May or may not help since you're in W.V., but refreshers do exist. There is one at Durham Technical Community College in Durham, N.C. I believe it lasts for one semester, 4 days a week, for a cost of about $300.00. I checked into it once myself, but decided to just go back for my RN. Good luck. For what it is worth, I also worked Home Health in Ohio and even though there was no RN in the field with me, I still reported to one. Sure that doesn't count?