard, Grayson, KY 41143 (opens Google Maps) · Carter County · (606) 474-7835· 120 certified beds · avg 110 residents/day · certified since Feb 21, 1991 · Medicare and Medicaid certified
Certified for both programmes. Certification means the facility can bill Medicaid — it does not mean a Medicaid-funded bed is free right now, so ask directly. Who pays for nursing home care →
Abuse citation flag (CMS)
Part of chain: DAVID MARX (10 facilities, chain avg rating 2.9★)
The abuse flag means inspectors cited this facility for abuse that caused harm to a resident within the past year, or potential for harm in each of the last two years. Source: CMS.
New to these records? How to read an inspection report →
Health inspection rating: ★☆☆☆☆1/5 · CMS overall rating: 1/5 · how star ratings work →
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and quality measures from resident assessments and claims.
▲ Immediate jeopardy, pattern · Jul 17, 2023 · F-0689
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.
Severity (K): Immediate jeopardy to resident health or safety was cited. The scope was a pattern: more than a limited occurrence, without being widespread. Scope describes the extent of the deficiency, not whether it happened on previous inspections.
Corrected: Aug 6, 2023 (Deficient, Provider has date of correction)
▲ Actual harm, isolated · Aug 29, 2025 · F-0600 · triggered by a complaint
The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors.
Why it matters: Abuse and neglect cause direct physical and emotional harm and are among the most serious failures a nursing home can have.
Severity (G): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.
Corrected: Sep 12, 2025 (Deficient, Provider has date of correction)
▲ Actual harm, isolated · Aug 29, 2025 · F-0609 · triggered by a complaint
The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation.
Why it matters: When incidents aren't reported promptly, abusers may continue harming residents and outside authorities can't step in.
Severity (G): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.
Corrected: Sep 12, 2025 (Deficient, Provider has date of correction)
Showing the latest 3 of 16 inspection findings. Open the full record below to read every finding.
The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint F-0600
The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint F-0609
The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. F-0812
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed — that window is CMS's, not ours. Within it, every citation CMS publishes for this facility is listed here: none excluded.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Aug 29, 2025 | ▲ G · Actual harm, isolated | The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint · F-0600 |
| Aug 29, 2025 | ▲ G · Actual harm, isolated | The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint · F-0609 |
| Aug 29, 2025 | F · Potential for more than minimal harm, widespread | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · F-0812 |
| Aug 29, 2025 | D · Potential for more than minimal harm, isolated | The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow. · from a complaint · F-0658 |
| Aug 29, 2025 | D · Potential for more than minimal harm, isolated | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · F-0880 |
| Jul 17, 2023 | ▲ K · Immediate jeopardy, pattern | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · F-0689 |
| Jul 17, 2023 | E · Potential for more than minimal harm, pattern | The facility's medication error rate was 5 percent or higher — meaning too many doses were given incorrectly, such as the wrong drug, dose, or time. · F-0759 |
| Jul 17, 2023 | E · Potential for more than minimal harm, pattern | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · F-0812 |
| Jul 17, 2023 | D · Potential for more than minimal harm, isolated | The facility did not protect residents from misuse of their belongings or money — this is called misappropriation, and it includes theft or improper use of a resident's property or funds. · F-0602 |
| Jul 17, 2023 | D · Potential for more than minimal harm, isolated | The facility hired someone with an official finding of abuse, neglect, exploitation, or theft against them. Facilities are not allowed to employ people with such findings. · F-0606 |
| Jul 17, 2023 | D · Potential for more than minimal harm, isolated | The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. · F-0656 |
| Jul 17, 2023 | D · Potential for more than minimal harm, isolated | The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. · F-0657 |
| Jul 17, 2023 | D · Potential for more than minimal harm, isolated | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. · F-0761 |
| Jul 17, 2023 | D · Potential for more than minimal harm, isolated | The facility did not provide food that accounts for each resident's allergies, intolerances, and personal preferences, or did not offer appealing alternatives. · F-0806 |
| Jul 17, 2023 | D · Potential for more than minimal harm, isolated | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · F-0880 |
| Nov 7, 2019 | D · Potential for more than minimal harm, isolated | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. · F-0761 |
Citations from standard inspections decreased between the last two inspection cycles (10 → 5).
All bars start at zero. Exact values and supporting details remain below.
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2019 | 1 | 0 | D |
| 2023 | 10 | 1 | K ▲ |
| 2025 | 5 | 2 | G ▲ |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
How to file a complaint about care →
2 fines totaling $18,000.
Every penalty CMS publishes for this facility in the 3-year window is listed —none excluded. The count and the dollar total come from two different CMS datasets and agree for this facility. Penalties older than the window are dropped by CMS before publication, not by us.
| Date | Type | Amount / length |
|---|---|---|
| Aug 29, 2025 | Fine | $8,000 |
| Aug 29, 2025 | Fine | $10,000 |
What these staffing numbers mean →
All bars start at zero. Exact values and supporting details remain below.
| Measure | This facility | Kentucky avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 3.21 | 3.71 | 3.95 | bottom 36% in Kentucky; bottom 22% in the U.S. |
| Registered Nurse hours | 0.37 | 0.74 | 0.69 | bottom 11% in Kentucky; bottom 18% in the U.S. |
| Weekend total nurse staffing | 2.54 | 3.27 | 3.50 | bottom 15% in Kentucky; bottom 10% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.21 | 0.53 | 0.48 | bottom 10% in Kentucky; bottom 13% in the U.S. |
| Total nursing staff turnover (%) | 68.5 | 46.4 | 45.8 | bottom 5% in Kentucky; bottom 7% in the U.S. |
| RN turnover (%) | 61.5 | 41.8 | 42.9 | bottom 16% in Kentucky; bottom 20% in the U.S. |
Hours are per resident per day for the most recent quarter of payroll data in this CMS release (2026-08-01) — the same quarter for every facility — case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 3.21, RN 0.37, weekend 2.54.Comparing with Medicare Care Compare? Care Compare shows the raw figure (3.21 here, displayed there as hours and minutes), not the adjusted one above. Both are correct; they answer different questions. Staffing rating: 1/5.
Note: CMS combines facility-reported resident assessments (MDS) with claims-based measures. These are different sources from on-site inspection findings. Read the measures alongside inspection and staffing records; a high QM rating does not establish that a home is safe.
Quality measures rating: 3/5 · long-stay residents: 5/5 · short-stay residents: 1/5
Price evidence · separate from quality
No verified facility-specific private-pay price is available in our data for Carter Nursing and Rehabilitation. CMS inspection and staffing records do not tell us what this home will charge you.
Use a written private-pay quote. This worksheet adds only the amounts you enter; it does not calculate Medicare, Medicaid or insurance benefits.
Formula: (room rate + daily extras) × days + one-time charges. A 30-day scenario is not a calendar-month quote. Refundable deposits, rate changes and charges you omit are not automatically included. Entries are not saved or sent to our server.
Understand who pays for care · How we handle price evidence · Report an incorrect price
How to read ownership records →
Ownership records as published by CMS on 2026-08-01. CMS records when an owner joined but not when they left. Listed here and no longer involved? Tell us →
For profit - Corporation
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Carter Nursing and Rehabilitation Holdings LLC | Organization | 5% or Greater Direct Ownership Interest | 100% | 07/25/2019 |
| 250 McDavid Blvd SNF Realty Holdings LLC | Organization | ADP of the SNF | NOT APPLICABLE | 09/01/2019 |
| 250 McDavid Blvd SNF Realty LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 09/01/2019 |
| 250 McDavid Blvd SNF Realty LLC | Organization | ADP of the SNF | NOT APPLICABLE | 09/01/2019 |
| Alexander, David | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/01/2023 |
| Alexander, David | Individual | ADP of the SNF | NOT APPLICABLE | 05/01/2023 |
| Bluegrass Consulting Group LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 09/01/2019 |
| Bluegrass Consulting Group LLC | Organization | ADP of the SNF | NOT APPLICABLE | 07/16/2025 |
| Chamberlain, Margaret | Individual | Operational/Managerial Control | NOT APPLICABLE | 09/11/2023 |
| Chamberlain, Margaret | Individual | ADP of the SNF | NOT APPLICABLE | 09/11/2023 |
| Gibbs, Sarah | Individual | Operational/Managerial Control | NOT APPLICABLE | 01/01/2025 |
| Gibbs, Sarah | Individual | ADP of the SNF | NOT APPLICABLE | 01/01/2025 |
| Kentucky SNF Realty Holdings LLC | Organization | ADP of the SNF | NOT APPLICABLE | 09/01/2019 |
| Marx, David | Individual | Operational/Managerial Control | NOT APPLICABLE | 09/01/2019 |
| Marx, David | Individual | ADP of the SNF | NOT APPLICABLE | 09/01/2019 |
| MDG Real Estate Global Limited | Organization | ADP of the SNF | NOT APPLICABLE | 09/01/2019 |
| Pruitt, Paul | Individual | Managing Control - Governing Body | NOT APPLICABLE | 05/01/2023 |
| Pruitt, Paul | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/01/2023 |
| Pruitt, Paul | Individual | ADP of the SNF | NOT APPLICABLE | 05/01/2023 |
| Rewa, Angela | Individual | Operational/Managerial Control | NOT APPLICABLE | 10/23/2023 |
Showing 20 of 29 parties CMS has on file for this facility; 9 are not displayed. The full list is in the CMS Ownership dataset.
CMS lists this facility under the chain David Marx — 10 facilities in the current records. Chain membership says who operates these homes. It says nothing about how any individual one of them was inspected; each has its own record.
Listed by state, then facility name — not a ranking. Showing 8 of the 9 others, continuing from this facility's own place in that list.
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Boyd Nursing and Rehabilitation | 10.1 mi | Ashland, KY | ★★★☆☆ | 2/5 | |
| Kingsbrook Lifecare Center | 14.3 mi | Ashland, KY | ★★★★☆ | 3/5 | |
| Wurtland Nursing and Rehabilitation | 17.1 mi | Wurtland, KY | ★☆☆☆☆ | 1/5 | |
| Woodland Oaks | 17.7 mi | Ashland, KY | ★★★★☆ | 4/5 | |
| Oakmont Manor | 18.2 mi | Flatwoods, KY | ★★★☆☆ | 3/5 | |
| Sanctuary at Ohio Valley | 18.9 mi | Ironton, OH | ★★★★☆ | 4/5 | |
| Harbor Healthcare of Ironton | 19.3 mi | Ironton, OH | ★★★★☆ | 3/5 | |
| Crystal Care of Coal Grove | 19.5 mi | Coal Grove, OH | ★★★☆☆ | 3/5 |
Facility data as of CMS processing date 2026-08-01. CCN 185253.
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