01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-11-13 | 8 | 2025-11-13 | 1 |
| Cycle 2 | 2024-05-06 | 16 | 2024-05-06 | 1 |
| Cycle 3 | 2022-12-15 | 12 | 2022-12-15 | 27 |
CMS CCN 0352902026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Haven Health Sky Harbor, Llc
1880 East Van Buren Street · Phoenix, AZ 85006 · Maricopa County
Certified beds120CMS provider file
Recent citation rows65current CMS citation release
Penalty rows0current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
65 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 7 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-03-03 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2026-04-16 · complaint2025-11-13 · HEALTHF0550Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Correction field: Deficient, Provider has date of correction · 2025-12-052025-11-13 · HEALTHF0609Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Deficient, Provider has date of correction · 2025-12-05 · complaint2025-11-13 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2025-12-052025-11-13 · HEALTHF0842Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2025-12-05 · complaint2025-11-13 · FIREK0221Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Provide rooms that can be unlocked from inside without a key.
Correction field: Deficient, Provider has date of correction · 2025-12-162025-08-12 · HEALTHF0607Severity E · pattern; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Correction field: Deficient, Provider has date of correction · 2025-09-25 · complaint2025-08-12 · HEALTHF0609Severity E · pattern; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Deficient, Provider has date of correction · 2025-09-25 · complaint2025-08-12 · HEALTHF0610Severity E · pattern; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
Correction field: Deficient, Provider has date of correction · 2025-09-25 · complaint2025-03-24 · HEALTHF0842Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2025-04-25 · complaint2024-10-22 · HEALTHF0657Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Correction field: Deficient, Provider has date of correction · 2024-11-06 · complaint2024-08-01 · HEALTHF0622Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.
Correction field: Deficient, Provider has date of correction · 2024-08-20 · complaint2024-05-06 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2024-07-032024-05-06 · HEALTHF0676Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.
Correction field: Deficient, Provider has date of correction · 2024-07-032024-05-06 · HEALTHF0677Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Correction field: Deficient, Provider has date of correction · 2024-07-032024-05-06 · HEALTHF0679Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide activities to meet all resident's needs.
Correction field: Deficient, Provider has date of correction · 2024-07-032024-05-06 · HEALTHF0725Severity D · isolated; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Correction field: Deficient, Provider has date of correction · 2024-07-032024-05-06 · HEALTHF0727Severity D · isolated; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Correction field: Deficient, Provider has date of correction · 2024-07-032024-05-06 · HEALTHF0757Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Correction field: Deficient, Provider has date of correction · 2024-07-032024-05-06 · HEALTHF0790Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide routine and 24-hour emergency dental care for each resident.
Correction field: Deficient, Provider has date of correction · 2024-07-032024-05-06 · HEALTHF0804Severity D · isolated; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Correction field: Deficient, Provider has date of correction · 2024-07-032024-05-06 · HEALTHF0812Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2024-07-032024-05-06 · HEALTHF0842Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2024-07-032024-05-06 · HEALTHF0867Severity E · pattern; potential for more than minimal harm
Administration Deficiencies
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Correction field: Deficient, Provider has date of correction · 2024-07-0303 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- SAMUELIAN, SPENCERIndividual · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 08/01/2023
- SEASTRAND, JASONIndividual · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 08/01/2023
- HAVEN HEALTH PROPERTIES LLCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTEREST8% · since 08/01/2023
- HEALTH GROUP MANAGEMENT LLCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTEREST8% · since 08/01/2023
- ESPINOSA, STEPHANIEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 10/14/2024
- FRAGOSO, LINDSAYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 08/01/2023
- SEASTRAND, JASONIndividual · CORPORATE OFFICERNOT APPLICABLE · since 08/01/2023
- HEALTH GROUP MANAGEMENT LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/01/2023
- BRADY, MITCHELLIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/14/2025
- ESPINOSA, STEPHANIEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/14/2024
- FRAGOSO, LINDSAYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/01/2023
- GREINER, RUSSELLIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/16/2023
- KNIGHT, TASHAYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/14/2025
- NASSER, MOHAMMADIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/13/2025
- ROBERTSON, BRETTIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/01/2023
- SAMUELIAN, ROBERTIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/01/2023
- SAMUELIAN, SPENCERIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/14/2025
- SAMUELIAN, STEPHENIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/01/2023
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours4.31per resident day
RN hours0.44per resident day
Weekend nurse hours3.99per resident day
Staff turnover41.1%CMS reported field
06 / LOCAL RECORDS
Open the Phoenix ledger →Other published facilities nearby
Acacia Health Center78 beds · CMS overall 5/56 citation rowsAhwatukee Post Acute192 beds · CMS overall 3/548 citation rowsArizona State Veteran Home-Phx200 beds · CMS overall 2/558 citation rowsBeatitudes Campus72 beds · CMS overall 3/536 citation rowsCamelback Post Acute Care And Rehabilitation107 beds · CMS overall 3/526 citation rowsChristian Care Nursing Center20 beds · CMS overall 4/517 citation rowsCoronado Healthcare Center191 beds · CMS overall 5/514 citation rowsDesert Haven Care Center115 beds · CMS overall 1/539 citation rows