01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-06-27 | 19 | 2025-06-27 | 10 |
| Cycle 2 | 2024-01-31 | 26 | 2024-01-31 | 22 |
| Cycle 3 | 2022-07-18 | 43 | 2022-07-18 | 13 |
CMS CCN 0553182026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Skyline Healthcare Center - San Jose
2065 Forest Avenue · San Jose, CA 95128 · Santa Clara County
Certified beds253CMS provider file
Recent citation rows133current CMS citation release
Penalty rows1current 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
133 rows in the current release
3 rows carry G–L scope/severity codes; 2 carry J–L. 36 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-03-26 · HEALTHF0600Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Correction field: Deficient, Provider has date of correction · 2026-04-09 · complaint2025-06-27 · 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 · 2025-07-242025-06-27 · HEALTHF0558Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
Correction field: Deficient, Provider has date of correction · 2025-07-242025-06-27 · HEALTHF0577Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.
Correction field: Deficient, Provider has date of correction · 2025-07-242025-06-27 · HEALTHF0582Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Correction field: Deficient, Provider has date of correction · 2025-07-242025-06-27 · HEALTHF0636Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
Correction field: Deficient, Provider has date of correction · 2025-07-242025-06-27 · 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 · 2025-07-242025-06-27 · HEALTHF0655Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Correction field: Deficient, Provider has date of correction · 2025-07-242025-06-27 · 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 · 2025-07-242025-06-27 · HEALTHF0658Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
Correction field: Deficient, Provider has date of correction · 2025-07-242025-06-27 · HEALTHF0700Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Correction field: Deficient, Provider has date of correction · 2025-07-242025-06-27 · HEALTHF0755Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Correction field: Deficient, Provider has date of correction · 2025-07-242025-06-27 · HEALTHF0761Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Correction field: Deficient, Provider has date of correction · 2025-07-242025-06-27 · 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 · 2025-07-242025-06-27 · HEALTHF0812Severity F · widespread; 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 · 2025-07-242025-06-27 · HEALTHF0814Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Dispose of garbage and refuse properly.
Correction field: Deficient, Provider has date of correction · 2025-07-242025-06-27 · HEALTHF0880Severity E · pattern; 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 · 2025-07-242025-06-27 · HEALTHF0921Severity E · pattern; potential for more than minimal harm
Environmental Deficiencies
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Correction field: Deficient, Provider has date of correction · 2025-07-242025-06-27 · HEALTHF0945Severity E · pattern; potential for more than minimal harm
Infection Control Deficiencies
Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program.
Correction field: Deficient, Provider has date of correction · 2025-07-242025-06-27 · 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 · 2025-07-102025-06-27 · FIREK0363Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2025-07-102025-06-27 · FIREK0374Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Correction field: Deficient, Provider has date of correction · 2025-07-10 · complaint2025-06-27 · FIREK0521Severity D · isolated; potential for more than minimal harm
Services Deficiencies
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Correction field: Deficient, Provider has date of correction · 2025-07-102025-06-27 · FIREK0741Severity D · isolated; potential for more than minimal harm
Miscellaneous Deficiencies
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Correction field: Deficient, Provider has date of correction · 2025-07-1803 / 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 |
|---|---|---|---|
| 2023-12-11 | Fine | $105,089 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- GC OPERATING COMPANY LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST99% · since 12/06/2011
- GRANCARE LLCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 11/17/2010
- MARINER HEALTH CARE, INC.Organization · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 11/17/2010
- MHC HOLDING COMPANYOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 11/17/2010
- MHC WEST HOLDING COMPANYOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 11/17/2010
- NATIONAL SENIOR CARE, INC.Organization · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 11/17/2010
- GRUNSTEIN, EMILYIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 02/06/2019
- CAPITAL FUNDING LLCOrganization · 5% OR GREATER SECURITY INTERESTNOT APPLICABLE · since 06/01/2015
- AZOREZ, ALEXINEIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 12/02/2024
- PENYACSEK, MARKIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 04/08/2024
- SARCAUGA, DENNISIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 02/06/2025
- AZOREZ, ALEXINEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/02/2024
- PENYACSEK, MARKIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/08/2024
- SABOUNCHI, SAMANIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/01/2021
- SARCAUGA, DENNISIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/06/2025
- SKYLINE SAN JOSE OPERATING COMPANY GP LLCOrganization · GENERAL PARTNERSHIP INTERESTNOT APPLICABLE · since 08/27/2014
- GC OPERATING COMPANY LLCOrganization · LIMITED PARTNERSHIP INTERESTNOT APPLICABLE · since 08/27/2014
- AZOREZ, ALEXINEIndividual · ADP OF THE SNFNOT APPLICABLE · since 12/02/2024
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 hours4.07per resident day
RN hours0.40per resident day
Weekend nurse hours3.90per resident day
Staff turnover38.9%CMS reported field
06 / LOCAL RECORDS
Open the San Jose ledger →Other published facilities nearby
A Grace Sub Acute & Skilled Care166 beds · CMS overall 4/580 citation rowsAlmaden Health And Rehabilitation Center77 beds · CMS overall 4/577 citation rowsCanyon Springs Post-Acute199 beds · CMS overall 4/5109 citation rowsCourtyard Care Center76 beds · CMS overall 3/574 citation rowsCreekside Post-Acute130 beds · CMS overall 5/572 citation rowsEmpress Care Center, Llc67 beds · CMS overall 4/568 citation rowsHerman Health Care Center99 beds · CMS overall 1/5107 citation rowsInspire Behavioral Health116 beds · CMS overall 2/567 citation rows