Skilled nursing facility · CMS certification number 555221
SURPRISE VALLEY COMMUNITY HOSPITAL D/P SNF
CEDARVILLE, California · Medicare and Medicaid
Certified beds, as filed in Care Compare: 22
Download this facility’s record (CSV)
A CSV file of this facility’s record: its name and location, its Medicare cost-report finances year by year, its ownership, its inspections, deficiencies and penalties, and the Care Compare provider information — each figure with the worksheet, line and column or file it came from.
In Care Compare’s provider information: Penalties: 0 · Fines: 0 · Fines, total amount: $0.00 · Payment denials: 0. Every penalty on file ↓
For this facility: the citable document with full history — $295 · an email when this record changes — $99/month
Finances, as filed
No Medicare cost report on file for this facility.
Nurse staffing
Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.
Ownership, as filed with CMS
Care Compare
As filed in the CMS file dated September 1, 2026 (Care Compare ownership).
| Owner or manager | Role | Type | Ownership percentage | Association |
|---|---|---|---|---|
| No owner named in the filing | Ownership Data Not Available | Not stated in the filing | Not stated in the filing | Not stated in the filing |
Medicare enrollment
No owner listed for this facility in CMS’s Medicare enrollment ownership data.
Changes in ownership
No change in ownership appears in the CMS files on record since September 20, 2022.
Recent changes on this record
No change has appeared in the CMS files since this record began.
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | May 8, 2025 | May 8, 2025 | 4 | 8 |
| 2 | April 18, 2024 | April 18, 2024 | 4 | 14 |
| 3 | May 12, 2022 | May 12, 2022 | 14 | 6 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
22 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| February 26, 2026 | Health | F 0684 | Quality of Life and Care Deficiencies | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Yes | Deficient, Provider has date of correction | February 27, 2026 |
| December 19, 2025 | Health | F 0609 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Yes | Deficient, Provider has date of correction | January 8, 2026 |
| May 8, 2025 | Health | F 0657 | 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. | D | No | Deficient, Provider has date of correction | May 30, 2025 |
| May 8, 2025 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | No | Deficient, Provider has date of correction | June 2, 2025 |
| April 18, 2024 | Health | F 0692 | Quality of Life and Care Deficiencies | Provide enough food/fluids to maintain a resident's health. | D | No | Deficient, Provider has date of correction | May 8, 2024 |
| April 18, 2024 | Health | F 0761 | 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. | D | No | Deficient, Provider has date of correction | May 2, 2024 |
| April 18, 2024 | Health | F 0851 | Administration Deficiencies | Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data. | F | No | Deficient, Provider has date of correction | May 6, 2024 |
| April 18, 2024 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | F | No | Deficient, Provider has date of correction | May 13, 2024 |
| December 28, 2023 | Health | F 0600 | 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. | D | Yes | Deficient, Provider has date of correction | December 28, 2023 |
| December 5, 2023 | Health | F 0600 | 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. | D | Yes | Deficient, Provider has date of correction | December 18, 2023 |
| May 12, 2022 | Health | F 0552 | Resident Rights Deficiencies | Ensure that residents are fully informed and understand their health status, care and treatments. | E | No | Deficient, Provider has date of correction | July 13, 2022 |
| May 12, 2022 | Health | F 0604 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | D | No | Deficient, Provider has date of correction | July 13, 2022 |
| May 12, 2022 | Health | F 0656 | 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. | F | No | Deficient, Provider has date of correction | July 13, 2022 |
| May 12, 2022 | Health | F 0741 | Quality of Life and Care Deficiencies | Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents. | D | No | Deficient, Provider has date of correction | July 13, 2022 |
| May 12, 2022 | Health | F 0756 | Pharmacy Service Deficiencies | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | F | No | Deficient, Provider has date of correction | July 13, 2022 |
| May 12, 2022 | Health | F 0758 | Pharmacy Service Deficiencies | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | F | No | Deficient, Provider has date of correction | July 13, 2022 |
| May 12, 2022 | Health | F 0838 | Administration Deficiencies | Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies. | E | No | Deficient, Provider has date of correction | July 13, 2022 |
| May 12, 2022 | Health | F 0867 | Administration Deficiencies | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | E | No | Deficient, Provider has date of correction | July 13, 2022 |
| May 12, 2022 | Health | F 0868 | Administration Deficiencies | Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | E | No | Deficient, Provider has date of correction | July 13, 2022 |
| May 12, 2022 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | F | No | Deficient, Provider has date of correction | July 13, 2022 |
| May 12, 2022 | Health | F 0881 | Infection Control Deficiencies | Implement a program that monitors antibiotic use. | E | No | Deficient, Provider has date of correction | July 13, 2022 |
| May 12, 2022 | Health | F 0883 | Infection Control Deficiencies | Develop and implement policies and procedures for flu and pneumonia vaccinations. | F | No | Deficient, Provider has date of correction | July 13, 2022 |
From the Care Compare health citations file NH_HealthCitations_Sep2026_2.csv, processed on September 1, 2026.
Penalties
No penalty on file for this facility in CMS’s Care Compare penalties data.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | Government - Hospital district |
| Legal Business Name | Legal Business Name Not Available |
| Date First Approved to Provide Medicare and Medicaid Services | 1986-04-15 |
| Provider Resides in Hospital | Y |
| Continuing Care Retirement Community | N |
| Urban | N |
| County/Parish | Modoc |
| Telephone Number | 5302796111 |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | Resident |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Number of Certified Beds | 22 |
| Average Number of Residents per Day | 18.4 |
| Overall Rating | 4 |
| Health Inspection Rating | 4 |
| QM Rating | 5 |
| Long-Stay QM Rating | 5 |
| Processing Date | 2026-09-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Sep2026_3.csv, processed on September 1, 2026.
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The citable document for SURPRISE VALLEY COMMUNITY HOSPITAL D/P SNF
This page shows the record as it stands today. The report is the citable document: the same figures with the cell each came from, and beyond this page — five facilities of a similar size in California at the same fiscal year, listed by name; every change on the record rather than the recent ones below; the inspection and staffing history in blocks of their own; and a citation block naming every CMS file it was read from.
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Every figure on this page is printed as it appears in the CMS file named beside it. A figure that does not match its file? Tell us on the corrections page, quoting certification number 555221.