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 is the premier skilled nursing facility in Roanoke, offering its residents a sense of belonging. With an emphasis on skilled nursing, rehabilitation, and long-term care nursing service, the staff excels in practicing a personal approach to the meaningful service they are guaranteed to deliver to the seniors. The upscale skilled nursing home built its trusted reputation on excellent customer service and exceptional care that has earned the respect of being a reliable senior living community that one’s individual needs.
The short and long-term care nursing home strives to improve the lifestyle of its elderly through community, connection, and care. They offer a personalized care program to meet each individual’s unique needs. Amenities and services include an exceptional dining experience, innovative programs, and educational activities that all aim to ensure a wonderful experience during your golden years and provide additional support.
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 47th out of 89 homes 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.
| 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.
|
26m per day | ▼ 37% State avg: 41m 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 10m per day | ▲ 16% State avg: 1h 0m 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.
|
1h 46m per day | ▼ 17% State avg: 2h 8m per day · National avg: 2h 21m 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.
|
2h 51m per day | ▼ 14% State avg: 3h 19m 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.
|
3m per day | ▼ 32% State avg: 5m 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.
|
16m per day | ▼ 45% State avg: 28m per day · National avg: 29m per day |
Key information about the people who lead and staff this community.
In Virginia, the Department of Social Services (for assisted living facilities) and the Department of Health (for nursing homes) perform the inspections required to maintain state and federal licensing.
This scorecard compares key inspection, deficiency, and complaint metrics at this facility against the Virginia state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.
Deficiencies
|
This Facility | VA Average | vs. VA Avg |
|---|---|---|---|
|
Total deficiencies
Formal regulatory issues recorded by inspectors across all inspection types.
|
108 | 32 | This facility has 238% more total deficiencies than a typical Virginia nursing home (108 vs. VA avg 32).↑ 238% worse |
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Deficiencies per year
Average deficiencies per year since 2021.
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21.6 | 6.4 | This facility has 238% more deficiencies per year than a typical Virginia nursing home (21.6 vs. VA avg 6.4).↑ 238% worse |
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Deficiencies per inspection
Average deficiencies per inspection.
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13.5 | 2.3 | This facility has 487% more deficiencies per inspection than a typical Virginia nursing home (13.5 vs. VA avg 2.3).↑ 487% worse |
Inspections
|
This Facility | VA Average | vs. VA Avg |
|---|---|---|---|
|
Total inspections
Combined count of all routine and focused inspections. Excludes complaint investigations.
|
8 | 14 | This facility has 43% fewer total inspections than a typical Virginia nursing home (8 vs. VA avg 14).↓ 43% better |
An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.
Virginia average 4.2
Last Health inspection on Jul 2024
Virginia average 38.4
Virginia average 8.93
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
79 of 131 citations resulted from standard inspections; 47 of 131 resulted from complaint investigations; and 5 of 131 came from combined inspections (standard and complaint).
100% better than Virginia average
Virginia average: 0.4
300% worse than Virginia average
Virginia average: 1
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
16% more staff per resident than Virginia average
8% better than Virginia average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
All 9 RN Staff are full-time employees. No contractors work on this role.
9
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.1 hours
Assists with medical care and medications.
51 total: 22 full-time employees and 29 contractors.
51
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.6 hours
Helps with daily care and mobility.
42 total: 39 full-time employees and 3 contractors.
42
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.2 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
1,302 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 39 | 3 | 42 | 13,583 | 92 | 100% | 9.2 |
| Licensed Practical Nurse | 22 | 29 | 51 | 6,070 | 92 | 100% | 9.6 |
| RN Director of Nursing | 10 | 0 | 10 | 2,819 | 90 | 98% | 7.7 |
| Registered Nurse | 9 | 0 | 9 | 2,137 | 91 | 99% | 8.1 |
| Clinical Nurse Specialist | 2 | 0 | 2 | 588 | 70 | 76% | 7.2 |
| Administrator | 1 | 0 | 1 | 559 | 66 | 72% | 8.5 |
| Nurse Practitioner | 1 | 0 | 1 | 559 | 66 | 72% | 8.5 |
| Qualified Social Worker | 2 | 0 | 2 | 485 | 66 | 72% | 7.3 |
| Dietitian | 1 | 0 | 1 | 438 | 60 | 65% | 7.3 |
| Other Dietary Services Staff | 1 | 0 | 1 | 433 | 57 | 62% | 7.6 |
| Respiratory Therapy Technician | 3 | 0 | 3 | 433 | 58 | 63% | 5.1 |
| Physical Therapy Aide | 1 | 0 | 1 | 384 | 58 | 63% | 6.6 |
| Speech Language Pathologist | 1 | 0 | 1 | 372 | 64 | 70% | 5.8 |
| Mental Health Service Worker | 1 | 0 | 1 | 238 | 34 | 37% | 7 |
| Physical Therapy Assistant | 2 | 0 | 2 | 15 | 9 | 10% | 1.6 |
Includes penalties issued in 2023-2024
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 Jan 2026)
193% higher than Virginia average
Virginia average: $52K
241% more fines than Virginia average
Virginia average: 1.8
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
1
1214% more payment denials than Virginia average
Virginia average: 0.1
Penalties are imposed by CMS for violations of federal nursing home regulations.
3 penalties in the past 3 years
Multiple penalties were reported in the last 3 years.
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Mar 29, 2024
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
Mar 29, 2024
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Aug 16, 2023
Last updated: Jan 2026
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.
11.2
10% worse than Virginia average
Virginia average: 10.1
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
21.2
7% worse than Virginia average
Virginia average: 19.7
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
17.5%
In line with Virginia average
Virginia average: 16.8%
Percent of long-stay residents whose ability to move independently worsened
21.2%
7% worse than Virginia average
Virginia average: 19.7%
Percent of low risk long-stay residents who lose control of their bowels or bladder
24.9%
10% worse than Virginia average
Virginia average: 22.6%
Percent of long-stay residents experiencing one or more falls with major injury
3.4%
7% better than Virginia average
Virginia average: 3.6%
Percent of long-stay high risk residents with pressure ulcers
7.8%
44% worse than Virginia average
Virginia average: 5.4%
Percent of long-stay residents with a urinary tract infection
1.5%
In line with Virginia average
Virginia average: 1.5%
Percent of long-stay residents who lose too much weight
6.1%
In line with Virginia average
Virginia average: 5.9%
Percent of long-stay residents who have depressive symptoms
14.4%
In line with Virginia average
Virginia average: 14.9%
Percent of long-stay residents who received an antipsychotic medication
16.2%
26% worse than Virginia average
Virginia average: 12.9%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
60.7%
34% worse than Virginia average
Virginia average: 91.3%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
20.0%
79% worse than Virginia average
Virginia average: 94.0%
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
18.2%
76% worse than Virginia average
Virginia average: 74.9%
Percent of short-stay residents who newly received an antipsychotic medication
2.4%
101% worse than Virginia average
Virginia average: 1.2%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
5.7%
92% worse than Virginia average
Virginia average: 73.6%
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
25.7%
17% worse than Virginia average
Virginia average: 22.0%
Percentage of short-stay residents who had an outpatient emergency department visit.
7.2%
38% better than Virginia average
Virginia average: 11.7%
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
100% better than Virginia average
Virginia average: 0.8%
Rate of successful return to home or community from a skilled nursing facility.
30.6%
40% worse than Virginia average
Virginia average: 50.6%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
14% of new residents, usually for short-term rehab.
22% of new residents, often for short stays.
64% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
66
Residents meet regularly to discuss policies, care quality, and activities
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 Old Southwest Rehabilitation and Nursing from 2012–2023, based on CMS SNF Cost Reports.
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 #79 / 89Payroll — State benchmarkedThis home is ranked 79th out of 89 homes in Virginia. Shows total annual staff payroll benchmarked to the Virginia average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Rankings are based only on facilities in Virginia 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 #23 / 89Payroll % — State benchmarkedThis home is ranked 23rd out of 89 homes in Virginia. Shows payroll as a percentage of revenue versus the Virginia average. Well-run Virginia facilities typically land around 51–60% — the top third Statewide. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Rankings are based only on facilities in Virginia 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).
Most residents stay for extended periods and receive ongoing daily care.
Most new residents arrive under Medicaid (64% of admissions), and a typical Medicaid stay runs around 3 - 4 months.
Coverage residents most often arrive under.
Coverage residents most often leave under.
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.
Add your location
The information below is reported by the Virginia Department of Social Services and Department of Health.
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| Brandon Oaks Nursing and Rehabilitation Center |
NH
AL
HC
IL
MC
NC
|
Roanoke (Westland) |
43
Facility
43
VA AVG
95
Rank
#319 / 371
|
53.5%
Facility
53.5%
VA AVG
85.7%
Rank
#255 / 314
| -38% |
5.33
Facility
5.33
VA AVG
3.74
Rank
#16 / 89
| +28% | +42% |
$0
Facility
$0
VA AVG
$54.3k
Rank
#1 / 93
|
12
Facility
12
VA AVG
38.4
Rank
#9 / 90
|
4.0
Facility
4.0
VA AVG
8.9
Rank
#11 / 90
| - | 23 | - |
33
Facility
33
VA AVG
44
Rank
#282 / 449
| Heather Neff |
$7.2M
Facility
$7.2M
VA AVG
$18.3M
Rank
#32 / 89
|
$7.0M
Facility
$7.0M
VA AVG
$6.9M
Rank
#60 / 89
|
96.3%
Facility
96.3%
VA AVG
39.7%
Rank
#86 / 89
| 495373 | ||||
| Our Lady of the Valley |
NH
AL
MC
NC
RC
|
Roanoke (Gainsboro) |
127
Facility
127
VA AVG
95
Rank
#78 / 371
|
87.4%
Facility
87.4%
VA AVG
85.7%
Rank
#65 / 314
| +2% |
3.79
Facility
3.79
VA AVG
3.74
Rank
#47 / 89
| -42% | +1% |
$0
Facility
$0
VA AVG
$54.3k
Rank
#1 / 93
|
14
Facility
14
VA AVG
38.4
Rank
#15 / 90
|
4.7
Facility
4.7
VA AVG
8.9
Rank
#19 / 90
| - | 111 | A+ |
68
Facility
68
VA AVG
44
Rank
#74 / 449
| David Rawlings |
$14.8M
Facility
$14.8M
VA AVG
$18.3M
Rank
#58 / 89
|
$8.2M
Facility
$8.2M
VA AVG
$6.9M
Rank
#53 / 89
|
55.5%
Facility
55.5%
VA AVG
39.7%
Rank
#37 / 89
| 495357 | ||||
| Friendship Retirement Community |
NH
AL
IL
MC
RC
|
Roanoke (Hollins) |
253
Facility
253
VA AVG
95
Rank
#5 / 371
|
93.1%
Facility
93.1%
VA AVG
85.7%
Rank
#27 / 314
| +9% |
4.46
Facility
4.46
VA AVG
3.74
Rank
#33 / 89
| +4% | +19% |
$0
Facility
$0
VA AVG
$54.3k
Rank
#1 / 93
|
18
Facility
18
VA AVG
38.4
Rank
#29 / 90
|
4.5
Facility
4.5
VA AVG
8.9
Rank
#18 / 90
| - | 231 | A+ |
48
Facility
48
VA AVG
44
Rank
#186 / 449
| Friendship Foundation Inc |
$29.8M
Facility
$29.8M
VA AVG
$18.3M
Rank
#20 / 89
|
$15.3M
Facility
$15.3M
VA AVG
$6.9M
Rank
#22 / 89
|
51.5%
Facility
51.5%
VA AVG
39.7%
Rank
#55 / 89
| 495092 | ||||
| Pheasant Ridge Nursing and Rehab Center |
NH
MC
|
Roanoke (Southern Hills) |
101
Facility
101
VA AVG
95
Rank
#140 / 371
| - | - |
3.56
Facility
3.56
VA AVG
3.74
Rank
#52 / 89
| +4% | -5% |
$0
Facility
$0
VA AVG
$54.3k
Rank
#1 / 93
|
25
Facility
25
VA AVG
38.4
Rank
#43 / 90
|
6.3
Facility
6.3
VA AVG
8.9
Rank
#33 / 90
| 1 | 19 | A+ |
15
Facility
15
VA AVG
44
Rank
#385 / 449
| Victor Bell |
$10.9M
Facility
$10.9M
VA AVG
$18.3M
Rank
#63 / 89
|
$5.1M
Facility
$5.1M
VA AVG
$6.9M
Rank
#87 / 89
|
47.1%
Facility
47.1%
VA AVG
39.7%
Rank
#71 / 89
| 495325 | ||||
| Old Southwest Rehabilitation and Nursing |
NH
HC
MC
PC
RC
|
Roanoke (Old Southwest) |
130
Facility
130
VA AVG
95
Rank
#69 / 371
|
25.4%
Facility
25.4%
VA AVG
85.7%
Rank
#307 / 314
| -70% |
3.82
Facility
3.82
VA AVG
3.74
Rank
#47 / 89
| -27% | +2% |
$143.8k
Facility
$143.8k
VA AVG
$54.3k
Rank
#93 / 93
|
131
Facility
131
VA AVG
38.4
Rank
#89 / 90
|
18.7
Facility
18.7
VA AVG
8.9
Rank
#88 / 90
| 4 | 33 | A+ |
57
Facility
57
VA AVG
44
Rank
#133 / 449
| Andrew Shuler |
$8.8M
Facility
$8.8M
VA AVG
$18.3M
Rank
#85 / 89
|
$4.2M
Facility
$4.2M
VA AVG
$6.9M
Rank
#79 / 89
|
47.8%
Facility
47.8%
VA AVG
39.7%
Rank
#23 / 89
| 495156 |
Old Southwest Rehabilitation and Nursing is located in Roanoke, Virginia.
Here are the financial assistance programs available to residents in Virginia.
Old Southwest Rehabilitation and Nursing is in the Old Southwest neighborhood of Roanoke.
Old Southwest Rehabilitation and Nursing has a walk score of 57. Moderately walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.
Old Southwest Rehabilitation and Nursing's occupancy is 51.3%.
Old Southwest Rehabilitation and Nursing is registered as a for-profit in VA.
Yes — there are 4 photos of Old Southwest Rehabilitation and Nursing in the photo gallery on this page.
Old Southwest Rehabilitation and Nursing is located at 324 King George Ave Sw, Roanoke, VA 24016.
(540) 345-8139 will put you in contact with the team at Old Southwest Rehabilitation and Nursing.
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