Not rated by CMS — ratings are suppressed for new or low-volume facilities.
The next survey window likely opens around January 2027
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Totally Kids Specialty Healthcare - Sun Valley during CMS and state inspections, most recent first.
A resident with multiple congenital conditions, a tracheostomy, and moderately impaired cognition, on a regular diet with pureed texture, did not receive all items listed on the facility’s lunch menu. The posted menu called for a turkey burger on a bun with lettuce, tomato, sweet potato fries, pea and cheese salad, chilled peaches, and 1% milk, but the meal card and tray contained only pureed turkey, peas, and peaches with water. The DS reported omitting the bun based on an undocumented belief that the resident did not like bread and admitted failing to provide lettuce, tomato, sweet potato fries, cheese in the peas, and milk because the menu was not checked while rushing, contrary to facility menu guidelines.
The facility failed to submit direct care staffing information based on payroll data for the first quarter of 2024. The CASPER PBJ Staffing Report review showed missing data for this period. The Financial Coordinator claimed to have submitted the reports quarterly but did not retain copies or provide documentation for the specified dates. The Administrator in Training confirmed the FC's responsibility for submission but could not provide proof of submission to CMS.
The facility failed to develop comprehensive person-centered care plans for six residents, leading to potential inadequate care. A resident at risk for pressure injuries, another with bladder incontinence, and two on anticonvulsant medications lacked appropriate care plans. Additionally, a resident on a toileting program and another at high fall risk did not have care plans addressing these needs. The absence of these care plans was confirmed by the DON, highlighting the importance of care plans in guiding staff interventions.
A facility failed to properly store medications, leaving two medication carts unlocked and unattended, risking unauthorized access. Opened olopatadine hydrochloride vials were not discarded after 30 days for a resident with severe disabilities, and an expired antibiotic was not removed from a cart for a resident with epilepsy. Staff acknowledged these oversights, which compromised medication safety.
A resident with cerebral palsy and contractures did not receive prescribed PROM exercises, as indicated by missing documentation in the Restorative Treatment Record. Interviews with staff confirmed the lack of documentation, which is considered as the treatment not being performed. Additionally, the facility failed to develop a person-centered care plan for the resident's contracture management, contrary to its policies.
A resident with severe cognitive impairment and a physician's order to wear a soft helmet when out of the crib was observed without the helmet, placing them at risk for injury. The facility's policy required all physician orders to be followed, but staff failed to ensure the resident's safety by not adhering to this order.
A facility failed to follow physician orders for a resident with bladder incontinence by not applying warm compresses and performing bladder massages before catheterization. The resident, in a vegetative state, required specific interventions when bladder scans showed over 300 ml of urine. Records showed multiple instances where these interventions were not documented, confirmed by interviews with staff, indicating a failure to adhere to care protocols.
The facility failed to document the output of two residents, both dependent on enteral feeding, as required by policy. This lack of documentation, confirmed by the DON, is crucial for monitoring hydration and preventing dehydration or fluid overload.
A facility failed to follow its enteral tube feeding policy for a resident with a GT by not labeling the y-connector with the date it was last changed. This was observed during medication administration, where the LVN confirmed the oversight. The resident, with severe medical conditions and total dependence on staff, was at risk due to this non-compliance. The DON also acknowledged the requirement for weekly changes and labeling to prevent infection.
A facility failed to change and label the ventilator humidifier water bottle for a resident requiring mechanical ventilation, as per policy. The resident, with a history of cerebral palsy and anoxic brain damage, was dependent on staff for all ADLs. The oversight was confirmed by a Respiratory Care Practitioner and the Respiratory Department Supervisor, who noted the increased risk of infection due to this deficiency.
A facility failed to ensure a specific indication was written for an antibiotic order for a resident, as required by their medication administration policy. The order for Augmentin lacked a specific diagnosis, which was confirmed by the Infection Preventionist and DON as incomplete. This deficiency placed the resident at risk of receiving inappropriate care due to inaccurate medical records.
The facility's Arbitration Agreement failed to include a venue selection suitable for both the resident and the facility, compromising the fairness of the arbitration process. This omission was confirmed by the Social Service Director, and the Administrator in Training was unaware of this requirement.
A facility failed to follow its Sterile Tracheal Suction policy when a Respiratory Care Practitioner did not remove non-sterile gloves before donning sterile gloves during a procedure on a resident with a tracheostomy. This oversight, confirmed by the Respiratory Department Supervisor, had the potential to increase the risk of healthcare-acquired infections for the resident, who was dependent on staff for all activities of daily living.
Failure to Follow Menu and Provide All Planned Food Items for a Pureed Diet
Penalty
Summary
Surveyors identified a deficiency in which the facility failed to follow the planned menu and provide all menu items to a resident receiving a regular diet with pureed texture. The resident had diagnoses including septo-optic dysplasia of the brain, multiple congenital malformations, and a tracheostomy, and an MDS showing moderately impaired cognition with a need for staff assistance with eating and oral hygiene. The facility’s weekly menu for the relevant lunch meal listed a turkey burger on a hamburger bun with lettuce leaf, tomato slices, sweet potato fries, pea and cheese salad, chilled peaches, and 1% milk. However, the resident’s meal card for that lunch only listed turkey burger, peas, peaches, and water. During kitchen observations, the Dietary Supervisor (DS) prepared and pureed a turkey patty, peas, and peaches, and then assembled the resident’s tray with only those three pureed items. When the tray was later observed in the resident’s room, it did not include a hamburger bun, lettuce leaf, tomato slices, sweet potato fries, pea and cheese salad (including cheese), or 1% milk as specified on the menu. In interview, the DS stated she did not serve the bun because she believed the resident did not like bread, but acknowledged there was no documentation of this preference in the resident’s nutritional assessment and that the bun should have been served because it was on the menu. The DS further stated she did not serve the lettuce, tomato slices, sweet potato fries, or cheese with the peas because she had not checked the menu and was in a rush, despite facility policy requiring foods to be prepared according to the menu and the DFNS to supervise meal preparation and service to assure the menu is followed and diet orders are implemented.
Failure to Submit Staffing Data for Q1 2024
Penalty
Summary
The facility failed to electronically submit direct care staffing information daily, based on payroll data, for the first quarter of 2024. This deficiency was identified during a review of the Certification and Survey Provider Enhanced Report (CASPER) payroll-based Journal (PBJ) Staffing Report, which indicated that the facility did not submit the required data for the period from January 1, 2024, through March 31, 2024. During an interview, the Financial Coordinator (FC) stated that she submitted the Staffing Data report every quarter for 2024 but did not keep copies of the PBJ Reports. Although she received electronic confirmation of data submission, she could not provide documentation for the staffing report submission for the specified dates. The Administrator in Training (AIT) confirmed that the FC was responsible for submitting the CASPER PBJ Staffing Report to CMS but was also unable to provide proof of submission for 2024.
Failure to Develop Comprehensive Care Plans for Residents
Penalty
Summary
The facility failed to develop and implement comprehensive person-centered care plans for six residents, leading to potential inadequate care. Resident 16, who was at risk for developing pressure injuries, did not have a care plan addressing this risk despite being immobile and having a stage one pressure injury. The MDS nurse acknowledged the absence of a long-term care plan for pressure injury prevention, which is crucial for addressing the resident's needs and preventing further skin injuries. The Director of Nursing (DON) confirmed the lack of a care plan and highlighted the potential outcome of inadequate care and monitoring. Resident 27, diagnosed with quadriplegia and bladder incontinence, also lacked a comprehensive care plan addressing bladder incontinence. The resident required intermittent catheterization, as ordered by the physician, but no care plan was developed to guide staff in providing the necessary care. The DON confirmed the absence of a person-centered care plan for bladder incontinence, which could lead to a lack of care and inability to implement specific services required by the resident. Additionally, Residents 22 and 24, who were on anticonvulsant medications, did not have care plans addressing their medication use. The MDS nurse and DON acknowledged the oversight, noting the importance of care plans in providing specific interventions for residents on high-risk medications. Resident 13, on a bowel and bladder toileting program, and Resident 39, at high risk for falls, also lacked care plans addressing these needs. The absence of these care plans was confirmed by the DON, who emphasized the importance of care plans in guiding staff interventions and preventing adverse outcomes.
Medication Storage Deficiencies in LTC Facility
Penalty
Summary
The facility failed to ensure that drugs and biologicals were stored in accordance with accepted professional principles. Two medication carts were left unlocked and unattended, posing a risk of unauthorized access and contamination. On one occasion, a Respiratory Therapist left a medication cart unlocked while stepping into another room, and on another occasion, a Licensed Vocational Nurse left a cart with prepared medications in syringes unattended while using the restroom. Both staff members acknowledged that the carts should not have been left unattended, as it compromised the safety of the medications. The facility also failed to discard opened olopatadine hydrochloride solution vials after 30 days of opening for a resident with severe intellectual disabilities and cervical spinal cord injury. The resident was dependent on staff for all activities of daily living and received the eye drops twice daily. During an inspection, two opened vials of the solution were found in the medication cart without a beyond-use date, and the Licensed Vocational Nurse confirmed that they should have been discarded after 30 days. Additionally, the facility did not remove an expired antibiotic, nitrofurantoin, from the medication cart for a resident with epilepsy and spastic quadriplegic cerebral palsy. The resident was dependent on staff for personal care and had been receiving the antibiotic for a urinary tract infection. The medication was found in the cart three days past its expiration date, and the Licensed Vocational Nurse acknowledged that it should have been removed to prevent accidental administration of an expired medication.
Failure to Provide PROM Exercises and Develop Care Plan for Resident with Contractures
Penalty
Summary
The facility failed to provide appropriate care for a resident with limited range of motion (ROM) by not administering Passive Range of Motion (PROM) exercises as ordered by the physician. The resident, who was admitted with diagnoses including cerebral palsy and contractures of the elbow and wrist, had physician orders for PROM exercises to be performed on both upper and lower extremities twice daily. However, the Restorative Treatment Record showed multiple instances where these exercises were not documented, indicating they may not have been performed. Interviews with the Licensed Vocational Nurse (LVN) and the Director of Nursing (DON) confirmed the lack of documentation for the PROM exercises on several dates. The LVN acknowledged that if the treatment was not documented, it was considered not done, and the DON emphasized the importance of these exercises in preventing the worsening of the resident's contractures. Additionally, it was revealed that the facility did not develop a person-centered care plan for the resident's contracture management, which is crucial for monitoring the resident's condition and ensuring adequate care. The facility's policies and procedures require that ROM exercises be documented immediately after being performed, and any gaps in documentation are not acceptable. The lack of documentation and the absence of a care plan for the resident's contracture management highlight deficiencies in the facility's adherence to its own policies, potentially leading to inadequate care for the resident.
Failure to Ensure Resident Wore Required Safety Helmet
Penalty
Summary
The facility failed to ensure that a resident with a physician's order to wear a soft helmet when out of the crib was wearing the helmet, placing the resident at risk for injury. The resident, admitted on February 1, 2018, had diagnoses including congenital malformations and required attention to a tracheostomy. The Minimum Data Set (MDS) dated February 1, 2024, indicated the resident had severely impaired cognitive skills and required varying levels of assistance with daily activities. On December 28, 2024, the resident was observed ambulating independently in the activities room without wearing the required helmet. A registered nurse confirmed that the resident should have been wearing the helmet for safety reasons and stated that it was the responsibility of all staff to ensure compliance with the physician's order. The facility's policy, dated February 5, 2023, indicated that all physician orders should be carried out completely and in a timely manner, which was not adhered to in this instance.
Failure to Follow Physician Orders for Bladder Incontinence Care
Penalty
Summary
The facility failed to provide appropriate treatment and services for a resident with bladder incontinence, specifically by not adhering to physician orders for warm compress application and bladder massage prior to in and out catheterization. The resident, who was in a persistently vegetative state and dependent on staff for all care, had a history of anoxic brain damage, epilepsy, and urinary infections. Physician orders required a bladder scan four times a day, and if 300 ml or more of urine was detected, a warm compress and bladder massage were to be performed before catheterization. The Treatment Administration Records (TAR) for the resident indicated multiple instances where the bladder scan showed more than 300 ml of urine, yet there was no documentation of the warm compress and bladder massage being performed, nor the subsequent catheterization as ordered. Specifically, on several dates, the records showed significant urine retention, but the required interventions were not documented, indicating a failure to follow the physician's orders. Interviews with the Licensed Vocational Nurse (LVN) and the Director of Nursing (DON) confirmed that the staff did not document the necessary interventions or catheterizations in the resident's records. The facility's policies required documentation of all treatments and adherence to physician orders, which was not followed in this case, potentially increasing the resident's risk for urinary tract infections.
Failure to Document Resident Output
Penalty
Summary
The facility failed to implement its policy on intake and output documentation, which led to a deficiency in monitoring the hydration status of two residents, Resident 18 and Resident 8. Resident 18, who was admitted with conditions including spastic diplegic cerebral palsy, tracheostomy, and gastrostomy, was found to have no documented evidence of total output every shift as required by the facility's policy. The Director of Nursing (DON) confirmed the absence of documentation in Resident 18's Treatment Administration Record (TAR) for December 2024, which is crucial for monitoring hydration and preventing dehydration, especially given the resident's dependence on enteral feeding and issues with constipation. Similarly, Resident 8, diagnosed with spastic quadriplegic cerebral palsy and also dependent on enteral feeding, had no documented output records in their TAR for the same period. The DON acknowledged the lack of documentation, which is essential for assessing the resident's hydration status and preventing fluid overload. The facility's policy, reviewed in August 2023, mandates that the charge nurse evaluate and document each resident's intake and output every shift to ensure adequate hydration, which was not adhered to in these cases.
Failure to Label GT Y-Connector as per Policy
Penalty
Summary
The facility failed to adhere to its enteral tube feeding policy and procedure for a resident with a gastrostomy tube (GT). The deficiency was identified during an observation of medication administration, where it was noted that the y-connector of the resident's GT was not labeled with the date it was last changed. This oversight was confirmed by the Licensed Vocational Nurse (LVN) who administered the medication and acknowledged that the y-connector should be changed every Sunday and labeled accordingly. The absence of a date on the y-connector label indicated non-compliance with the facility's policy, which requires labeling to ensure timely changes and prevent microbial growth. The resident involved had a history of severe medical conditions, including encephalopathy, respiratory failure, and cerebral palsy, and was totally dependent on staff for all activities of daily living. The facility's Director of Nursing (DON) also confirmed the requirement for the y-connector to be changed weekly and labeled to prevent infection risks. The facility's policy on medication administration via enteral feeding tubes emphasizes the importance of maintaining cleanliness and safety, further underscoring the deficiency in this instance.
Failure to Change and Label Ventilator Humidifier Water Bottle
Penalty
Summary
The facility failed to provide appropriate respiratory care for a resident, identified as Resident 22, who required mechanical ventilation. The deficiency was identified when it was observed that the aerosol/ventilator humidifier water bottle connected to the resident was not labeled with the date it was last changed. According to the facility's policy, the humidifier water bottle should be changed every three days and labeled with the date of change. This oversight was confirmed during an observation and interview with a Respiratory Care Practitioner, who acknowledged that the lack of labeling and timely change could lead to a respiratory infection. Resident 22 had a history of cerebral palsy, anoxic brain damage, and convulsions, and was totally dependent on staff for all activities of daily living. The resident's care plan emphasized the importance of remaining free from complications related to ventilator dependence, including upper respiratory infections. The facility's policy, last reviewed in 2018, required that all respiratory equipment be dedicated to individual residents and maintained according to specific guidelines, including the regular changing and labeling of humidifier water bottles. The failure to adhere to these guidelines was further corroborated by the Respiratory Department Supervisor, who noted the increased risk of healthcare-acquired infections due to this oversight.
Incomplete Antibiotic Order Lacks Specific Diagnosis
Penalty
Summary
The facility failed to maintain complete and accurate medical records for one of the sampled residents by not ensuring a specific indication was written for an order of Augmentin, an antibiotic. This oversight was identified during a review of the resident's medical records, which showed an order for Augmentin ES-600 oral suspension to be administered via gastrostomy tube twice a day for seven days. However, the order lacked a specific diagnosis or infection that the medication was intended to treat, which is a requirement for antibiotic orders. Interviews with the Infection Preventionist and the Director of Nursing confirmed that the physician's order was incomplete, as it did not specify the infection being targeted by the antibiotic. The facility's policy on medication administration requires that physician-ordered medications include the proper resident name, medication, dosage, time, route, and rationale. The absence of a specific diagnosis in the antibiotic order placed the resident at risk of not receiving appropriate care due to inaccurate medical information.
Arbitration Agreement Lacks Venue Selection
Penalty
Summary
The facility failed to provide an Arbitration Agreement that included the selection of a venue suitable for both the resident or their representative and the facility, which is necessary to ensure a fair arbitration process. During a review of the facility's Arbitration Agreement, it was found that the agreement did not specify a neutral venue that would meet the needs of both parties involved. This was confirmed during an interview with the Social Service Director, who acknowledged the omission. Additionally, the Administrator in Training was unaware of the requirement for the Arbitration Agreement to include a suitable venue for both parties.
Failure to Follow Sterile Tracheal Suction Protocol
Penalty
Summary
The facility failed to implement its policy on Sterile Tracheal Suction, which led to a deficiency in infection prevention and control. During an observation, Respiratory Care Practitioner 2 (RCP 2) did not remove non-sterile gloves before donning sterile gloves while performing a sterile tracheal suction on Resident 4. This action was contrary to the facility's policy, which requires the removal of non-sterile gloves before applying sterile gloves to maintain a sterile field. RCP 2 was unaware of this requirement, as confirmed during an interview. Resident 4, who was admitted with diagnoses including encephalopathy and chronic respiratory failure, had a tracheostomy in place and was totally dependent on staff for all activities of daily living. The resident's care plan required regular assessment and suctioning for excessive secretions. The failure to follow proper glove protocol during the suction procedure had the potential to increase the risk of healthcare-acquired infections for Resident 4, as noted by the Respiratory Department Supervisor.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Sun Valley
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Villa Scalabrini Special Care | 0.4 mi | — | 10 | 0 |
| The Hills Healthcare Center | 2.1 mi | — | 17 | 0 |
| Pacifica Hospital Of The Valley Dp Snf | 2.3 mi | — | 22 | 0 |
| All Saints Healthcare Subacute | 2.5 mi | — | 36 | 1 |
| High Valley Lodge | 2.7 mi | — | 1 | 0 |
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