Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record
SOUTH ROANOKE NURSING AND REHABILITATION
ROANOKE, VA · 98 certified beds · Last Life Safety survey April 24, 2025
CMS Certification Number 495002 · first certified January 1967
Ownership
Operated by HERITAGE HALL · For profit - Corporation
- Ownership changed June 1, 2019 (change of ownership)from SOUTH ROANOKE NURSING HOME, INC.
Position within VA
20 citations — more than 84% 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
The latest survey found 5 citations; the earlier surveys in the window averaged 7.5. With 3 surveys on file this is a direction of travel, not a conclusion.
When is the next survey likely?
The window opens November 2027 — about 14 months from now. This facility’s last Life Safety survey was April 2025. 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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Emergency preparedness
16 of the 20 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)
5 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 20 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-0922 Have enough backup water supply for essential areas of the nursing home.
- F-0880 Provide and implement an infection prevention and control program.
- F-0926 Have policies on smoking.
How that compares
Compared with the median facility in VA, and nationally. Surveyors differ markedly between states, so the VA figure is the meaningful one.
| Measure | Citations |
|---|---|
| This facility | 20 |
| Median facility in VA | 10 |
| Median facility nationally | 11 |
Survey history
| Survey date | Citations |
|---|---|
| July 9, 2019 | 13 |
| March 24, 2022 | 2 |
| April 24, 2025 | 5 |
Most-cited tags
| Tag | What the surveyor checks | Times cited | Last cited |
|---|---|---|---|
| E-0015 | Address subsistence needs for staff and patients. | 2 | 2025-04-24 |
| E-0007 | Address patient/client population and determine types of services needed. | 2 | 2025-04-24 |
| E-0018 | Establish procedures for tracking staff and patients during an emergency. | 1 | 2019-07-09 |
| E-0033 | Establish methods for sharing information. | 1 | 2019-07-09 |
| E-0022 | Establish policies and procedures for sheltering. | 1 | 2019-07-09 |
| K-0223 | Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector. | 1 | 2019-07-09 |
| K-0324 | Provide properly protected cooking facilities. | 1 | 2022-03-24 |
| K-0291 | Install emergency lighting that can last at least 1 1/2 hours. | 1 | 2022-03-24 |
What the citations cover
- Emergency Preparedness Deficiencies 16
- Egress Deficiencies 2
- Smoke Deficiencies 1
- Miscellaneous Deficiencies 1
| Category | Citations |
|---|---|
| Emergency Preparedness Deficiencies | 16 |
| Egress Deficiencies | 2 |
| Smoke Deficiencies | 1 |
| Miscellaneous Deficiencies | 1 |
Every citation on file
As published by CMS, newest survey first. Descriptions are CMS’s own wording.
April 24, 2025 — 5 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| E-0007 | Address patient/client population and determine types of services needed. | Deficient, Provider has date of correction (June 3, 2025) |
| E-0015 | Address subsistence needs for staff and patients. | Deficient, Provider has date of correction (June 3, 2025) |
| E-0031 | Provide emergency officials' contact information. | Deficient, Provider has date of correction (June 3, 2025) |
| E-0036 | Establish emergency prep training and testing. | Deficient, Provider has date of correction (June 3, 2025) |
| E-0039 | Conduct testing and exercise requirements. | Deficient, Provider has date of correction (June 3, 2025) |
March 24, 2022 — 2 citations
| 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 (March 31, 2022) |
| K-0324 | Provide properly protected cooking facilities. | Deficient, Provider has date of correction (March 31, 2022) |
July 9, 2019 — 13 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| E-0006 | Conduct risk assessment and an All-Hazards approach. | Deficient, Provider has date of correction (August 23, 2019) |
| E-0007 | Address patient/client population and determine types of services needed. | Deficient, Provider has date of correction (August 23, 2019) |
| E-0013 | Develop Emergency Preparedness policies and procedures. | Deficient, Provider has date of correction (August 23, 2019) |
| E-0015 | Address subsistence needs for staff and patients. | Deficient, Provider has date of correction (August 23, 2019) |
| E-0018 | Establish procedures for tracking staff and patients during an emergency. | Deficient, Provider has date of correction (August 23, 2019) |
| E-0022 | Establish policies and procedures for sheltering. | Deficient, Provider has date of correction (August 23, 2019) |
| E-0023 | Establish policies and procedures for medical documentation. | Deficient, Provider has date of correction (August 23, 2019) |
| E-0024 | Establish policies and procedures for volunteers. | Deficient, Provider has date of correction (August 23, 2019) |
| E-0026 | Establish roles under a Waiver declared by secretary. | Deficient, Provider has date of correction (August 23, 2019) |
| E-0033 | Establish methods for sharing information. | Deficient, Provider has date of correction (August 23, 2019) |
| E-0035 | Provide family notifications of emergency plan. | Deficient, Provider has date of correction (August 23, 2019) |
| K-0223 | Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector. | Deficient, Provider has date of correction (August 7, 2019) |
| K-0712 | Have simulated fire drills held at unexpected times. | Deficient, Provider has date of correction (August 7, 2019) |
Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.