Falls Run Nursing and Rehabilitation

Name: Falls Run Nursing and Rehabilitation
Address: 140 BRIMLEY DRIVE, Fredericksburg, VA, 22406, US
Telephone: 5407520111

140 Brimley Drive, Fredericksburg, VA 22406 · Stafford County · 90 certified beds · avg 87 residents/day · certified since Oct 21, 2010

Part of chain: SABER HEALTHCARE GROUP (126 facilities, chain avg rating 2.9★)

3/5

Health inspection rating (on-site)

Serious findings on record

Fines, last 3 years

3.40

Nurse hours/resident/day (adjusted)

What health inspectors found (on-site government inspections — the most independent evidence available)

Health inspection rating: ★★★☆☆3/5 · CMS overall rating: 4/5

⚠ The most recent standard health inspection was more than 2 years ago — conditions may have changed.

The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.

All citations in the current public record (28)

CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.

Date	Severity	What the facility was cited for
Mar 16, 2023	E · Potential for harm, repeated	The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines.
Mar 16, 2023	E · Potential for harm, repeated	The facility did not provide safe and appropriate pain management for a resident who needed it.
Mar 16, 2023	E · Potential for harm, repeated	The facility did not keep residents' medications free from unnecessary drugs. Residents should only take medicines they truly need, at the right dose, for a clear reason.
Mar 16, 2023	D · Potential for harm, one-off	The facility did not honor residents' right to voice complaints without discrimination or retaliation, or did not have a working complaint process that resolves issues promptly.
Mar 16, 2023	D · Potential for harm, one-off	The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Mar 16, 2023	D · Potential for harm, one-off	The facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections.
Mar 16, 2023	D · Potential for harm, one-off	The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it.
Mar 16, 2023	D · Potential for harm, one-off	The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock.
Mar 16, 2023	D · Potential for harm, one-off	The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards.
Aug 26, 2021	E · Potential for harm, repeated	The facility did not give residents (and their representatives and the ombudsman, a state advocate for residents) proper advance notice before a transfer or discharge, including information about their right to appeal.
Aug 26, 2021	E · Potential for harm, repeated	The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards.
Aug 26, 2021	D · Potential for harm, one-off	The facility did not make reasonable adjustments to fit each resident's individual needs and preferences — things like call buttons within reach, preferred wake-up times, or accessible room setups.
Aug 26, 2021	D · Potential for harm, one-off	The facility did not create and follow a basic care plan covering a new resident's most immediate needs within 48 hours of admission. The first days are when a new resident is most vulnerable.
Aug 26, 2021	D · Potential for harm, one-off	The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines.
Aug 26, 2021	D · Potential for harm, one-off	The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it.
Aug 26, 2021	D · Potential for harm, one-off	The facility did not observe each nurse aide's job performance or provide regular training as required.
Aug 26, 2021	D · Potential for harm, one-off	The facility did not keep residents' medications free from unnecessary drugs. Residents should only take medicines they truly need, at the right dose, for a clear reason.
Aug 26, 2021	D · Potential for harm, one-off	The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide.
Sep 6, 2019	E · Potential for harm, repeated	The facility did not honor residents' rights to request, refuse, or stop treatment, to decline participation in medical research, or to make an advance directive — a written statement of their wishes for future medical care.
Sep 6, 2019	E · Potential for harm, repeated	The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards.
Sep 6, 2019	D · Potential for harm, one-off	The facility did not keep residents' personal and medical information private and confidential.
Sep 6, 2019	D · Potential for harm, one-off	The facility transferred or discharged a resident without a valid reason, or failed to provide the required documentation and information when moving a resident out.
Sep 6, 2019	D · Potential for harm, one-off	The facility did not give residents (and their representatives and the ombudsman, a state advocate for residents) proper advance notice before a transfer or discharge, including information about their right to appeal.
Sep 6, 2019	D · Potential for harm, one-off	The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives.
Sep 6, 2019	D · Potential for harm, one-off	The facility did not create and follow a basic care plan covering a new resident's most immediate needs within 48 hours of admission. The first days are when a new resident is most vulnerable.
Sep 6, 2019	D · Potential for harm, one-off	The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines.
Sep 6, 2019	D · Potential for harm, one-off	The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it.
Sep 6, 2019	D · Potential for harm, one-off	The facility used bed rails without first trying safer alternatives, or without assessing the resident's safety risk, discussing the risks and benefits with the resident or family, getting consent, and installing the rails correctly.

Inspection trend by year

Citations from standard inspections stayed about the same across the last two inspection cycles (9 → 9).

Year	Citations	Worst severity that year
2019	10	E
2021	9	E
2023	9	E

Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.

Fines and enforcement (last 3 years)

No fines or payment denials in the published 3-year window.

Nurse staffing (from payroll records, adjusted for how much care residents need)

Measure	This facility	Virginia avg	U.S. avg	Where it stands
Total nurse staffing (hours per resident per day)	3.40	3.67	3.95	top 47% in Virginia; bottom 31% in the U.S.
Registered Nurse hours	0.73	0.66	0.69	top 20% in Virginia; top 33% in the U.S.
Weekend total nurse staffing	3.03	3.21	3.50	top 42% in Virginia; bottom 33% in the U.S.
Weekend RN hours (not acuity-adjusted)	0.65	0.46	0.48	top 13% in Virginia; top 19% in the U.S.
Total nursing staff turnover (%)	48.6	48.1	45.8	bottom 48% in Virginia; bottom 40% in the U.S.
RN turnover (%)	42.9	48.2	42.9	top 38% in Virginia; bottom 49% in the U.S.

Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 3.73, RN 0.80, weekend 3.33. Staffing rating: 3/5.

Self-reported quality measures

Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.

Quality measures rating: 5/5 · long-stay residents: 5/5 · short-stay residents: 5/5

Who owns this facility

For profit - Corporation

Owner / manager	Type	Role	Stake	Since
Ahmad, Imran	Individual	ADP of the SNF	NOT APPLICABLE	01/08/2026
Bundle Tenant LLC	Organization	ADP of the SNF	NOT APPLICABLE	02/05/2026
Citrin Cooperman Advisors LLC	Organization	ADP of the SNF	NOT APPLICABLE	09/22/2010
Kulp, Jeffrey	Individual	Operational/Managerial Control	NOT APPLICABLE	10/09/2017
Kulp, Jeffrey	Individual	ADP of the SNF	NOT APPLICABLE	10/09/2017
Ms Stafford, L.P.	Organization	ADP of the SNF	NOT APPLICABLE	08/01/2015
Nicoluzakis, Gregory	Individual	Corporate Officer	NOT APPLICABLE	03/01/2019
Nicoluzakis, Gregory	Individual	ADP of the SNF	NOT APPLICABLE	03/01/2019
Saber Governance LLC	Organization	ADP of the SNF	NOT APPLICABLE	09/01/2019
Saber Healthcare Group LLC	Organization	ADP of the SNF	NOT APPLICABLE	10/21/2010
SHG Management LLC	Organization	Operational/Managerial Control	NOT APPLICABLE	09/01/2019
SHG Management LLC	Organization	ADP of the SNF	NOT APPLICABLE	09/01/2019
TCF National Bank	Organization	ADP of the SNF	NOT APPLICABLE	07/19/2019
Volpe, Benjamin	Individual	Corporate Director	NOT APPLICABLE	03/01/2019
Volpe, Benjamin	Individual	Corporate Officer	NOT APPLICABLE	03/01/2019
Volpe, Benjamin	Individual	ADP of the SNF	NOT APPLICABLE	03/01/2019
Walker & Associates PC	Organization	ADP of the SNF	NOT APPLICABLE	09/22/2010
Weisberg, William	Individual	Corporate Director	NOT APPLICABLE	03/01/2019
Weisberg, William	Individual	Corporate Officer	NOT APPLICABLE	03/01/2019
Weisberg, William	Individual	Individual Is an Owner, Partner or Trustee of Any ADP of the SNF	NOT APPLICABLE	04/02/2026

Questions to ask on your visit

Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.

"Can you show me an example care plan, and how are families included when it's created and updated?"
"How do you assess and manage residents' pain, especially for those who have trouble communicating?"
"How often is each resident's medication list reviewed, and who decides when a drug can be reduced or stopped?"
"Walk me through what happens when a resident or family files a grievance — who responds and how fast?"
"What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
"How do you care for residents with incontinence or catheters, and what do you do to prevent urinary tract infections?"
"How many residents here use oxygen or breathing equipment, and who checks that equipment each shift?"
"Can you show me how medications are stored and secured on the units, including controlled drugs?"
"What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
"Can I see the results and plan of correction from your most recent state inspection?"

Nearby facilities (within 20 miles)

Facility	Distance	City	Overall	Inspection
Berea Health & Rehab Center	0.0 mi	Fredericksburg, VA	★★☆☆☆	2/5
Fredericksburg Health and Rehab	5.4 mi	Fredericksburg, VA	★★☆☆☆	2/5
Woodmont Center	5.5 mi	Fredericksburg, VA	★☆☆☆☆	1/5
Carriage Hill Health & Rehab Center	5.9 mi	Fredericksburg, VA	★★★☆☆	3/5
Heritage Hall King George	18.2 mi	King George, VA	★★☆☆☆	2/5

Compare this facility with the 3 closest →

All facilities in Fredericksburg →

Facility data as of CMS processing date 2026-08-01. CCN 495407.

The Care File

Visit checklist — Falls Run Nursing and Rehabilitation

140 Brimley Drive, Fredericksburg, VA 22406 · 5407520111

Health inspection rating 3/5 · CMS overall 4/5· Fines (3y): $0

Questions for the administrator:

☐ "Can you show me an example care plan, and how are families included when it's created and updated?"
☐ "How do you assess and manage residents' pain, especially for those who have trouble communicating?"
☐ "How often is each resident's medication list reviewed, and who decides when a drug can be reduced or stopped?"
☐ "Walk me through what happens when a resident or family files a grievance — who responds and how fast?"
☐ "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
☐ "How do you care for residents with incontinence or catheters, and what do you do to prevent urinary tract infections?"
☐ "How many residents here use oxygen or breathing equipment, and who checks that equipment each shift?"
☐ "Can you show me how medications are stored and secured on the units, including controlled drugs?"
☐ "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
☐ "Can I see the results and plan of correction from your most recent state inspection?"

While you're there, notice:

☐ Smell and cleanliness in hallways, not just the lobby
☐ How staff speak to residents; call lights answered promptly
☐ Residents up, dressed, and engaged (visit mealtimes and a weekend if you can)

Data: CMS Provider Data Catalog, version 2026-08-01 · CCN 495407 · Verify at medicare.gov/care-compare · Printed from The Care File (thecarefile.com)