01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-06-05 | 5 | 2025-06-05 | 5 |
| Cycle 2 | 2024-03-29 | 0 | 2024-03-29 | 11 |
| Cycle 3 | 2023-04-20 | 5 | 2023-04-20 | 12 |
CMS CCN 5554672026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Mountains Community Hosp Dp/Snf
29101 Hospital Road · Lake Arrowhead, CA 92352 · San Bernardino County
Certified beds19CMS provider file
Recent citation rows38current 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
38 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 8 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-06-05 · HEALTHF0637Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Assess the resident when there is a significant change in condition
Correction field: Deficient, Provider has date of correction · 2025-07-052025-06-05 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2025-07-052025-06-05 · 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 · 2025-07-052025-06-05 · HEALTHF0760Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2025-07-052025-06-05 · HEALTHF0880Severity F · widespread; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2025-07-052025-06-05 · FIREK0161Severity D · isolated; potential for more than minimal harm
Construction Deficiencies
Use approved construction type or materials.
Correction field: Deficient, Provider has date of correction · 2025-06-182025-06-05 · FIREK0353Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2025-06-182025-06-05 · FIREK0355Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Properly select, install, inspect, or maintain portable fire extinguishes.
Correction field: Deficient, Provider has date of correction · 2025-07-022025-06-05 · FIREK0363Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2025-06-192025-06-05 · FIREK0920Severity D · isolated; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure proper usage of power strips and extension cords.
Correction field: Deficient, Provider has date of correction · 2025-06-192024-03-29 · FIREE0022Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish policies and procedures for sheltering.
Correction field: Deficient, Provider has date of correction · 2024-04-292024-03-29 · FIREE0030Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
List the names and contact information of those in the facility.
Correction field: Deficient, Provider has date of correction · 2024-04-292024-03-29 · FIREE0035Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Provide family notifications of emergency plan.
Correction field: Deficient, Provider has date of correction · 2024-04-292024-03-29 · FIREK0321Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Correction field: Deficient, Provider has date of correction · 2024-04-292024-03-29 · FIREK0324Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2024-04-292024-03-29 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2024-04-292024-03-29 · FIREK0351Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install an approved automatic sprinkler system.
Correction field: Deficient, Provider has date of correction · 2024-04-292024-03-29 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2024-04-292024-03-29 · FIREK0355Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Properly select, install, inspect, or maintain portable fire extinguishes.
Correction field: Deficient, Provider has date of correction · 2024-04-292024-03-29 · FIREK0914Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Correction field: Deficient, Provider has date of correction · 2024-04-292024-03-29 · FIREK0918Severity D · isolated; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Correction field: Deficient, Provider has date of correction · 2024-04-292023-04-20 · FIREE0004Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
Develop and maintain an Emergency Preparedness Program (EP).
Correction field: Deficient, Provider has date of correction · 2023-05-232023-04-20 · FIREE0007Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
Address patient/client population and determine types of services needed.
Correction field: Deficient, Provider has date of correction · 2023-05-232023-04-20 · FIREE0026Severity E · pattern; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish roles under a Waiver declared by secretary.
Correction field: Deficient, Provider has date of correction · 2023-05-2303 / 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
- SAN BERNARDINO MOUNTAINS COMMUNITY HOSPITAL DISTRICTOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 02/11/2013
- PENA, TERRYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 09/03/2013
- TURNER, MARKIndividual · CORPORATE OFFICERNOT APPLICABLE · since 02/21/2022
- WAGGENER, YVONNEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 10/01/2009
- ALTMEYER, CHERIIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/16/2012
- BUSH, CYNTHIAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 07/08/2011
- DAHLQUIST, GREGORYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 09/01/2023
- HERNANDEZ, CARMENIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/20/2013
- TURNER, MARKIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/21/2022
- WAGGENER, YVONNEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/01/2009
- WEILAND, TAYLORIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/24/2022
- BUSH, CYNTHIAIndividual · ADP OF THE SNFNOT APPLICABLE · since 07/08/2011
- DAHLQUIST, GREGORYIndividual · ADP OF THE SNFNOT APPLICABLE · since 09/01/2023
- HERNANDEZ, CARMENIndividual · ADP OF THE SNFNOT APPLICABLE · since 03/20/2013
- TURNER, MARKIndividual · ADP OF THE SNFNOT APPLICABLE · since 07/29/2025
- WAGGENER, YVONNEIndividual · ADP OF THE SNFNOT APPLICABLE · since 10/01/2009
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 hours7.12per resident day
RN hours1.22per resident day
Weekend nurse hours6.38per resident day
Staff turnover37.5%CMS reported field
06 / LOCAL RECORDS
Open the California ledger →Other published facilities nearby
No second facility in the same city met the directory rule.