Every person who worked here at any point in the quarter, employees and contractors. It is not how many are on site at once: that is the "on an average day" figure.
148
93 employees · 55 contractors · 38 on an average day Old Southwest Rehabilitation and Nursing
Nursing Home, Hospice Care, Memory Care, Palliative Care, Respite Care & Skilled Nursing · Roanoke, VA
ALM Inspection Grade
F
ALM's inspection grade is 58 / 100, an F — 20 points below the Virginia average for CMS-certified facilities (78/100) · A proprietary Assisted Living Magazine grade.A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. It is not a government rating.
ALM's inspection grade is 58 / 100, an F — 20 points below the Virginia average for CMS-certified facilities (78/100) · A proprietary Assisted Living Magazine grade.A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. It is not a government rating.
CMS overall rating
1/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
1/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
Old Southwest Rehabilitation and Nursing
Nursing Home, Hospice Care, Memory Care, Palliative Care, Respite Care & Skilled Nursing · Roanoke, VA
ALM Inspection Grade
F
ALM's inspection grade is 58 / 100, an F — 20 points below the Virginia average for CMS-certified facilities (78/100) · A proprietary Assisted Living Magazine grade.A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. It is not a government rating.
ALM's inspection grade is 58 / 100, an F — 20 points below the Virginia average for CMS-certified facilities (78/100) · A proprietary Assisted Living Magazine grade.A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. It is not a government rating.
CMS overall rating
1/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
1/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
Old Southwest Rehabilitation and Nursing accepts Medicare, Medicaid, and private pay.
Overview of Old Southwest Rehabilitation and Nursing
Operating for 41 years, Old Southwest Rehabilitation and Nursing is a nursing home in Roanoke, VA, offering skilled nursing, memory care, hospice care, palliative care, and respite care. The community provides comfort-focused care for those with serious illness, while recovery support is given to those in rehabilitation. 24-hour staffing also ensures residents receive support as needed.
The home has 130 beds, with total nurse staffing of 4 hours and 1 minute per resident each day. Payment options include Medicare, Medicaid, and private pay. Meanwhile, a Walk Score of 57 places the area in the somewhat walkable band, meaning some errands can be completed on foot.
Quality ratings
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Staffing
Data period: Q2 2026 (April 1 – June 30, 2026).
Nursing care per resident per day and state rankings: CMS Provider Information.
Headcount, shifts and contractors: CMS Payroll-Based Journal (PBJ).
Resident count: CMS Long-Term Care Facility Characteristics (data as of Sep 2026).
Total nursing care per resident / day
This nursing home is ranked 33rd out of 68 nursing homes we track in Virginia for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
4h 1m
This nursing home is ranked 33rd out of 68 nursing homes we track in Virginia for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
4h 1mStandout metric: LPN / LVN is +66% above Virginia average
4 of 6 metrics below Virginia average
Daily care time per resident, by role
Registered nurse (RN)
RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes. All 7 are the facility's own employees; no agency contractors work in this role.
7 staff · 8.3-hour shifts
27m
↓ 34% · VA 41mThis facility: 27m per resident per day, 34% below the Virginia average of 41m (among Virginia facilities reporting a recent figure).
RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes. All 7 are the facility's own employees; no agency contractors work in this role.
7 staff · 8.3-hour shiftsUS average: 41m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 41m
LPN / LVN
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care. 41 total: 17 of the facility's own employees and 24 agency contractors.
41 staff · 9.5-hour shifts
1h 39m
↑ 66% · VA 1h 0mThis facility: 1h 39m per resident per day, 66% above the Virginia average of 1h 0m (among Virginia facilities reporting a recent figure).
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care. 41 total: 17 of the facility's own employees and 24 agency contractors.
41 staff · 9.5-hour shiftsUS average: 52m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 52m
Certified nursing assistant
Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life. 73 total: 42 of the facility's own employees and 31 agency contractors.
73 staff · 8-hour shifts
1h 55m
↓ 10% · VA 2h 8mThis facility: 1h 55m per resident per day, 10% below the Virginia average of 2h 8m (among Virginia facilities reporting a recent figure).
Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life. 73 total: 42 of the facility's own employees and 31 agency contractors.
73 staff · 8-hour shiftsUS average: 2h 21m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 2h 21m
Physical therapist
Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
5m
↓ 6% · VA 5mThis facility: 5m per resident per day, 6% below the Virginia average of 5m (among Virginia facilities reporting a recent figure).
Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
US average: 4m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 4m
Total nursing, weekends
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
RN + LPN + aide · Sat–Sun
3h 24m
↑ 3% · VA 3h 19mThis facility: 3h 24m per resident per day, 3% above the Virginia average of 3h 19m (among Virginia facilities reporting a recent figure).
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
RN + LPN + aide · Sat–SunUS average: 3h 26m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 3h 26m
RN, weekends
Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
Sat–Sun
15m
↓ 47% · VA 28mThis facility: 15m per resident per day, 47% below the Virginia average of 28m (among Virginia facilities reporting a recent figure).
Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
Sat–SunUS average: 29m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 29m
Headcount
Every person who worked here at any point in the quarter, employees and contractors. It is not how many are on site at once: that is the "on an average day" figure.
148
93 employees · 55 contractors · 38 on an average day
148 total staff / 66 residents. Residents: CMS Long-Term Care Facility Characteristics (data as of Sep 2026); staff: CMS Payroll-Based Journal (Q2 2026).Residents and staff come from two different CMS releases, so the two counts can be a few months apart.
2.24 : 1
↑ 35% · VA 1.66This facility: 2.24 staff per resident, 35% above the Virginia average of 1.66 (among Virginia facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
148 staff ÷ 66 residents
See full Virginia ranking →
Average hours one staff member works on a day they are on shift, across every role.
8.1 h
↑ 1% · VA 8 hThis facility: 8.1 h, 1% above the Virginia average of 8 h (among Virginia facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
27,950 staff hours this quarter
See full Virginia ranking →89.4% of staff hours were worked by the facility's own employees
Virginia average: 91.5% · Contractors this quarter: Certified Nursing Assistant (31), Licensed Practical Nurse (24)
Why it matters: employees work here week after week and get to know each resident's routines and needs. Agency contractors often rotate between facilities, so a higher employee share usually means more consistent care.
By The Numbers
Community insights.
Bed count
A mid-sized community that may balance personal attention with shared amenities and social activities.
130
Rank #33 / 74Bed count — State benchmarked This nursing home is ranked 33rd out of 74 nursing homes we track in Virginia for bed count. Shows this facility's certified or reported bed count compared to other Virginia facilities. Larger communities may offer more amenities, programs, and on-site services for residents and families. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Virginia that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
A mid-sized community that may balance personal attention with shared amenities and social activities.
130
Rank #33 / 74Bed count — State benchmarked This nursing home is ranked 33rd out of 74 nursing homes we track in Virginia for bed count. Shows this facility's certified or reported bed count compared to other Virginia facilities. Larger communities may offer more amenities, programs, and on-site services for residents and families. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Virginia that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.Medium-capacity home · Offers a balance of services and community atmosphere.
Years of operating
A longer operating history, which may indicate experience navigating regulations and delivering ongoing care. This is the number of years in operation under current management.
A longer operating history, which may indicate experience navigating regulations and delivering ongoing care. This is the number of years in operation under current management.
41
years
Walk Score
Somewhat walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.
Rank #23 / 76Walk Score — State benchmarked This nursing home is ranked 23rd out of 76 nursing homes we track in Virginia for walk score. Shows how walkable this facility's neighborhood is compared to the average walk score across Virginia facilities. Higher scores benefit residents, families, and staff. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Virginia that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Somewhat walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.
Rank #23 / 76Walk Score — State benchmarked This nursing home is ranked 23rd out of 76 nursing homes we track in Virginia for walk score. Shows how walkable this facility's neighborhood is compared to the average walk score across Virginia facilities. Higher scores benefit residents, families, and staff. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Virginia that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
57
/ 100
Occupancy rate
Occupancy lower than 85% suggests more openings may be available.
Rank #51 / 60Occupancy rate — State benchmarked This nursing home is ranked 51st out of 60 nursing homes we track in Virginia for occupancy. Shows this facility's occupancy rate versus the Virginia average, with its Statewide rank out of 60. Higher occupancy signals strong local demand and financial stability. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Virginia that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Occupancy lower than 85% suggests more openings may be available.
Rank #51 / 60Occupancy rate — State benchmarked This nursing home is ranked 51st out of 60 nursing homes we track in Virginia for occupancy. Shows this facility's occupancy rate versus the Virginia average, with its Statewide rank out of 60. Higher occupancy signals strong local demand and financial stability. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Virginia that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
58.8%
This home usually has availability
Based on residents per day and 130 beds.
Lower than the Virginia average: 79.3%
Residents per day (avg)
The average number of residents living at this facility on a given day. CMS calculates this figure from the facility's Minimum Data Set (MDS) assessments and uses this value for other measures like Hours Per Resident Per Day (HPRD) and 5-Star Staffing rating.
The average number of residents living at this facility on a given day. CMS calculates this figure from the facility's Minimum Data Set (MDS) assessments and uses this value for other measures like Hours Per Resident Per Day (HPRD) and 5-Star Staffing rating.
77
Source: CMS Provider Information, average daily residents (data as of Oct 2026)
Avg. Length of Stay
Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
79
days
BBB Rating
An independent rating from the Better Business Bureau based on factors such as complaint history, transparency, and business practices.
An independent rating from the Better Business Bureau based on factors such as complaint history, transparency, and business practices.
A+
Not Accredited
How BBB ratings workAbout This Community
Resident Council
Palliative CareCare focused on relieving pain, symptoms, and stress while supporting quality of life. It can be provided alongside treatment for a serious illness.
Respite CareRespite care provides families and unpaid caregivers with short-term relief from caregiving duties. Care can range from a few hours to a few weeks.
Pets not allowed
CMS Health Inspection History
ALM Inspection Grade
58 / 100
Calculated from CMS inspection data for this community's nursing-home beds
How it compares
20 points below the Virginia average for CMS-certified facilities (78/100)
Category breakdown
Citations
Concern
338 severity-weighted points (126 citations) · 5× higher than the typical CMS-certified VA facility (median: 69)
Enforcement
Concern
$135,633 in fines · 2 enforcement actions
Persistence
Concern
82 days to fix issues · much slower than the typical CMS-certified VA facility (median: 41)
Total health inspections
5
↑ 22% · VA 4.1This facility: 5, 22% above the Virginia average of 4.1 (among Virginia facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Total health citations
126
Rank #70 / 71Health citations — State benchmarked This nursing home is ranked 70th out of 71 nursing homes we track in Virginia for health citations. Shows this facility's total health deficiency citations benchmarked to the Virginia State average, with a ranking across all 71 VA facilities. Lower citation counts earn a better rank. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Virginia that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.↑ 226% · VA 38.7This facility: 126, 226% above the Virginia average of 38.7 (among Virginia facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Citations per inspection
25.2
Rank #71 / 71Citations per inspection — State benchmarked This nursing home is ranked 71st out of 71 nursing homes we track in Virginia for citations per inspection. Shows average deficiency citations per CMS inspection for this facility versus the Virginia mean across 71 facilities with citation data. Lower is better. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Virginia that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.↑ 175% · VA 9.15This facility: 25.2, 175% above the Virginia average of 9.15 (among Virginia facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Citation severity
100% corrected
126 of 126 citations corrected
Critical
J–L
0
↓ 100% · VA 0.5This facility: 0, 100% below the Virginia average of 0.5 (among Virginia facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Immediate jeopardy
Serious
G–I
3
↑ 200% · VA 1This facility: 3, 200% above the Virginia average of 1 (among Virginia facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Actual harm
Moderate
D–F
121
↑ 231% · VA 36.6This facility: 121, 231% above the Virginia average of 36.6 (among Virginia facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
No harm, more than minimal risk
Minor
A–C
2
↑ 186% · VA 0.7This facility: 2, 186% above the Virginia average of 0.7 (among Virginia facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
No harm, minimal riskLatest inspection: Jul 16, 2024 · 24 citations, all corrected
Most cited category: Quality of Life & Care, 31 of 126 citations · 9 categories in total
Citations history
Most recent first
Jul 16, 2024
24 citations
Nursing Services moderate citation
Corrected
Corrected
Administration moderate citation
Corrected
Corrected
Resident Rights moderate citation
Corrected
Corrected
Resident Rights moderate citation
Corrected
Corrected
Resident Rights moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Infection Control moderate citation
Corrected
Corrected
Administration moderate citation
Corrected
Corrected
Resident Rights moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Pharmacy moderate citation
Corrected
Corrected
Pharmacy moderate citation
Corrected
Corrected
Pharmacy moderate citation
Corrected
Corrected
Pharmacy moderate citation
Corrected
Corrected
Administration moderate citation
Corrected
Corrected
Administration moderate citation
Corrected
Corrected
Administration moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Infection Control moderate citation
Corrected
Corrected
Infection Control moderate citation
Corrected
Corrected
Mar 29, 2024
26 citations
Pharmacy serious citation
Corrected
Corrected
Administration serious citation
Corrected
Corrected
Nursing Services moderate citation
Corrected
Corrected
Resident Rights moderate citation
Corrected
Corrected
Abuse/Neglect moderate citation
Corrected
Corrected
Abuse/Neglect moderate citation
Corrected
Corrected
Resident Rights moderate citation
Corrected
Corrected
Resident Rights moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Nursing Services moderate citation
Corrected
Corrected
Nursing Services moderate citation
Corrected
Corrected
Pharmacy moderate citation
Corrected
Corrected
Pharmacy moderate citation
Corrected
Corrected
Infection Control moderate citation
Corrected
Corrected
Infection Control moderate citation
Corrected
Corrected
Administration moderate citation
Corrected
Corrected
Administration moderate citation
Corrected
Corrected
Resident Rights moderate citation
Corrected
Corrected
Abuse/Neglect moderate citation
Corrected
Corrected
Administration moderate citation
Corrected
Corrected
Nursing Services moderate citation
Corrected
Corrected
Administration moderate citation
Corrected
Corrected
Resident Rights moderate citation
Corrected
Corrected
Resident Rights moderate citation
Corrected
Corrected
Showing the 50 most recent of 126 citations.
Top deficiency categories
Share of 126 citations
Quality of Life & Care
31 deficiencies (25%)
Resident Assessment & Care Planning
23 deficiencies (18%)
Resident Rights
19 deficiencies (15%)
Pharmacy Services
17 deficiencies (13%)
Administration
15 deficiencies (12%)
Infection Control
8 deficiencies (6%)
Abuse, Neglect & Exploitation
7 deficiencies (6%)
Nursing & Physician Services
5 deficiencies (4%)
Environmental
1 deficiency (1%)
How citations are counted
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
79 of 126 citations resulted from standard inspections; 42 of 126 resulted from complaint investigations; and 5 of 126 came from combined inspections (standard and complaint).
Includes all CMS health inspection records for this property, which could include management/ownership changes.
Source
Data sourced from CMS Health Deficiencies reports. Citation severity codes range from A (least serious) to L (most serious). Immediate Jeopardy (J-L) citations indicate situations where the facility's noncompliance has placed residents at risk of death or serious harm.
Show Inspection Reports
Enforcement
Penalties and fines
Penalties and fines
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database · Data as of Oct 2026
2 penalties in the past 3 years
Latest: Mar 29, 2024 · $135,633 civil money penalty
Mar 29, 2024 · $135,633 civil money penalty
Mar 29, 2024 · 61-day payment denial
Total fines
$135,633
↑ 120% · VA $62KThis facility: $135,633, 120% above the Virginia average of $61,623. Average among the 110 Virginia facilities with a penalty on record.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.US avg $66KUS average: $66,281, among the 6,725 US facilities with a penalty on record.Rank #70 / 71Federal fines — State benchmarked This nursing home is ranked 70th out of 71 nursing homes we track in Virginia for federal fines. Shows this facility's cumulative CMS federal fine dollars versus the Virginia average among facilities with fines, and where it ranks among 71 facilities in the pool. Lower total dollars mean a better rank. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Virginia that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Number of fines
1
↓ 30% · VA 1.44This facility: 1, 30% below the Virginia average of 1.44. Average among the 110 Virginia facilities with a penalty on record.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.US avg 1.88US average: 1.88, among the 6,725 US facilities with a penalty on record.
Payment denials
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
1
61 days
VA avg 0.11Virginia average: 0.11. Average among the 110 Virginia facilities with a penalty on record.US avg 0.35US average: 0.35, among the 6,725 US facilities with a penalty on record.
Penalty history · past 3 years
Mar 29, 2024
Civil money penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
$135,633
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
$135,633
Mar 29, 2024
Payment denial
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
New admissions not paid
61 days
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
New admissions not paid
61 daysFine amount comparison
This facility
$135,633
Virginia average
$61,623
US average
$66,281
Totals count every penalty on record; the history lists the past 3 years. Virginia and US averages are among facilities with a penalty on record.
A civil money penalty is a fine for noncompliance, per day or per instance. A payment denial stops Medicare/Medicaid payments for new residents until issues are fixed.
Health Outcomes
Quality of care over time
How residents at this home fare on health outcomes and preventive care, compared with the Virginia average.
CMS star rating for the care of long-stay residents, who live at the home for 100 days or more. It is built from the long-stay quality measures below. 5 stars is the best.
2
/ 5
Below average
↓ 48% · VA 3.9This facility: 2.0, 48% below the VA average of 3.9 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Average of five long-stay measures: pressure ulcers, falls with major injury, unplanned weight loss, worsening ability to walk, and needing more help with daily activities. Each is the % of residents affected, so lower is better.
8.7
Score · lower is better
↑ 5% · VA 8.3This facility: 8.7, 5% above the VA average of 8.3 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Average of three long-stay measures: needing more help with daily activities, worsening ability to walk, and loss of bowel or bladder control. Each is the % of residents affected, so lower is better.
19.2
Score · lower is better
↑ 15% · VA 16.7This facility: 19.2, 15% above the VA average of 16.7 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.11 long-stay measures: 3 better, 8 worse
7 short-stay measures: 2 better, 3 worse, 2 compared with US only
Long-stay residents
People who live at the home · 11 measures
Daily care & independence
Needed more help with daily activities
Percent of long-stay residents whose need for help with daily activities has increased
15.8%
↑ 9% · VA 14.5This facility: 15.8, 9% above the VA average of 14.5 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents whose need for help with daily activities has increased
15.8%
↑ 9% · VA 14.5This facility: 15.8, 9% above the VA average of 14.5 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Walking ability worsened
Percent of long-stay residents whose ability to move independently worsened
11.6%
↓ 18% · VA 14.2This facility: 11.6, 18% below the VA average of 14.2 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents whose ability to move independently worsened
11.6%
↓ 18% · VA 14.2This facility: 11.6, 18% below the VA average of 14.2 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Bowel or bladder incontinence (low-risk residents)
Percent of low risk long-stay residents who lose control of their bowels or bladder
30.3%
↑ 42% · VA 21.3This facility: 30.3, 42% above the VA average of 21.3 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of low risk long-stay residents who lose control of their bowels or bladder
30.3%
↑ 42% · VA 21.3This facility: 30.3, 42% above the VA average of 21.3 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Safety & clinical stability
Urinary tract infection
Percent of long-stay residents with a urinary tract infection
1.9%
↑ 15% · VA 1.6This facility: 1.9, 15% above the VA average of 1.6 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents with a urinary tract infection
1.9%
↑ 15% · VA 1.6This facility: 1.9, 15% above the VA average of 1.6 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Falls with major injury
Percent of long-stay residents experiencing one or more falls with major injury
4.0%
↑ 14% · VA 3.5This facility: 4.0, 14% above the VA average of 3.5 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents experiencing one or more falls with major injury
4.0%
↑ 14% · VA 3.5This facility: 4.0, 14% above the VA average of 3.5 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Pressure ulcers (high-risk residents)
Percent of long-stay high risk residents with pressure ulcers
6.9%
↑ 57% · VA 4.4This facility: 6.9, 57% above the VA average of 4.4 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay high risk residents with pressure ulcers
6.9%
↑ 57% · VA 4.4This facility: 6.9, 57% above the VA average of 4.4 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Physical & mental health
Lost too much weight
Percent of long-stay residents who lose too much weight
5.1%
↓ 5% · VA 5.3This facility: 5.1, 5% below the VA average of 5.3 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents who lose too much weight
5.1%
↓ 5% · VA 5.3This facility: 5.1, 5% below the VA average of 5.3 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Depressive symptoms
Percent of long-stay residents who have depressive symptoms
16.6%
↓ 19% · VA 20.5This facility: 16.6, 19% below the VA average of 20.5 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents who have depressive symptoms
16.6%
↓ 19% · VA 20.5This facility: 16.6, 19% below the VA average of 20.5 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Antipsychotic use
Percent of long-stay residents who received an antipsychotic medication
19.8%
↑ 39% · VA 14.2This facility: 19.8, 39% above the VA average of 14.2 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents who received an antipsychotic medication
19.8%
↑ 39% · VA 14.2This facility: 19.8, 39% above the VA average of 14.2 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Preventive care
Pneumococcal vaccine
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
52.2%
↓ 43% · VA 91.2This facility: 52.2, 43% below the VA average of 91.2 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
52.2%
↓ 43% · VA 91.2This facility: 52.2, 43% below the VA average of 91.2 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Flu vaccine
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
39.3%
↓ 58% · VA 93.3This facility: 39.3, 58% below the VA average of 93.3 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
39.3%
↓ 58% · VA 93.3This facility: 39.3, 58% below the VA average of 93.3 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Short-stay residents
Rehab and recovery after a hospital stay · 7 measures
Daily care & independence
Returned home or to the community
Rate of successful return to home or community from a skilled nursing facility.
30.6%
↓ 40% · US 50.6This facility: 30.6, 40% below the US average of 50.6 (among US facilities reporting a recent figure).
Rate of successful return to home or community from a skilled nursing facility.
30.6%
↓ 40% · US 50.6This facility: 30.6, 40% below the US average of 50.6 (among US facilities reporting a recent figure).Safety & clinical stability
Falls with major injury
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
↓ 100% · US 0.8This facility: 0.0, 100% below the US average of 0.8 (among US facilities reporting a recent figure).
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
↓ 100% · US 0.8This facility: 0.0, 100% below the US average of 0.8 (among US facilities reporting a recent figure).Physical & mental health
New antipsychotic medication
Percent of short-stay residents who newly received an antipsychotic medication
0.0%
↓ 100% · VA 1.3This facility: 0.0, 100% below the VA average of 1.3 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of short-stay residents who newly received an antipsychotic medication
0.0%
↓ 100% · VA 1.3This facility: 0.0, 100% below the VA average of 1.3 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Preventive care
Pneumococcal vaccine
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
5.5%
↓ 93% · VA 74.2This facility: 5.5, 93% below the VA average of 74.2 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
5.5%
↓ 93% · VA 74.2This facility: 5.5, 93% below the VA average of 74.2 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Flu vaccine
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
10.5%
↓ 86% · VA 73.3This facility: 10.5, 86% below the VA average of 73.3 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
10.5%
↓ 86% · VA 73.3This facility: 10.5, 86% below the VA average of 73.3 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Hospital & emergency visits
Re-hospitalized after admission
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
25.7%
↑ 17% · VA 22.0This facility: 25.7, 17% above the VA average of 22.0 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
25.7%
↑ 17% · VA 22.0This facility: 25.7, 17% above the VA average of 22.0 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
ER visits
Percentage of short-stay residents who had an outpatient emergency department visit.
7.2%
↓ 38% · VA 11.7This facility: 7.2, 38% below the VA average of 11.7 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percentage of short-stay residents who had an outpatient emergency department visit.
7.2%
↓ 38% · VA 11.7This facility: 7.2, 38% below the VA average of 11.7 (among VA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Arrows show whether a figure is above or below the average. Green is better for residents, red is worse, and yellow means within 5% of the average. Grey compares with the US average only, because CMS publishes no state figure. The line on each bar marks the average.
Quality measures are calculated by CMS from Minimum Data Set (MDS) resident assessments and Medicare claims.
Money and staffing.
Old Southwest Rehabilitation and Nursing’s finances from its CMS cost report for the fiscal year ending March 2025, compared with 68 Virginia nursing homes that filed a recent report. Includes all financial data for this property, which could include management/ownership changes.
FY Mar 2025
Is it financially stable?
Losing money on care, but less than last year
−1.2% operating margin
+6.2 pts vs prior year
An operating loss in 8 of the last 8 reported years. Other income ($0.0M) trims the net loss to −$0.1M. Watch for cost-cutting that reaches staffing.
Does it invest in staff?
Spends less on payroll than most Virginia homes
50.8% payroll share of revenue
VA average 64.1%Rank #28 / 68Payroll % of net patient revenue — State benchmarked This nursing home is ranked 28th out of 68 nursing homes we track in Virginia for payroll % of net patient revenue. Shows payroll as a percentage of net patient revenue versus the Virginia average, among facilities reporting a recent fiscal year. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Virginia that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Payroll rose $0.6M while revenue rose $0.7M. A low share can mean leaner staffing; check hours per resident in the staffing section.
FY 2025 scorecard
Each row shows the FY 2025 figure, the change since the prior report, the trend, and how it compares with Virginia homes.
Revenue & profit
Losing money on care
| Metric | FY 2025 | vs prior year | Trend 2014 → 2025Trend | VA median | Compared with VA homesRank in VA | In short |
|---|---|---|---|---|---|---|
| Net patient revenue What the home earns from resident care, after discounts and bad debt. | $9.5M | +$0.7M | Trend 20142025 | VA median $21.0M | Rank in VA Rank #63 / 68Net patient revenue — State benchmarked This nursing home is ranked 63rd out of 68 nursing homes we track in Virginia for net patient revenue. Shows this facility's net patient revenue compared to the Virginia average, among facilities reporting a recent fiscal year. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Virginia that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 7% of homes | Below VA median Higher net patient revenue than 7% of VA homes that filed a recent report. Revenue mostly follows how big a home is. |
| Operating expenses Everything it costs to run the home: staff, supplies, rent, admin. | $9.6M | +$0.2M | Trend 20142025 | VA median $23.7M | Rank in VA Rank #66 / 68Operating expenses — State benchmarked This nursing home is ranked 66th out of 68 nursing homes we track in Virginia for operating expenses. Shows everything it cost to run the home — staff, supplies, rent, admin — compared with other Virginia homes reporting a recent fiscal year. Expenses in dollars mostly follow how big a home is, so this compares size, not efficiency; read it next to operating margin. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Virginia that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 3% of homes | Exceeds revenue Operating expenses are higher than net patient revenue, so resident care runs at a loss. |
| Net patient income Revenue minus operating expenses. Negative means care loses money. | −$0.1M | +$0.5M | Trend 20142025 | VA median −$0.1M | Rank in VA Rank #36 / 68Net patient income — State benchmarked This nursing home is ranked 36th out of 68 nursing homes we track in Virginia for net patient income. Shows net patient revenue minus operating expenses, compared with other Virginia homes reporting a recent fiscal year. Homes that lost money on care are in the pool too, so a rank in the bottom half usually means a loss. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Virginia that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 48% of homes | Loss, narrowing Resident care lost money this year, less than in the prior report. |
| Operating margin Net patient income as a share of revenue. The clearest health signal. | −1.2% | +6.2 pts | Trend 20142025 | VA median −0.4% | Rank in VA Rank #37 / 68Operating margin — State benchmarked This nursing home is ranked 37th out of 68 nursing homes we track in Virginia for operating margin. Shows net patient income as a share of net patient revenue, compared with other Virginia homes reporting a recent fiscal year. Unlike the dollar figures it does not follow size, so it is the fairest comparison of financial health between a small home and a large one. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Virginia that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 46% of homes | Loss A negative margin means resident care costs more than it earns. |
| Other income Money not from resident care: investments, grants, services. | $0.0M | — | Trend — | VA median $0.6M | Rank in VA Rank #64 / 67Other income — State benchmarked This nursing home is ranked 64th out of 67 nursing homes we track in Virginia for other income. Shows income from outside resident care — investments, grants, rentals, services — compared with other Virginia homes reporting a recent fiscal year. It is not part of net patient revenue; a high rank here can offset a loss on care. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Virginia that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 5% of homes | Offsets part of the loss Income from outside resident care covers part of the loss on care. |
| Net income The bottom line after other income. | −$0.1M | +$0.5M | Trend — | VA median $1.7M | Rank in VA Rank #56 / 68Net income — State benchmarked This nursing home is ranked 56th out of 68 nursing homes we track in Virginia for net income. Shows the bottom line after other income, compared with other Virginia homes reporting a recent fiscal year. Homes with a net loss are in the pool too, so a rank in the bottom half usually means a loss. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Virginia that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 18% of homes | Loss The bottom line is below zero even after other income. |
Staffing spend
Spends less of revenue on staff than most Virginia homes
| Metric | FY 2025 | vs prior year | Trend 2014 → 2025Trend | VA median | Compared with VA homesRank in VA | In short |
|---|---|---|---|---|---|---|
| Payroll costs Salaries and wage-related benefits, not counting contract labor. | $4.8M | +$0.6M | Trend 20142025 | VA median $9.6M | Rank in VA Rank #66 / 68Payroll costs — State benchmarked This nursing home is ranked 66th out of 68 nursing homes we track in Virginia for payroll costs. Shows total staff payroll — salaries plus wage-related benefits — benchmarked to the Virginia average, among facilities reporting a recent fiscal year. Higher payroll relative to peers often signals better staffing and less reliance on contract labor. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Virginia that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 3% of homes | Below VA median Higher payroll than 3% of VA homes. Payroll in dollars mostly follows how big a home is, so this compares size, not staffing levels. |
| Payroll share of revenue Payroll divided by revenue. Higher usually means more staff per resident. | 50.8% | +3.0 pts | Trend 20142025 | VA median 49.2% | Rank in VA Rank #28 / 68Payroll % of net patient revenue — State benchmarked This nursing home is ranked 28th out of 68 nursing homes we track in Virginia for payroll % of net patient revenue. Shows payroll as a percentage of net patient revenue versus the Virginia average, among facilities reporting a recent fiscal year. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Virginia that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 60% of homes | 13.3 pts under VA average The VA average is 64.1% of revenue. Within 3 points of it reads as near the average. |
Charts, 2014–2025 2 charts · VA benchmark drawn as a dashed line
Revenue, expenses and income
What the home earned from resident care (net patient revenue), what it cost to run (operating expenses) and the difference between the two (net patient income), for each fiscal year it filed a CMS cost report.
USD, millions
Net patient revenue Operating expenses Net patient income No report
Where revenue goes
Both lines are a share of net patient revenue. Payroll share is what goes to salaries and wage-related benefits; operating margin is what is left after every operating cost (below 0%, resident care lost money). The dashed line is the Virginia payroll average.
% of net patient revenue
Payroll share Operating margin VA payroll average No report
Year-by-year data, 2014–2025 every reported year · latest first, scroll sideways
| Metric | 2014 | 2015 | 2016 | 2017 | 2018no report | 2019no report | 2020 | 2021 | 2022no report | 2023 | 2024no report | 2025 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Net patient revenue | $6.7M | $7.1M | $6.6M | $6.7M | $7.4M | $6.5M | $8.8M | $9.5M | ||||
| Operating expenses | $7.0M | $7.6M | $7.3M | $7.6M | $9.1M | $7.3M | $9.4M | $9.6M | ||||
| Net patient income | −$0.3M | −$0.6M | −$0.7M | −$0.8M | −$1.7M | −$0.8M | −$0.6M | −$0.1M | ||||
| Operating margin | −4.1% | −7.9% | −10.2% | −12.0% | −22.5% | −11.7% | −7.3% | −1.2% | ||||
| Net income | −$0.2M | −$0.6M | −$0.8M | −$0.8M | −$0.8M | −$0.5M | −$0.6M | −$0.1M | ||||
| Payroll costs | $4.0M | $3.9M | $3.6M | $3.6M | $3.2M | $2.6M | $4.2M | $4.8M | ||||
| Payroll share of revenue | 59.4% | 54.4% | 54.9% | 54.0% | 42.5% | 39.9% | 47.8% | 50.8% | ||||
| Beds | 130 | 130 | 130 | 130 | 130 | 130 | 130 | 130 | ||||
| Gross revenue | $9.0M | $8.5M | $8.6M | $8.5M | $7.8M | $6.9M | $10.4M | $9.6M | ||||
| Salaries | $3.4M | $3.3M | $3.1M | $3.1M | $2.9M | $2.3M | $3.8M | $4.4M | ||||
| Wage-related costs | $0.6M | $0.6M | $0.5M | $0.5M | $0.3M | $0.3M | $0.4M | $0.5M | ||||
| Contract labor | $0.0M | $0.1M | $0.2M | $0.3M | $2.0M | $1.1M | $1.4M | $1.0M | ||||
| Other operating costs | $3.0M | $3.8M | $3.7M | $3.9M | $5.9M | $4.7M | $5.2M | $4.8M | ||||
| Net patient revenue per day | $217 | $238 | $237 | $227 | $289 | $300 | $362 | $339 | ||||
| Cost per day | $226 | $257 | $261 | $255 | $354 | $335 | $388 | $343 | ||||
| Average length of stay | 161.6 days | 187.1 days | 174.4 days | 127.4 days | 124.9 days | 69.8 days | 85.7 days | 78.7 days |
Showing 2025–2023 · scroll sideways for 9 earlier years
Earlier and partial years are in the download. Download CSV
Who this home usually serves
Residents split by who pays for their care: Medicare, Medicaid, or private pay and other sources.
Over a year: CMS SNF Cost Report, FY2025
Snapshot: CMS Long-Term Care Facility Characteristics (quarterly), Sep 2026
Arriving
377 admissions · FY2025
Residents admitted during the year.
Medicare
22 · 6%
Medicaid
277 · 73%
Private pay & other
78 · 21%
Resident snapshot
66 residents · Sep 2026
Residents counted on the date of the latest CMS report, which updates quarterly.
Medicare
4 · 6%
Medicaid
56 · 85%
Private pay & other
6 · 9%
Leaving
337 discharges · FY2025
Residents discharged during the year.
Medicare
8 · 2%
Medicaid
255 · 76%
Private pay & other
74 · 22%
Mostly long-term care residents
Most residents stay for extended periods and receive ongoing daily care.
Reviews (2)
Old Southwest Rehabilitation and Nursing Reviews
Jazmin Vance
The absolute worst ever the administrator is a failure the DON is a failure it should be shut down IMMEDIATELY.
Rating Their Experiences
What do you like most about living here?
Nothing
Are there enough caregivers to handle the residents' needs, especially during emergencies?
No
Are the common areas pleasant and comfortable for socializing or relaxing?
No
How do you feel about the level of social interaction available with other residents?
It’s horrible
How was the units offered in this community?
There wasn’t any
Do you feel safe living in this community?
No
How well do you think the community handles emergencies or unexpected events?
Not well
How would you rate the quality and variety of the meals? (1-5)
1
Are special diets handled well?
No
Is the dining schedule flexible enough to meet your preferences?
No
Are there any hidden fees or unexpected charges?
No
Would you recommend this community to others looking for senior living options?
No
Is there anything you wish you knew before moving in?
No
Angela Stinnett
Please do not let your loved one go here. Worst mistake you will ever make. Starting from the administrator which he has no business in that position to the director of nursing and again, she is just laughable, and keep going on down to the kitchen staff. They treat the residents like trash and the family members even worse. When my family member need someone during the night now one could even be found. The CNA's and nurses would actually hide so they didn't have to work and help the residents. I'm so glad my family member has gotten out of there. They withheld his medication and left him laying in his own feces because he is not mobile. It's horrible.
Rating Their Experiences
What do you like most about living here?
His roommate was always helpful.
Are there enough caregivers to handle the residents' needs, especially during emergencies?
Yes
Are the common areas pleasant and comfortable for socializing or relaxing?
No
How do you feel about the level of social interaction available with other residents?
None except roommate which was good.
How was the units offered in this community?
N/A
Do you feel safe living in this community?
No
How well do you think the community handles emergencies or unexpected events?
Not well at all. As stated above, during the night on numerous occasions there were not any employees to be found in the entire home.
How would you rate the quality and variety of the meals? (1-5)
1
Are special diets handled well?
No
Is the dining schedule flexible enough to meet your preferences?
No
Are there any hidden fees or unexpected charges?
N/A
Would you recommend this community to others looking for senior living options?
Absolutely Not
Is there anything you wish you knew before moving in?
Yes, I wish I would have been told how terrible they would treat my family member beforehand.
Places of interest near Old Southwest Rehabilitation and Nursing
0.8 miles from city center
Estimated distance in miles from Roanoke's city center to Old Southwest Rehabilitation and Nursing's address, calculated via Google Maps.
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Info below is compiled from CMS reports & the VA Depts. of Social Services & Health, senior community websites & trusted data sources such as Walk Score & BBB.
Communities are listed from highest-ranked to lowest-ranked based on our methodology.
The facility name. Click to view the full profile page on Assisted Living Magazine, including photos, services, and contact info.
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CMS (Centers for Medicare & Medicaid Services, the federal agency that regulates nursing homes) Overall 5-star rating — a composite of Health Inspection, Staffing, and Quality Measures scores. 5 stars = top 10% nationally. 1 star = bottom 10%. The single most important number to start with when comparing facilities.
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Care Types in This Table
AL (Assisted Living):
Housing with help for daily activities like bathing, dressing, and medication, without 24-hour skilled nursing.
NH (Nursing Home):
24/7 skilled nursing care for residents with complex, ongoing medical needs.
SNF (Skilled Nursing Facility):
Round-the-clock nursing care, often for recovery after surgery, injury, or illness.
MC (Memory Care):
Secured, specialized care for people living with Alzheimer's or dementia.
RC (Respite Care):
Short-term temporary care that gives family caregivers a break.
IL (Independent Living):
Community living with dining, activities, and transportation for active seniors who need little personal care.
HC (Home Care):
Professional care delivered in the person's own home, from companionship to skilled nursing.
HOS (Hospice Care):
Comfort-focused care for those with a terminal illness, prioritizing quality of life over treatment.
PC (Palliative Care):
Comfort-focused care for serious illness at any stage, including alongside curative treatment.
CCRC (Continuing Care Retirement Community):
A campus with multiple care levels so residents can age in place without moving.
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Neighborhood or city area where the facility is located. Proximity to family, hospitals, and green space matters for both quality of life and ease of visitation. Consider drive time and transit access when evaluating location.
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Licensed bed capacity. Larger facilities (300+ beds) often have more specialized programs but can feel institutional. Smaller homes (under 150 beds) tend to deliver more personalized care. Compare with Avg Res/Day to understand how full the facility typically runs.
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A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. This is a proprietary Assisted Living Magazine grade. It is not a government rating. A dash means we have no inspection data for that facility.
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Percentage of licensed beds filled on an average day. Color indicates financial health: green (90%+) = operationally strong, typically profitable. Amber (80–89%) = stable but leaving revenue on the table. Orange (70–79%) = financial strain likely, may struggle with fixed costs. Red (<70%) = significant distress, closure or ownership change risk increases sharply.
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This facility's occupancy rate compared to the statewide average for similar facilities. A positive number means above-average demand. Facilities running 5%+ above the state average are typically the most sought-after in their market — a strong proxy for reputation.
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CMS-adjusted total nurse hours per resident per day (RN + LPN + CNA combined). The national average is approximately 3.5 hrs. Higher is better — more direct care time per resident. Below 3.0 is a red flag. CMS weights RN hours more heavily because RNs handle complex clinical decisions that CNAs cannot.
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CMS Health Inspection star rating (1–5 stars), based on the 3 most recent annual state surveys plus any complaint investigations. This is the hardest rating to manipulate — it reflects real surveyor findings on-site. 5 stars = fewest deficiencies found. 1 star = most. It carries the heaviest weight in the Overall CMS rating.
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CMS Staffing star rating (1–5 stars), based on daily nurse staffing hours submitted to CMS via verified payroll data. Compares RN, LPN, and CNA coverage relative to resident acuity level. 5 stars = well above expected staffing. Weekend staffing is evaluated separately, as that's where many facilities quietly reduce coverage.
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CMS Quality Measures star rating (1–5 stars), based on 15 clinical outcome metrics including fall rates, pressure ulcers, antipsychotic drug use, and hospital readmissions. Captures actual resident health outcomes, not just compliance. High QM combined with low Health Inspection scores can indicate a facility with strong care but weak documentation practices.
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Registered Nurse hours per resident/day compared to the statewide average. RNs are the highest-skilled nursing staff — they assess residents, manage medications, and respond to emergencies. A value of +50% means RN coverage is 50% above the state norm. Negative values are a concern for residents with complex or acute medical needs.
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Total nursing staff hours (RN + LPN + CNA combined) per resident/day vs. the statewide average. A broader measure than RN vs State — it captures the entire care team. A facility can have high total staffing but low RN hours, meaning more aides and fewer nurses. Read both columns together for the full picture.
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Total dollar amount of federal monetary fines (civil money penalties) issued by CMS in the past 3 years. Fines are only levied for serious violations — typically actual harm to residents, repeated uncorrected deficiencies, or systemic non-compliance. Even a single fine is noteworthy. Multiple fines strongly suggest a pattern, not isolated incidents.
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Total health deficiency citations from the most recent standard inspection cycle. Minor citations (scope A–C) are common and often administrative in nature. Higher counts aren't always disqualifying, but should be read alongside Severe Citations to understand actual harm levels. Under 10 is strong for a large facility; 30+ warrants a closer look.
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Average deficiency citations per CMS inspection (survey) in the reporting window — total citations divided by the number of inspections. Lower is better; compare alongside total Citations and Severe Citations for context.
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Citations at CMS scope/severity level G or higher — G–I means actual harm occurred; J–L means residents were placed in immediate jeopardy. (D–F is potential for harm only). Examples include unaddressed falls, medication errors causing injury, neglect, or abuse.
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Average number of residents in the building on any given day, derived from annual census data. Reflects true operating scale — a 400-bed facility running 200 residents/day operates very differently from one at 390. Higher resident counts generally mean more funded staffing hours.
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Better Business Bureau rating (A+ to F). Reflects complaint history, business transparency, and how family disputes were resolved. A+ means no significant unresolved complaints. A blank (—) means the facility isn't BBB-accredited, which is common for healthcare providers and not necessarily a negative signal.
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Walk Score® (0–100). Measures walkability of the surrounding area. 90–100 = Walker's Paradise. 70–89 = Very Walkable. 50–69 = Somewhat Walkable. Below 50 = Car-Dependent. Higher scores benefit family visitors, resident outings, and staff commuting.
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The licensed owner or operator of record filed with CMS — the individual or organization legally accountable for the facility. Searching the operator name across other facilities can reveal chain or multi-site ownership, which matters: chain-operated homes tend to have more variable quality outcomes than independently run facilities.
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What the home actually collects for resident care, after contractual allowances, bad debt and discounts — not gross billings. Taken from the latest complete annual cost report, so it is comparable across homes reporting the same period. Revenue alone doesn't indicate care quality, but it funds staffing and capital reinvestment. Pair with Payroll %. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
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Staff salaries plus wage-related benefits from the latest complete annual cost report. Contract and agency labour is counted separately, under other operating costs, so a home leaning on agency staff can show a low figure here. Payroll is the cost most directly tied to care quality — compare with Payroll % for full context. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
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Payroll as a share of NET PATIENT REVENUE (not gross revenue). Both figures come from the same cost-report year. A higher figure means more of each revenue dollar goes to staff pay. Read with the Staffing star rating to judge whether spend translates into coverage — and note that homes whose patient revenue covers only part of their operation can read implausibly high. The Virginia average is: 64.1% Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
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CMS Certification Number: the unique federal identifier for this skilled nursing provider.
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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Friendship Retirement Community | NH AL CCRC IL MC RC SNF | Roanoke (Hollins) | 253
Facility
253
VA AVG
149
Rank
#7 / 74 | A |
90.6%
Facility
90.6%
VA AVG
79.3%
Rank
#23 / 60 | +14% | 4.25
Facility
4.25
VA AVG
3.80
Rank
#28 / 68 | -13% | +12% | $0
Facility
$0
VA AVG
$61.6k
Rank
#1 / 71 | 17
Facility
17
VA AVG
38.7
Rank
#24 / 71 | 5.7
Facility
5.7
VA AVG
9.2
Rank
#25 / 71 | - | 229 | A+ |
48
Facility
48
VA AVG
41
Rank
#28 / 76 | Friendship Foundation Inc | $31.6MFiscal year ending 06/2025
Facility
$31.6MFiscal year ending 06/2025
VA AVG
$22.5M
Rank
#14 / 68 | $16.2MFiscal year ending 06/2025
Facility
$16.2MFiscal year ending 06/2025
VA AVG
$12.2M
Rank
#19 / 68 | 51.2%Fiscal year ending 06/2025
Facility
51.2%Fiscal year ending 06/2025
VA AVG
64.1%
Rank
#26 / 68 | 495092 | ||||
| Brandon Oaks Nursing and Rehabilitation Center | NH AL HC IL MC SNF | Roanoke (Westland) | 105
Facility
105
VA AVG
149
Rank
#54 / 74 | A- |
55.8%
Facility
55.8%
VA AVG
79.3%
Rank
#54 / 60 | -30% | 6.16
Facility
6.16
VA AVG
3.80
Rank
#5 / 68 | +33% | +62% | $0
Facility
$0
VA AVG
$61.6k
Rank
#1 / 71 | 13
Facility
13
VA AVG
38.7
Rank
#13 / 71 | 3.3
Facility
3.3
VA AVG
9.2
Rank
#6 / 71 | - | 24 | - |
33
Facility
33
VA AVG
41
Rank
#42 / 76 | Heather Neff | $7.7MFiscal year ending 12/2024
Facility
$7.7MFiscal year ending 12/2024
VA AVG
$22.5M
Rank
#65 / 68 | $7.8MFiscal year ending 12/2024
Facility
$7.8MFiscal year ending 12/2024
VA AVG
$12.2M
Rank
#45 / 68 | 101.1%Fiscal year ending 12/2024
Facility
101.1%Fiscal year ending 12/2024
VA AVG
64.1%
Rank
#4 / 68 | 495373 | ||||
| Virginia Veterans Care Center | NH | Roanoke (Shenandoah Avenue Northwest) | 183
Facility
183
VA AVG
149
Rank
#18 / 74 | A- | - | - | 4.81
Facility
4.81
VA AVG
3.80
Rank
#24 / 68 | +9% | +27% | $0
Facility
$0
VA AVG
$61.6k
Rank
#1 / 71 | 10
Facility
10
VA AVG
38.7
Rank
#7 / 71 | 3.3
Facility
3.3
VA AVG
9.2
Rank
#6 / 71 | - | 190 | - |
19
Facility
19
VA AVG
41
Rank
#58 / 76 | Todd Barnes | $30.5MFiscal year ending 06/2025
Facility
$30.5MFiscal year ending 06/2025
VA AVG
$22.5M
Rank
#16 / 68 | $26.0MFiscal year ending 06/2025
Facility
$26.0MFiscal year ending 06/2025
VA AVG
$12.2M
Rank
#5 / 68 | 85%Fiscal year ending 06/2025
Facility
85%Fiscal year ending 06/2025
VA AVG
64.1%
Rank
#8 / 68 | 495274 | ||||
| Our Lady of the Valley | NH AL MC RC SNF | Roanoke (Gainsboro) | 197
Facility
197
VA AVG
149
Rank
#16 / 74 | B+ |
81.1%
Facility
81.1%
VA AVG
79.3%
Rank
#36 / 60 | +2% | 4.12
Facility
4.12
VA AVG
3.80
Rank
#29 / 68 | -31% | +9% | $16.4k
Facility
$16.4k
VA AVG
$61.6k
Rank
#60 / 71 | 12
Facility
12
VA AVG
38.7
Rank
#11 / 71 | 4.0
Facility
4.0
VA AVG
9.2
Rank
#14 / 71 | - | 103 | A+ |
68
Facility
68
VA AVG
41
Rank
#11 / 76 | David Rawlings | $15.9MFiscal year ending 06/2025
Facility
$15.9MFiscal year ending 06/2025
VA AVG
$22.5M
Rank
#43 / 68 | $9.0MFiscal year ending 06/2025
Facility
$9.0MFiscal year ending 06/2025
VA AVG
$12.2M
Rank
#41 / 68 | 56.2%Fiscal year ending 06/2025
Facility
56.2%Fiscal year ending 06/2025
VA AVG
64.1%
Rank
#18 / 68 | 495357 | ||||
| Old Southwest Rehabilitation and Nursing | NH HOS MC PC RC SNF | Roanoke (Old Southwest) | 130
Facility
130
VA AVG
149
Rank
#33 / 74 | F |
58.8%
Facility
58.8%
VA AVG
79.3%
Rank
#51 / 60 | -26% | 4.02
Facility
4.02
VA AVG
3.80
Rank
#33 / 68 | -55% | +6% | $135.6k
Facility
$135.6k
VA AVG
$61.6k
Rank
#70 / 71 | 126
Facility
126
VA AVG
38.7
Rank
#70 / 71 | 25.2
Facility
25.2
VA AVG
9.2
Rank
#71 / 71 | 3 | 77 | A+ |
57
Facility
57
VA AVG
41
Rank
#23 / 76 | Andrew Shuler | $9.5MFiscal year ending 03/2025
Facility
$9.5MFiscal year ending 03/2025
VA AVG
$22.5M
Rank
#63 / 68 | $4.8MFiscal year ending 03/2025
Facility
$4.8MFiscal year ending 03/2025
VA AVG
$12.2M
Rank
#66 / 68 | 50.8%Fiscal year ending 03/2025
Facility
50.8%Fiscal year ending 03/2025
VA AVG
64.1%
Rank
#28 / 68 | 495156 |
Rank badges are statewide and care-type specific: each nursing home is ranked against every other VA nursing home we track that reports that metric, not just the 5 on this page. See how we rank facilities
Financial assistance
Get financial aid guidance Programs that may help with care and living costs in Virginia
Old Southwest Rehabilitation and Nursing is in Roanoke, Virginia. These programs may support different care settings or living expenses. A listing does not confirm this community participates; our concierge team can help confirm.
Auxiliary Grant Program
Virginia Auxiliary Grant (AG)
- Income limit
- Eligibility and grant amount depend on countable income and the applicable Auxiliary Grant rate.
Eligibility
- General
- Virginia Auxiliary Grant assists eligible aged blind or disabled people in participating assisted living adult foster care or approved supportive settings; not a general cash grant for any older adult living at home.
- VA specifics
- DARS publishes participating facilities; local social services determines individual eligibility and supplement amount.
What it provides
- Income supplement toward eligible residential care and personal needs.
VA Aid and Attendance (A&A) and Housebound Benefits
Virginia VA Aid and Attendance/Housebound
- Who it is for
- Veterans or survivors with VA pension eligibility and an Aid and Attendance or Housebound medical need
- Income limit
- Countable income must be below the applicable Maximum Annual Pension Rate (MAPR); the rate depends on dependents and benefit category; Qualifying unreimbursed medical expenses may reduce countable income.
- Asset limit
- VA pension net-worth limit is $163,699 from December 1 2025 through November 30 2026; net worth includes countable assets and annual income under VA rules.
Eligibility
- General
- Additional pension benefits for qualifying Veterans or survivors who satisfy VA pension eligibility and the medical requirements for Aid and Attendance or Housebound status; being an older veteran or spouse alone does not qualify.
- VA specifics
- This is a federal VA benefit rather than a state-specific grant; Aid and Attendance and Housebound benefits cannot be received together.
What it provides
- Increased monthly VA pension based on the applicable MAPR less countable income.
Commonwealth Coordinated Care Plus (CCC Plus) Waiver
VA Medicaid CCC Plus
Eligibility
- General
- Virginia Medicaid financial eligibility and an LTSS screening are required; waiver serves qualifying older adults people with physical disabilities and people with substantial medical needs who otherwise require nursing-facility or hospital care.
- VA specifics
- CCC Plus remains the waiver name; individual service authorization determines coverage; Managed-care arrangements must not be confused with a separate eligibility entitlement.
What it provides
- Authorized home/community services including personal care and respite through agency or consumer-directed arrangements.
Adult Services Program
Virginia Adult Services (AS)
- Income limit
- Home-based-service financial eligibility follows categorical or income-scale rules; SSI TANF and Auxiliary Grant recipients can meet categorical financial eligibility.
- Asset limit
- Adult Services financial rules count income rather than resources for the covered home-based-service determination.
Eligibility
- General
- Virginia Adult Services eligibility is determined through local social services assessment; services address eligible adults with impairments and needs affecting daily living.
- VA specifics
- Local departments administer services and service availability depends on assessed needs and resources.
What it provides
- Assessed adult services and home-based assistance.
Medicare Savings Program (MSP)
Virginia Medicare Savings Program
- Who it is for
- Medicare beneficiaries with limited income who need help with premiums or cost sharing
Eligibility
- General
- Virginia Medicare beneficiary who meets the eligibility rules of the applicable Medicare Savings Program.
- VA specifics
- Coverage depends on the applicable Medicare Savings Program tier.
What it provides
- QMB provides qualifying Medicare premium and cost-sharing assistance; SLMB and QI provide Part B premium assistance.
Energy Assistance Program (EAP)
Virginia Energy Assistance Program
- Income limit
- Gross household income at or below 150% of the federal poverty level; household-size limits apply.
Eligibility
- General
- Virginia household responsible for home heating or cooling expenses and meeting program requirements; additional vulnerable-household criteria apply to cooling assistance.
- VA specifics
- Separate Fuel Crisis Cooling and Weatherization components; Fuel applications run from the second Tuesday in October through the second Friday in November; crisis and cooling have separate windows.
What it provides
- Eligible fuel heating-equipment emergency and cooling expenses under the relevant component.
Know before you visit
Frequently Asked Questions about Old Southwest Rehabilitation and Nursing
Quick answers from public records and the community's own listing.01 What neighborhood is Old Southwest Rehabilitation and Nursing in?
Old Southwest Rehabilitation and Nursing is in the Old Southwest neighborhood of Roanoke.
02 Is Old Southwest Rehabilitation and Nursing in a walkable area?
Old Southwest Rehabilitation and Nursing has a walk score of 57. Somewhat walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.
03 What is the occupancy rate at Old Southwest Rehabilitation and Nursing?
Old Southwest Rehabilitation and Nursing's occupancy is 58.8%.
04 How long has Old Southwest Rehabilitation and Nursing been in business?
Old Southwest Rehabilitation and Nursing has been operating for approximately 41 years, based on available licensing and registration records.
05 Are pets allowed at Old Southwest Rehabilitation and Nursing?
No, Old Southwest Rehabilitation and Nursing has a no-pet policy.
06 Does Old Southwest Rehabilitation and Nursing operate as a for-profit or non-profit?
Old Southwest Rehabilitation and Nursing is registered as a for-profit in VA.
07 What is the overall rating for Old Southwest Rehabilitation and Nursing?
Old Southwest Rehabilitation and Nursing received a 1-star overall rating from the CMS (Centers for Medicare and Medicaid Services). This score combines results from staffing levels, quality measures, and health inspections.
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