White Sulphur Springs Center: Grievance Rights Failure - WV
The complaint at White Sulphur Springs Center exposed a breakdown in the facility's grievance system that left families without recourse when personal items disappeared. Federal inspectors found staff documented the missing socks but failed to follow their own policies for investigating and resolving the complaint.
On September 27, Resident 31's sister reported to staff that she had brought twelve pairs of socks for her brother, but he no longer had any in his room. RN 68 documented the complaint at 10:32 AM and checked with laundry staff, who said they had not seen the socks.
That was the end of the investigation.
When federal inspectors reviewed the facility's electronic medical records on November 18 — nearly two months after the initial complaint — they found no further documentation about the missing socks. The facility's grievance log contained no written record of the complaint either.
During a telephone interview the next day, the resident's sister confirmed she had received no contact from the facility since reporting the missing items.
The facility's own grievance policy outlined clear steps staff should have taken. Concerns could be registered by telephone, mail, office visit, or direct contact with staff. Upon receiving a grievance, staff were required to initiate a Grievance/Concern Form. The Administrator or designee was supposed to document the complaint in the grievance log. The department manager was expected to contact the person filing the grievance to acknowledge receipt and notify them of resolution "in a timely manner."
None of this happened.
Staff interviews revealed confusion about who was responsible for following up on missing clothing complaints. Unit Manager 9 said she would check with laundry first, then report missing items to the social worker "who would handle everything from there." LPN 10 described a different process, saying she would report directly to the Administrator for paperwork and follow-up. LPN 68, who originally documented the missing socks, said she reported the matter to her Unit Manager for further follow-up after laundry came up empty.
But the Social Worker told inspectors she had never been informed about Resident 31's missing socks.
The breakdown highlighted how easily resident concerns could fall through administrative cracks. RN 68 remembered documenting the complaint and checking with laundry. She recalled reporting to her Unit Manager when the socks weren't found. Yet somewhere in that chain of communication, the complaint disappeared as completely as the socks themselves.
Federal regulations require nursing homes to honor residents' right to voice grievances without discrimination or reprisal. Facilities must establish grievance policies and make prompt efforts to resolve complaints. The policy exists to ensure families have a voice when things go wrong and can expect accountability from the institution caring for their loved ones.
At White Sulphur Springs Center, that system failed over something as basic as missing socks.
The facility houses 65 residents. For families bringing personal items to make their loved ones more comfortable, the case raised questions about what happens when those items vanish. The resident's sister had made the effort to provide twelve pairs of socks for her brother's comfort and dignity. When they disappeared, she deserved more than a single check with laundry and months of silence.
During his interview with inspectors, the Administrator acknowledged the facility could not produce evidence that the missing socks complaint had been investigated according to their grievance policy. The admission came nearly two months after a simple question about missing socks had exposed the gaps in a system designed to protect residents and their families.
The resident's sister still had no answers about where twelve pairs of socks had gone.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for White Sulphur Springs Center from 2025-11-19 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: June 20, 2026 · Our methodology
WHITE SULPHUR SPRINGS CENTER in WHITE SULPHUR SPRING, WV was cited for violations during a health inspection on November 19, 2025.
Federal inspectors found staff documented the missing socks but failed to follow their own policies for investigating and resolving the complaint.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.