2960 Chelsea Road, West Point, VA 23181 · King William County · (757) 843-4323
60 certified beds, about 58 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 1995
CMS Care Compare ratings, data as of September 1, 2026 · CCN 495303 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on March 1, 2024, inspectors cited 8 health deficiencies (the Virginia average is 14.3, the national average 9.2).
Of 36 health citations since November 2018, 2 were rated as actual harm or immediate jeopardy to residents.
CMS lists no fines against this home in the last three years.
Nurses and nurse aides worked 3.15 hours per resident per day, against 3.76 across Virginia and 3.86 nationally. Registered nurses accounted for 0.47 of those hours.
42.0% of nursing staff left within the year CMS measured (Virginia average 48.1%).
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.
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 36 health citations on file.
Inspectors wroteBased on observation, staff interview, and facility document review, the facility staff failed to provide Registered Nurse coverage 8 consecutive hours per day for 16 days out of 180 days reviewed.
Inspectors wroteBased on staff interview, clinical record review, and facility documentation review, the facility staff failed to provide pneumococcal immunization for 5 residents, Residents #4, #7, #12, #30, and #36, out of 5 residents reviewed for pneumococcal immunization.
Inspectors wroteBased on interview, clinical record review, and facility documentation the facility staff failed to notify physician of pharmacy alerts for ordered medications for one Resident (#106) in a survey sample of 23 Residents.
Inspectors wroteBased on observation, interview, clinical record review, and facility documentation review, the facility staff failed to review and revise care plans for one Resident (#26), in a survey sample of 23 Residents.
Inspectors wroteBased on observation, interview, and clinical record review the facility staff failed to provide medication administration per professional standards of quality for one Resident (#106) in a survey sample of 23 Residents.
Inspectors wroteBased on interview, clinical record review and facility documentation the facility staff failed to provide necessary services to maintain good nutrition, grooming, and personal and oral hygiene, for one Resident (#26) in a survey sample of 23 Residents.
Inspectors wroteBased on interview, clinical record review, and facility documentation review, the facility staff failed to ensure residents were free from unnecessary psychotropic medication for one Resident (#10) in a survey sample of 23 Residents.
Inspectors wroteBased on interview, clinical record review and facility documentation, the facility staff failed to ensure residents were free from significant medication errors for one Resident (#106) in a survey sample of 23 Residents.
Inspectors wroteBased on staff interview, Ombudsman interview, family interview, facility documentation review, clinical record review, and in the course of a complaint investigation, the facility staff failed to ensure one resident (Resident #2) was free from significant medication errors in a survey sample of four (4) residents, resulting in harm. For Resident #2, the facility discontinued all of the resident's cardiac, antihypertensive, and blood thinning medications after 30 days resulting in hospitalization for a stroke. The medications were Diltiazem, Metoprolol, and Apixaban anticoagulation (blood thinner) medication for new onset atrial fibrillation.
Inspectors wroteBased on staff interview, Ombudsman interview, family interview, facility documentation review, clinical record review, and in the course of a complaint investigation, the facility staff failed to ensure a demented resident's responsible party and physician were notified of a change in treatment for one resident (Residents #2) in a survey sample of four (4) residents. For Resident #2, the facility discontinued all of the resident's cardiac, antihypertensive, and blood thinning medications after 30 days, and did not notify the physician, nor family of the discontinuance. These following medications were discontinued: Diltiazem, Metoprolol, and Apixaban anticoagulation (blood thinner) medication for new onset atrial fibrillation.
Inspectors wroteBased on clinical record review, staff interview, and facility documentation review, the facility staff failed to provide timely notification to the Responsible Party of a change in condition for 1 Resident, Resident #5, in a sample size of 6 Residents.
Inspectors wroteBased on staff interview, Ombudsman interview, family interview, facility documentation review, clinical record review, and in the course of a complaint investigation, the facility staff failed to develop and implement a baseline care plan for cardiac treatment for two residents (Residents #2 and #1) in a survey sample of four (4) Residents. 1. For Resident #2, the facility did not develop nor implement a cardiac care plan for the primary admitting diagnosis of new onset atrial fibrillation, heart attack, with cardiac doctor oversight, and new cardiac medication therapy. 2. For Resident #1, the facility staff did not provide a baseline care plan for moisture associated skin damage (MASD), care for inguinal dialysis shunt placement site, and sutures in the neck and knee after hospitalization.
Inspectors wroteBased on staff interview, Ombudsman interview, family interview, facility documentation review, clinical record review, and in the course of a complaint investigation, the facility staff failed to maintain the professional standards of nursing practice for two residents (Residents #2 and #1) in a survey sample of four (4) Residents. 1. For Resident #2, the facility staff discontinued all the resident's cardiac, antihypertensive, and blood thinning medications after 30 days for new onset atrial fibrillation. They also failed to notify the family and doctor of the discontinuance, did not obtain follow-up appointments with the resident's doctors as ordered by a physician, and did not develop nor implement a nursing care plan for cardiac treatment. 2. [...]
Inspectors wroteBased on staff interview, facility document review, clinical record review, and in the course of a complaint investigation, the facility staff failed to ensure incontinence and wound care was provided timely for 1 resident (Resident #1) of four (4) residents in the survey sample. For Resident #1, the facility staff did not provide incontinence care timely resulting in moisture associated skin damage (MASD), and further failed to care for inguinal dialysis shunt placement site, and sutures in the neck and knee after hospitalization.
Inspectors wroteBased on observation, resident interview, staff interview, clinical record review, and facility documentation review the facility staff failed to prevent, identify, and appropriately treat pressure wounds for 1 Resident (Resident #13) in a sample size of 22 Residents. This resulted in harm to Resident # 13.
Inspectors wroteBased on staff interview and facility documentation review, the facility staff failed to implement their abuse policy regarding the screening of employees for 4 employees (CNA F, CNA G, LPN C, and RN B) in a sample of 25 employee records reviewed. CNA F, CNA LPN C faild to sign their sworn statements timely, or completely. RN B did not have reference checks.
Inspectors wroteBased on observation, staff interview, and facility documentation review, the facility staff failed to store and prepare foods in accordance with professional standards in one out of one facility kitchens. Specifically, the facility staff failed to: 1) measure food temperatures for cold and steam table foods for lunch and dinner on 07/23/2021; and all 3 meals on 07/24/2021, 07/25/2021, and 07/26/2021 (11 out of 12 meals). 2) ensure the #4 walk-in refrigerator, #8 freezer, and #8 low-boy freezer were maintained at acceptable temperature ranges on 07/20/2021- 07/26/2021. 3) ensure dishwasher was reaching acceptable temperatures during the wash and rinse cycles in order to properly sanitize dishes on 07/10/2021, 07/13/2021, 07/21/2021, 07/22/2021, and 07/26/2021.
Inspectors wroteBased on Resident and Staff interview, clinical record review and facility documentation the facility staff failed to treat Residents with respect and dignity for 1 Resident (#28) in a survey sample of 22 Residents. For Resident # 28 the facility staff undressed the Resident wrapped her in a sheet, put her in the shower chair and wheeled her down the hall to wait in line for a shower causing Resident to state it feels like punishment.
Inspectors wroteBased on observation, interview, facility record review the faculty staff failed to provide Residents with a written description of legal rights which includes the names and addresses and phone numbers of State Office of Licensure and Certification, LTC agencies and Ombudsman.
Inspectors wroteBased on staff interview, clinical record review, and in the course of a complaint investigation, the facility staff failed to notify the responsible party of a change of condition for 1 Resident (Resident #13) in a sample size of 22 Residents.
Inspectors wroteBased on staff interview, facility documentation review and clinical record review, the facility staff failed to complete a SNF ABN (Skilled Nursing Facility Advance Beneficiary Notice) for 1 Resident (Resident #27) in a survey sample of 3 Residents reviewed for Beneficiary Notifications. For Resident #27, the facility staff failed to provide a SNF ABN notice prior to skilled care services ending. As a result of this deficient practice Resident #27 was not afforded the opportunity to continue skilled care services and have Medicare make a determination about coverage of such services, known as a demand bill.
Inspectors wroteBased on observations, staff interview, clinical record review, facility documentation review, and in the course of a complaint investigation, the facility staff failed to develop a comprehensive care plan for one Resident (Resident #13) in a sample size of 22 Residents. For Resident #13, the facility staff failed to include: 1) focus, goals, and interventions addressing his pressure wounds 2) focus, goals, and interventions addressing his limited range of motion.
Inspectors wroteBased on observation, interview, clinical record review and facility documentation the facility staff failed to provide adequate care for 1 dependent (#28) in a survey sample of 22 Residents.
Inspectors wroteBased on observations, staff interview, clinical record review, facility documentation review, and in the course of a complaint investigation, the facility staff failed to provide appropriate treatment and services for the prevention of further decrease in range of motion for one Resident (Resident #13) in a sample size of 22 Residents. For Resident #13, the facility staff failed to provide a left palm guard on 07/27/2021 and 07/28/2021 as ordered by the physician.
Inspectors wroteBased on observation, resident interview, staff interview, and clinical record review, the facility failed to provide oxygen therapy consistent with infection control measures and the plan of care for 2 Residents (Resident # 17 and # 19) in a survey sample of 22 Residents in the survey sample.
Inspectors wroteBased on observation, interview, and document review, the facility failed to post the nurse staffing timely and daily, resulting in the potential for inaccurate information to be presented to residents and visitors.
Inspectors wroteBased on staff interview and clinical record review, the facility staff failed for 1 resident (Resident # 540) in the survey sample of 22 residents, to ensure medications were available for administration. For Resident # 54, the facility staff failed to provide medications as ordered by the Physician.
Inspectors wroteBased on interview, clinical record review, and facility documentation the facility staff failed to ensure 1 Resident (Resident #6 ) in a survey sample of 22 Residents, was free of significant medication errors. For Resident #6, the facility staff failed to provide the Resident with 10 doses Sevelamer Carbonate between 6/10/21 and 7/22/21.
Inspectors wroteBased on observation, interview, clinical record review and facility documentation the facility staff failed to ensure the Residents had access to services outside the facility for 1 Resident (#19) in a survey sample of 22 Residents. For Resident #19 the facility staff failed to ensure he had transportation to the wound clinic and subsequently had to reschedule 7 appointments.
Inspectors wroteBased on observation, resident interview, group interview and staff interview and clinical record review, the facility staff failed to maintain a dignified existence for one resident (Resident # 33) in a survey sample of 27 residents. For Resident # 33, the facility staff failed to toilet her timely resulting in an incontinent episode.
Inspectors wroteBased on staff interview and facility documentation review, the facility staff failed to provide notice to Resident #38's responsible party of a change in Medicare or Medicaid coverage in a survey sample of 27 residents.
Inspectors wroteBased on staff interview and facility documentation review the facility failed to notify a receiving provider of the resident's comprehensive care plan goals for one of 27 sampled residents (Resident #20).
Inspectors wroteBased on observation, staff interview, facility documentation review and clinical record review the facility staff failed to provide an environment free from accident hazards for 2 residents (Resident #49 and #55) of 27 residents in the survey sample. 1. Resident #49 was not observed wearing a wander guard or gripper socks per physician order. 2. Resident #55's wheel chair breaks were not applied when transferred by the Certified Nursing Assistant (CNA) resulting in a fall.
Inspectors wroteBased on observation, resident interview, group interview and staff interview and clinical record review, the facility staff failed to provide continence services for one resident (Resident # 33) in a survey sample of 27 residents. For Resident # 33, the facility staff failed to toilet her timely resulting in an incontinent episode.
Inspectors wroteBased on observation, staff interview, and clinical record review the facility staff failed to ensure oxygen was available for 1 residents (Resident #55) of 27 residents in the survey sample. Resident #55 was observed seated in her wheelchair in the hallway wearing a nasal cannula for oxygen. The tubing was connected to a portable oxygen tank that was empty.
Inspectors wroteBased on observation, staff interview, and clinical record review the facility staff failed to ensure medication was available for administration for 1 residents (Resident #107) of 27 residents in the survey sample. For Resident #107, a Vitamin B-12 injection was unavailable during the medication pour and pass observation.
6 fire safety citations on file: 3 on March 1, 2024, 3 on November 1, 2018.
CMS lists no fines or payment denials against this home in the last three years. The national average is 0.9 fines per home.
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) | 3.15 | 3.76 | 3.86 |
| Registered nurses | 0.47 | 0.69 | 0.69 |
| All nursing staff on weekends | 2.83 | 3.29 | 3.42 |
| Nurse aides | 1.80 | ||
| Licensed practical nurses | 0.87 | ||
| Nursing staff turnover (share who left in a year) | 42.0% | 48.1% | 45.8% |
| Registered nurse turnover | 42.9% | 48.2% | 42.9% |
| Administrators who left | 1 |
CMS expects 4.15 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
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 3.28 on weekdays and 2.83 on weekends, 14% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 15.5% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.33 in April to June 2025 to 3.15 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 | 3.15 | 0.47 | 3.28 | 2.83 | 15.5% | 0 of 90 | 58 |
| Oct to Dec 2025 | 3.47 | 0.53 | 3.69 | 2.91 | 6.5% | 0 of 92 | 52 |
| Jul to Sep 2025 | 3.41 | 0.53 | 3.63 | 2.86 | 3.6% | 1 of 92 | 50 |
| Apr to Jun 2025 | 3.33 | 0.47 | 3.55 | 2.77 | 2.0% | 0 of 91 | 50 |
| 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.
Staff pay reports
No staff pay figure for this home has passed review yet. A figure appears only after at least 5 reports from at least 3 different people, sent over at least 60 days, have passed review. If you work here, your report helps start one.
| Job | Median | Middle half | Employed |
|---|---|---|---|
| Virginia, all employers | |||
| CNAs (nursing assistants) | $20.77 | $17.80 to $22.56 | 40,580 |
| LPNs and LVNs | $31.21 | $28.66 to $35.84 | 15,550 |
| Registered nurses | $45.00 | $38.51 to $49.53 | 77,490 |
| United States, nursing care facilities | |||
| CNAs (nursing assistants) | $20.67 | $17.91 to $22.55 | 534,270 |
| LPNs and LVNs | $33.86 | $30.05 to $37.40 | 188,210 |
| Registered nurses | $41.11 | $37.85 to $47.68 | 142,270 |
Hourly wages; the middle half runs from the 25th to the 75th percentile. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025. BLS has no separate estimate for medication aides. These are survey estimates for whole occupations, not figures for any one home.
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 | 6.3 | 14.8 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.5 | 0.4 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 0.6 | 1.6 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 5.2 | 3.6 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.0 | 1.3 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 11.7 | 15.6 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 0.8 | 4.7 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 14.6 | 14.2 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 20.3 | 22.3 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 15.8 | 11.5 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.4 | 1.5 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 0.7 | 1.5 | 1.8 |
For a stay to recover after a hospital visit, these are the results CMS publishes for Three Rivers Health & Rehab Center's Medicare short-stay residents. On returning residents home or to the community, CMS rates it no different from the national rate (60.4% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.
60.4% this home
No different from the national rate
US median of homes 51.5% · Virginia: 101 better, 22 worse
Rate of successful return to home or community from a SNF (risk-standardized discharge to community rate). Higher is better. October 2022 to September 2024. 77 eligible stays.
11.0% this home
No different from the national rate
US median of homes 10.7% · Virginia: 1 better, 9 worse
Rate of potentially preventable hospital readmissions 30 days after discharge from a SNF (risk-standardized rate). Lower is better. October 2022 to September 2024. 95 eligible stays.
5.7% this home
No different from the national rate
US median of homes 7.1% · Virginia: 2 better, 8 worse
Percentage of infections residents got during their SNF stay that resulted in hospitalization (risk-standardized rate). Lower is better. October 2023 to September 2024. 66 eligible stays.
70.4% this home
Median of homes: Virginia60.0% · US 56.6%
Percentage of residents who are at or above an expected ability to care for themselves and move around at discharge. Higher is better. October 2024 to September 2025. 54 residents counted.
0.0% this home
Median of homes: Virginia0.7% · US 0.0%
Percentage of SNF residents who experience one or more falls with major injury during their SNF stay. Lower is better. October 2024 to September 2025. 94 residents counted.
0.0% this home
Median of homes: Virginia2.1% · US 1.7%
Percentage of residents with pressure ulcers or pressure injuries that are new or worsened (adjusted rate). Lower is better. October 2024 to September 2025. 94 residents counted.
92.0% this home
Median of homes: Virginia97.8% · US 98.7%
Percentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge. Higher is better. October 2024 to September 2025. 50 residents counted.
Source: CMS Skilled Nursing Facility Quality Reporting Program - Provider Data, released 2026-09-30. Better, no different and worse are CMS's own comparisons with the national rate, after adjusting for how sick residents were. Medians of homes and the state counts are worked out by us from the same file.
Legal business name: THREE RIVERS SNF OPERATIONS LLC.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| VA 3 Opco Holdco LLC | 5% or greater direct ownership interest | Organization | 100% | 03/01/2023 |
| Bsd Eom Irrevocable Trust | 5% or greater indirect ownership interest | Organization | 25% | 03/01/2023 |
| Hlhk Irrevocable Trust | 5% or greater indirect ownership interest | Organization | 25% | 03/01/2023 |
| South East Virginia Hold Co LLC | 5% or greater indirect ownership interest | Organization | 25% | 03/01/2023 |
| Vogue NHC LLC | 5% or greater indirect ownership interest | Organization | 25% | 03/01/2023 |
| Montfordd, Nicola | W-2 managing employee | Individual | 03/01/2023 | |
| Hartstein, Jake | Corporate officer | Individual | 03/01/2023 |
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.
Chosen from this home's own inspection record.
These are the official offices in Virginia. NursingHomeClear cannot take or act on complaints.