Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

Mountains Community Hosp DP/SNF

Lake Arrowhead, CA · 19 certified beds · Last Life Safety survey June 5, 2025

CMS Certification Number 555467 · first certified June 1991

Ownership

Independently operated (no chain recorded by CMS) · Government - Hospital district

No change of ownership on CMS record since January 1, 2016, when the records begin.

28
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
6
Tags cited more than once
Across separate surveys
12
Inspection & testing records
Of the citations on file

Position within CA

28 citations — more than 79% of the 1,165 certified nursing homes in CA. Compared within CA rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated

Improvingfewer citations at the latest survey than at its earlier surveys in the window.

The latest survey found 5 citations; the earlier surveys in the window averaged 11.5. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

The window is open now: June 2026 to November 2026. This facility’s last Life Safety survey was June 2025. Facilities in CA are typically surveyed 12–18 months after the last one (median 14), measured over 1,766 consecutive surveys in the last two years of CMS records.

A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured

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Which alerts

4 inspection-and-testing tags have been cited here at more than one survey. Nationally, that pattern is common: about three quarters of cited facilities have at least one repeated tag, and half of the facilities ever cited for sprinkler inspection and testing are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.

Emergency preparedness

7 of the 28 citations on file are Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index

Physical environment (health survey)

2 physical-environment citations on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 28 Life Safety citations above. The Physical Environment Index

  • F-0880 Provide and implement an infection prevention and control program.

How that compares

Citations on file over three years

Compared with the median facility in CA, and nationally. Surveyors differ markedly between states, so the CA figure is the meaningful one.

This facility28CA median19National median11
Citations on file over three years, compared
MeasureCitations
This facility28
Median facility in CA19
Median facility nationally11

Survey history

Citations at each Life Safety survey
122023-04112024-0352025-06
Citations at each Life Safety survey
Survey dateCitations
April 20, 202312
March 29, 202411
June 5, 20255

Most-cited tags

Most-cited tags at this facility
K-03533K-03512K-03552K-09182K-01612K-03242E-00351K-03451
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0353Inspect, test, and maintain automatic sprinkler systems.32025-06-05
K-0351Install an approved automatic sprinkler system.22024-03-29
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.22025-06-05
K-0918Have generator or other power source capable of supplying service within 10 seconds.22024-03-29
K-0161Use approved construction type or materials.22025-06-05
K-0324Provide properly protected cooking facilities.22024-03-29
E-0035Provide family notifications of emergency plan.12024-03-29
K-0345Have approved installation, maintenance and testing program for fire alarm systems.12024-03-29

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 13
  • Emergency Preparedness Deficiencies 7
  • Gas, Vacuum, and Electrical Systems Deficiencies 5
  • Construction Deficiencies 2
  • Other 1
Citations by CMS category
CategoryCitations
Smoke Deficiencies13
Emergency Preparedness Deficiencies7
Gas, Vacuum, and Electrical Systems Deficiencies5
Construction Deficiencies2
Miscellaneous Deficiencies1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

June 5, 2025 — 5 citations

Citations issued on June 5, 2025
TagWhat the surveyor checksStatus
K-0161Use approved construction type or materials.Deficient, Provider has date of correction (June 18, 2025)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (June 18, 2025)
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.Deficient, Provider has date of correction (July 2, 2025)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (June 19, 2025)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (June 19, 2025)

March 29, 2024 — 11 citations

Citations issued on March 29, 2024
TagWhat the surveyor checksStatus
E-0022Establish policies and procedures for sheltering.Deficient, Provider has date of correction (April 29, 2024)
E-0030List the names and contact information of those in the facility.Deficient, Provider has date of correction (April 29, 2024)
E-0035Provide family notifications of emergency plan.Deficient, Provider has date of correction (April 29, 2024)
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (April 29, 2024)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (April 29, 2024)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (April 29, 2024)
K-0351Install an approved automatic sprinkler system.Deficient, Provider has date of correction (April 29, 2024)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (April 29, 2024)
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.Deficient, Provider has date of correction (April 29, 2024)
K-0914Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.Deficient, Provider has date of correction (April 29, 2024)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (April 29, 2024)

April 20, 2023 — 12 citations

Citations issued on April 20, 2023
TagWhat the surveyor checksStatus
E-0004Develop and maintain an Emergency Preparedness Program (EP).Deficient, Provider has date of correction (May 23, 2023)
E-0007Address patient/client population and determine types of services needed.Deficient, Provider has date of correction (May 23, 2023)
E-0026Establish roles under a Waiver declared by secretary.Deficient, Provider has date of correction (May 23, 2023)
E-0031Provide emergency officials' contact information.Deficient, Provider has date of correction (May 23, 2023)
K-0161Use approved construction type or materials.Deficient, Provider has date of correction (May 23, 2023)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (May 23, 2023)
K-0325Have properly installed hallway dispensers for alcohol-based hand rub.Deficient, Provider has date of correction (May 23, 2023)
K-0351Install an approved automatic sprinkler system.Deficient, Provider has date of correction (May 23, 2023)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (May 23, 2023)
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.Deficient, Provider has date of correction (May 23, 2023)
K-0905Ensure that gas containers are correctly designed and tested, and in locations that are labeled.Deficient, Provider has date of correction (May 23, 2023)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (May 23, 2023)

Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.