Map showing the location of ALTERNATIVE HEALTHCARE SOLUTIONS LLC in SAN JUAN, Puerto Rico
SEPTIMO PISO DOCTORS CENTER HOSPITAL, SAN JUAN, PR, 00910

Overall Score

CMS Five-Star Quality Rating
4/5Above averageCMS Five-Star overall rating
  1. Much below average
  2. Below average
  3. Average
  4. Above average
  5. Much above average

Where it ranks

  • Puerto RicoAbove only 40% of peers6 rated homes · average 3.2★
  • United StatesAbove 61% of peers14,574 rated homes · average 3.0★

How the rating is built

  • Health inspectionsStarting point3★±0.0 vs PR avg
  • StaffingCan add or remove a star5★+1.4 vs PR avg
  • Quality measuresCan add or remove a star

CMS starts from the health inspection stars, then adds or subtracts a star for staffing and for quality measures. Stars are assigned relative to other facilities in the same state.

Ratings & measures

Tap a row to see what it means
Health inspection ratingCMS stars from the last three on-site inspection cycles3★Above only 20% of peersPR avg3.0★U.S. avg2.8★
What is health inspection rating?

Stars assigned from the last three standard surveys and every complaint investigation in that window, weighted toward the most recent and the most serious findings. CMS assigns these stars relative to other facilities in the same state.

Why it matters

It carries the most weight in the overall rating and is the only domain based on what trained inspectors saw on site rather than what the facility reported.

Staffing ratingCMS stars from payroll-reported hours and turnover5★Above 75% of peersPR avg3.6★U.S. avg2.9★
What is staffing rating?

Nurse and aide hours per resident day from payroll records CMS collects every quarter, adjusted for how much care residents need, plus staff turnover and weekend coverage.

Why it matters

More hours and lower turnover are the strongest predictors of fewer falls, pressure sores, and avoidable hospital stays.

Quality measures ratingCMS stars from clinical outcomes and resident assessmentsNo dataPR avg—★U.S. avg3.6★
What is quality measures rating?

Clinical outcomes from resident assessments and Medicare claims: falls with injury, pressure ulcers, hospitalizations, antipsychotic use, and more, for both short-stay and long-stay residents.

Why it matters

It shows whether care is working, but part of it comes from the facility’s own assessments, so read it alongside the inspection results.

Total nurse hoursPer resident per day, all nursing staff6.95hrsTop 1%PR avg3.77Benchmark4.10
What is total nurse hours?

All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.

Why it matters

Federal research links 4.1 hours a day to fewer avoidable harms. Below about 3 hours, residents wait longer for help with basics like toileting and repositioning.

RN hoursPer resident per day, registered nurses only6.15hrsTop 1%PR avg2.91Benchmark0.75
What is rn hours?

Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.

Why it matters

RN coverage is the staffing measure most tied to fewer hospital transfers and infections, and it is where thinly staffed facilities cut first.

Nursing staff turnoverShare of nursing staff who left within a year · lower is better33%Above only 40% of peersPR avg34%RN turnover26%
What is nursing staff turnover?

The share of nursing staff who left within the past year, from the same payroll data.

Why it matters

High turnover means residents are cared for by people who do not know them, and it is one of the strongest predictors of inspection problems.

Fines in the last three yearsCivil money penalties imposed by CMS · lower is better$9,125Above only 25% of peersPR avg$5,551Fines · denials2 · 0
What is fines in the last three years?

Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.

Why it matters

Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.

Inspection history

Last three inspection cycles
33citations
3inspection dates
0actual harm (G–I)
0immediate jeopardy (J–L)
Dec 3, 2024most recent

Citations by monthFeb 2023 – Dec 2024

  • No actual harm (D–F)
  • Actual harm (G–I)
  • Immediate jeopardy (J–L)
  • $Fine or payment denial

Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.

Dec 3, 20249 citationsCycle 1worst F · no actual harm
  1. F584Honor 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.Resident RightsE · patternCorrected Jan 9, 2025
  2. F732Post nurse staffing information every day.Nursing and Physician ServicesC · widespreadCorrected May 2, 2025
  3. F802Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.Nutrition and DietaryF · widespreadCorrected Jun 12, 2025
  4. F804Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.Nutrition and DietaryF · widespreadCorrected May 2, 2025
  5. F806Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.Nutrition and DietaryD · isolatedCorrected May 2, 2025
  6. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryF · widespreadCorrected Jun 12, 2025
  7. F880Provide and implement an infection prevention and control program.Infection ControlF · widespreadCorrected May 2, 2025
  8. F883Develop and implement policies and procedures for flu and pneumonia vaccinations.Infection ControlC · widespreadCorrected May 2, 2025
  9. F921Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.EnvironmentalF · widespreadCorrected May 2, 2025
Apr 18, 20248 citationsCycle 2worst F · no actual harm
  1. F584Honor 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.Resident RightsE · patternCorrected May 13, 2024
  2. F655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedResident Assessment and Care PlanningE · patternCorrected May 13, 2024
  3. F694Provide for the safe, appropriate administration of IV fluids for a resident when needed.Quality of Life and CareE · patternCorrected May 15, 2024
  4. F726Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.Nursing and Physician ServicesF · widespreadCorrected May 15, 2024
  5. F802Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.Nutrition and DietaryF · widespreadCorrected May 14, 2024
  6. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryF · widespreadCorrected May 13, 2024
  7. F813Have a policy regarding use and storage of foods brought to residents by family and other visitors.Nutrition and DietaryF · widespreadCorrected Apr 20, 2024
  8. F908Keep all essential equipment working safely.EnvironmentalF · widespreadCorrected May 15, 2024
May 2, 202316 citationsCycle 3worst F · no actual harm
  1. F578Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.Resident RightsE · patternCorrected May 15, 2023
  2. F582Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.Resident RightsF · widespreadCorrected May 15, 2023
  3. F584Honor 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.Resident RightsE · patternCorrected May 5, 2023
  4. F655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedResident Assessment and Care PlanningF · widespreadCorrected May 15, 2023
  5. F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Resident Assessment and Care PlanningD · isolatedCorrected May 15, 2023
  6. F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.Resident Assessment and Care PlanningE · patternCorrected May 15, 2023
  7. F677Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and CareD · isolatedCorrected May 15, 2023
  8. F732Post nurse staffing information every day.Nursing and Physician ServicesC · widespreadCorrected May 17, 2023
  9. F740Ensure each resident must receive and the facility must provide necessary behavioral health care and services.Quality of Life and CareC · widespreadCorrected May 18, 2023
  10. F741Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents.Quality of Life and CareC · widespreadCorrected Jun 1, 2023
  11. F756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.Pharmacy ServiceD · isolatedCorrected Jun 12, 2023
  12. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryF · widespreadCorrected May 26, 2023
  13. F865Have a plan that describes the process for conducting QAPI and QAA activities.AdministrationF · widespreadCorrected May 26, 2023
  14. F868Have the Quality Assessment and Assurance group have the required members and meet at least quarterlyAdministrationF · widespreadCorrected May 15, 2023
  15. F880Provide and implement an infection prevention and control program.Infection ControlF · widespreadCorrected May 15, 2023
  16. F882Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.Infection ControlF · widespreadCorrected May 17, 2023

Staffing

From quarterly payroll reports

Hours per resident per day

  • All nursing staffRNs, LPNs and aides combined6.95hrsTop 1%+3.18 vs PR avg
  • Registered nursesRN hours only6.15hrsTop 1%+3.24 vs PR avg
  • Licensed practical nursesLPN hours0.79hrs
  • Nurse aidesCNA hours0.00hrs
  • Weekend nursingAll staff on Saturdays and Sundays4.90hrs
  • Puerto Rico average
  • Research benchmark (4.10 total, 0.75 RN)

Turnover & capacity

  • Nursing staff turnoverShare who left within a year · lower is better33%Above only 40% of peersPR avg 34%
  • RN turnoverRegistered nurses only26%Not ranked by CMS
  • Administrators who leftIn the past year0Stable leadership
  • Occupancy22 certified beds · ~15 residents a day69%Above only 43% of peersPR avg 73%

Fines & penalties

Roughly the past three years

Enforcement summary

  • $9,125In fines
  • 2Fines
  • 0Payment denials
  • $5,551PR avg in fines
Above only 25% of peersFewer fines than 25% of rated homes in Puerto Rico

Actions on record

  1. Feb 28, 2023Civil money penalty$4,545
  2. Feb 21, 2023Civil money penalty$4,580

Ownership

As filed with CMS

Structure

Ownership type
For profit - Limited Liability company
Chain
Independent
Certification
Medicare
Location type
Urban
Ownership change
None in the last 12 months

People and entities on file

Ownership Data Not Available

    Person Organization

    Sources & notes

    Public data, updated quarterly

    Data sources

    • CMS Care Compare · Provider InformationStar ratings, staffing hours, turnover, penalties and flags · processed February 2026.
    • CMS Health CitationsEvery deficiency from the last three inspection cycles, with scope, severity and inspection cycle.
    • CMS Penalties and Ownership filesCivil money penalties, payment denials, and the owners and managers on file.

    Notes

    • CMS Certification Number 405000 · SEPTIMO PISO DOCTORS CENTER HOSPITAL, SAN JUAN, PR, 00910.
    • Percentiles compare this facility with every rated nursing home in Puerto Rico and San Juan County. Turnover and fines are inverted so a high percentile is always good.
    • This is an informational summary of public data, not medical, legal, or placement advice. Facilities cannot pay to change it; a facility that believes a record is wrong can dispute it with CMS.

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