Charlottesville Health & Rehab: Discharge Planning Failure - VA
The resident, identified in inspection records only as R6, was discharged without home health services in place. When inspectors arrived in September and began asking questions, the social worker on staff, identified as OS #5, said she could not recall the details of what happened. She was not sure which home health agency had been contacted, if any. She was not sure whether she had even been working the week R6 left.
That uncertainty had a consequence. R6 did not receive home health care at the time of discharge. The care eventually came, but not because the facility arranged it. An administrative staff member, identified as AS #3, made calls to home health agencies in the area on September 3, the day before inspectors completed their visit, and pieced together what had actually happened. R6 had started receiving home health services on March 27, weeks after discharge, after R6's own primary care physician saw the patient and made the referral.
The facility had not made that referral. The doctor had.
Inspectors presented the finding to the administrator, the director of nursing, and a nurse consultant at 5:30 p.m. on September 3. No additional information was provided before the exit conference the following day.
The facility's own discharge instruction policy stated that discharge planning would be initiated and coordinated by the social service department, which would assist patients and families in making arrangements for transportation, care equipment, and home health services. The policy assigned responsibility for completing those arrangements to the social service department and therapy staff.
That policy was not followed for R6.
The violation was cited at a level of minimal harm or potential for actual harm, affecting a few residents. It falls under F0627, which covers the adequacy of discharge planning, including whether a facility ensures that residents receive the services they need after leaving.
What the inspection record leaves open is how R6 managed during the gap. The report does not say how long R6 had been at the facility before discharge, what condition required ongoing home health care, or what the weeks without that care looked like. The record shows only that the care was eventually arranged, and that it took a physician's intervention, not the facility's, to make it happen.
The social worker's uncertainty, documented in the inspection record, raises a question the report does not answer: whether anyone at the facility noticed the gap at all before inspectors started asking.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Charlottesville Health & Rehabilitation Center from 2025-09-04 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: June 30, 2026 · Our methodology
CHARLOTTESVILLE HEALTH & REHABILITATION CENTER in CHARLOTTESVILLE, VA was cited for violations during a health inspection on September 4, 2025.
The resident, identified in inspection records only as R6, was discharged without home health services in place.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.