Cycle 1
Health 2025-12-04 · Fire 2025-12-04
10 health deficiencies
Top issue: Pharmacy Service (3 deficiencies)
2 fire-safety deficiencies
Top issue: Emergency Preparedness (1 deficiency)
Yucca Valley, CA
Indian Canyon Post Acute
4-star overall rating with 4-star inspections with 10 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle
57333 Joshua Ln, Yucca Valley, CA
(760) 853-4750
Overall
4 / 5
CMS overall stars
Health inspections
4 / 5
Survey and complaint cycles
Staffing
3 / 5
RN + nurse staffing
Quality measures
3 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
99
Certified beds
Average residents
93
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Sweetwater Care
Operator or chain grouping
Approved since
2001-06-08
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
9 facilities
Chain averages 3 overall / 2 health / 2 staffing / 4 quality stars
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
0.33
Registered nurse staffing · state 0.65 · national 0.68
LPN hours / resident day
1.03
Licensed practical nurse staffing · state 1.22 · national 0.87
Aide hours / resident day
2.43
Nurse aide staffing · state 2.64 · national 2.35
Total nurse hours
3.79
All reported nurse hours · state 4.51 · national 3.89
Licensed hours
1.36
RN + LPN hours · state 1.87 · national 1.54
Weekend hours
3.45
Weekend nurse staffing · state 4.08 · national 3.43
Weekend RN hours
0.25
Weekend registered nurse coverage · state 0.50 · national 0.47
Physical therapist
0.00
Reported PT staffing · state 0.10 · national 0.07
Adjusted RN hours
0.34
CMS adjusted RN staffing hours
Adjusted total hours
3.92
CMS adjusted total nurse staffing hours
Case-mix index
1.32
Higher values indicate more complex resident acuity
RN turnover
17%
Annual RN turnover · state 42% · national 45%
Total nurse turnover
48%
Annual nurse turnover · state 38% · national 46%
SNF VBP
Value-based purchasing
Program rank
10,956
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
18.52
Composite VBP score used to determine payment impact.
Payment multiplier
0.9820
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
0
Performance 21.92% · Measure score 0 · Achievement 0 · This facility did not have sufficient data to calculate a baseline period measure result.
Healthcare-associated infections
0
Performance 7.99% · Measure score 0 · Achievement 0 · This facility did not have sufficient data to calculate a baseline period measure result.
Total nurse turnover
5.14
Baseline 100.00% · Performance 57.61% · Measure score 5.14 · Achievement 1.49 · Improvement 5.14
Adjusted total nurse staffing
2.27
Baseline 2.62 hours · Performance 3.49 hours · Measure score 2.27 · Achievement 1.46 · Improvement 2.27
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 10.91% |
10.72%
0.2 pts worse
|
No Different than the National Rate · Eligible stays 75 · Observed rate 13.33% · Lower 95% interval 7.58% |
| Discharge to community | 50.78% |
50.57%
0.2 pts better
|
No Different than the National Rate · Eligible stays 55 · Observed rate 41.82% · Lower 95% interval 38.52% |
| Medicare spending per beneficiary | 1.49 |
1.02
0.5 pts worse
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 49 · Denominator 49 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 49 |
| Discharge self-care score | 59.09% |
53.69%
5.4 pts better
|
Numerator 13 · Denominator 22 |
| Discharge mobility score | 40.91% |
50.94%
10 pts worse
|
Numerator 9 · Denominator 22 |
| Pressure ulcers or injuries, new or worsened | 6.12% |
2.29%
3.8 pts worse
|
Numerator 3 · Denominator 49 · Adjusted rate 5.75% |
| Healthcare-associated infections requiring hospitalization | 7.99% |
7.12%
0.9 pts worse
|
No Different than the National Rate · Eligible stays 42 · Observed rate 11.9% · Lower 95% interval 4.54% |
| Staff COVID-19 vaccination coverage | 43% |
8.2%
34.8 pts better
|
Numerator 43 · Denominator 100 |
| Staff flu vaccination coverage | 17.21% |
42%
24.8 pts worse
|
Numerator 21 · Denominator 122 |
| Discharge function score | 45.45% |
56.45%
11 pts worse
|
Numerator 10 · Denominator 22 |
| Transfer of health information to provider | 100% |
95.95%
4 pts better
|
Numerator 28 · Denominator 28 |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 9 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | 42.31% |
25.2%
17.1 pts better
|
Numerator 11 · Denominator 26 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 1.5 |
2.3
0.8 pts better
|
1.9
0.4 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.5 · Observed 1.7 · Expected 2.1 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 7.0 |
1.6
5.4 pts worse
|
1.8
5.2 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 7.0 · Observed 7.2 · Expected 1.7 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 99.7% |
98.5%
1.2 pts better
|
93.4%
6.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 98.8% · Q4 100.0% · 4Q avg 99.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 98.9% |
98.2%
0.7 pts better
|
95.5%
3.4 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 98.9% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 1.8% |
1.6%
0.2 pts worse
|
3.3%
1.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 3.8% · Q2 2.3% · Q3 1.2% · Q4 0.0% · 4Q avg 1.8% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 10.0% |
6.8%
3.2 pts worse
|
11.4%
1.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.4% · Q2 7.3% · Q3 11.5% · Q4 19.5% · 4Q avg 10.0% |
| Percentage of long-stay residents who lose too much weight | 0.9% |
4.1%
3.2 pts better
|
5.4%
4.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.3% · Q2 0.0% · Q3 0.0% · Q4 2.5% · 4Q avg 0.9% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 26.5% |
13.7%
12.8 pts worse
|
19.6%
6.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 28.6% · Q2 25.3% · Q3 26.2% · Q4 25.9% · 4Q avg 26.5% |
| Percentage of long-stay residents who received an antipsychotic medication | 7.5% |
14.2%
6.7 pts better
|
16.7%
9.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 8.9% · Q2 7.1% · Q3 5.7% · Q4 8.5% · 4Q avg 7.5% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.4%
0.4 pts better
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 10.6% |
11.0%
0.4 pts better
|
16.3%
5.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 9.8% · Q2 10.2% · Q3 4.6% · Q4 17.6% · 4Q avg 10.6% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 12.0% |
10.7%
1.3 pts worse
|
14.9%
2.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 5.6% · Q2 15.4% · Q3 14.7% · Q4 12.0% · 4Q avg 12.0% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.5% |
1.0%
0.5 pts better
|
1.0%
0.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 1.0% · Q3 0.0% · Q4 0.9% · 4Q avg 0.5% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 0.0% |
1.2%
1.2 pts better
|
1.7%
1.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 16.4% |
10.9%
5.5 pts worse
|
19.8%
3.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 13.6% · Q2 21.1% · Q3 13.1% · Q4 17.4% · 4Q avg 16.4% |
| Percentage of long-stay residents with pressure ulcers | 8.4% |
4.7%
3.7 pts worse
|
5.1%
3.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 7.7% · Q2 11.9% · Q3 8.8% · Q4 5.1% · 4Q avg 8.4% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 82.4% |
94.0%
11.6 pts worse
|
81.7%
0.7 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 86.5% · Q2 82.7% · Q3 78.9% · Q4 81.7% · 4Q avg 82.4% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 22.9% |
11.2%
11.7 pts worse
|
12.0%
10.9 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 22.9% · Observed 25.0% · Expected 12.2% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 2.9% |
1.5%
1.4 pts worse
|
1.6%
1.3 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 5.6% · Q2 5.3% · Q3 0.0% · Q4 2.1% · 4Q avg 2.9% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 71.4% |
93.2%
21.8 pts worse
|
79.7%
8.3 pts worse
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 71.4% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 32.1% |
23.2%
8.9 pts worse
|
23.9%
8.2 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 32.1% · Observed 35.4% · Expected 26.3% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-11-14 · Fire 2024-11-14
6 health deficiencies
Top issue: Resident Assessment and Care Planning (4 deficiencies)
3 fire-safety deficiencies
Top issue: Emergency Preparedness (1 deficiency)
Cycle 3
Health 2021-12-10 · Fire 2021-12-10
19 health deficiencies
Top issue: Resident Assessment and Care Planning (6 deficiencies)
10 fire-safety deficiencies
Top issue: Smoke (4 deficiencies)
Fire safety
Fire-safety citations
E · Potential for more than minimal harm
2025-12-04
E31 · Emergency Preparedness Deficiencies
Fire Safety
Provide emergency officials' contact information.
Corrected 2026-01-06
E · Potential for more than minimal harm
2025-12-04
K345 · Smoke Deficiencies
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2026-01-06
F · Potential for more than minimal harm
2024-11-14
K345 · Smoke Deficiencies
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2024-12-15
D · Potential for more than minimal harm
2024-11-14
E31 · Emergency Preparedness Deficiencies
Fire Safety
Provide emergency officials' contact information.
Corrected 2024-12-13
D · Potential for more than minimal harm
2024-11-14
K920 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure proper usage of power strips and extension cords.
Corrected 2024-12-15
D · Potential for more than minimal harm
2021-12-10
E31 · Emergency Preparedness Deficiencies
Fire Safety
Provide emergency officials' contact information.
Corrected 2021-12-29
D · Potential for more than minimal harm
2021-12-10
E37 · Emergency Preparedness Deficiencies
Fire Safety
Establish staff and initial training requirements.
Corrected 2021-12-29
D · Potential for more than minimal harm
2021-12-10
K161 · Construction Deficiencies
Fire Safety
Use approved construction type or materials.
Corrected 2021-12-29
D · Potential for more than minimal harm
2021-12-10
K211 · Egress Deficiencies
Fire Safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2021-12-29
D · Potential for more than minimal harm
2021-12-10
K325 · Smoke Deficiencies
Fire Safety
Have properly installed hallway dispensers for alcohol-based hand rub.
Corrected 2021-12-29
D · Potential for more than minimal harm
2021-12-10
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2021-12-29
D · Potential for more than minimal harm
2021-12-10
K355 · Smoke Deficiencies
Fire Safety
Properly select, install, inspect, or maintain portable fire extinguishes.
Corrected 2021-12-29
D · Potential for more than minimal harm
2021-12-10
K363 · Smoke Deficiencies
Fire Safety
Install corridor and hallway doors that block smoke.
Corrected 2021-12-29
D · Potential for more than minimal harm
2021-12-10
K511 · Services Deficiencies
Fire Safety
Have properly installed electrical wiring and gas equipment.
Corrected 2021-12-29
D · Potential for more than minimal harm
2021-12-10
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2021-12-29
Inspection history
Recent health citations
F · Potential for more than minimal harm
2025-12-04
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2025-12-22
E · Potential for more than minimal harm
2025-12-04
F565 · Resident Rights Deficiencies
Health
Honor the resident's right to organize and participate in resident/family groups in the facility.
Corrected 2025-12-22
E · Potential for more than minimal harm
2025-12-04
F676 · Quality of Life and Care Deficiencies
Health
Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.
Corrected 2025-12-22
D · Potential for more than minimal harm
2025-12-04
F656 · Resident Assessment and Care Planning Deficiencies
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2025-12-22
D · Potential for more than minimal harm
2025-12-04
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2025-12-22
D · Potential for more than minimal harm
2025-12-04
F686 · Quality of Life and Care Deficiencies
Health
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected 2025-12-22
D · Potential for more than minimal harm
2025-12-04
F755 · Pharmacy Service Deficiencies
Health
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2025-12-22
D · Potential for more than minimal harm
2025-12-04
F756 · Pharmacy Service Deficiencies
Health
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Corrected 2025-12-22
D · Potential for more than minimal harm
2025-12-04
F761 · Pharmacy Service Deficiencies
Health
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.
Corrected 2025-12-22
D · Potential for more than minimal harm
2025-12-04
F810 · Nutrition and Dietary Deficiencies
Health
Provide special eating equipment and utensils for residents who need them and appropriate assistance.
Corrected 2025-12-22
D · Potential for more than minimal harm
2025-01-30
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2025-02-20
D · Potential for more than minimal harm
2024-11-14
F645 · Resident Assessment and Care Planning Deficiencies
Health
PASARR screening for Mental disorders or Intellectual Disabilities
Corrected 2024-12-05
D · Potential for more than minimal harm
2024-11-14
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2024-12-05
D · Potential for more than minimal harm
2024-11-14
F677 · Quality of Life and Care Deficiencies
Health
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected 2024-12-05
D · Potential for more than minimal harm
2024-11-14
F842 · Resident Assessment and Care Planning Deficiencies
Health
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected 2024-12-05
D · Potential for more than minimal harm
2024-03-25
F656 · Resident Assessment and Care Planning Deficiencies
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2024-04-05
D · Potential for more than minimal harm
2024-01-18
F584 · Resident Rights Deficiencies
Health
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.
Corrected 2024-02-08
D · Potential for more than minimal harm
2023-11-27
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2023-12-14
D · Potential for more than minimal harm
2023-11-15
F573 · Resident Rights Deficiencies
Health
Let each resident or the resident's legal representative access or purchase copies of all the resident's records.
Corrected 2023-12-06
F · Potential for more than minimal harm
2023-10-19
F642 · Resident Assessment and Care Planning Deficiencies
Health
Ensure a qualified health professional conducts resident assessments.
Corrected 2023-10-30
F · Potential for more than minimal harm
2021-12-10
F637 · Resident Assessment and Care Planning Deficiencies
Health
Assess the resident when there is a significant change in condition
Corrected 2022-01-11
F · Potential for more than minimal harm
2021-12-10
F638 · Resident Assessment and Care Planning Deficiencies
Health
Assure that each resident’s assessment is updated at least once every 3 months.
Corrected 2022-01-11
F · Potential for more than minimal harm
2021-12-10
F640 · Resident Assessment and Care Planning Deficiencies
Health
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Corrected 2022-01-11
F · Potential for more than minimal harm
2021-12-10
F642 · Resident Assessment and Care Planning Deficiencies
Health
Ensure a qualified health professional conducts resident assessments.
Corrected 2022-01-11
F · Potential for more than minimal harm
2021-12-10
F725 · Nursing and Physician Services Deficiencies
Health
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Corrected 2022-01-11
F · Potential for more than minimal harm
2021-12-10
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2022-01-11
D · Potential for more than minimal harm
2021-12-10
F557 · Resident Rights Deficiencies
Health
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
Corrected 2022-01-11
D · Potential for more than minimal harm
2021-12-10
F558 · Resident Rights Deficiencies
Health
Reasonably accommodate the needs and preferences of each resident.
Corrected 2022-01-11
D · Potential for more than minimal harm
2021-12-10
F636 · Resident Assessment and Care Planning Deficiencies
Health
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
Corrected 2022-01-11
D · Potential for more than minimal harm
2021-12-10
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2022-01-11
D · Potential for more than minimal harm
2021-12-10
F686 · Quality of Life and Care Deficiencies
Health
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected 2022-01-11
D · Potential for more than minimal harm
2021-12-10
F711 · Nursing and Physician Services Deficiencies
Health
Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.
Corrected 2022-01-11
D · Potential for more than minimal harm
2021-12-10
F755 · Pharmacy Service Deficiencies
Health
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2022-01-11
D · Potential for more than minimal harm
2021-12-10
F761 · Pharmacy Service Deficiencies
Health
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.
Corrected 2022-01-11
D · Potential for more than minimal harm
2021-12-10
F881 · Infection Control Deficiencies
Health
Implement a program that monitors antibiotic use.
Corrected 2022-01-11
Penalties and ownership
What sits behind the stars
Ownership
Ajc Healthcare LLC
5% Or Greater Indirect Ownership Interest · Organization
Chesley, Aaron
5% Or Greater Indirect Ownership Interest · Individual
Chesley, Aaron
Corporate Officer · Individual
Gamett, James
5% Or Greater Indirect Ownership Interest · Individual
Gamett, James
Corporate Officer · Individual
Jbg Partners LLC
5% Or Greater Indirect Ownership Interest · Organization
Jennings, Travis
5% Or Greater Indirect Ownership Interest · Individual
Jennings, Travis
W-2 Managing Employee · Individual
Sweetwater Care Opco LLC
5% Or Greater Indirect Ownership Interest · Organization
Nearby options
Other facilities in reach
#1
Joshua Tree Post Acute
Yucca Valley, CA
4-star overall rating with 4-star inspections with $41,900 in total fines with 10 recent health deficiencies with 7 fire-safety deficiencies in the latest cycle
#2
Hi-Desert Medical Center D/P SNF
Joshua Tree, CA
4-star overall rating with 4-star inspections with 9 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
#3
California Nursing & Rehabilitation Center
Palm Springs, CA
1-star overall rating with 1-star inspections with $82,845 in total fines with 27 recent health deficiencies with 8 fire-safety deficiencies in the latest cycle
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