Charles Town, WV

Shenandoah Center

1-star overall rating with 1-star inspections with abuse icon flag with $48,469 in total fines with 23 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle

50 Mulberry Tree Street, Charles Town, WV

(304) 724-1101

Compare this facility

Overall

1 / 5

CMS overall stars

Health inspections

1 / 5

Survey and complaint cycles

Staffing

2 / 5

RN + nurse staffing

Quality measures

4 / 5

Resident outcomes and process measures

Quick facts

Facility snapshot

Beds

Certified beds

Average residents

Average occupied residents

Ownership

For-Profit

Publicly displayed owner type

Chain

Genesis Healthcare

Operator or chain grouping

Approved since

1998-04-16

CMS approved date

Coverage

Medicare + Medicaid

Participation flags

Chain footprint

193 facilities

Chain averages 2 overall / 2 health / 3 staffing / 3 quality stars

Changed ownership

Within the last 12 months

Family council

Yes

Resident and family council reported

Sprinklers

Yes

Automatic sprinklers in all required areas

Staffing

Hours and turnover

RN hours / resident day

0.87

Registered nurse staffing · state 0.71 · national 0.68

LPN hours / resident day

0.40

Licensed practical nurse staffing · state 0.92 · national 0.87

Aide hours / resident day

1.75

Nurse aide staffing · state 2.07 · national 2.35

Total nurse hours

3.03

All reported nurse hours · state 3.69 · national 3.89

Licensed hours

1.27

RN + LPN hours · state 1.62 · national 1.54

Weekend hours

2.67

Weekend nurse staffing · state 3.18 · national 3.43

Weekend RN hours

0.51

Weekend registered nurse coverage · state 0.39 · national 0.47

Physical therapist

0.07

Reported PT staffing · state 0.05 · national 0.07

Adjusted RN hours

0.72

CMS adjusted RN staffing hours

Adjusted total hours

2.52

CMS adjusted total nurse staffing hours

Case-mix index

1.64

Higher values indicate more complex resident acuity

RN turnover

40%

Annual RN turnover · state 40% · national 45%

Total nurse turnover

46%

Annual nurse turnover · state 43% · national 46%

SNF VBP

Value-based purchasing

Program rank

11,642

Lower is better among SNFs in the FY 2026 VBP program.

Performance score

15.92

Composite VBP score used to determine payment impact.

Payment multiplier

0.9815

Above 1.000 increases Medicare payment; below 1.000 reduces it.

Program components

How the VBP score is built

Readmission

6.37

Baseline 21.73% · Performance 18.50% · Measure score 6.37 · Achievement 6.32 · Improvement 6.37

Healthcare-associated infections

Baseline 6.41% · Performance 8.37% · Measure score 0 · Achievement 0 · Improvement 0

Total nurse turnover

Baseline 61.63% · Performance 64.37% · Measure score 0 · Achievement 0 · Improvement 0

Adjusted total nurse staffing

Baseline 2.95 hours · Performance 2.74 hours · Measure score 0 · Achievement 0 · Improvement 0

SNF QRP

Medicare quality reporting measures

Measure	Facility	National	Note
Potentially preventable 30-day readmission	12.05%	10.72% 1.3 pts worse	No Different than the National Rate · Eligible stays 196 · Observed rate 13.78% · Lower 95% interval 8.67%
Discharge to community	61.32%	50.57% 10.8 pts better	Better than the National Rate · Eligible stays 164 · Observed rate 57.93% · Lower 95% interval 54.56%
Medicare spending per beneficiary	0.97	1.02 0.1 pts better
Drug regimen review with follow-up	93.4%	95.27% 1.9 pts worse	Numerator 99 · Denominator 106
Falls with major injury	0.94%	0.77% 0.2 pts worse	Numerator 1 · Denominator 106
Discharge self-care score	54.05%	53.69% 0.4 pts better	Numerator 40 · Denominator 74
Discharge mobility score	56.76%	50.94% 5.8 pts better	Numerator 42 · Denominator 74
Pressure ulcers or injuries, new or worsened	2.83%	2.29% 0.5 pts worse	Numerator 3 · Denominator 106 · Adjusted rate 3.16%
Healthcare-associated infections requiring hospitalization	8.37%	7.12% 1.2 pts worse	No Different than the National Rate · Eligible stays 107 · Observed rate 10.28% · Lower 95% interval 5.36%
Staff COVID-19 vaccination coverage	1.33%	8.2% 6.9 pts worse	Numerator 1 · Denominator 75
Staff flu vaccination coverage	60.22%	42% 18.2 pts better	Numerator 56 · Denominator 93
Discharge function score	59.46%	56.45% 3 pts better	Numerator 44 · Denominator 74
Transfer of health information to provider	97.4%	95.95% 1.5 pts better	Numerator 75 · Denominator 77
Transfer of health information to patient	Not Available	96.28%	Numerator Not Available · Denominator 5 · Too few residents or stays to report publicly.
Resident COVID-19 vaccinations up to date	8.93%	25.2% 16.3 pts worse	Numerator 5 · Denominator 56

Quality measures

Resident outcomes and process scores

Measure	Facility	State	National	Note
Number of hospitalizations per 1000 long-stay resident days	1.1	1.9 0.8 pts better	1.9 0.8 pts better	Long Stay · 20240701-20250630 · Adjusted 1.1 · Observed 1.1 · Expected 1.8 · Used in QM five-star
Number of outpatient emergency department visits per 1000 long-stay resident days	2.4	1.9 0.5 pts worse	1.8 0.6 pts worse	Long Stay · 20240701-20250630 · Adjusted 2.4 · Observed 2.3 · Expected 1.6 · Used in QM five-star
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine	100.0%	96.7% 3.3 pts better	93.4% 6.6 pts better	Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 100.0%
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine	100.0%	97.6% 2.4 pts better	95.5% 4.5 pts better	Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0%
Percentage of long-stay residents experiencing one or more falls with major injury	6.7%	4.5% 2.2 pts worse	3.3% 3.4 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 4.8% · Q2 3.6% · Q3 9.1% · Q4 9.6% · 4Q avg 6.7% · Used in QM five-star
Percentage of long-stay residents who have depressive symptoms	4.7%	6.8% 2.1 pts better	11.4% 6.7 pts better	Long Stay · 2024Q4-2025Q3 · Q1 6.8% · Q2 7.4% · Q3 3.8% · Q4 0.0% · 4Q avg 4.7%
Percentage of long-stay residents who lose too much weight	9.9%	6.6% 3.3 pts worse	5.4% 4.5 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 11.7% · Q2 12.2% · Q3 10.6% · Q4 4.3% · 4Q avg 9.9%
Percentage of long-stay residents who received an antianxiety or hypnotic medication	19.9%	27.0% 7.1 pts better	19.6% 0.3 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 18.0% · Q2 20.8% · Q3 17.3% · Q4 24.0% · 4Q avg 19.9%
Percentage of long-stay residents who received an antipsychotic medication	9.7%	15.5% 5.8 pts better	16.7% 7 pts better	Long Stay · 2024Q4-2025Q3 · Q1 9.8% · Q2 10.0% · Q3 11.9% · Q4 7.0% · 4Q avg 9.7% · Used in QM five-star
Percentage of long-stay residents who were physically restrained	0.0%	0.2% 0.2 pts better	0.1% 0.1 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0%
Percentage of long-stay residents whose ability to walk independently worsened	23.8%	19.5% 4.3 pts worse	16.3% 7.5 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 18.8% · Q2 27.9% · 4Q avg 23.8% · Used in QM five-star
Percentage of long-stay residents whose need for help with daily activities has increased	30.3%	17.6% 12.7 pts worse	14.9% 15.4 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 35.0% · Q2 30.8% · Q3 36.7% · Q4 17.0% · 4Q avg 30.3% · Used in QM five-star
Percentage of long-stay residents with a catheter inserted and left in their bladder	0.0%	0.5% 0.5 pts better	1.0% 1 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star
Percentage of long-stay residents with a urinary tract infection	1.8%	1.8% About the same	1.7% 0.1 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 3.2% · Q2 1.9% · Q3 0.0% · Q4 2.0% · 4Q avg 1.8% · Used in QM five-star
Percentage of long-stay residents with new or worsened bowel or bladder incontinence	23.4%	22.4% 1 pts worse	19.8% 3.6 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 24.3% · Q2 22.6% · Q3 16.4% · Q4 29.9% · 4Q avg 23.4%
Percentage of long-stay residents with pressure ulcers	5.0%	4.7% 0.3 pts worse	5.1% 0.1 pts better	Long Stay · 2024Q4-2025Q3 · Q1 4.1% · Q2 6.2% · Q3 3.9% · Q4 6.1% · 4Q avg 5.0% · Used in QM five-star
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine	96.7%	78.8% 17.9 pts better	81.7% 15 pts better	Short Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 94.8% · Q4 92.6% · 4Q avg 96.7%
Percentage of short-stay residents who had an outpatient emergency department visit	13.4%	12.4% 1 pts worse	12.0% 1.4 pts worse	Short Stay · 20240701-20250630 · Adjusted 13.4% · Observed 12.9% · Expected 10.7% · Used in QM five-star
Percentage of short-stay residents who newly received an antipsychotic medication	0.5%	1.1% 0.6 pts better	1.6% 1.1 pts better	Short Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 1.0% · Q3 1.0% · Q4 0.0% · 4Q avg 0.5% · Used in QM five-star
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine	89.9%	79.4% 10.5 pts better	79.7% 10.2 pts better	Short Stay · 2024Q3-2025Q2 · 4Q avg 89.9%
Percentage of short-stay residents who were rehospitalized after a nursing home admission	18.3%	23.0% 4.7 pts better	23.9% 5.6 pts better	Short Stay · 20240701-20250630 · Adjusted 18.3% · Observed 17.8% · Expected 23.2% · Used in QM five-star

Survey summary

Recent inspection cycles

Cycle 1 Health 2024-07-26 · Fire 2024-07-26

23 health deficiencies

Top issue: Quality of Life and Care (5 deficiencies)

5 fire-safety deficiencies

Top issue: Egress (1 deficiency)

Cycle 2 Health 2022-09-30 · Fire 2022-09-30

22 health deficiencies

Top issue: Nutrition and Dietary (5 deficiencies)

6 fire-safety deficiencies

Top issue: Smoke (3 deficiencies)

Cycle 3 Health 2019-11-20 · Fire 2019-11-20

16 health deficiencies

Top issue: Quality of Life and Care (4 deficiencies)

0 fire-safety deficiencies

No concentrated fire-safety issue counts in this cycle.

Fire safety

Fire-safety citations

F · Potential for more than minimal harm 2024-07-26

E39 · Emergency Preparedness Deficiencies

Fire Safety

Conduct testing and exercise requirements.

Corrected 2024-08-26

F · Potential for more than minimal harm 2024-07-26

K211 · Egress Deficiencies

Fire Safety

Keep aisles, corridors, and exits free of obstruction in case of emergency.

Corrected 2024-08-26

F · Potential for more than minimal harm 2024-07-26

K351 · Smoke Deficiencies

Fire Safety

Install an approved automatic sprinkler system.

Corrected 2024-08-26

D · Potential for more than minimal harm 2024-07-26

K923 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Have proper medical gas storage and administration areas.

Corrected 2024-08-26

C · Minimal harm 2024-07-26

K712 · Miscellaneous Deficiencies

Fire Safety

Have simulated fire drills held at unexpected times.

Corrected 2024-08-26

D · Potential for more than minimal harm 2022-09-30

K321 · Smoke Deficiencies

Fire Safety

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

Corrected 2022-11-14

D · Potential for more than minimal harm 2022-09-30

K761 · Miscellaneous Deficiencies

Fire Safety

To conduct inspection, testing and maintenance of fire doors by qualified individuals.

Corrected 2022-11-14

C · Minimal harm 2022-09-30

E4 · Emergency Preparedness Deficiencies

Fire Safety

Develop and maintain an Emergency Preparedness Program (EP).

Corrected 2022-11-14

C · Minimal harm 2022-09-30

K345 · Smoke Deficiencies

Fire Safety

Have approved installation, maintenance and testing program for fire alarm systems.

Corrected 2022-11-14

C · Minimal harm 2022-09-30

K353 · Smoke Deficiencies

Fire Safety

Inspect, test, and maintain automatic sprinkler systems.

Corrected 2022-11-14

C · Minimal harm 2022-09-30

K712 · Miscellaneous Deficiencies

Fire Safety

Have simulated fire drills held at unexpected times.

Corrected 2022-11-14

Inspection history

Recent health citations

D · Potential for more than minimal harm 2025-11-06

F657 · Resident Assessment and Care Planning Deficiencies

Health

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

Corrected 2025-12-11

K · Immediate jeopardy 2024-07-26

F698 · Quality of Life and Care Deficiencies

Health

Provide safe, appropriate dialysis care/services for a resident who requires such services.

Corrected 2024-09-05

J · Immediate jeopardy 2024-07-26

F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Corrected 2023-11-11

J · Immediate jeopardy 2024-07-26

F760 · Pharmacy Service Deficiencies

Health

Ensure that residents are free from significant medication errors.

Corrected 2024-09-05

G · Actual harm 2024-07-26

F677 · Quality of Life and Care Deficiencies

Health

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

Corrected 2024-09-05

F · Potential for more than minimal harm 2024-07-26

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2024-09-05

E · Potential for more than minimal harm 2024-07-26

F561 · Resident Rights Deficiencies

Health

Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.

Corrected 2024-09-05

E · Potential for more than minimal harm 2024-07-26

F583 · Resident Rights Deficiencies

Health

Keep residents' personal and medical records private and confidential.

Corrected 2024-09-05

E · Potential for more than minimal harm 2024-07-26

F584 · Resident Rights Deficiencies

Health

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

Corrected 2024-09-05

E · Potential for more than minimal harm 2024-07-26

F656 · Resident Assessment and Care Planning Deficiencies

Health

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Corrected 2024-09-05

E · Potential for more than minimal harm 2024-07-26

F689 · Quality of Life and Care Deficiencies

Health

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

Corrected 2024-09-05

E · Potential for more than minimal harm 2024-07-26

F730 · Nursing and Physician Services Deficiencies

Health

Observe each nurse aide's job performance and give regular training.

Corrected 2024-09-05

E · Potential for more than minimal harm 2024-07-26

F758 · Pharmacy Service Deficiencies

Health

Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.

Corrected 2024-09-05

E · Potential for more than minimal harm 2024-07-26

F761 · Pharmacy Service Deficiencies

Health

Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.

Corrected 2024-09-05

E · Potential for more than minimal harm 2024-07-26

F812 · Nutrition and Dietary Deficiencies

Health

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Corrected 2024-09-05

E · Potential for more than minimal harm 2024-07-26

F919 · Environmental Deficiencies

Health

Make sure that a working call system is available in each resident's bathroom and bathing area.

Corrected 2024-09-05

D · Potential for more than minimal harm 2024-07-26

F623 · Resident Rights Deficiencies

Health

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

Corrected 2024-09-05

D · Potential for more than minimal harm 2024-07-26

F641 · Resident Assessment and Care Planning Deficiencies

Health

Ensure each resident receives an accurate assessment.

Corrected 2024-09-05

D · Potential for more than minimal harm 2024-07-26

F657 · Resident Assessment and Care Planning Deficiencies

Health

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

Corrected 2024-09-05

D · Potential for more than minimal harm 2024-07-26

F679 · Quality of Life and Care Deficiencies

Health

Provide activities to meet all resident's needs.

Corrected 2024-09-05

D · Potential for more than minimal harm 2024-07-26

F688 · Quality of Life and Care Deficiencies

Health

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

Corrected 2024-09-05

D · Potential for more than minimal harm 2024-07-26

F725 · Nursing and Physician Services Deficiencies

Health

Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

Corrected 2024-09-05

D · Potential for more than minimal harm 2024-07-26

F842 · Resident Assessment and Care Planning Deficiencies

Health

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

Corrected 2024-09-05

D · Potential for more than minimal harm 2023-06-14

F684 · Quality of Life and Care Deficiencies

Health

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

Corrected 2023-07-22

D · Potential for more than minimal harm 2023-03-01

F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Corrected 2023-03-23

D · Potential for more than minimal harm 2023-03-01

F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Respond appropriately to all alleged violations.

Corrected 2023-03-23

F · Potential for more than minimal harm 2022-09-30

F725 · Nursing and Physician Services Deficiencies

Health

Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

Corrected 2022-11-01

F · Potential for more than minimal harm 2022-09-30

F727 · Nursing and Physician Services Deficiencies

Health

Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.

Corrected 2022-11-01

F · Potential for more than minimal harm 2022-09-30

F885 · Infection Control Deficiencies

Health

Report COVID19 data to residents and families.

Corrected 2022-11-01

E · Potential for more than minimal harm 2022-09-30

F684 · Quality of Life and Care Deficiencies

Health

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

Corrected 2022-11-01

E · Potential for more than minimal harm 2022-09-30

F689 · Quality of Life and Care Deficiencies

Health

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

Corrected 2022-11-01

E · Potential for more than minimal harm 2022-09-30

F698 · Quality of Life and Care Deficiencies

Health

Provide safe, appropriate dialysis care/services for a resident who requires such services.

Corrected 2022-11-01

E · Potential for more than minimal harm 2022-09-30

F732 · Nursing and Physician Services Deficiencies

Health

Post nurse staffing information every day.

Corrected 2022-11-01

E · Potential for more than minimal harm 2022-09-30

F755 · Pharmacy Service Deficiencies

Health

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

Corrected 2022-11-01

E · Potential for more than minimal harm 2022-09-30

F802 · Nutrition and Dietary Deficiencies

Health

Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.

Corrected 2022-11-01

E · Potential for more than minimal harm 2022-09-30

F803 · Nutrition and Dietary Deficiencies

Health

Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.

Corrected 2022-11-01

E · Potential for more than minimal harm 2022-09-30

F804 · Nutrition and Dietary Deficiencies

Health

Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

Corrected 2022-11-01

E · Potential for more than minimal harm 2022-09-30

F809 · Nutrition and Dietary Deficiencies

Health

Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.

Corrected 2022-11-01

E · Potential for more than minimal harm 2022-09-30

F812 · Nutrition and Dietary Deficiencies

Health

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Corrected 2022-11-01

E · Potential for more than minimal harm 2022-09-30

F838 · Administration Deficiencies

Health

Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.

Corrected 2022-11-01

E · Potential for more than minimal harm 2022-09-30

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2022-11-01

D · Potential for more than minimal harm 2022-09-30

F561 · Resident Rights Deficiencies

Health

Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.

Corrected 2022-11-01

D · Potential for more than minimal harm 2022-09-30

F607 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Develop and implement policies and procedures to prevent abuse, neglect, and theft.

Corrected 2022-11-01

D · Potential for more than minimal harm 2022-09-30

F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Corrected 2022-11-01

D · Potential for more than minimal harm 2022-09-30

F641 · Resident Assessment and Care Planning Deficiencies

Health

Ensure each resident receives an accurate assessment.

Corrected 2022-11-01

D · Potential for more than minimal harm 2022-09-30

F657 · Resident Assessment and Care Planning Deficiencies

Health

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

Corrected 2022-11-01

D · Potential for more than minimal harm 2022-09-30

F695 · Quality of Life and Care Deficiencies

Health

Provide safe and appropriate respiratory care for a resident when needed.

Corrected 2022-11-01

D · Potential for more than minimal harm 2022-09-30

F697 · Quality of Life and Care Deficiencies

Health

Provide safe, appropriate pain management for a resident who requires such services.

Corrected 2022-11-01

F · Potential for more than minimal harm 2019-11-20

F756 · Pharmacy Service Deficiencies

Health

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

Corrected 2020-01-02

F · Potential for more than minimal harm 2019-11-20

F867 · Administration Deficiencies

Health

Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.

Corrected 2020-01-02

F · Potential for more than minimal harm 2019-11-20

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2020-01-02

F · Potential for more than minimal harm 2019-11-20

F881 · Infection Control Deficiencies

Health

Implement a program that monitors antibiotic use.

Corrected 2020-01-02

E · Potential for more than minimal harm 2019-11-20

F755 · Pharmacy Service Deficiencies

Health

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

Corrected 2020-01-02

E · Potential for more than minimal harm 2019-11-20

F812 · Nutrition and Dietary Deficiencies

Health

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Corrected 2020-01-02

D · Potential for more than minimal harm 2019-11-20

F558 · Resident Rights Deficiencies

Health

Reasonably accommodate the needs and preferences of each resident.

Corrected 2020-01-02

D · Potential for more than minimal harm 2019-11-20

F655 · Resident Assessment and Care Planning Deficiencies

Health

Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted

Corrected 2020-01-02

D · Potential for more than minimal harm 2019-11-20

F656 · Resident Assessment and Care Planning Deficiencies

Health

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Corrected 2020-01-02

D · Potential for more than minimal harm 2019-11-20

F679 · Quality of Life and Care Deficiencies

Health

Provide activities to meet all resident's needs.

Corrected 2020-01-02

D · Potential for more than minimal harm 2019-11-20

F684 · Quality of Life and Care Deficiencies

Health

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

Corrected 2020-01-02

D · Potential for more than minimal harm 2019-11-20

F692 · Quality of Life and Care Deficiencies

Health

Provide enough food/fluids to maintain a resident's health.

Corrected 2020-01-02

D · Potential for more than minimal harm 2019-11-20

F842 · Resident Assessment and Care Planning Deficiencies

Health

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

Corrected 2020-01-02

Penalties and ownership

What sits behind the stars

$8,018 2024-07-26

Fine

Fine · fine $8,018

Fine

$10,023 2024-07-26

Fine

Fine · fine $10,023

Fine

$13,627 2024-07-26

Fine

Fine · fine $13,627

Fine

$16,801 2024-07-26

Fine

Fine · fine $16,801

Fine

Ownership

Genesis Wv Holdings LLC

5% Or Greater Direct Ownership Interest · Organization

100% 18 facilities 2011-04-01

Albaugh, Miranda

Operational/Managerial Control · Individual

0% 2 facilities 2020-05-01

Berg, Michael

Corporate Officer · Individual

0% 175 facilities 2012-12-01

Bridgeford, Laura

Corporate Officer · Individual

0% 150 facilities 2024-06-01

Burner, Eilish

Operational/Managerial Control · Individual

0% 1 facilities 2020-05-11

Fc-Gen Operations Investment LLC