Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record
ALTERNATIVE HEALTHCARE SOLUTIONS LLC
SAN JUAN, PR · 22 certified beds · Last Life Safety survey May 21, 2026
CMS Certification Number 405000 · first certified April 2022
Ownership
Independently operated (no chain recorded by CMS) · For profit - Limited Liability company
No change of ownership on CMS record since January 1, 2016, when the records begin.
Position within PR
29 citations — more than 63% of the 9 certified nursing homes in PR. Compared within PR 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
The latest survey found 14 citations; the earlier surveys in the window averaged 7.5. With 3 surveys on file this is a direction of travel, not a conclusion.
When is the next survey likely?
The window opens June 2027 — about 8 months from now. This facility’s last Life Safety survey was May 2026. Nursing homes nationally are typically surveyed 12–17 months after the last one (median 14), measured over 19,385 consecutive surveys in the last two years of CMS records. PR has too few recent surveys to measure on its own, so the national interval is used.
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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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
6 of the 29 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)
7 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 29 Life Safety citations above. The Physical Environment Index
- F-0880 Provide and implement an infection prevention and control program.
- F-0908 Keep all essential equipment working safely.
- F-0584 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.
- F-0921 Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
How that compares
Compared with the median facility in PR, and nationally. Surveyors differ markedly between states, so the PR figure is the meaningful one.
| Measure | Citations |
|---|---|
| This facility | 29 |
| Median facility in PR | 25 |
| Median facility nationally | 11 |
Survey history
| Survey date | Citations |
|---|---|
| April 18, 2024 | 10 |
| December 3, 2024 | 5 |
| May 21, 2026 | 14 |
Most-cited tags
| Tag | What the surveyor checks | Times cited | Last cited |
|---|---|---|---|
| K-0355 | Properly select, install, inspect, or maintain portable fire extinguishes. | 2 | 2026-05-21 |
| K-0345 | Have approved installation, maintenance and testing program for fire alarm systems. | 2 | 2026-05-21 |
| K-0351 | Install an approved automatic sprinkler system. | 2 | 2026-05-21 |
| K-0918 | Have generator or other power source capable of supplying service within 10 seconds. | 2 | 2026-05-21 |
| K-0324 | Provide properly protected cooking facilities. | 2 | 2026-05-21 |
| K-0293 | Have properly located and lighted "Exit" signs. | 1 | 2024-04-18 |
| K-0281 | Install proper backup exit lighting. | 1 | 2026-05-21 |
| K-0921 | Ensure that testing and maintenance of electrical equipment is performed. | 1 | 2026-05-21 |
What the citations cover
- Smoke Deficiencies 12
- Emergency Preparedness Deficiencies 6
- Egress Deficiencies 5
- Gas, Vacuum, and Electrical Systems Deficiencies 4
- Other 2
| Category | Citations |
|---|---|
| Smoke Deficiencies | 12 |
| Emergency Preparedness Deficiencies | 6 |
| Egress Deficiencies | 5 |
| Gas, Vacuum, and Electrical Systems Deficiencies | 4 |
| Miscellaneous Deficiencies | 2 |
Every citation on file
As published by CMS, newest survey first. Descriptions are CMS’s own wording.
May 21, 2026 — 14 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| K-0211 | Keep aisles, corridors, and exits free of obstruction in case of emergency. | Deficient, Provider has date of correction (July 1, 2026) |
| K-0222 | 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. | Deficient, Provider has date of correction (July 1, 2026) |
| K-0281 | Install proper backup exit lighting. | Deficient, Provider has date of correction (July 1, 2026) |
| K-0291 | Install emergency lighting that can last at least 1 1/2 hours. | Deficient, Provider has date of correction (July 1, 2026) |
| K-0324 | Provide properly protected cooking facilities. | Past Non-Compliance (May 2, 2025) |
| K-0341 | Install a fire alarm system that can be heard throughout the facility. | Deficient, Provider has date of correction (July 1, 2026) |
| K-0345 | Have approved installation, maintenance and testing program for fire alarm systems. | Deficient, Provider has date of correction (July 1, 2026) |
| K-0351 | Install an approved automatic sprinkler system. | Deficient, Provider has date of correction (July 1, 2026) |
| K-0352 | Properly install and monitor supervisory attachments on automatic sprinkler systems. | Deficient, Provider has date of correction (July 1, 2026) |
| K-0353 | Inspect, test, and maintain automatic sprinkler systems. | Deficient, Provider has date of correction (July 1, 2026) |
| K-0355 | Properly select, install, inspect, or maintain portable fire extinguishes. | Deficient, Provider has date of correction (July 1, 2026) |
| K-0761 | To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Deficient, Provider has date of correction (July 1, 2026) |
| K-0918 | Have generator or other power source capable of supplying service within 10 seconds. | Deficient, Provider has date of correction (July 1, 2026) |
| K-0921 | Ensure that testing and maintenance of electrical equipment is performed. | Deficient, Provider has date of correction (July 1, 2026) |
December 3, 2024 — 5 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| K-0324 | Provide properly protected cooking facilities. | Deficient, Provider has date of correction (May 2, 2025) |
| K-0345 | Have approved installation, maintenance and testing program for fire alarm systems. | Deficient, Provider has date of correction (May 2, 2025) |
| K-0351 | Install an approved automatic sprinkler system. | Deficient, Provider has plan of correction (March 12, 2026) |
| K-0355 | Properly select, install, inspect, or maintain portable fire extinguishes. | Deficient, Provider has date of correction (May 2, 2025) |
| K-0907 | Ensure medical gas and vacuum systems have documented maintenance programs. | Deficient, Provider has date of correction (May 2, 2025) |
April 18, 2024 — 10 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| E-0009 | Include a process for Emergency Preparedness collaboration. | Deficient, Provider has date of correction (May 16, 2024) |
| E-0022 | Establish policies and procedures for sheltering. | Deficient, Provider has date of correction (May 14, 2024) |
| E-0024 | Establish policies and procedures for volunteers. | Deficient, Provider has date of correction (May 16, 2024) |
| E-0034 | Provide a means of sharing information on occupancy/needs. | Deficient, Provider has date of correction (May 31, 2024) |
| E-0035 | Provide family notifications of emergency plan. | Deficient, Provider has date of correction (May 14, 2024) |
| E-0037 | Establish staff and initial training requirements. | Deficient, Provider has date of correction (May 15, 2024) |
| K-0293 | Have properly located and lighted "Exit" signs. | Deficient, Provider has date of correction (April 19, 2024) |
| K-0321 | Ensure 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 (May 5, 2024) |
| K-0712 | Have simulated fire drills held at unexpected times. | Deficient, Provider has date of correction (May 14, 2024) |
| K-0918 | Have generator or other power source capable of supplying service within 10 seconds. | Deficient, Provider has date of correction (April 24, 2024) |
Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.