01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2024-08-21 | 8 | 2024-08-21 | 0 |
| Cycle 2 | 2023-04-26 | 1 | 2023-04-26 | 1 |
| Cycle 3 | 2021-11-04 | 7 | 2021-11-04 | 0 |
CMS CCN 4951712026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Goodwin House Bailey'S Crossroads
3440 S Jefferson Street · Falls Church, VA 22041 · Fairfax County
Certified beds73CMS provider file
Recent citation rows17current CMS citation release
Penalty rows0current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
17 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 3 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2024-08-21 · HEALTHF0554Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Allow residents to self-administer drugs if determined clinically appropriate.
Correction field: Deficient, Provider has date of correction · 2024-10-042024-08-21 · HEALTHF0655Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Correction field: Deficient, Provider has date of correction · 2024-10-042024-08-21 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2024-10-042024-08-21 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2024-10-042024-08-21 · HEALTHF0692Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Correction field: Deficient, Provider has date of correction · 2024-10-042024-08-21 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2024-10-042024-08-21 · HEALTHF0757Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Correction field: Deficient, Provider has date of correction · 2024-10-042024-08-21 · HEALTHF0812Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2024-10-042023-04-26 · HEALTHF0812Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2023-05-262023-04-26 · FIREK0222Severity D · isolated; potential for more than minimal harm
Egress Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2023-06-152021-11-04 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2021-12-172021-11-04 · HEALTHF0584Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Correction field: Deficient, Provider has date of correction · 2021-12-172021-11-04 · HEALTHF0623Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Correction field: Deficient, Provider has date of correction · 2021-12-172021-11-04 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2021-12-172021-11-04 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2021-12-172021-11-04 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2021-12-172021-11-04 · HEALTHF0700Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Correction field: Deficient, Provider has date of correction · 2021-12-1703 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- LIEBREICH, ROBERTIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST5% · since 07/01/2019
- BERNATEAU, SHERRETTAIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 09/19/2019
- CHOI, PHOEBEIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 12/21/2020
- SIEGEL, ANDREWIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 05/23/2017
- SMITH, TIMOTHYIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 08/30/2021
- CALLOWAY, DONALDIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2012
- CARWILE, JUSTINIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 11/01/2016
- CLARK, CYRILLENEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2013
- CLARKE, DAVIDIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2013
- FORBES, DEBORAHIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2012
- HANSEN, JANETIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2012
- HIX, MARYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2012
- HUDSON, MELINDAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2012
- RANDOLPH, NANCYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2013
- REGNELL, TOMIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2014
- SMITH, CHARLESIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2012
- WEST, THOMASIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2014
- BERNATEAU, SHERRETTAIndividual · CORPORATE OFFICERNOT APPLICABLE · since 09/19/2019
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours5.42per resident day
RN hours1.57per resident day
Weekend nurse hours5.11per resident day
Staff turnover19.3%CMS reported field
06 / LOCAL RECORDS
Open the Falls Church ledger →