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Shenandoah Valley Westminster Canterbury Inspection Report, Violations & Safety Grade (WINCHESTER, Virginia)

300 WESTMINSTER CANTERBURY DR, WINCHESTER, Virginia 22603

Phone: 5406650156

CMS Overall:4/5

Overview & Bed Count

Certified Beds
51
Avg Residents/Day
43.3
Ownership
Non profit - Corporation
Provider Type
Medicare and Medicaid
County
Frederick
Sprinkler Systems
Yes
Special Focus
None
Abuse Icon
No

CMS Star Ratings

Overall4/5
Health3/5
Staffing5/5
Quality4/5

Nurse Staffing Check

MetricThis FacilityVirginia AvgDifference
RN Hours per Resident per Day0.660.71-0.04
Total Nurse Hours per Resident per Day5.833.88+1.95
CMS Staffing Rating5/52.5/5-
Nursing Staff Turnover25.4%47.5%-

Health Citation History

22 health citations on record

DateCategoryDescriptionSeverity
2026-05-01Nursing and Physician Services DeficienciesHave 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.F – Moderate Harm Potential
2026-05-01Infection Control DeficienciesEducate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.F – Moderate Harm Potential
2026-05-01Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.E – Moderate Harm Potential
2023-03-23Infection Control DeficienciesDesignate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.F – Moderate Harm Potential
2023-03-23Resident Assessment and Care Planning DeficienciesDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.E – Moderate Harm Potential
2023-03-23Quality of Life and Care DeficienciesProvide appropriate pressure ulcer care and prevent new ulcers from developing.E – Moderate Harm Potential
2023-03-23Quality of Life and Care DeficienciesProvide safe, appropriate pain management for a resident who requires such services.E – Moderate Harm Potential
2023-03-23Pharmacy Service DeficienciesEnsure each resident’s drug regimen must be free from unnecessary drugs.E – Moderate Harm Potential
2023-03-23Pharmacy Service DeficienciesImplement 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.E – Moderate Harm Potential
2023-03-23Resident Rights DeficienciesNotify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.D – Moderate Harm Potential
2023-03-23Resident Assessment and Care Planning DeficienciesCreate and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedD – Moderate Harm Potential
2023-03-23Resident Assessment and Care Planning DeficienciesDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.D – Moderate Harm Potential
2023-03-23Quality of Life and Care DeficienciesProvide appropriate treatment and care according to orders, resident’s preferences and goals.D – Moderate Harm Potential
2023-03-23Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.D – Moderate Harm Potential
2023-03-23Resident Assessment and Care Planning DeficienciesSafeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.D – Moderate Harm Potential
2021-09-23Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.E – Moderate Harm Potential
2021-09-23Resident Rights DeficienciesNot transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.D – Moderate Harm Potential
2021-09-23Resident Assessment and Care Planning DeficienciesDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.D – Moderate Harm Potential
2021-09-23Quality of Life and Care DeficienciesProvide appropriate treatment and care according to orders, resident’s preferences and goals.D – Moderate Harm Potential
2021-09-23Quality of Life and Care DeficienciesProvide safe and appropriate respiratory care for a resident when needed.D – Moderate Harm Potential
2021-09-23Pharmacy Service DeficienciesEnsure each resident’s drug regimen must be free from unnecessary drugs.D – Moderate Harm Potential
2021-09-23Environmental DeficienciesRegularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame.D – Moderate Harm Potential

Fire Safety Citation History

9 fire safety citations on record

DateCategoryDescriptionSeverity
2026-05-01Egress DeficienciesMeet other general requirements that are deficient.D – Moderate Harm Potential
2026-05-01Gas, Vacuum, and Electrical Systems DeficienciesHave a battery powered remote alarm panel in a location accessible by operating personnel.D – Moderate Harm Potential
2023-03-23Emergency Preparedness DeficienciesAddress patient/client population and determine types of services needed.F – Moderate Harm Potential
2023-03-23Smoke DeficienciesInstall corridor and hallway doors that block smoke.D – Moderate Harm Potential
2023-03-23Emergency Preparedness DeficienciesProvide family notifications of emergency plan.C – Minimal Harm Potential
2021-09-23Egress DeficienciesHave properly located and lighted "Exit" signs.D – Moderate Harm Potential
2021-09-23Smoke DeficienciesHave approved installation, maintenance and testing program for fire alarm systems.D – Moderate Harm Potential
2021-09-23Smoke DeficienciesInstall smoke barrier doors that can resist smoke for at least 20 minutes.D – Moderate Harm Potential
2021-09-23Gas, Vacuum, and Electrical Systems DeficienciesMeet requirements for the use of electrical equipment.D – Moderate Harm Potential

Total Penalties & Fines

$0
Total Fine Amount (CMS)
0
Number of Fines
0
Total Penalties

No penalty records found.

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