Home / Puerto Rico / San Juan
Alternative Healthcare Solutions LLC
Septimo Piso Doctors Center Hospital, San Juan, PR 00910 · San Juan County · (787) 999-2959
22 certified beds, about 22 residents a day · For profit - Limited Liability company · Medicare since 2022
Certified for Medicare
Overall
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
Not rated
CMS note: Not enough data available to calculate a star rating.
CMS Care Compare ratings, data as of September 1, 2026 · CCN 405000 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on May 21, 2026, inspectors cited 11 health deficiencies (the Puerto Rico average is 7.3, the national average 9.2).
None of its 28 health citations since April 2024 was rated as actual harm or immediate jeopardy.
CMS lists no fines against this home in the last three years.
Nurses and nurse aides worked 4.54 hours per resident per day, against 3.80 across Puerto Rico and 3.86 nationally. Registered nurses accounted for 3.95 of those hours.
31.8% of nursing staff left within the year CMS measured (Puerto Rico average 35.7%).
Health inspections
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
804/24
912/24
1105/26
Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit
Where its citations fall on CMS's grid
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 28 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
0K
0L
Actual harm
0G
0H
0I
Potential for more than minimal harm
4D
5E
17F
Potential for minimal harm
0A
0B
2C
May 21, 2026Standard inspection · 11 citations
- F 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.
Inspectors wroteBased on observations and staff interviews, it was determined that the facility failed to ensure medications and supplements from unauthorized access.
- F Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Inspectors wroteBased on observations made in the kitchen in the company of the kitchen coordinator (employee #6), it was determined that the nutritional value of the food was not being ensured due to improper storage in the refrigerator which can affect all admitted residents.
- F Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on observation, interviews, and food temperature measurements, it was determined that the facility failed to maintain proper food handling practices for disease prevention and food safety which can affect 13 out of 13 residents admitted .
- F Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Inspectors wroteBased on review of Quality Assessment Performance Improvement-QAPI and interview with facility QAPI officer (employee #2) on 05/21/26 at 11:55 am, it was determined that the facility failed to assure QAPI program feedback and data system monitoring performed by the Director of Nursing and Administrator are included in every committee meeting.
- F Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Inspectors wroteBased on review of Quality Assessment Performance Improvement-QAPI and interview with facility QAPI officer (employee #2) on 05/21/26 at 11:55 am, it was determined that the facility failed to maintain a QAPI committee with participation of the required members established in 483.75 (g)(1):
- F Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation and staff interview, it was determined that the facility failed to implement and maintain an effective infection prevention and control program by failing to ensure proper hand hygiene practices during medication administration. These deficient practices had the potential to increase the risk of cross-contamination and transmission of infectious organisms among residents.
- F Keep all essential equipment working safely.
Inspectors wroteBased on observation, it was determined that the facility failed to maintain the kitchen freezer in proper condition.
- E Keep residents' personal and medical records private and confidential.
Inspectors wroteBased on observations and staff interviews, the facility failed to maintain the confidentiality of residents' clinical information by leaving identifiable resident documents exposed and unattended on the top of cart for 5 of 5 residents observed during medication administration pass. (Resident #17, # 20, #25, #26 and new resident admitted on [DATE], late in the afternoon at 5:05 PM on room [ROOM NUMBER]B).
- D Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Inspectors wroteBased on interview and review of documents during initial pool on 5/20/26 at 9:10 am and further investigation on 5/21/26 at 8:55 am, it was identified facility failed to document a smoking plan of care for a resident who was receiving services and smokes in 1 out of 1 resident. (RR#19)
- D Ensure services provided by the nursing facility meet professional standards of quality.
Inspectors wroteBased on records reviewed and observation, it was determined that the facility failed to meet professional quality standards to 1 out 1 resident. (RR#25)
- D Ensure each resident’s drug regimen must be free from unnecessary drugs.
Inspectors wroteBased on records review (RR) and staff interview, the facility failed to ensure documentation of education regarding the risk and benefits of antipsychotic medication and documentation of informed consent for its use for 1 out 1 resident reviewed for psychotropic medications (RR #28).
December 3, 2024Standard inspection · 9 citations
- F Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
Inspectors wroteBased on dining observations, review of staffing pattern and facility staff interview performed on 12/02/2024 through 12/03/2024 to from 8:30 AM through 4:30 PM, it was determined that the facility failed to ensure that facility failed to have sufficient staff to carry out the functions of the food and nutrition services. This deficiency affects 5 out of 5 cases admitted receiving services.
- F Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Inspectors wroteBased on dining observations, review of policies procedures and facility staff interview performed on 12/02/2024 through 12/03/2024 to from 8:30 AM through 4:30 PM, it was determined that the facility failed to ensure that each resident receives, and the facility provides food and drinks that are palatable, attractive, and at a safe and appetizing temperature. This deficiency affects 1 out of 5 cases admitted receiving services (Resident #4).
- F Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on flash tour and kitchen observations, performed on 12/02/2024 through 12/03/2024 from 8:30 AM through 4:30 PM, it was determined that the facility failed to ensure that facility failed to store, prepare, distribute and serve food in accordance with professional standards for food service safety. This deficiency affects 5 out of 5 cases admitted receiving services
- F Provide and implement an infection prevention and control program.
Inspectors wroteBased on announces recertification survey, during the observation procedure by the staff on 12/02/2024, it was determined that the facility failed to ensure follow accepted standards of practice to prevent the transmission of infections and communicable disease for 2 out of 5 Resident. (Resident #4 and #111)
- F Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Inspectors wroteBased on observations of the physical environment and facility staff interview performed on 12/02/2024 through 12/03/2024 from 8:00 AM through 4:00 PM, it was determined that the facility failed to ensure to provide the residents a safe, funtional, sanitary and comfortable environment.
- E 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.
Inspectors wroteBased on Physical enviroment observations, performed on 12/02/2024 through 12/03/2024 to from 8:30 AM through 3:30 PM, it was determined that the facility failed to ensure a safe, clean, comfortable and homelike environment for 3 out of 3 rooms observed.
- D Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Inspectors wroteBased on dining observations, review of policies procedures and facility staff interview performed on 12/02/2024 through 12/03/2024 to from 8:30 AM through 4:30 PM, it was determined that the facility failed to ensure that each resident receives, and the facility provides food and drink that is palatable, attractive, and at a safe and appetizing temperature. This deficiency affects 1 out of 5 cases admitted receiving services (Resident #4).
- C Post nurse staffing information every day.
Inspectors wroteBased on unannounced recertification survey, during the observation conducted at the nursing desk on 12/02/2024, it was determined that the facility failed did not ensure that the following information was provided daily postings.
- C Develop and implement policies and procedures for flu and pneumonia vaccinations.
Inspectors wroteBased on records reviewed (RR) and observations on 12/02/2024, it was determined that the facility failed to ensure that education was provided to residents on the benefits and side effects of Covid-19, influenza and pneumococcal vaccines.
April 18, 2024Standard inspection · 8 citations
- F Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Inspectors wroteBased on an interview with the Director of Nursing (DON) employee #3 on 04/17/2024 through 04/18/2024 from 8:00 AM to 4:30 PM, it was determined that the facility failed to ensure that care and management of peripherally inserted central catheter (PICC) lines is provided by competent and trained nursing staff. Which can affect 2 out of 2 residents with PICC lines. (RR#6 and #8)
- F Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
Inspectors wroteBased on observations and interview with the Dietitian (employee #1) performed from 04/17/2024 thru 04/18/2024, from 8:00 AM thru 4:00 PM, it was determined that the facility failed to provide sufficient support for personnel safely and effectively carry out the functions of the food and nutrition service.
- F Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on observations of the Kitchen, review of policies procedures and facility staff interview performed on 04/17/2024 to from 8:00 AM through 4:00 PM, it was determined that the facility failed to comply with the required sink compartment sanitations.
- F Have a policy regarding use and storage of foods brought to residents by family and other visitors.
Inspectors wroteBased on review of policies, procedures and facility staff interview performed on 04/17/2024 to from 8:00 AM through 4:30 PM, it was determined that the facility failed to comply with the policy regarding use and storage of foods brought to residents by family and other visitors to ensure safe and sanitary storage, handling, and consumption.
- F Keep all essential equipment working safely.
Inspectors wroteBased on observations performed from 04/17/2024 through 04/18/2024, from 8:20 AM through 4:30 PM, it was determined that the facility failed to maintain equipment in a safe operating condition.
- E 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.
Inspectors wroteBased on observations of the physical environment, review of policies and procedures and facility staff interview performed on 04/17/2024 through 04/18/2024, from 8:00 AM through 5:00 PM, it was determined that the facility failed to promote the resident right to receive services in a safe, clean, comfortable, and homelike environment.
- E Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Inspectors wroteBased on eleven records reviewed (RR) resident interview, and interview with the Nursing Supervisor (employee #2) performed from 04/17/2024 thru 04/18/20234 from 8:30 AM thru 4:30 PM, it was determined that the facility failed to ensure to develop and implement a baseline care plan that includes the instructions needed to provide the local care to the right power line. This deficient practice was identified in 1 out of 2 residents with central line (RR #8).
- E Provide for the safe, appropriate administration of IV fluids for a resident when needed.
Inspectors wrote2. R. R #8 is a [AGE] year-old male resident admitted [DATE] with a diagnosis of Lumbar Discitis plus Osteomyelitis. Resident was admitted to complete 90 days of antibiotic therapy. This resident was admitted with a power central line in the right subclavian to be used to administer antibiotic therapy. While reviewing the medical record on 04/18/2024 at 10:00 AM with Nursing Supervisor (employee #2) it was identified that no order for the care to the power line was found. During interview on 04/18/2024 at 1:10 PM Nursing Supervisor (employee #2) stated that this case does not have an order for the care to the power line and that this vascular access was inserted in another facility and that the resident had it when he was admitted . [...]
Fire safety inspections
29 fire safety citations on file: 14 on May 21, 2026, 5 on December 3, 2024, 10 on April 18, 2024.
Every fire safety citation29 citations
- F Properly select, install, inspect, or maintain portable fire extinguishes.
- F To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- F Ensure that testing and maintenance of electrical equipment is performed.
- E Keep aisles, corridors, and exits free of obstruction in case of emergency.
- E Install emergency lighting that can last at least 1 1/2 hours.
- E Provide properly protected cooking facilities.
- E Install an approved automatic sprinkler system.
- E Inspect, test, and maintain automatic sprinkler systems.
- D Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
- D Install proper backup exit lighting.
- D Install a fire alarm system that can be heard throughout the facility.
- D Have approved installation, maintenance and testing program for fire alarm systems.
- D Properly install and monitor supervisory attachments on automatic sprinkler systems.
- D Have generator or other power source capable of supplying service within 10 seconds.
- F Have approved installation, maintenance and testing program for fire alarm systems.
- F Install an approved automatic sprinkler system.
- F Ensure medical gas and vacuum systems have documented maintenance programs.
- E Provide properly protected cooking facilities.
- D Properly select, install, inspect, or maintain portable fire extinguishes.
- F Have simulated fire drills held at unexpected times.
- F Have generator or other power source capable of supplying service within 10 seconds.
- E Have properly located and lighted "Exit" signs.
- E Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- C Include a process for Emergency Preparedness collaboration.
- C Establish policies and procedures for sheltering.
- C Establish policies and procedures for volunteers.
- C Provide a means of sharing information on occupancy/needs.
- C Provide family notifications of emergency plan.
- C Establish staff and initial training requirements.
Fines and payment denials
CMS lists no fines or payment denials against this home in the last three years. The national average is 0.9 fines per home.
Staffing
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Puerto Rico | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 4.54 | 3.80 | 3.86 |
| Registered nurses | 3.95 | 3.01 | 0.69 |
| All nursing staff on weekends | 3.41 | 3.03 | 3.42 |
| Nurse aides | 0.00 | ||
| Licensed practical nurses | 0.59 | ||
| Nursing staff turnover (share who left in a year) | 31.8% | 35.7% | 45.8% |
| Registered nurse turnover | 29.4% | 35.7% | 42.9% |
| Administrators who left | 0 |
CMS expects 3.07 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Staffing by quarter, from daily payroll records
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 4.99 on weekdays and 3.41 on weekends, 32% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 10.1% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 7.62 in April to June 2025 to 4.54 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 4.54 | 3.95 | 4.99 | 3.41 | 10.1% | 0 of 90 | 22 |
| Oct to Dec 2025 | 5.40 | 4.58 | 5.91 | 4.11 | 11.7% | 0 of 92 | 18 |
| Jul to Sep 2025 | 6.95 | 6.15 | 7.80 | 4.90 | 7.7% | 0 of 92 | 15 |
| Apr to Jun 2025 | 7.62 | 6.27 | 8.12 | 6.35 | 10.1% | 0 of 91 | 13 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Puerto Rico, Jan to Mar 2026 | 3.47 | 2.82 | 3.76 | 2.77 | 5.2% | 1.2% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Quality measures
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Puerto Rico | US |
|---|---|---|---|
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.8 | 0.3 | 1.6 |
Owners and operators
Legal business name: Legal Business Name Not Available.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Ownership data not available |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Questions to ask on a visit
Chosen from this home's own inspection record.
- Can we see a week of menus and the kitchen, and how are special diets handled?Inspectors cited 9 problems in this area, most recently on May 21, 2026: "Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature."
- What changed in infection control since the last inspection, and who on staff is the infection preventionist?Inspectors cited 3 problems in this area, most recently on May 21, 2026: "Provide and implement an infection prevention and control program."
- Can we see a resident room, a shower room and the dining room on this visit?Inspectors cited 3 problems in this area, most recently on May 21, 2026: "Keep all essential equipment working safely."
- How do residents and families raise a complaint or grievance, and how fast is it answered?Inspectors cited 3 problems in this area, most recently on May 21, 2026: "Keep residents' personal and medical records private and confidential."
Other nursing homes nearby
- Multy Medical Skilled Nursing Facility Rio Piedras, 2.3 mi · 1 of 5 stars · 77 citations
- Centro De Cuidado Prolongado San Lucas Rio Piedras, 3.5 mi · 1 of 5 stars · 86 citations
- Millennium Institute for Advance Nursing Care Inc Rio Piedras, 4.8 mi · 5 of 5 stars · 19 citations
- Centro Medico Wilma N Vazquez SNF Vega Baja, 21.4 mi · 3 of 5 stars · 35 citations
Puerto Rico contacts for a concern about a nursing home
These are the official offices in Puerto Rico. NursingHomeClear cannot take or act on complaints.
- Inspections and complaints: Departamento de Salud de Puerto Rico, Secretaria Auxiliar para la Regulacion de la Salud Publica (Division de Medicare), the state agency that inspects nursing homes for CMS and takes complaints about care.
- Resident advocate: Programa Estatal del Procurador de Cuidado de Larga Duracion (Ombudsman CLD), Oficina del Procurador de las Personas de Edad Avanzada, (787) 721-6121. The long-term care ombudsman is a free, confidential advocate for residents and families, set up under the federal Older Americans Act.
Common questions
- What is Alternative Healthcare Solutions LLC's Medicare star rating?
- CMS rates Alternative Healthcare Solutions LLC 4 out of 5 stars overall, with 3 for health inspections, 5 for staffing and no for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did Alternative Healthcare Solutions LLC get at its last inspection?
- 11 health deficiencies at the standard inspection on May 21, 2026. The Puerto Rico average is 7.3.
- Has Alternative Healthcare Solutions LLC been fined?
- CMS lists no fines in the last three years.
- Does Alternative Healthcare Solutions LLC accept Medicaid?
- CMS lists it as "Medicare", so it is not certified for Medicaid.
- Who owns Alternative Healthcare Solutions LLC?
- CMS lists 1 owner or manager. Legal business name: Legal Business Name Not Available.
Sources
- Ratings, staffing and fines: CMS Provider Information, released September 30, 2026, data as of September 1, 2026.
- Citations: CMS Health Deficiencies and Fire Safety Deficiencies.
- Owners: CMS Ownership. Penalties: CMS Penalties.
- Staffing by quarter: CMS Payroll Based Journal Daily Nurse Staffing, April 2025 to March 2026, summed by NursingHomeClear.
- Inspector summaries: CMS Full Statement of Deficiencies (CMS-2567 text), data as of September 1, 2026. Each quote is the part of the statement before the detailed findings.
- Inspection reports with the inspectors' full notes are on this home's Medicare.gov page.
- Something wrong on this page? Ask for a correction. We fix errors in our copy of the data; findings themselves can only be changed by CMS and the state.
- NursingHomeClear is independent and not affiliated with CMS, Medicare or any state agency. This page reports federal records; it does not rate, recommend or endorse any home, and it is not medical or legal advice.