Brian Center Of Fincastle

Location & what’s nearby

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Nearest of each type, straight-line distance. Hospitals come from the CMS Hospital General Information registry; everything else from Overture Maps (public data). Hospital and park hours are typical — call ahead to confirm.

Quality measures — how residents actually fare

Quality-measure stars summarize outcomes CMS tracks from the assessments each home submits — avoidable hospitalizations and ER visits, falls with injury, pressure ulcers, unplanned weight loss, and long-term antipsychotic use. Because the underlying data is self-reported, weigh a high score against the independent inspection record. Long-stay = permanent residents; short-stay = rehab and post-hospital stays.

Short-stay rehab — if you are coming here from a hospital

Arriving from a hospital right now? Read the discharge guide → — your appeal rights, how to slow a rushed discharge, and what to ask about the numbers below.

Therapy staffing: this home’s payroll records show 0.51 therapist hours per resident per day in 2026Q1 — more than 82% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 0% of this home’s weekday level — it runs therapy on weekdays, with essentially none at the weekend. The median home that reports therapy runs 13% — weekday-focused therapy is the industry norm, not a shortfall. But recovery does not pause on a Saturday: ask what the weekend actually looks like here.

This section is about rehab stays, not living here. Most of this page — the stars, the quality measures, the inspection record — describes the home the way a permanent resident experiences it. These figures describe the short Medicare stay after a hospital discharge: a hip, a stroke, a bad infection, six weeks and home. They are different residents, different staff, often a different wing. Therapy hours are per resident in the building, not per rehab patient — the count includes every long-stay resident, and they mostly get no therapy at all. So a home with a small rehab wing inside a large nursing population reads low here even if its rehab patients get plenty of therapy, and a mostly-rehab home reads high. Use it to compare homes doing similar work, ask what a rehab resident actually gets in a day, and remember that CMS does not publish therapy minutes per patient — nobody does.

Staffing

How full it usually is: this home is certified for 60 beds and averages 51.0 residents a day — about 85% occupied, or roughly 9 beds typically open. It runs fairly full. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.

Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 4.61 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 1.33 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.15 is below the 2.45-hour aide benchmark. What federal law does require today is unchanged: “sufficient” nursing staff for residents’ needs and an RN on duty at least 8 consecutive hours a day, 7 days a week (42 CFR 483.35). Those are judged by inspectors on site, not by these averages, so read this comparison alongside the inspection record rather than as a pass/fail.

Weekend coverage: total nurse staffing is 3.99 hrs/resident/day on weekends vs 4.86 on weekdays — 18% thinner on weekends. RN hours go from 1.58 to 0.73 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 53% is about the same as the national median of 45%. 1 administrator has left in the past year.

Payroll-based (PBJ) staffing hours, as reported for Jan–Mar 2026 (CMS PBJ CY2026Q1) — the most recent quarter CMS has published, so they can lag a change of operator or staffing agency. Higher is generally better. Registered-nurse coverage and weekend staffing are the numbers families most often overlook — an RN on site matters most when something goes wrong, and coverage usually thins on weekends. High turnover means residents rarely see the same caregiver twice. One caveat: these are hours as reported, not adjusted for how sick or heavy-care this home’s residents are. CMS separately publishes a case-mix-adjusted view; we show the reported hours. A home caring for higher-acuity residents needs more hours to deliver the same care, so compare these figures against homes doing similar work, and read them next to the inspection record rather than alone.

Inspection trend

Deficiencies are fewer than at the previous inspection — improving. Fewer citations over time suggests a home is fixing problems; a rising count is a warning sign — though two surveys are a short record, and survey teams differ. These counts are from the standard annual health survey only; the full citation list below may also include findings from complaint investigations, so the two won’t always add up.

This trend is not current. The most recent of these two inspections was over 4 years ago; the arrow describes what inspectors found then, not what the home is like now.

Inspection deficiencies

State health-inspection citations, most serious first. Each carries an F-code (the federal rule it cites, e.g. F-684 = quality of care) and a letter A–L marking how serious and how widespread the problem was — we translate that grid into the plain tiers shown here. Wording is the official federal description.

Each letter is a CMS scope-severity level; highlighted ones are where this home has citations. A–C = no harm found; D–F = potential for harm; G–I = actual harm; J–L = immediate jeopardy. Within each band the later letter is the more widespread finding (an isolated G is one resident; a widespread I is a pattern), so rightward and downward is worse.

21 citations, most serious first. The 11 most serious are shown; the remaining 10 are one tap away and print in full.

• Actual harm · G2024-03-21 · tag F0695 — failed to provide proper breathing / tracheostomy care — isolated
  Provide safe and appropriate respiratory care for a resident when needed.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, staff interview, clinical record review, and facility document review, facility staff failed to ensure a ventilator dependent resident was provided with such care consistent with professional standards of practice resulting in death of the resident for 1 of 4 residents in the survey sample (Resident #1). Resident #1 was admitted to the facility with diagnoses which included acute and chronic respiratory failure with hypoxia, respiratory ventilator dependence, tracheostomy status, cerebral palsy, epilepsy, and dysphagia. On the most recent Minimum Data Set assessment, the resident was assessed as comatose/persistent vegetative state. Clinical record review revealed: On 3/13/2024, Resident #1 was found unresponsive and without pulse or respirations. Death was pronounced at 9:05 PM. A physician/provider order dated 3/6/2024 for NC/CAP (oxygen through nasal cannula/cap treacheostomy) 1-2 hours BID (twice per day). The Respiratory Department worksheet dated 3/13/2024 documented the resident was receiving oxygen through a nasal cannula at 20:15. Cuff Status…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2022-08-18 · tag F0684 — failed to provide proper treatment and quality of care — isolated
  Provide appropriate treatment and care according to orders, resident’s preferences and goals.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on staff interview, clinical record review, and during a medication pass and pour observation the facility staff failed to follow the providers order in regards to administering the medication Peridex for 1 of 3 residents observed during the medication pass and pour observation, Resident #44. The findings included: Resident #44's diagnosis included, but were not limited to, chronic respiratory failure, candida stomatitis, and encounter for attention to tracheostomy. Section C (cognitive patterns) of Resident #44's quarterly minimum data set (MDS) assessment with an assessment reference date (ARD) of 07/07/22 included a brief interview for mental status (BIMS) summary score of 15 out of a possible 15 points. Resident #44's care plan included the focus area requires assistance with oral care. Interventions included, but were not limited to, provide oral hygiene. 08/09/22 8:15 a.m., the surveyor observed Licensed Practical Nurse (LPN) #2 prepare and administer Resident #44's morning medications. Resident #44's clinical record included an order for Peridex solution give 15 ml by…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2022-08-18 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolated
  Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, staff interview, and clinical record review, the facility staff failed to ensure 1 of 18 current residents, Resident #9 was free of accident hazards. Resident #9 did not have their provider ordered bilateral floor mats in place. The findings included: Resident #9's diagnoses included, but were not limited to, anoxic brain damage, bipolar disorder, and restlessness and agitation. Section C (cognitive patterns) of Resident #9's quarterly minimum data set (MDS) assessment with an assessment reference date (ARD) of 07/22/22 was coded to indicate the resident was severely impaired in cognitive skills for daily decision-making. Section G (functional status) was coded to indicate Resident #9 was totally dependent on two staff for bed mobility and transfers. Resident #9's fall risk assessment completed 07/20/22 included a documented score of 8. Per the preprinted code on this document 8=medium risk. Resident #9's comprehensive care plan included the focus area at risk for falls related to motor agitation, inability to stand or bear weight. Interventions included…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2022-08-18 · tag F0690 — failed to manage incontinence, catheters, and urinary infections — isolated
  Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on interviews, clinical record reviews, facility document review, and during the course of a complaint investigation, the facility staff failed to ensure indwelling urinary catheter care orders were obtained and indwelling urinary catheter care was provided for two (2) of 20 sampled residents (Resident #15 and Resident #102). The findings include: 1. The facility staff failed to have current orders to address Resident #15's indwelling urinary catheter care. Consistent documentation of Resident #15 receiving indwelling urinary catheter care between the dates of 8/1/22 and 8/9/22 was neither found by nor provided to the surveyor. Resident #15's minimum data set (MDS) assessment, with an assessment reference date (ARD) of 5/4/22, was dated as being completed on 5/11/22. Resident #15 was assessed as able to make self understood and as able to understand others. Resident #15's Brief Interview for Mental Status (BIMS) summary score was documented as a 14 out of 15; this indicated intact or borderline cognition. Resident #15 was assessed as requiring assistance with bed mobility,…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2022-08-18 · tag F0880 — failed to prevent and control infections — isolated
  Provide and implement an infection prevention and control program.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observations, interviews, clinical record review, and facility document review, the facility staff failed to ensure infection control isolation precautions signage was posted for two (2) resident rooms that housed residents requiring infection control precautions; one (1) of the rooms housed a newly admitted /readmitted resident that was not fully vaccinated for COVID-19. Resident #105's room did not have an isolation precaution sign posted outside their room. After the missing isolation precaution sign was discussed with facility staff, Resident #105 had an incorrect isolation precaution sign initially posted outside their room. Resident #2's room did not have an isolation precaution sign posted outside their room. The findings include: On 8/8/22 at 7:39 p.m., it was noted that two (2) rooms had infection control personal protective equipment (PPE) placed in the hallway at the entrance to the rooms; no signage was posted to indicate what kind of isolation precautions were required to be taken when entering these rooms. (One of these rooms was Resident #105's; the other…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Infection Control Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2022-08-18 · tag F0888 — isolated
  Ensure staff are vaccinated for COVID-19
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on staff interviews and facility document review, the facility staff failed to implement infection control prevention and control processes related to the vaccination status of one of three sampled staff members (LPN #5), as part of the plan to decrease the risks of the development and transmission of COVID-19. For licensed practical nurse (LPN#5), the facility staff failed to ensure the nurse was fully vaccinated for COVID-19 resulting in the facility's staff vaccination rate being less than 100% (99.2%). The findings were: On 08/09/2022, the administrator provided the facility's COVID-19 Staff Vaccination Status information. After multiple discussions about the facility's staff vaccination statistics, the administrator provided a final staff vaccination status log. The facility's percent of current staff who were fully vaccinated was 99.2%. Out of 118 total staff, there was one staff member who had received one dose of a two-dose series of the Pfizer COVID-19 vaccine. This staff member, LPN #5, did not…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Infection Control Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2021-03-04 · tag F0607 — failed to have anti-abuse policies — isolated
  Develop and implement policies and procedures to prevent abuse, neglect, and theft.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on staff interview, employee record review, and facility document review, the facility staff failed to implement their policy related to preventing abuse, neglect and exploitation in regards to new hires for 1 of 15 new hires, (RN) registered nurse #1. The findings included: The facility failed to ensure the contracting company obtained a (VSP) Virginia State Police criminal background check as required by Code of Virginia 32.1-126.01 for RN #1 and failed to obtain a sworn statement. The facility policy titled, Abuse dated 11/28/2016 read in part, .Criminal record checks will be obtained in accordance with state law and/or facility policy .Each applicant will provide a sworn statement or affirmation disclosing any criminal convictions or any pending criminal charges .Criminal record checks will be obtained on all new employees within 30 days of date of hire. If contract staff is used .the vendor providing the contracted service will be asked to obtain criminal record checks for all staff assigned to the nursing facility and to make the criminal record check information…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2021-03-04 · tag F0684 — failed to provide proper treatment and quality of care — isolated
  Provide appropriate treatment and care according to orders, resident’s preferences and goals.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on staff interview and clinical record review, facility staff failed to ensure that residents receive treatment and care in accordance with the comprehensive person-centered care plan as evidenced by failure to follow physician's orders for 1 of 15 residents, Resident # 35. The findings included: For Resident #35, the facility staff failed to follow physician's orders for the administration of Digoxin (medication used to treat heart failure and abnormal heart rhythms) and failed to administer treatments to the resident's right buttock and left lower leg as ordered. Resident #35's diagnosis list indicated diagnoses, which included, but not limited to Chronic Respiratory Failure with Hypercapnia, Chronic Diastolic (Congestive) Heart Failure, Pulmonary Hypertension Unspecified, Paroxysmal Atrial Fibrillation, Quadriplegia Unspecified, Dependence on Respirator (Ventilator) Status, and Peripheral Vascular Disease Unspecified. The significant change MDS (minimum data set) with an ARD (assessment reference date) of 1/15/21 assigned the resident a BIMS (brief interview for mental…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2021-03-04 · tag F0686 — failed to prevent and treat pressure sores (bedsores) — isolated
  Provide appropriate pressure ulcer care and prevent new ulcers from developing.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on staff interview and clinical record review facility staff failed to provided wound care as ordered by the physician for 1 of 15 residents, Resident #28. Facility staff members failed to ensure Resident #28's wound care was performed according to medical provider orders. Resident #28's minimum data set (MDS) assessment with an assessment reference date (ARD) of 12/29/2020 had the resident assessed as usually able to make self understood and as usually able to understand others. Resident #28's Brief Interview for Mental Status (BIMS) summary score was documented as 12 out of 15. Resident #28 was documented as being dependent with bed mobility, dressing, toilet use, personal hygiene, and eating. Resident #28's diagnoses included, but were not limited to: anemia, heart disease, high blood pressure, lung disease, diabetes, and paraplegia. Resident #28's clinical record included an order for daily wound care for a sacral wound. This order had a start date of 12/24/2020 and was a current order at the time of the survey. Resident #28's clinical record included an order for daily…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2021-03-04 · tag F0693 — failed to provide proper feeding-tube care — isolated
  Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observations, interviews, and the review of documents, it was determined the facility staff failed to ensure tube feeding orders were correctly implemented for two (2) of 15 residents (Resident #17 and Resident #29). The findings include: 1. Facility staff members failed to ensure Resident #17's tube feeding was administered as ordered by the medical provider as evidenced by: (a) observations of an Osmolite tube feeding container still hanging (although not running) greater than 11 hours after it should have been replaced with a new Osmolite tube feeding container and (b) the absence of documentation detailing when Resident #17's Osmolite tube feed and flushes were hung and replaced. Resident #17's minimum data set (MDS) assessment with an assessment reference date (ARD) of 12/16/2020 had the resident assessed as usually able to make self understood and as able to understand others. Resident #17's Brief Interview for Mental Status (BIMS) summary score was documented as three (3) out of 15. Resident #17 was documented as being dependent for bed mobility, transfers, dressing,…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2021-03-04 · tag F0756 — failed to review each resident's drug regimen — isolated
  Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on staff interview and clinical record review, the facility staff failed to act upon a monthly drug regimen review for 1 of 15 residents in the survey sample, Resident #48. The findings included: For Resident #48, facility staff failed to address a drug regimen review completed by the pharmacist on 1/10/21 requesting a gradual dose reduction review for the psychotropic medications Diazepam, Mirtazapine, and Lexapro. Resident #48's diagnosis list indicated diagnoses, which included, but not limited to Chronic Respiratory Failure with Hypoxia, Dependence on Respirator (Ventilator) Status, Quadriplegia Unspecified, Bipolar Disorder Unspecified, and Major Depressive Disorder Single Episode Unspecified. The annual MDS (minimum data set) with an ARD (assessment reference date) of 1/26/21 assigned the resident a BIMS (brief interview for mental status) score of 15 out of 15 in section C, Cognitive Patterns. Upon review of Resident #48's clinical record on 3/03/21, surveyor was unable to locate the January 2021 drug regimen review completed by the pharmacist. Surveyor spoke with the…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Pharmacy Service Deficiencies · Deficient, Provider has date of correction

“Cited before” means this same F-tag appears on at least one other survey date in the record we hold — counting complaint investigations as well as standard surveys, with no time limit. It is our own read of the data, not CMS’s: CMS uses repeat deficiency as a formal term tied to consecutive standard surveys, and that is a narrower test than this one. A tag marked here may or may not meet it.

Fines & penalties

$23,102 in federal fines across 2 penalties.

• $11,190 — penalty dated 2025-05-29
• $11,912 — penalty dated 2024-03-21

Dates are the dates CMS records the penalty, not the date of the conduct behind it. CMS publishes penalties on a rolling window, so this is what is currently on the public file — not the home’s lifetime history, and an older fine may attach to a problem that has since been corrected. The amounts are as imposed: the CMS file does not record whether a penalty was appealed, reduced, or paid, so we don’t say. Ask the home what each one was for and what changed since.

Who owns this facility

The source lists no ownership percentage for any party here — PECOS records a share only for equity interests, not for board or management roles.

Follow the money — this home’s finances

Where a nursing home’s revenue comes from and where it goes — including money paid to companies under the same ownership. Most consumer sites never show this; we reproduce it straight from the Medicare cost report.

About 92% of this home’s resident-days are paid by Medicaid, which reimburses well below the cost of care in most states. Heavily Medicaid-dependent homes run on thinner budgets — a context worth holding next to the staffing and inspection record, not a fault in itself. This home reported $716K paid to related parties (affiliated landlords or management companies) in its most recent cost report.

Source: CMS Healthcare Provider Cost Reporting Information System (HCRIS), Medicare cost report Form CMS-2540 · fiscal year 2023. Facilities self-file these reports; figures are unaudited and a year or two behind. A home with no Medicare cost report on file shows no figures here.

Cost & finances

Straight from this home’s Medicare cost report (CMS, FY2023). These are its operating economics — what it costs to run per resident-day and what it collects on average across Medicare, Medicaid, and private pay — not a private-pay quote. Your out-of-pocket cost depends on payer and room type, so ask the facility directly; a higher operating cost can reflect richer staffing or a sicker population. The cost-of-care planner shows regional benchmarks by care type.

What families pay in VA