Norton Community Hospital SNF Unit
100 15th St NW, Norton, VA 24273 · Non profit - Corporation · 44 certified beds · (276) 679-9100 Medicare & Medicaid certified
The public record raises real questions here. Weigh the concerns below carefully.
- a strong health-inspection score (4/5) — the hardest rating to game (though it’s ranked within its own state, not nationally)
- a high payroll-based staffing rating (5/5)
- lower-than-typical staff turnover (12% vs 45% nationally) — better care continuity
- fewer deficiencies at its most recent standard inspection than at the one before — a sign of improvement
- it has 1 actual-harm citation
- a high number of inspection citations overall (21) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags
- the CMS record shows $10,400 in federal fines (most recent 2026-02-12)
One thing this read cannot see: what residents and families actually experience day to day. Public data misses the feel of a place — visit unannounced, ideally at a mealtime or on a weekend, talk to staff and families, and ask your tour questions.
A plain-English summary of the public record below — not a rating, ranking, or recommendation. We take no money from any facility.
| Health inspectionSurveyor-assigned, ranked within your stateInspector-verified | 4 of 5 |
| StaffingFrom payroll records (PBJ) | 5 of 5 |
| Quality measuresSelf-reported by the facility | 4 of 5 |
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
| Overall quality measures | 4 of 5 |
| Short-stay residentsrehab / post-hospital | 4 of 5 |
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.
Trend — is this home getting better or worse?
Over 2025-02 to 2026-06, this home’s CMS overall rating improved from 3 to 5 stars. From monthly CMS archive snapshots.
Horizontal axis runs 2025-02 to 2026-06. That is where CMS’s monthly archive ends, so the right-hand edge of each line is that month — not today.
See all quality measures vs. state & national benchmarks
| Measure | This home | State avg | Typical state | vs typical state |
|---|---|---|---|---|
| Short-stay residents who newly got an antipsychotic medication | 3.4% | 1.3% | 1.4% | worse |
| Short-stay residents given the seasonal flu vaccine | 85.5% | 73.6% | 79.4% | typical |
| Short-stay residents rehospitalized after admission | 38.2% | 22.3% | 22.6% | worse |
| Short-stay residents with an outpatient ER visit | 8.5% | 11.5% | 12.0% | better |
CMS quality measures, as Care Compare shows them. For most rows lower is better (fewer falls, ulcers, hospitalizations); vaccination rates are the exception. Not every row is risk-adjusted. CMS adjusts some measures for resident mix, but falls with major injury, antipsychotic use, physical restraints and the vaccination rates are unadjusted rates — so a home caring for heavier or more behaviorally complex residents can look worse on them without providing worse care. The “typical state” column is the median of the 50 state averages — not a national average of all homes. We use it because a plain average across homes is pulled badly off course by a few states’ reporting habits (long-stay depressive symptoms is the clearest case: Illinois codes it several times higher than most states, which alone lifted the all-homes figure to about twice what a typical state records). The median of state averages resists that — but it does weigh every state equally, so a large state counts no more than a small one, and it is a benchmark of our construction rather than a CMS-published figure. better/worse means the home differs from that benchmark by more than 10% of it; closer than that reads typical. CMS does not publish how many residents each measure covers, and the counts are often small — a single resident can move a rate by several points — so treat small gaps as noise. These come from data the facility reports, so weigh them against the independent inspection record above.
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.
Met the expected recovery: 71.8% of this home’s Medicare short-stay residents left it at or above the ability to care for themselves and move around that CMS predicted for them, across 39 stays in Oct 2024–Sep 2025. The median of the 11,061 homes CMS publishes this for is 56.6%. Read it beside the getting-home figure, not instead of it: unlike the two measures above, CMS makes no better-or-worse call on this one and publishes no confidence interval for it, so this is a comparison and not a verdict — but it is the short-stay measure that separates homes most, and the one to ask about.
Therapy staffing: this home’s payroll records show 5.02 therapist hours per resident per day in 2026Q1 — more than 100% of the 13,892 homes that report any therapy hours at all.
Weekend therapy: weekend therapy hours are 10% of this home’s weekday level — it runs some therapy at the weekend, at a lower level than on weekdays. 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.
See every short-stay measure CMS publishes for this home
| Measure | This home | U.S. median | Period covered | CMS’s call |
|---|---|---|---|---|
| Got home and stayed homeRate of successful return to home or community from a SNF | not reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure. | — | ||
| Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF | not reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure. | — | ||
| Met the expected recoveryPercentage of residents who are at or above an expected ability to care for themselves and move around at discharge | 71.8% | 56.6% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Self-care at dischargePercentage of residents who are at or above an expected ability to care for themselves at discharge | 79.5% | 52.8% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Moving around at dischargePercentage of residents who are at or above an expected ability to move around at discharge | 71.8% | 50.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Medication problems followed upPercentage of residents whose medications were reviewed and who received follow-up care when medication issues were identified | 97.9% | 98.7% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Medication list to the next providerPercentage of residents where the SNF provided a current medication list to the next health care setting | 100.0% | 100.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Medication list to the familyPercentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge | not reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure. | — | ||
| Falls with major injuryPercentage of SNF residents who experience one or more falls with major injury during their SNF stay | 0.0% | 0.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| New or worsened pressure ulcersPercentage of residents with pressure ulcers/pressure injuries that are new or worsened | 0.0% | 1.9% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Infections that led to hospitalPercentage of infections residents got during their SNF stay that resulted in hospitalization | not reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure. | — | ||
| Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs | not reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure. | — | ||
From the CMS Skilled Nursing Facility Quality Reporting Program — Medicare short-stay outcomes, which is a different dataset from the long-stay quality measures above and describes a different set of residents. Where CMS risk-adjusts a measure we show its adjusted rate, and the CMS range beside it is the confidence interval CMS publishes: a home whose range is wide is a home with few stays, where one patient moves the number several points. Read the period column. These measures do not share a window — the claims-based ones (getting home, readmission, spending) lag by a year or more, because a stay has to finish and its claims settle before it can be counted. CMS’s call is CMS’s, not ours: it is the only place anyone tests whether this home differs from the national rate at all, and most homes on most measures do not. Two caveats on it. CMS tests only three of these measures — getting home, readmission, and infections that led to hospital; on the other nine it publishes a rate and no comparison, and rather than compute a verdict CMS declined to make, we say so in the column. And on readmission almost every home in the country lands on “no different”, so that row separates homes far less than getting-home does — which is why met the expected recovery, a measure CMS does not test but which spreads across the whole range, is called out above the table rather than left in this list. The U.S. median column is our own, taken across every home CMS publishes that measure for in this same file; it is not a CMS-published benchmark. Homes CMS gives no rate for are left out of it rather than counted as zero. Medicare spending per stay is a ratio, not a percentage — 1.00 means this home’s Medicare spending for a stay matched the national figure CMS compares it against, and it measures cost to Medicare, not quality of care.
Staffing
How full it usually is: this home is certified for 44 beds and averages 7.6 residents a day — about 17% occupied, or roughly 36 beds typically open. It often has substantial empty capacity — worth asking why, since low census can reflect either a new or shrinking home or one families are avoiding. 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 7.23 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 4.23 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.52 is at or above 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 6.33 hrs/resident/day on weekends vs 7.59 on weekdays — 17% thinner on weekends. RN hours go from 4.63 to 3.22 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)
This home’s total nursing-staff turnover of 12% is below the national median of 45%.
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.
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 · G2026-02-12 · tag F0887 — isolatedEducate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
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 interview, clinical record review, and facility document review, the facility staff failed to offer a 2025-2026 COVID-19 vaccine for three (3) of eight (8) sampled residents (Resident #5, Resident #13, and Resident #12). Resident #5 developed COVID-19 26 days following admission thus resulting in harm for Resident #5. The facility staff also failed to offer 2025-2026 COVID-19 vaccines to the facility staff. The findings included:1. For Resident #5, the facility staff failed to offer the resident a 2025-2026 COVID-19 vaccine following admission to the facility on 1/14/26. The resident tested positive for COVID-19 on 2/09/26 thus resulting in harm to the resident. A facility policy titled, COVID Vaccines, revised 4/04/25, indicated Residents/resident representatives will receive education regarding the benefits, risks and potential side effects associated with the COVID-19 Vaccine. B. Residents will be offered the COVID-19 vaccine unless they have previously immunized, or it is medically…
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.
- Potential for harm · D2026-02-12 · tag F0636 — isolatedAssess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on staff interview, clinical record review, and facility document review, the facility staff failed to conduct an admission minimum data set (MDS) assessment within 14 calendar days after admission for two (2) of eight (8) sampled residents (Resident #1 and Resident #5).The findings included: 1. For Resident #1, the facility staff failed to conduct an admission MDS assessment within 14 calendar days after admission.A facility policy titled, Care Plan/Comprehensive Assessment revised 4/04/25 indicated The RAI (Resident Assessment Instrument) manual provides instructions for when and how to use the time frames for completing assessments and transmitting data.The resident demographic record indicated the facility admitted Resident #1 on 11/26/25. According to the active problem list, Resident #1 had a medical history that included a fracture of the right ankle, debility, and chronic diastolic heart failure.Resident #1's admission MDS with an assessment reference date (ARD) of 12/11/25 was signed as completed by the Director of Nursing on 12/11/25, 16 days following admission to…
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.
- Potential for harm · D2026-02-12 · tag F0640 — isolatedEncode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on staff interview, clinical record review, and facility document review, the facility staff failed to electronically transmit an admission minimum data set (MDS) assessment within 14 days following completion for one (1) of eight (8) sampled residents (Resident #1).The findings included: A facility policy titled Care Plan/Comprehensive Assessment revised 4/04/25 indicated The RAI (Resident Assessment Instrument) manual provides instructions for when and how to use the time frames for completing assessments and transmitting data.The Resident demographic record indicated the facility admitted Resident #1 on 11/26/25. According to the active problem list, Resident #1 had a medical history that included a fracture of the right ankle, debility, and chronic diastolic heart failure.Resident #1's admission MDS with an assessment reference date (ARD) of 12/11/25 was signed as completed by the Director of Nursing (DON) on 12/11/25. The 12/11/25 admission MDS was transmitted on 1/06/26, 26 days following completion. During an interview on 2/10/26 at 8:54 AM, the DON stated Resident #1's…
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.
- Potential for harm · D2026-02-12 · tag F0756 — failed to review each resident's drug regimen — isolatedEnsure 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, clinical record review, and facility document review, the facility staff failed to ensure the drug regimen review of each resident was reviewed at least monthly by a licensed pharmacist for one (1) of eight (8) sampled residents (Resident #1). The findings included:A facility policy titled, Medication Reconciliation/Drug Regimen revised 3/07/25 indicated, Residents drug regimen will be reviewed on admission prior to midnight the second day of admission, monthly and prn (as needed) as determined by the medical condition of the resident and risk of adverse consequences of medications.According to Resident #1's active problem list, the resident has a medical history that included a fracture of the right ankle, debility, chronic diastolic heart failure, and depression. An admission minimum data set (MDS) with an assessment reference date (ARD) of 12/11/25, revealed Resident #1 had a Brief Interview for Mental Status (BIMS) score of 15, which indicated the resident had intact cognition. On 2/10/26, a review of Resident #1's clinical record revealed the most…
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.
- Potential for harm · Dcited before2026-02-12 · tag F0880 — failed to prevent and control infections — isolatedProvide and implement an infection prevention and control program.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation and facility document review, the facility staff failed to maintain an infection prevention and control program designed to provide a safe and sanitary environment to help prevent the transmission of infections as evidenced by failure to use appropriate hand hygiene during medication administration. The findings included:During an observation of medication administration on 2/10/26 at 9:45 AM, Registered Nurse (RN) #1 performed hand hygiene, donned gloves, scanned Resident #11's identification band with the medication cart's handheld scanner. RN #1 returned to the medication cart and returned the scanner. RN #1 then obtained and applied ointment to Resident #11's nares using a cotton applicator and returned to the cart. While wearing the same gloves, RN #1 then opened the resident's oral medications, placed a tablet into her gloved hand and then into the medication cup with additional oral tablets. RN #1 then proceeded to administer the oral medications to Resident #11. After administration, RN #1 removed her gloves and performed hand hygiene. 2/10/26 at 9:55…
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.
- Potential for harm · D2026-02-12 · tag F0883 — failed to offer flu and pneumonia vaccines — isolatedDevelop and implement policies and procedures for flu and pneumonia vaccinations.
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 interview, clinical record review, and facility document review, the facility staff failed to offer a pneumococcal vaccine in accordance with nationally recognized standards for two (2) of eight (8) sampled residents (Resident #1 and Resident #12). The findings included:1. For Resident #1, the facility staff failed to offer the resident a pneumococcal conjugate vaccine 15 (PCV15), pneumococcal conjugate vaccine 20 (PCV20), or pneumococcal conjugate vaccine 21 (PCV21) following admission to the facility.The resident demographic record indicated the facility admitted Resident #1 on 11/26/25. According to the active problem list, Resident #1 had a medical history that included a fracture of the right ankle, debility, and chronic diastolic heart failure. An admission minimum data set (MDS) with an assessment reference date (ARD) of 12/11/25, revealed Resident #1 had a Brief Interview for Mental Status (BIMS) score of 15, which indicated the resident had intact cognition. A review of Resident #1's…
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.
- Potential for harm · F2021-04-29 · tag F0812 — failed to store, cook, and serve food safely — widespreadProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, staff interview, and policy review the facility failed to ensure the sanitizing solution was maintained at an acceptable level to sanitize food contact surfaces; and failed to perform hand hygiene after contaminating their gloves and before touching resident food. This had the potential to affect 25 of 25 residents residing in the facility. Findings include: 1.On 04/26/21 at 11:07 AM one of two red containers of sanitizing solution used to sanitize food preparation surfaces and to hold wiping cloths measured at zero parts per million (ppm). The wiping container was located by the three-compartment sink. The Dietary Supervisor and the System Chef both verified the solution was not at the proper sanitizer level to sanitize the food contact surfaces. The Dietary Supervisor stated she made the solution about 8:00 AM that morning. The System Executive Chef tested the sanitizing solution with a test strip and verified it measured zero ppm. The facility policy titled Sanitizing Food Contact Surfaces with a revised date of 01/19 stated the J-512 sanitizer must be…
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.
- Potential for harm · D2021-04-29 · tag F0641 — isolatedEnsure each resident receives an accurate assessment.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on record review and staff interviews the facility failed to ensure Resident (R)23's assessment accurately reflected gradual dose reduction attempts for an antipsychotic. This failure affected one of five residents reviewed for unnecessary medications. Findings include: Review of the diagnosis tab in the electronic medical record (EMR) revealed Resident (R) 23's diagnosis included Alzheimer's Disease, Unspecified Dementia with behavioral disturbance, anxiety disorder due to know physiological condition, restlessness and agitation, and repeated falls. Review of physician's orders under the orders tab in the EMR revealed R23 had an order for Seroquel Tablet 25 MG (an Antipsychotic) give 0.5 tablet by mouth in the morning related to unspecified dementia with behavioral disturbance and an order for Seroquel tablet 25 MG give 1 tablet by mouth at bedtime related to unspecified dementia with behavioral disturbance. Both orders had a start date of 04/22/19. Review of R23's Minimum Data set (MDS) assessments for the past year revealed each of the assessments was inaccurately coded at…
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.
- Potential for harm · D2021-04-29 · tag F0684 — failed to provide proper treatment and quality of care — isolatedProvide 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
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview, record review and facility policy/procedure review the facility failed to ensure a resident's Port-A-Cath (also known as an intravenous vascular access port -IVAP) was flushed with heparin by a Registered Nurse (RN) and not by a Licensed Practical Nurse (LPN). Per accepted standards of practice, these flushes are outside an LPN's scope of practice. The deficient practice affected one sampled resident (R)21 and one unsampled resident R22; and had the potential for poor quality of care for all residents, if staff operated outside their accepted scope of practice. Findings include: Review of the facility procedure titled Implanted Venous Access Port: Flushing, dated February 9, 2018, revealed RNs, physicians, nurse practitioners and physician assistants can flush IVAPs. RNs are generally responsible for monitoring the effects of injected medications or fluids for administering appropriate treatment for adverse effects. Tasks related to the use and maintenance of an IVAP cannot be delegated to…
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.
- Potential for harm · D2021-04-29 · tag F0686 — failed to prevent and treat pressure sores (bedsores) — isolatedProvide appropriate pressure ulcer care and prevent new ulcers from developing.
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 observation, interview, record review, and facility policy review, the facility failed to ensure the correct physician's order was followed for wound care for one of 12 sampled residents (Resident (R)11). The failure to follow current physician's orders for wound care could impede healing of the sacral pressure ulcer being treated, and increase the health risks associated with a wound, such as infection and sepsis. Findings include: Review of the Face Sheet in the Electronic Medical Record (EMR) revealed R11 was admitted to the facility on [DATE] and readmitted on [DATE], with diagnoses including Alzheimer's Disease and chronic kidney disease, stage four. Review of the Orders tab in the EMR for R11, a new physician's order dated 04/18/21 revealed Wound Care-Sacrum: Clean with normal saline (NS), pat dry, cover with Allevyn daily and as needed (PRN). On 04/28/21 at 6:22 AM, in R11's room, the pressure ulcer dressing was changed by Licensed Practical Nurse (LPN)1. The resident was positioned on her side…
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.
- Potential for harm · D2021-04-29 · tag F0758 — failed to limit and justify psychotropic drugs — isolatedImplement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on record review and staff interview the facility failed to ensure residents who received antipsychotic medications had a gradual dose reduction attempt at least annually. This failure affected 1 resident (R)esident 23) of 5 residents reviewed for unnecessary medications. Findings include: The diagnosis tab in the electronic medical record (EMR) revealed Resident (R) 23's diagnosis included Alzheimer's Disease, Unspecified Dementia with behavioral disturbance, restlessness and agitation, and repeated falls. Review of physician's orders under the orders tab in the EMR revealed R23 had an order for Seroquel Tablet 25 MG give 0.5 tablet by mouth in the morning related to unspecified dementia with behavioral disturbance and an order for Seroquel tablet 25 MG give 1 tablet by mouth at bedtime related to unspecified dementia with behavioral disturbance. Both orders had a start date of 04/22/19. Seroquel is an antipsychotic medication. Antipsychotics are a class of psychotropic medications primarily used to manage psychosis (including delusions hallucinations, or disordered thought),…
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.
Show the remaining 10 citations
- Potential for harm · Dcited before2021-04-29 · tag F0761 — failed to label and store drugs safely — isolatedEnsure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, interview and facility policy review the facility failed to ensure expired medications were removed from the medication cart and the medication storage room. This deficient practice occurred in one of one med rooms and two of two med carts; and could potentially lead to administering ineffective, outdated medications to the residents. Findings include: On 04/29/21 at 12:12 PM, in the medication cart for resident rooms 4-11 and 29-32, two individual Tylenol 325 milligram (mg) packets were found with an expiration date of 03/04/21. On 04/29/21 at 12:12 PM, Licensed Practical Nurse (LPN)3 verified the Tylenol packets were outdated and confirmed the medication should have been removed from the cart and not available for administration. On 04/29/21 at 12:43 PM, three 10 cubic centimeters (cc) heparin flush syringes were found in the medication storage room with an expiration date of 2/2021. On 04/29/21 at 12:43 PM, LPN2 verified the heparin syringes were outdated and confirmed the syringes should be sent back to the pharmacy and not available for resident use. On…
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.
- Potential for harm · D2021-04-29 · tag F0803 — failed to meet residents' dietary needs — isolatedEnsure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, menu review, and staff interview the facility failed to follow the menu selected for the residents. This affected three (Resident (R) 2, R20, R23) of 25 residents in the facility. Findings include: The lunch meal was observed in the kitchenette on the nursing unit on 04/28/21 continuously from 11:54 AM through 12:40 PM. At 12:36 PM the [NAME] ran out of spaghetti (pasta). As a result, Resident (R) 2, R22, and R23 did not receive any pasta. The pasta was served as a side dish with chicken parmesan and the last three residents served were not offered or provided a substitiute of equal nutritive value when there was not enough spaghetti prepared. Review of the orders tab in each of the resident's electronic medical records revealed R2 had an order for a regular, dysphagia mechanically altered texture; R20 had an order for a Regular diet; and R23 an order for a Regular, dysphagia mechanically altered, regular consistency diet. Review of the menu revealed R20 was supposed to receive pasta and R2 and R23 mechanically altered diets were supposed to receive chopped…
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.
- Potential for harm · Dcited before2021-04-29 · tag F0880 — failed to prevent and control infections — isolatedProvide and implement an infection prevention and control program.
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 observation, interview, record review, and facility policy review the facility failed to ensure the scissors, used by the nurse, to cut dressings for a pressure ulcer were cleaned prior to use on the dressing for one of 12 sampled residents (Resident (R) 11). The failure to follow accepted standards of practice related to infection control with wound care could potentially introduce bacteria into the wound causing an infection. Findings include: Review of the Face Sheet in the Electronic Medical Record (EMR) revealed R11 was admitted to the facility on [DATE] and readmitted on [DATE], with diagnoses including Alzheimer's Disease and chronic kidney disease, stage four. Review of the Orders tab in the EMR for R11, a physician's order dated 04/18/21 revealed Wound Care-Sacrum: Clean with normal saline (NS), pat dry, cover with Allevyn daily and as needed (PRN). On 04/28/21 at 6:22 AM, in R11's room, the pressure ulcer dressing was changed by Licensed Practical Nurse (LPN)1. The resident was positioned on…
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.
- Potential for harm · D2018-09-06 · tag F0583 — failed to protect personal privacy — isolatedKeep residents' personal and medical records private and confidential.
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 observation, staff interview, and clinical record review, the facility staff failed to protect the private health care information for 1 of 15 Residents, Resident #192. The findings included: For Resident #192, the facility staff failed to close the computer screen during a medication administration observation. This computer screen included Resident #192's personal healthcare information and was visible to any person(s) in the hallway. Resident #192 was admitted to the facility on [DATE]. Diagnoses included, but were not limited to, muscle weakness, low back pain, fracture of the first lumbar vertebra, and fracture of second lumbar vertebra. Resident #192 did not have a MDS (minimum data set) assessment completed at this time due to being a new admission. Resident # 192 is alert and oriented. On 09/05/18 at approximately 8:19 a.m., surveyor #1 observed RN (registered nurse) #1 during a medication administration observation. RN #1 was observed preparing and administering medications to Resident # 192.…
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.
- Potential for harm · D2018-09-06 · tag F0658 — failed to meet professional standards of care — isolatedEnsure services provided by the nursing facility meet professional standards of quality.
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 interview, clinical record review, and facility document review the facility staff failed to follow professional standards of practice for 1 of 15 Residents, Resident #12. The findings included: For Resident #12 the facility staff failed to assess Resident and document that Resident had been admitted to the hospital. Resident #12 was admitted to the facility on [DATE] and readmitted on 0831/18. Diagnoses included but not limited to hypertension, diabetes mellitus, hyperlipidemia, thyroid disorder, osteoporosis, Alzheimer's disease, anxiety and depression. The most recent MDS (minimum data set) with an ARD (assessment reference date) of 07/05/18 coded the Resident as 5 out of 15 in section C, cognitive patterns. This is an annual MDS. Resident #12's clinical record was reviewed on 09/04/18. It contained progress note dated 08/29/18 at 03:37, which read in part, Bed alarm went off when walked into room [ROOM NUMBER] Patient was laying in the floor beside of bed. Patient stated that she was trying to…
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.
- Potential for harm · D2018-09-06 · tag F0698 — failed to provide proper dialysis care — isolatedProvide safe, appropriate dialysis care/services for a resident who requires such services.
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 interview, clinical record review, and facility document review, the facility staff failed to coordinate care with dialysis center for 1 of 15 Residents, Resident #41. The findings included: For Resident #41 the facility staff failed to coordinate care with dialysis center. Resident #41 was admitted to the facility on [DATE] and readmitted on [DATE]. Diagnoses included but not limited to dependence on renal dialysis, depression, chronic obstructive pulmonary disease, gastroesophageal reflux disease, diabetes mellitus, hypothyroidism, hypertension and end stage renal disease. The most recent MDS (minimum data set) with an ARD (assessment reference date) of 08/23/18 coded the Resident as 15 of 15 in section C, cognitive patterns. This is a quarterly MDS. Resident #41's CCP (comprehensive care plan) was reviewed and contained a care plan for receives hemodialysis r/t (related to) end stage renal failure. Resident #41's clinical record was reviewed on 09/04/18. The surveyor could not locate any…
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.
- Potential for harm · D2018-09-06 · tag F0757 — failed to avoid unnecessary drugs — isolatedEnsure each resident’s drug regimen must be free from unnecessary drugs.
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 ensure one of 15 Residents were free from unnecessary medications, Resident #30. The findings included. The facility nursing staff administered the Residents digoxin when the Residents pulse was documented in the EHR (electronic health record) as being less than 60. Resident #30 had a physician's order to hold the digoxin if pulse was less than 60. The clinical record review revealed that Resident #30 had been admitted to the facility 11/01/17. Diagnoses included, but were not limited to, Alzheimer's disease, anemia, heart failure, hypertension, acute kidney failure, and anxiety disorder. Section C (cognitive patterns) of the Residents quarterly MDS (minimum data set) assessment with an ARD (assessment reference date) of 08/02/18 was coded 1/1/3 to indicate the Resident had problems with long and short term memory was severely impaired in cognitive skills for daily decision making. The Residents EHR included the order digoxin give 0.125 mg one time a day for heart check pulse, hold for HR (heart rate)…
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.
- Potential for harm · D2018-09-06 · tag F0760 — failed to prevent significant medication errors — isolatedEnsure that residents are free from significant medication errors.
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 ensure two of 15 Residents, were free of significant medication errors, Residents #14 and #30. The findings included. 1. For Resident #14, the facility failed to administer the Residents physician ordered lasix. The Resident had a stat (immediate) order for lasix. The facility was unable to provide any proof that this medication had been administered. The clinical record review revealed that Resident #14 had been admitted to the facility 12/03/15. Diagnoses included but were not limited to, dementia, insomnia chronic kidney disease, diabetes, hypertension, and anxiety disorder. Section C (cognitive patterns) of the Residents annual MDS (minimum data set) assessment with an ARD (assessment reference date) of 07/12/18 included a BIMS (brief interview for mental status) summary score of five out of a possible 15 points. The EHR (electronic health record) included a physicians order dated 08/26/18 for Lasix Tablet 20 MG (Furosemide) Give 3 tablet by mouth STAT for chf (congestive heart failure) one time…
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.
- Potential for harm · Dcited before2018-09-06 · tag F0761 — failed to label and store drugs safely — isolatedEnsure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
What the surveyor found here — an excerpt from the official record, may be distressing
2. The facility staff failed to ensure the medication cart was locked when unattended. On 09/05/18 at approximately 8:19 a.m., surveyor #1 observed RN ( registered nurse) #1 during a medication administration observation. During this observation RN #1 was observed preparing and administering medications. After preparing the medications RN #1 entered a Resident's rooms to administer the medications leaving medication draw open and medication cart unlocked in hallway. The medication cart was out of RN#1's view. Surveyor #2 observed housekeeping personnel, dietary personnel and one resident in the hallway during this observation. After the medication administration surveyor #1 approached RN #1 and interviewed her regarding the medication cart being open. RN #1 verbalized to the surveyor that she leaves the cart open if it is facing the room. The DON (director of nursing) was notified of the above on 09/05/18 at approximately 4:30p.m., during an end of the day meeting. On 09/06/18 the DON provided the surveyor with a copy of a policy/procedure titled Storage of Medications page 1 of…
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.
- Potential for harm · Dcited before2018-09-06 · tag F0880 — failed to prevent and control infections — isolatedProvide and implement an infection prevention and control program.
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 observation, staff interview, clinical record review, and facility document review, the facility staff failed to ensure an effective infection control program for one of 15 Residents, Resident #194. The findings included: For Resident #194, facility staff failed to ensure nebulizer mouthpiece was kept inside a bag per facility policy. Resident #194 was admitted to the facility on [DATE]. Diagnoses included, but were not limited to, muscle weakness, essential (primary) hypertension, chronic obstructive pulmonary disease with (acute) exacerbation, and benign prostatic hyperplasia with lower urinary tract symptoms. Resident #194 did not have a MDS (minimum data set) assessment completed at this time due to being a new admission. Resident # 194 is alert and oriented. Resident #194 physician order summary dated 8/27/-9/26/18 read ipratropium (ATROVENT) 0.02% nebulizer solution 0.5mg Nebulization, Every 6 hours; albuterol (PROVENTIL/ACCUNEB) 0.083% nebulizer solution 1.25mg Nebulization, Every 6 hours PRN (as…
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.
“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.
- Long-Term Care Ombudsman — a free, confidential advocate for the resident. They act only with the resident’s consent and work to resolve the problem. Find yours at theconsumervoice.org/get_help.
- Adult Protective Services — the state agency that investigates suspected abuse, neglect, or exploitation of a vulnerable adult. Not sure of your state’s APS number? The federal Eldercare Locator will route you: 1-800-677-1116 or eldercare.acl.gov.
- State survey agency — the regulator that licenses and inspects the home. Every state has an official nursing-home complaint line and most take complaints online; the Ombudsman or Eldercare Locator can connect you.
Fines & penalties
$10,400 in federal fines across 1 penalty.
- $10,400 — penalty dated 2026-02-12
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
| Owner / manager | Type | Role | Share | Since |
|---|---|---|---|---|
| WELLMONT HEALTH SYSTEM | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST; ADP OF THE SNF | 100% | since 04/01/2004 |
| BENNETT, JULIE | Individual | CORPORATE DIRECTOR; CORPORATE OFFICER | — | since 02/01/2023 |
| DEATON, BUFORD | Individual | CORPORATE DIRECTOR; CORPORATE OFFICER | — | since 02/01/2018 |
| EICHORN, MARVIN | Individual | CORPORATE DIRECTOR; CORPORATE OFFICER | — | since 02/01/2018 |
| HILTON, SHANE | Individual | CORPORATE DIRECTOR; CORPORATE OFFICER | — | since 04/04/2024 |
| LEVINE, ALAN | Individual | CORPORATE DIRECTOR; CORPORATE OFFICER | — | since 02/01/2018 |
| WILGOCKI, GREGORY | Individual | CORPORATE DIRECTOR | — | since 02/01/2018 |
| NEWBERRY, BRIAN | Individual | OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | — | since 01/31/2025 |
| SHOWALTER, SHANNON | Individual | OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | — | since 01/31/2025 |
| BALLAD HEALTH | Organization | ADP OF THE SNF | — | since 01/31/2025 |
CMS files one row per role, so the 18 rows in the source record cover these 10 parties — each is shown once here with every role it holds. Nothing is omitted.
2 organizational owners listed — a facility can be part of a larger chain. CMS ownership data is known to under-report private-equity and REIT ties; treat as a starting point.
What families pay in VA
This is a Medicare- and Medicaid-certified nursing home, so it can accept Medicaid for long-term care — like nearly all U.S. nursing homes. The private-pay figures below are what families without Medicaid pay; once a resident qualifies for Medicaid, out-of-pocket cost for covered nursing-home care is typically close to $0 (almost all of their income goes to the home as their share of the cost; they keep a small personal needs allowance — for clothing, haircuts, a phone — and Medicaid pays the rest). The amount of that allowance is set by each state. Confirm Medicaid-bed availability with the home, and see the Virginia Medicaid page.
Median private-pay cost, CareScout (Genworth) 2025 Cost of Care Survey — a regional midpoint, not any single community’s rate. Private rooms and higher care levels cost more; ask for a current quote. Project your own in the cost-of-care planner.
Every figure above is reproduced from the CMS Provider Data Catalog (a public record), from the CMS extract processed 2026-08-01 — CMS provider number 495374. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2026-02-12, which can lag current conditions. Staffing hours are CMS PBJ CY2026Q1 (Jan–Mar 2026). Check this record against the government’s own page for it: this home on Medicare Care Compare ↗ — the authoritative source, and the place to confirm anything here before you act on it. How we present it →
Not a government site. Eldercare Lens is not affiliated with, endorsed by, or authorized by the Centers for Medicare & Medicaid Services (CMS), Medicare, or any government agency. The star ratings, citations, and inspection wording on this page are reproduced from the public CMS record; the plain-English summaries, tiers, and comparisons around them are ours. We do not speak for CMS, and CMS has not reviewed this page. For the official record, go to Medicare Care Compare. How we’re funded →
Are you this operator? If the record here is out of date, or misses what you have since fixed, tell us and we will look: hello@eldercarelens.com. We reproduce the public CMS record and cannot change what it says — corrections to the underlying data go through CMS and your state survey agency — but we will correct anything we have got wrong about it, and we will say so on the page.