3/5
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.
3/5
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.
Resting on 120 acres of serene lands on Ratliff Road, Birmingham, AL, Kirkwood by the River is a charming senior living community that offers assisted living, independent living, memory care, and skilled nursing. Experience unparalleled comfort and convenience with cozy and elegant residences in variations of studio, one-bedroom, and two-bedroom floor plans. With a compassionate and highly skilled team providing top-tier care and assistance around the clock, seniors let go of their worries and make the most of their best years.
Have a balance of independence and utmost support in your retirement with Kirkwood by the River. Mingle with friends and learn new things through enjoyable activities and engaging programs. Moreover, delicious and healthy meals are available to meet residents’ dietary needs and tastes. Kirkwood by the River strives to enhance seniors’ quality of life with care plans that best match seniors’ needs and preferences.
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.
Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.
This home is ranked 15th out of 126 homes in Alabama 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.
| Staff type | Hours / Day / Resident | vs state avg |
|---|---|---|
|
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.
| 35m per day | ▼ 7% State avg: 38m per day · National avg: 41m per day |
|
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.
| 1h 22m per day | ▲ 75% State avg: 47m per day · National avg: 52m per day |
|
Nurse Aide
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.
| 2h 38m per day | ▲ 6% State avg: 2h 30m per day · National avg: 2h 20m per day |
|
Weekend Total Nursing
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.
| 4h 9m per day | ▲ 26% State avg: 3h 17m per day · National avg: 3h 26m per day |
|
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.
| 1m per day | ▼ 36% State avg: 2m per day · National avg: 4m per day |
|
Weekend RN
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.
| 33m per day | ▲ 50% State avg: 22m per day · National avg: 28m per day |
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.
Higher than the Alabama average: 80.8%Kirkwood By the River is administered by Jeff Burchfield.
Key information about the people who lead and staff this community.
In Alabama, the Department of Public Health, Bureau of Health Provider Standards conducts unannounced surveys to ensure facilities meet state licensing and federal certification safety standards.
This scorecard compares key inspection, deficiency, and complaint metrics at this facility against the Alabama state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.
Deficiencies
| This Facility | AL Average | vs. AL Avg |
|---|---|---|---|
|
Total deficiencies
Formal regulatory issues recorded by inspectors across all inspection types.
| 13 | 17 | This facility has 24% fewer total deficiencies than a typical Alabama nursing home (13 vs. AL avg 17).↓ 24% better |
An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.
State average 2.9
Last Health inspection on Oct 2021
State average 10.4
State average 3.46
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
All 8 citations resulted from standard inspections.
100% better than State averageState average: 0.7
100% better than State averageState average: 0.2
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
83% more staff per resident than Alabama average
6% better than Alabama average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
7 total: 3 full-time employees and 4 contractors.
7
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10.7 hoursAssists with medical care and medications.
4 total: 2 full-time employees and 2 contractors.
4
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.5 hoursHelps with daily care and mobility.
60 total: 37 full-time employees and 23 contractors.
60
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.2 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
3,414 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 37 | 23 | 60 | 13,386 | 92 | 100% | 8.2 |
| RN Director of Nursing | 13 | 0 | 13 | 5,780 | 92 | 100% | 10.1 |
| Registered Nurse | 3 | 4 | 7 | 1,825 | 92 | 100% | 10.7 |
| Licensed Practical Nurse | 2 | 2 | 4 | 1,157 | 83 | 90% | 9.5 |
| Speech Language Pathologist | 0 | 3 | 3 | 753 | 65 | 71% | 6.1 |
| Qualified Social Worker | 0 | 4 | 4 | 733 | 67 | 73% | 5.7 |
| Clinical Nurse Specialist | 3 | 0 | 3 | 702 | 70 | 76% | 7.4 |
| Physical Therapy Assistant | 0 | 3 | 3 | 618 | 63 | 68% | 7.3 |
| Nurse Practitioner | 1 | 0 | 1 | 456 | 57 | 62% | 8 |
| Dietitian | 1 | 0 | 1 | 407 | 60 | 65% | 6.8 |
| Respiratory Therapy Technician | 0 | 8 | 8 | 108 | 42 | 46% | 2.5 |
| Occupational Therapy Aide | 0 | 1 | 1 | 79 | 20 | 22% | 3.9 |
| Medical Director | 0 | 1 | 1 | 48 | 35 | 38% | 1.4 |
| Physical Therapy Aide | 0 | 7 | 7 | 45 | 11 | 12% | 3.7 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 27 | 4 | 4% | 6.8 |
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
No penalties in the past 3 years
No civil money penalties or payment denials were reported in the last 3 years.
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
15.2
71% worse than Alabama averageAlabama average: 8.9
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
27.3
88% worse than Alabama averageAlabama average: 14.5
CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Percent of long-stay residents whose need for help with daily activities has increased
37.0%
167% worse than Alabama averageAlabama average: 13.9%
Percent of low risk long-stay residents who lose control of their bowels or bladder
17.5%
28% worse than Alabama averageAlabama average: 13.6%
Percent of long-stay residents experiencing one or more falls with major injury
5.7%
69% worse than Alabama averageAlabama average: 3.4%
Percent of long-stay high risk residents with pressure ulcers
10.8%
82% worse than Alabama averageAlabama average: 5.9%
Percent of long-stay residents with a urinary tract infection
2.9%
7% worse than Alabama averageAlabama average: 2.7%
Percent of long-stay residents who lose too much weight
7.4%
37% worse than Alabama averageAlabama average: 5.4%
Percent of long-stay residents who have depressive symptoms
0.0%
100% better than Alabama averageAlabama average: 1.2%
Percent of long-stay residents who received an antipsychotic medication
33.9%
64% worse than Alabama averageAlabama average: 20.7%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
100.0%
9% better than Alabama averageAlabama average: 91.5%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
98.0%
In line with Alabama averageAlabama average: 94.8%
Number of hospitalizations per 1,000 long-stay resident days.
1.61
20% better than Alabama averageAlabama average: 2.00
Number of outpatient emergency department visits per 1,000 long-stay resident days.
0.71
60% better than Alabama averageAlabama average: 1.79
CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
100.0%
19% better than Alabama averageAlabama average: 83.7%
Percent of short-stay residents who newly received an antipsychotic medication
2.9%
37% worse than Alabama averageAlabama average: 2.1%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
98.4%
23% better than Alabama averageAlabama average: 80.3%
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
55.0%
124% worse than Alabama averageAlabama average: 24.5%
Percentage of short-stay residents who had an outpatient emergency department visit.
16.8%
46% worse than Alabama averageAlabama average: 11.5%
Percentage of SNF residents who experience falls with major injury during their stay.
2.6%
242% worse than Alabama averageAlabama average: 0.8%
Percentage of residents at or above expected ability to care for themselves at discharge.
38.9%
28% worse than Alabama averageAlabama average: 53.7%
Rate of successful return to home or community from a skilled nursing facility.
42.7%
16% worse than Alabama averageAlabama average: 50.6%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
47% of new residents, usually for short-term rehab.
53% of new residents, often for short stays.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
41Residents meet regularly to discuss policies, care quality, and activities
Part of a Continuing Care Retirement Community offering multiple care levels
Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.
Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
Historical financial and operational data for Kirkwood By the River from 2011–2023, based on CMS SNF Cost Reports.
Key figures below are for fiscal year ending in 12/2023.
Based on CMS SNF Cost Report for fiscal year ending in 12/2023.
Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
Money the home earns outside of resident care — such as investments, grants, rentals and other non-operating sources (CMS cost report, Worksheet G-3). It is tracked separately from net patient revenue: it is not part of that figure, and it is not included in net patient income.
Staff salaries plus wage-related costs — benefits such as payroll taxes, health insurance and retirement — from the home's own accounting records (CMS cost report, Worksheet A). Contract or agency labor is counted separately, under other operating costs.
Rank #30 / 125Payroll — State benchmarkedThis home is ranked 30th out of 125 homes in Alabama for payroll. Shows total annual staff payroll benchmarked to the Alabama average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Facilities with the same value for a metric share the same rank. Rankings are based only on facilities in Alabama that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Payroll as a share of revenue: staff salaries and wage-related benefits divided by net patient revenue. A higher figure means more of each revenue dollar goes to staff pay.
Rank #78 / 121Payroll % — State benchmarkedThis home is ranked 78th out of 121 homes in Alabama for payroll %. Shows payroll as a percentage of revenue versus the Alabama average. Well-run Alabama facilities typically land around 54–68% — the top third Statewide. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Facilities with the same value for a metric share the same rank. Rankings are based only on facilities in Alabama that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Everything it costs to run the home apart from payroll — food, utilities, supplies, maintenance, contract labor and administration. Calculated as total operating expense minus payroll (staff salaries and wage-related benefits).
The home's total operating expense for the year — all the costs of running it, salaries included (CMS cost report, Worksheet G-3).
No pets allowed
Housing Options: Studio / 1 Bed / 2 Bed
Building Type: 2-story
Transportation Services
Fitness and Recreation
This home supports both short-term rehab and long-term care, with residents staying for a wide range of durations.
Most new residents arrive under private pay (53% of admissions), and a typical private pay stay runs around 4 - 5 months.
Coverage residents most often arrive under.
Coverage residents most often leave under.
Chad Carter has served Kirkwood by the River since 2014, bringing nearly two decades of senior care industry experience. A licensed Nursing Home Administrator for 18 years, Chad is dedicated to leading with care, kindness, and respect, honoring the senior population through his leadership in nonprofit, multi-family life plan communities.
3605 Ratliff Rd, Birmingham, AL 35210
Add your location
Info below is compiled from CMS reports & the AL Dept. of Public Health (ADPH), senior community websites & trusted data sources such as Walk Score & BBB.
Communities are listed from highest to lowest based on our ranking methodology.
| Albertville Nursing Home | NH RC SNF | North Albertville | 159
Facility
159
AL AVG
90
Rank
#23 / 241 |
97.5%
Facility
97.5%
AL AVG
78.3
Rank
#5 / 108 | +24% | 5.06
Facility
5.06
AL AVG
4.37
Rank
#15 / 126 | -21% | +16% | $0
Facility
$0
AL AVG
$59.8k
Rank
#1 / 127 | 9
Facility
9
AL AVG
10.4
Rank
#53 / 126 | 3.0
Facility
3.0
AL AVG
3.5
Rank
#47 / 126 | - | 155 | - |
66
Facility
66
AL AVG
36
Rank
#33 / 417 | Terri Brown | $18.0MFiscal year ending 06/2024
Facility
$18.0MFiscal year ending 06/2024
AL AVG
$11.1M
Rank
#17 / 125 | $10.6MFiscal year ending 06/2024
Facility
$10.6MFiscal year ending 06/2024
AL AVG
$4.7M
Rank
#5 / 125 | 58.9%Fiscal year ending 06/2024
Facility
58.9%Fiscal year ending 06/2024
AL AVG
45%
Rank
#22 / 121 | 15163 | ||||
| Piedmont Health Care Center | NH AL MC SNF | Piedmont | 91
Facility
91
AL AVG
90
Rank
#99 / 241 |
92.3%
Facility
92.3%
AL AVG
78.3
Rank
#25 / 108 | +18% | 5.41
Facility
5.41
AL AVG
4.37
Rank
#6 / 126 | -49% | +24% | $0
Facility
$0
AL AVG
$59.8k
Rank
#1 / 127 | 3
Facility
3
AL AVG
10.4
Rank
#5 / 126 | 3.0
Facility
3.0
AL AVG
3.5
Rank
#47 / 126 | - | 84 | - |
61
Facility
61
AL AVG
36
Rank
#58 / 417 | Piedmont Health Care Center | $9.3MFiscal year ending 06/2024
Facility
$9.3MFiscal year ending 06/2024
AL AVG
$11.1M
Rank
#76 / 125 | $5.6MFiscal year ending 06/2024
Facility
$5.6MFiscal year ending 06/2024
AL AVG
$4.7M
Rank
#41 / 125 | 60.9%Fiscal year ending 06/2024
Facility
60.9%Fiscal year ending 06/2024
AL AVG
45%
Rank
#14 / 121 | 15194 | ||||
| Southern Springs Healthcare | NH SNF | Union Springs | 123
Facility
123
AL AVG
90
Rank
#58 / 241 |
86.2%
Facility
86.2%
AL AVG
78.3
Rank
#53 / 108 | +10% | 4.65
Facility
4.65
AL AVG
4.37
Rank
#39 / 126 | -46% | +6% | $0
Facility
$0
AL AVG
$59.8k
Rank
#1 / 127 | 7
Facility
7
AL AVG
10.4
Rank
#38 / 126 | 2.3
Facility
2.3
AL AVG
3.5
Rank
#26 / 126 | - | 106 | - |
61
Facility
61
AL AVG
36
Rank
#58 / 417 | Estate Of Milton E. Mcgregor | $10.2MFiscal year ending 06/2024
Facility
$10.2MFiscal year ending 06/2024
AL AVG
$11.1M
Rank
#107 / 125 | $7.1MFiscal year ending 06/2024
Facility
$7.1MFiscal year ending 06/2024
AL AVG
$4.7M
Rank
#34 / 125 | 69.9%Fiscal year ending 06/2024
Facility
69.9%Fiscal year ending 06/2024
AL AVG
45%
Rank
#1 / 121 | 15171 | ||||
| Arbor Woods Health and Rehab | NH SNF | Reform | 85
Facility
85
AL AVG
90
Rank
#112 / 241 |
59.5%
Facility
59.5%
AL AVG
78.3
Rank
#93 / 108 | -24% | 6.07
Facility
6.07
AL AVG
4.37
Rank
#3 / 126 | +17% | +39% | $0
Facility
$0
AL AVG
$59.8k
Rank
#1 / 127 | 2
Facility
2
AL AVG
10.4
Rank
#3 / 126 | 1.0
Facility
1.0
AL AVG
3.5
Rank
#1 / 126 | - | 51 | A+ |
36
Facility
36
AL AVG
36
Rank
#210 / 417 | Linda Dill | $5.1MFiscal year ending 06/2024
Facility
$5.1MFiscal year ending 06/2024
AL AVG
$11.1M
Rank
#121 / 125 | $3.5MFiscal year ending 06/2024
Facility
$3.5MFiscal year ending 06/2024
AL AVG
$4.7M
Rank
#110 / 125 | 68.5%Fiscal year ending 06/2024
Facility
68.5%Fiscal year ending 06/2024
AL AVG
45%
Rank
#4 / 121 | 15141 | ||||
| Kirkwood By the River | NH AL IL MC SNF | Birmingham (Overton) | 46
Facility
46
AL AVG
90
Rank
#191 / 241 | - | - | 5.10
Facility
5.10
AL AVG
4.37
Rank
#15 / 126 | -41% | +17% | $0
Facility
$0
AL AVG
$59.8k
Rank
#1 / 127 | 8
Facility
8
AL AVG
10.4
Rank
#46 / 126 | 2.7
Facility
2.7
AL AVG
3.5
Rank
#38 / 126 | - | 53 | A+ |
0
Facility
0
AL AVG
36
Rank
#394 / 417 | William Widman | $14.5MFiscal year ending 12/2023
Facility
$14.5MFiscal year ending 12/2023
AL AVG
$11.1M
Rank
#29 / 125 | $7.2MFiscal year ending 12/2023
Facility
$7.2MFiscal year ending 12/2023
AL AVG
$4.7M
Rank
#30 / 125 | 49.9%Fiscal year ending 12/2023
Facility
49.9%Fiscal year ending 12/2023
AL AVG
45%
Rank
#78 / 121 | 15457 |
Kirkwood By the River is in the Overton neighborhood of Birmingham.
Kirkwood By the River's occupancy is 100%.
Kirkwood By the River has been operating for approximately 46 years, based on available licensing and registration records.
No, Kirkwood By the River has a no-pet policy.
Kirkwood By the River is registered as a non-profit in AL.
Jeff Burchfield is the administrator of Kirkwood By the River.
Kirkwood By the River has 46 beds.
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