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

The Suites Pasadena

Pasadena, TX · 50 certified beds · Last Life Safety survey January 16, 2026

CMS Certification Number 676332 · first certified March 2013

Ownership

Operated by EDURO HEALTHCARE · For profit - Corporation

New ownershipOwnership changed November 19, 2025 (change of ownership)from APOLLO HEALTHCARE AT BAY AREA LP

Citations on file

Rolling three-year window

Life Safety surveys

In the same window

Tags cited more than once

Across separate surveys

Inspection & testing records

Of the citations on file

Position within TX

26 citations — more than 98% of the 1,177 certified nursing homes in TX. Compared within TX 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

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

The latest survey found 13 citations; the earlier surveys in the window averaged 6.5. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

The window opens February 2027 — about 5 months from now. This facility’s last Life Safety survey was January 2026. Facilities in TX are typically surveyed 13–14 months after the last one (median 14), measured over 1,905 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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1 inspection-and-testing tag has 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 26 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)

4 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 26 Life Safety citations above. The Physical Environment Index

F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
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 TX, and nationally. Surveyors differ markedly between states, so the TX figure is the meaningful one.

Citations on file over three years, compared
Measure	Citations
This facility	26
Median facility in TX	7
Median facility nationally	11

Survey history

Citations at each Life Safety survey

Citations at each Life Safety survey
Survey date	Citations
September 19, 2023	11
October 31, 2024	2
January 16, 2026	13

Most-cited tags

Most-cited tags at this facility

Most-cited tags at this facility
Tag	What the surveyor checks	Times cited	Last cited
K-0712	Have simulated fire drills held at unexpected times.	2	2026-01-16
K-0711	Provide a written emergency evacuation plan.	2	2026-01-16
E-0030	List the names and contact information of those in the facility.	2	2026-01-16
E-0004	Develop and maintain an Emergency Preparedness Program (EP).	2	2026-01-16
K-0907	Ensure medical gas and vacuum systems have documented maintenance programs.	1	2023-09-19
K-0324	Provide properly protected cooking facilities.	1	2024-10-31
K-0293	Have properly located and lighted "Exit" signs.	1	2026-01-16
K-0281	Install proper backup exit lighting.	1	2023-09-19

What the citations cover

Citations by CMS category

Emergency Preparedness Deficiencies 7
Smoke Deficiencies 6
Miscellaneous Deficiencies 4
Gas, Vacuum, and Electrical Systems Deficiencies 4
Other 5

Citations by CMS category
Category	Citations
Emergency Preparedness Deficiencies	7
Smoke Deficiencies	6
Miscellaneous Deficiencies	4
Gas, Vacuum, and Electrical Systems Deficiencies	4
Egress Deficiencies	3
Construction Deficiencies	1
Services Deficiencies	1

Every citation on file

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

January 16, 2026 — 13 citations

Citations issued on January 16, 2026
Tag	What the surveyor checks	Status
E-0004	Develop and maintain an Emergency Preparedness Program (EP).	Deficient, Provider has date of correction (February 17, 2026)
E-0020	Establish policies and procedures including evacuation.	Deficient, Provider has date of correction (February 23, 2026)
E-0030	List the names and contact information of those in the facility.	Deficient, Provider has date of correction (February 19, 2026)
K-0161	Use approved construction type or materials.	Deficient, Provider has date of correction (February 19, 2026)
K-0293	Have properly located and lighted "Exit" signs.	Deficient, Provider has date of correction (April 16, 2026)
K-0342	Have a complete alarm system manually initiated and initiated by fire sprinkler system connection.	Deficient, Provider has date of correction (February 19, 2026)
K-0351	Install an approved automatic sprinkler system.	Deficient, Provider has date of correction (February 23, 2026)
K-0363	Install corridor and hallway doors that block smoke.	Deficient, Provider has date of correction (April 16, 2026)
K-0372	Ensure smoke barriers are constructed to a 1 hour fire resistance rating.	Deficient, Provider has date of correction (February 24, 2026)
K-0511	Have properly installed electrical wiring and gas equipment.	Deficient, Provider has date of correction (April 16, 2026)
K-0711	Provide a written emergency evacuation plan.	Deficient, Provider has date of correction (February 19, 2026)
K-0712	Have simulated fire drills held at unexpected times.	Deficient, Provider has date of correction (January 31, 2026)
K-0923	Have proper medical gas storage and administration areas.	Deficient, Provider has date of correction (February 21, 2026)

October 31, 2024 — 2 citations

Citations issued on October 31, 2024
Tag	What the surveyor checks	Status
K-0324	Provide properly protected cooking facilities.	Deficient, Provider has date of correction (November 22, 2024)
K-0918	Have generator or other power source capable of supplying service within 10 seconds.	Deficient, Provider has date of correction (November 22, 2024)

September 19, 2023 — 11 citations

Citations issued on September 19, 2023
Tag	What the surveyor checks	Status
E-0004	Develop and maintain an Emergency Preparedness Program (EP).	Deficient, Provider has date of correction (August 25, 2023)
E-0006	Conduct risk assessment and an All-Hazards approach.	Deficient, Provider has date of correction (August 25, 2023)
E-0030	List the names and contact information of those in the facility.	Deficient, Provider has date of correction (August 25, 2023)
E-0036	Establish emergency prep training and testing.	Deficient, Provider has date of correction (August 25, 2023)
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 (August 25, 2023)
K-0281	Install proper backup exit lighting.	Deficient, Provider has date of correction (August 25, 2023)
K-0353	Inspect, test, and maintain automatic sprinkler systems.	Deficient, Provider has date of correction (August 25, 2023)
K-0711	Provide a written emergency evacuation plan.	Deficient, Provider has date of correction (August 25, 2023)
K-0712	Have simulated fire drills held at unexpected times.	Deficient, Provider has date of correction (August 25, 2023)
K-0907	Ensure medical gas and vacuum systems have documented maintenance programs.	Deficient, Provider has date of correction (August 25, 2023)
K-0908	Ensure gas and vacuum systems are inspected and tested as part of a maintenance program.	Deficient, Provider has date of correction (August 25, 2023)

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