Old Southwest Health and Rehabilitation

324 King George Ave Sw · Roanoke, VA · 24016 · 5403458139

130 certified beds For profit - Limited Liability company Chain: Eastern Healthcare Group

Why this verdict

  • Inspection record is far worse than the national median (deficiency count and severity).
  • 4 citations involved actual harm to residents.

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Red flags

Cited under the freedom-from-abuse rule

Cited 1 time under F600 (freedom from abuse/neglect) below the actual-harm level — worth asking about on a tour.

2 actual-harm citations in the most recent cycle

Inspectors found deficiencies that caused real harm to residents, beyond potential-harm paperwork findings.

Medicare/Medicaid payments were denied

CMS refused payment for new admissions for a period — one of its strongest enforcement tools.

62% of nursing staff left within a year

High turnover disrupts continuity of care; the national median is 45%.

No standard inspection in over 2 years

The inspection record here is older than usual — conditions may have changed since.

Score breakdown

Inspection record 30% of score 8
Serious harm & abuse 20% 76
Staffing 20% 55
Federal penalties 15% 26
Trend 10% 47
Context 5% 60

Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.

CMS ratings & staffing

Overall: 1 of 5 Inspections: 1 of 5 Staffing: 2 of 5 Quality measures: 3 of 5

Total nurse hours / resident-day3.363.48 min · 4.1 strong
RN hours / resident-day0.430.55–0.75
Weekend hours / resident-day2.85≈ weekday level
Nursing turnover / year62%median 45%
Fines (3-yr window)2 · $143,823

Inspection citations (129 in the current record)

  • Potential for harm · E July 16, 2024 · found via complaint

    Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.

    Corrected August 29, 2024 · Resident Rights

  • Potential for harm · D July 16, 2024 · found via complaint

    Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

    Corrected August 29, 2024 · Resident Rights

  • Potential for harm · E July 16, 2024 · found via complaint

    Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

    Corrected August 29, 2024 · Resident Rights

  • Potential for harm · E July 16, 2024 · found via complaint

    Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.

    Corrected August 29, 2024 · Resident Rights

  • Potential for harm · D July 16, 2024 · found via complaint

    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

    Corrected August 29, 2024 · Resident Assessment and Care Planning

  • Potential for harm · D July 16, 2024 · found via complaint

    Ensure services provided by the nursing facility meet professional standards of quality.

    Corrected August 29, 2024 · Resident Assessment and Care Planning

  • Potential for harm · E July 16, 2024 · found via complaint

    Provide care and assistance to perform activities of daily living for any resident who is unable.

    Corrected August 29, 2024 · Quality of Life and Care

  • Potential for harm · E July 16, 2024 · found via complaint

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Corrected August 29, 2024 · Quality of Life and Care

  • Potential for harm · D July 16, 2024 · found via complaint

    Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.

    Corrected August 29, 2024 · Quality of Life and Care

  • Potential for harm · E July 16, 2024 · found via complaint

    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

    Corrected August 29, 2024 · Quality of Life and Care

  • Potential for harm · F July 16, 2024 · found via complaint

    Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.

    Corrected August 29, 2024 · Nursing and Physician Services

  • Potential for harm · D July 16, 2024 · found via complaint

    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

    Corrected August 29, 2024 · Pharmacy Service

  • Potential for harm · D July 16, 2024 · found via complaint

    Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

    Corrected August 29, 2024 · Pharmacy Service

  • Potential for harm · D July 16, 2024 · found via complaint

    Ensure each resident’s drug regimen must be free from unnecessary drugs.

    Corrected August 29, 2024 · Pharmacy Service

  • Potential for harm · D July 16, 2024 · found via complaint

    Ensure that residents are free from significant medication errors.

    Corrected August 29, 2024 · Pharmacy Service

  • Potential for harm · D July 16, 2024 · found via complaint

    Provide timely, quality laboratory services/tests to meet the needs of residents.

    Corrected August 29, 2024 · Administration

  • Potential for harm · D July 16, 2024 · found via complaint

    Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.

    Corrected August 29, 2024 · Administration

  • Potential for harm · D July 16, 2024 · found via complaint

    Keep complete, dated laboratory records in the resident's record.

    Corrected August 29, 2024 · Administration

  • Potential for harm · D July 16, 2024 · found via complaint

    Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

    Corrected August 29, 2024 · Resident Assessment and Care Planning

  • Potential for harm · F July 16, 2024 · found via complaint

    Have a plan that describes the process for conducting QAPI and QAA activities.

    Corrected August 29, 2024 · Administration

  • Potential for harm · E July 16, 2024 · found via complaint

    Provide and implement an infection prevention and control program.

    Corrected August 29, 2024 · Infection Control

  • Potential for harm · D July 16, 2024 · found via complaint

    Develop and implement policies and procedures for flu and pneumonia vaccinations.

    Corrected August 29, 2024 · Infection Control

  • Potential for harm · D July 16, 2024 · found via complaint

    Educate 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.

    Corrected August 29, 2024 · Infection Control

  • Potential for harm · E July 16, 2024 · found via complaint

    Develop, implement, and/or maintain an effective training program for all new and existing staff members.

    Corrected August 29, 2024 · Administration

  • Actual harm · G March 29, 2024

    Ensure that residents are free from significant medication errors.

    Corrected August 29, 2024 · Pharmacy Service

Showing the 25 most recent. The Safety Report includes every citation with full findings.

Federal penalties

DateTypeAmount / length
March 29, 2024Fine$135,633
March 29, 2024Payment Denial61 days
August 16, 2023Fine$8,190

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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 495156 · certified since April 25, 1985. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.