Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

SHALOM GARDENS HEALTH & REHABILITATION

RICHMOND, VA · 101 certified beds · Last Life Safety survey June 28, 2024

CMS Certification Number 495291 · first certified January 1995

Ownership

Operated by HILL VALLEY HEALTHCARE · For profit - Corporation

Ownership changed July 1, 2023 (change of ownership)from BETH SHOLOM HOME OF VIRGINIA

Citations on file

Rolling three-year window

Life Safety surveys

In the same window

Tags cited more than once

Across separate surveys

Inspection & testing records

Of the citations on file

Position within VA

36 citations — more than 99% of the 289 certified nursing homes in VA. Compared within VA rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated

Improvingfewer citations at the latest survey than at its earlier surveys in the window.

The latest survey found 6 citations; the earlier surveys in the window averaged 15. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

The window opens January 2027 — about 4 months from now. This facility’s last Life Safety survey was June 2024. Facilities in VA are typically surveyed 31–43 months after the last one (median 37), measured over 125 consecutive surveys in the last two years of CMS records.

A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured

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6 inspection-and-testing tags have been cited here at more than one survey. Nationally, that pattern is common: about three quarters of cited facilities have at least one repeated tag, and half of the facilities ever cited for sprinkler inspection and testing are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.

Emergency preparedness

5 of the 36 citations on file are Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index

Physical environment (health survey)

4 physical-environment citations on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 36 Life Safety citations above. The Physical Environment Index

F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
F-0880 Provide and implement an infection prevention and control program.

How that compares

Citations on file over three years

Compared with the median facility in VA, and nationally. Surveyors differ markedly between states, so the VA figure is the meaningful one.

Citations on file over three years, compared
Measure	Citations
This facility	36
Median facility in VA	10
Median facility nationally	11

Survey history

Citations at each Life Safety survey

Citations at each Life Safety survey
Survey date	Citations
March 14, 2019	21
July 22, 2021	9
June 28, 2024	6

Most-cited tags

Most-cited tags at this facility

Most-cited tags at this facility
Tag	What the surveyor checks	Times cited	Last cited
K-0353	Inspect, test, and maintain automatic sprinkler systems.	3	2024-06-28
K-0324	Provide properly protected cooking facilities.	2	2024-06-28
K-0521	Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.	2	2021-07-22
K-0511	Have properly installed electrical wiring and gas equipment.	2	2021-07-22
K-0363	Install corridor and hallway doors that block smoke.	2	2021-07-22
K-0222	Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.	2	2021-07-22
K-0345	Have approved installation, maintenance and testing program for fire alarm systems.	2	2024-06-28
K-0919	Meet requirements for the use of electrical equipment.	2	2024-06-28

What the citations cover

Citations by CMS category

Smoke Deficiencies 12
Egress Deficiencies 7
Gas, Vacuum, and Electrical Systems Deficiencies 6
Emergency Preparedness Deficiencies 5
Other 6

Citations by CMS category
Category	Citations
Smoke Deficiencies	12
Egress Deficiencies	7
Gas, Vacuum, and Electrical Systems Deficiencies	6
Emergency Preparedness Deficiencies	5
Services Deficiencies	4
Construction Deficiencies	1
Miscellaneous Deficiencies	1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

June 28, 2024 — 6 citations

Citations issued on June 28, 2024
Tag	What the surveyor checks	Status
K-0291	Install emergency lighting that can last at least 1 1/2 hours.	Deficient, Provider has date of correction (August 2, 2024)
K-0324	Provide properly protected cooking facilities.	Deficient, Provider has date of correction (August 2, 2024)
K-0345	Have approved installation, maintenance and testing program for fire alarm systems.	Deficient, Provider has date of correction (August 2, 2024)
K-0353	Inspect, test, and maintain automatic sprinkler systems.	Deficient, Provider has date of correction (August 2, 2024)
K-0914	Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.	Deficient, Provider has date of correction (August 2, 2024)
K-0919	Meet requirements for the use of electrical equipment.	Deficient, Provider has date of correction (August 2, 2024)

July 22, 2021 — 9 citations

Citations issued on July 22, 2021
Tag	What the surveyor checks	Status
K-0222	Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.	Deficient, Provider has date of correction (September 14, 2021)
K-0293	Have properly located and lighted "Exit" signs.	Deficient, Provider has date of correction (September 14, 2021)
K-0345	Have approved installation, maintenance and testing program for fire alarm systems.	Deficient, Provider has date of correction (September 14, 2021)
K-0353	Inspect, test, and maintain automatic sprinkler systems.	Deficient, Provider has date of correction (September 14, 2021)
K-0363	Install corridor and hallway doors that block smoke.	Deficient, Provider has date of correction (September 14, 2021)
K-0511	Have properly installed electrical wiring and gas equipment.	Deficient, Provider has date of correction (September 14, 2021)
K-0521	Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.	Deficient, Provider has date of correction (September 14, 2021)
K-0761	To conduct inspection, testing and maintenance of fire doors by qualified individuals.	Deficient, Provider has date of correction (September 14, 2021)
K-0920	Ensure proper usage of power strips and extension cords.	Deficient, Provider has date of correction (September 14, 2021)

March 14, 2019 — 21 citations

Citations issued on March 14, 2019
Tag	What the surveyor checks	Status
E-0004	Develop and maintain an Emergency Preparedness Program (EP).	Deficient, Provider has date of correction (April 28, 2019)
E-0013	Develop Emergency Preparedness policies and procedures.	Deficient, Provider has date of correction (April 28, 2019)
E-0032	Provide primary/alternate means for communication.	Deficient, Provider has date of correction (April 28, 2019)
E-0035	Provide family notifications of emergency plan.	Deficient, Provider has date of correction (April 28, 2019)
E-0036	Establish emergency prep training and testing.	Deficient, Provider has date of correction (April 28, 2019)
K-0161	Use approved construction type or materials.	Deficient, Provider has date of correction (May 1, 2019)
K-0211	Keep aisles, corridors, and exits free of obstruction in case of emergency.	Deficient, Provider has date of correction (May 1, 2019)
K-0222	Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.	Deficient, Provider has date of correction (May 1, 2019)
K-0225	Have stairways and smokeproof enclosures used as exits that meet safety requirements.	Deficient, Provider has date of correction (May 1, 2019)
K-0300	Meet other general requirements that are deficient.	Deficient, Provider has date of correction (May 1, 2019)
K-0321	Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.	Deficient, Provider has date of correction (May 1, 2019)
K-0324	Provide properly protected cooking facilities.	Deficient, Provider has date of correction (May 22, 2019)
K-0353	Inspect, test, and maintain automatic sprinkler systems.	Deficient, Provider has date of correction (May 1, 2019)
K-0363	Install corridor and hallway doors that block smoke.	Deficient, Provider has date of correction (May 1, 2019)
K-0372	Ensure smoke barriers are constructed to a 1 hour fire resistance rating.	Deficient, Provider has date of correction (May 1, 2019)
K-0374	Install smoke barrier doors that can resist smoke for at least 20 minutes.	Deficient, Provider has date of correction (May 1, 2019)
K-0511	Have properly installed electrical wiring and gas equipment.	Deficient, Provider has date of correction (May 22, 2019)
K-0521	Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.	Deficient, Provider has date of correction (May 22, 2019)
K-0914	Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.	Deficient, Provider has date of correction (May 1, 2019)
K-0918	Have generator or other power source capable of supplying service within 10 seconds.	Deficient, Provider has date of correction (May 1, 2019)
K-0919	Meet requirements for the use of electrical equipment.	Deficient, Provider has date of correction (May 1, 2019)

Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.