What is Brandon Oaks Nursing and Rehabilitation Center's Medicare star rating?

CMS rates Brandon Oaks Nursing and Rehabilitation Center 5 out of 5 stars overall, with 4 for health inspections, 5 for staffing and 4 for quality measures (CMS data as of September 1, 2026).

Has Brandon Oaks Nursing and Rehabilitation Center been fined?

CMS lists no fines in the last three years.

Does Brandon Oaks Nursing and Rehabilitation Center accept Medicaid?

It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.

Who owns Brandon Oaks Nursing and Rehabilitation Center?

CMS lists 10 owners and managers. Legal business name: VIRGINIA LUTHERAN HOMES, INC..

Brandon Oaks Nursing and Rehabilitation Center: Inspections

The record in brief

At its most recent standard inspection, on September 8, 2023, inspectors cited 3 health deficiencies (the Virginia average is 14.3, the national average 9.2).

None of its 12 health citations since February 2020 was rated as actual harm or immediate jeopardy.

CMS lists no fines against this home in the last three years.

Nurses and nurse aides worked 5.40 hours per resident per day, against 3.76 across Virginia and 3.86 nationally. Registered nurses accounted for 0.87 of those hours.

34.6% of nursing staff left within the year CMS measured (Virginia average 48.1%).

Health inspections

Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.

Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.

602/20

308/21

309/23

Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit

Where its citations fall on CMS's grid

CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 12 health citations on file.

Severity

Isolated

Pattern

Widespread

Immediate jeopardy

Actual harm

Potential for more than minimal harm

Potential for minimal harm

September 8, 2023Standard inspection, Complaint inspection · 3 citations

F

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

F812 · Nutrition and Dietary · No actual harm, potential for more than minimal harm, widespread · Corrected (the home has a date of correction) November 8, 2023

Inspectors wroteBased on observation, staff interview, and facility document review, facility staff failed to ensure food was stored under safe and sanitary conditions in the main kitchen.
D

Ensure each resident receives an accurate assessment.

F641 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) November 8, 2023

Inspectors wroteBased on staff interview and clinical record review, the facility staff failed to accurately code a significant change MDS assessment to capture the residents hospice status for 1 of 15 current residents, Resident #31.
D

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

F755 · Pharmacy Service · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) November 8, 2023

Inspectors wroteBased on resident interview, staff interview, clinical record review, and facility document review, the facility staff failed to ensure the nursing staff correctly implemented the facility's scheduled/controlled medication monitoring system to accurately account for the facility's scheduled/controlled medications for 1 of 15 current residents. Resident #19.

August 24, 2021Standard inspection · 3 citations

F

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

F812 · Nutrition and Dietary · No actual harm, potential for more than minimal harm, widespread · Corrected (the home has a date of correction) September 24, 2021

Inspectors wroteBased on observation, staff interview and facility document review, facility staff failed to ensure food was stored under safe and sanitary conditions in 1 walk-in freezer and 1 drink/prep refrigerator.
D

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

F684 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) September 24, 2021

Inspectors wroteBased on staff interview, clinical record review, and during a medication pass and pour observation, the facility staff failed to ensure that residents receive treatment by following physician orders concerning medication administration for 1 of 29 residents in the survey sample, Resident #9.
D

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.

F761 · Pharmacy Service · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) September 24, 2021

Inspectors wroteBased on observation, staff interview, and facility document review, the facility staff failed to dispose stored expired injectable medications in 1 of 3 medication storage rooms, Appalachian Unit.

February 27, 2020Standard inspection · 6 citations

E

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

F812 · Nutrition and Dietary · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) April 10, 2020

Inspectors wroteBased on observation, staff interview, and facility document review, the facility staff failed to properly store food in resident accessible refrigerators in 2 of 2 Nourishment Stations in the facility located on Units 1 and 3.
D

Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.

F578 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) April 10, 2020

Inspectors wroteBased on clinical record review and staff interview, the facility staff failed to ensure the resident's right to formulate an advanced directive by failing to ensure the advanced directive in the resident's record was complete for 2 of 19 residents, Resident #206 and #212.
D

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

F580 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) April 10, 2020

Inspectors wroteBased on staff interview and clinical record review, the facility staff failed to notify the physician in regards to administrating routine scheduled medications as evidenced by administrating medications to 1 of 19 residents at another time other than the routine scheduled times (Resident #12).
D

Ensure each resident receives an accurate assessment.

F641 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) April 10, 2020

Inspectors wroteBased on staff interview and clinical record review, the facility staff failed to ensure an accurate MDS (minimum data set) for 1 of 19 residents, Resident #53.
D

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

F657 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) April 10, 2020

Inspectors wroteBased on staff interview and clinical record review, the facility staff failed to have an interdisciplinary team prepared plan that was resident centered specifying Transfer per Handling Program on the comprehensive care plan for 1 of 19 residents (Resident #13).
D

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

F684 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) April 10, 2020

Inspectors wroteBased on clinical record review and staff interview, the facility staff failed to ensure that residents receive treatment and care in accordance with the comprehensive person-centered care plan as evidenced by failure to administer medication per physician's order for 1 of 19 residents, Resident #217.

Fire safety inspections

21 fire safety citations on file: 2 on September 8, 2023, 11 on August 24, 2021, 8 on February 27, 2020.

Every fire safety citation21 citations

D
Install emergency lighting that can last at least 1 1/2 hours.

K 291 · September 8, 2023 · Corrected (the home has a date of correction)
D
Meet other general requirements.

K 932 · September 8, 2023 · Corrected (the home has a date of correction)
F
Have approved installation, maintenance and testing program for fire alarm systems.

K 345 · August 24, 2021 · Corrected (the home has a date of correction)
F
Inspect, test, and maintain automatic sprinkler systems.

K 353 · August 24, 2021 · Corrected (the home has a date of correction)
F
Have properly installed electrical wiring and gas equipment.

K 511 · August 24, 2021 · Corrected (the home has a date of correction)
F
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

K 521 · August 24, 2021 · Corrected (the home has a date of correction)
E
Have properly located and lighted "Exit" signs.

K 293 · August 24, 2021 · Corrected (the home has a date of correction)
E
Provide properly protected cooking facilities.

K 324 · August 24, 2021 · Corrected (the home has a date of correction)
E
Properly install and monitor supervisory attachments on automatic sprinkler systems.

K 352 · August 24, 2021 · Corrected (the home has a date of correction)
E
Install corridor and hallway doors that block smoke.

K 363 · August 24, 2021 · Corrected (the home has a date of correction)
E
To conduct inspection, testing and maintenance of fire doors by qualified individuals.

K 761 · August 24, 2021 · Corrected (the home has a date of correction)
D
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.

K 222 · August 24, 2021 · Corrected (the home has a date of correction)
D
Have properly installed hallway dispensers for alcohol-based hand rub.

K 325 · August 24, 2021 · Corrected (the home has a date of correction)
F
Install a two-hour-resistant firewall separation.

K 133 · February 27, 2020 · Corrected (the home has a date of correction)
F
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.

K 223 · February 27, 2020 · Corrected (the home has a date of correction)
F
Install emergency lighting that can last at least 1 1/2 hours.

K 291 · February 27, 2020 · Corrected (the home has a date of correction)
F
Have properly located and lighted "Exit" signs.

K 293 · February 27, 2020 · Corrected (the home has a date of correction)
F
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

K 321 · February 27, 2020 · Corrected (the home has a date of correction)
F
Have approved installation, maintenance and testing program for fire alarm systems.

K 345 · February 27, 2020 · Corrected (the home has a date of correction)
F
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

K 372 · February 27, 2020 · Corrected (the home has a date of correction)
F
Install smoke barrier doors that can resist smoke for at least 20 minutes.

K 374 · February 27, 2020 · Corrected (the home has a date of correction)

Fines and payment denials

CMS lists no fines or payment denials against this home in the last three years. The national average is 0.9 fines per home.

Staffing

Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.

Measure	This home	Virginia	United States
All nursing staff (RN, LPN and aides)	5.40	3.76	3.86
Registered nurses	0.87	0.69	0.69
All nursing staff on weekends	4.54	3.29	3.42
Nurse aides	2.82
Licensed practical nurses	1.71
Nursing staff turnover (share who left in a year)	34.6%	48.1%	45.8%
Registered nurse turnover	47.1%	48.2%	42.9%
Administrators who left	0

CMS expects 3.45 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.

Staffing by quarter, from daily payroll records

Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 5.75 on weekdays and 4.54 on weekends, 21% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 0.0% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 5.06 in April to June 2025 to 5.40 in January to March 2026.

Quarter	All nursing staff	Registered nurses	Weekdays	Weekends	Contract staff share	Days with no RN hours	Residents a day
Jan to Mar 2026	5.40	0.87	5.75	4.54	0.0%	0 of 90	59
Oct to Dec 2025	5.72	0.93	6.08	4.81	0.0%	0 of 92	55
Jul to Sep 2025	5.37	0.72	5.66	4.63	0.0%	0 of 92	55
Apr to Jun 2025	5.06	0.81	5.48	4.02	0.0%	0 of 91	57
United States, Jan to Mar 2026	3.75	0.62	3.92	3.33	5.3%	0.5% of days
Virginia, Jan to Mar 2026	3.58	0.56	3.76	3.12	5.7%	0.2% of days

Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.

Quality measures

The measures CMS uses for the quality star. Lower is better for every one of them.

Measure	This home	Virginia	US
Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1	19.0	14.8	13.9
Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1	0.0	0.4	0.8
Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1	8.6	1.6	1.6
Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1	3.5	3.6	3.2
Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1	0.5	1.3	1.6
Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1	19.6	15.6	14.1
Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1	3.3	4.7	4.6
Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1	19.4	14.2	15.4
Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231	26.3	22.3	23.8
Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231	8.2	11.5	12.0
Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231	1.3	1.5	1.9
Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231	0.8	1.5	1.8

Owners and operators

Legal business name: VIRGINIA LUTHERAN HOMES, INC..

Name	Role	Type	Since
Duran-Ballen, J Esteban	Corporate director	Individual	05/23/2024
Downs, Charles	Corporate officer	Individual	08/01/2022
Hicklin, Jennifer	Corporate officer	Individual	08/22/2022
Virginia Lutheran Homes, Inc.	Operational/managerial control	Organization	04/01/2014
Downs, Charles	Operational/managerial control	Individual	08/01/2022
Duran-Ballen, J Esteban	Operational/managerial control	Individual	05/23/2024
Sandy, Phillip	Operational/managerial control	Individual	06/02/2025
Virginia Lutheran Homes, Inc.	Adp of the SNF	Organization	04/01/2014
Duran-Ballen, J Esteban	Adp of the SNF	Individual	05/23/2024
Mitchell, William	Adp of the SNF	Individual	04/01/2025

As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.

Questions to ask on a visit

Chosen from this home's own inspection record.

Can we see a week of menus and the kitchen, and how are special diets handled?Inspectors cited 3 problems in this area, most recently on September 8, 2023: "Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards."
When is the care plan meeting, and can family attend it?Inspectors cited 3 problems in this area, most recently on September 8, 2023: "Ensure each resident receives an accurate assessment."
How are medications reviewed, and how often are antipsychotic or sedating drugs used?Inspectors cited 2 problems in this area, most recently on September 8, 2023: "Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist."
How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 2 problems in this area, most recently on August 24, 2021: "Provide appropriate treatment and care according to orders, resident’s preferences and goals."

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Virginia contacts for a concern about a nursing home

These are the official offices in Virginia. NursingHomeClear cannot take or act on complaints.

Inspections and complaints: Virginia Department of Health, Office of Licensure and Certification, Division of Long-Term Care Services, the state agency that inspects nursing homes for CMS and takes complaints about care.
Resident advocate: Virginia Office of the State Long-Term Care Ombudsman, 800-552-5019. The long-term care ombudsman is a free, confidential advocate for residents and families, set up under the federal Older Americans Act.
State inspection reports: VDH Nursing Home and ICF/IID Inspections and Surveys, where Virginia publishes its own records on licensed homes.

Common questions

What is Brandon Oaks Nursing and Rehabilitation Center's Medicare star rating?: CMS rates Brandon Oaks Nursing and Rehabilitation Center 5 out of 5 stars overall, with 4 for health inspections, 5 for staffing and 4 for quality measures (CMS data as of September 1, 2026).
How many deficiencies did Brandon Oaks Nursing and Rehabilitation Center get at its last inspection?: 3 health deficiencies at the standard inspection on September 8, 2023. The Virginia average is 14.3.
Has Brandon Oaks Nursing and Rehabilitation Center been fined?: CMS lists no fines in the last three years.
Does Brandon Oaks Nursing and Rehabilitation Center accept Medicaid?: It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
Who owns Brandon Oaks Nursing and Rehabilitation Center?: CMS lists 10 owners and managers. Legal business name: VIRGINIA LUTHERAN HOMES, INC..

Sources

Ratings, staffing and fines: CMS Provider Information, released September 30, 2026, data as of September 1, 2026.
Citations: CMS Health Deficiencies and Fire Safety Deficiencies.
Owners: CMS Ownership. Penalties: CMS Penalties.
Staffing by quarter: CMS Payroll Based Journal Daily Nurse Staffing, April 2025 to March 2026, summed by NursingHomeClear.
Inspector summaries: CMS Full Statement of Deficiencies (CMS-2567 text), data as of September 1, 2026. Each quote is the part of the statement before the detailed findings.
Inspection reports with the inspectors' full notes are on this home's Medicare.gov page.
Something wrong on this page? Ask for a correction. We fix errors in our copy of the data; findings themselves can only be changed by CMS and the state.
NursingHomeClear is independent and not affiliated with CMS, Medicare or any state agency. This page reports federal records; it does not rate, recommend or endorse any home, and it is not medical or legal advice.