Velarion Records

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Facility record report · CMS certification number 405000

ALTERNATIVE HEALTHCARE SOLUTIONS LLC

SAN JUAN, Puerto Rico · Medicare

Finances, as filed

From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.

Cost report for 1 January 2024 to 31 December 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 29 August 2025.

None of these figures is carried on this report.

CMS report record 1437934, read from the public cost report file SNF10FY2024.zip.

Cost report for 1 January 2023 to 31 December 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 23 August 2024.

None of these figures is carried on this report.

CMS report record 1393023, read from the public cost report file SNF10FY2023.zip.

Cost report for 4 April 2022 to 31 December 2022 — a reporting period of 271 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 10 August 2023.

None of these figures is carried on this report.

CMS report record 1361797, read from the public cost report file SNF10FY2022.zip.

Five facilities of a similar size in Puerto Rico, fiscal year 2024

No other facility in Puerto Rico has a cost report on file for fiscal year 2024 with a bed count to set beside this one.

Ownership, as filed with CMS

Care Compare

As filed in the CMS file dated 1 August 2026 (Care Compare ownership).

Owner or managerRoleTypeOwnership percentageAssociation
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.Ownership Data Not AvailableCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.

Medicare enrollment

Not yet extracted for this facility.

Changes in ownership

Inspections

Inspection cycleHealth inspectionFire safety inspectionHealth deficienciesFire safety deficiencies
121 May 202621 May 20261114
23 December 20243 December 202495
318 April 202418 April 2024810

From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.

Deficiencies cited

28 deficiencies on file, newest inspection first
Inspection dateInspection typeTagCategoryWhat was citedScope and severityComplaintCorrectedCorrection date
21 May 2026HealthF 0583Resident Rights DeficienciesKeep residents' personal and medical records private and confidential.ENoDeficient, Provider has date of correction10 July 2026
21 May 2026HealthF 0656Resident Assessment and Care Planning DeficienciesDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.DNoDeficient, Provider has date of correction10 July 2026
21 May 2026HealthF 0658Resident Assessment and Care Planning DeficienciesEnsure services provided by the nursing facility meet professional standards of quality.DNoDeficient, Provider has date of correction10 July 2026
21 May 2026HealthF 0757Pharmacy Service DeficienciesEnsure each resident’s drug regimen must be free from unnecessary drugs.DNoDeficient, Provider has date of correction10 July 2026
21 May 2026HealthF 0761Pharmacy Service DeficienciesEnsure 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.FNoDeficient, Provider has date of correction10 July 2026
21 May 2026HealthF 0804Nutrition and Dietary DeficienciesEnsure food and drink is palatable, attractive, and at a safe and appetizing temperature.FNoDeficient, Provider has date of correction10 July 2026
21 May 2026HealthF 0812Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.FNoDeficient, Provider has date of correction10 July 2026
21 May 2026HealthF 0867Administration DeficienciesSet up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.FNoDeficient, Provider has date of correction10 July 2026
21 May 2026HealthF 0868Administration DeficienciesHave the Quality Assessment and Assurance group have the required members and meet at least quarterlyFNoDeficient, Provider has date of correction10 July 2026
21 May 2026HealthF 0880Infection Control DeficienciesProvide and implement an infection prevention and control program.FNoDeficient, Provider has date of correction10 July 2026
21 May 2026HealthF 0908Environmental DeficienciesKeep all essential equipment working safely.FNoDeficient, Provider has date of correction10 July 2026
3 December 2024HealthF 0584Resident Rights DeficienciesHonor 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.ENoDeficient, Provider has date of correction9 January 2025
3 December 2024HealthF 0732Nursing and Physician Services DeficienciesPost nurse staffing information every day.CNoDeficient, Provider has date of correction2 May 2025
3 December 2024HealthF 0802Nutrition and Dietary DeficienciesProvide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.FNoDeficient, Provider has date of correction12 June 2025
3 December 2024HealthF 0804Nutrition and Dietary DeficienciesEnsure food and drink is palatable, attractive, and at a safe and appetizing temperature.FNoDeficient, Provider has date of correction2 May 2025
3 December 2024HealthF 0806Nutrition and Dietary DeficienciesEnsure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.DNoDeficient, Provider has date of correction2 May 2025
3 December 2024HealthF 0812Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.FNoDeficient, Provider has date of correction12 June 2025
3 December 2024HealthF 0880Infection Control DeficienciesProvide and implement an infection prevention and control program.FNoDeficient, Provider has date of correction2 May 2025
3 December 2024HealthF 0883Infection Control DeficienciesDevelop and implement policies and procedures for flu and pneumonia vaccinations.CNoDeficient, Provider has date of correction2 May 2025
3 December 2024HealthF 0921Environmental DeficienciesMake sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.FNoDeficient, Provider has date of correction2 May 2025
18 April 2024HealthF 0584Resident Rights DeficienciesHonor 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.ENoDeficient, Provider has date of correction13 May 2024
18 April 2024HealthF 0655Resident Assessment and Care Planning DeficienciesCreate and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedENoDeficient, Provider has date of correction13 May 2024
18 April 2024HealthF 0694Quality of Life and Care DeficienciesProvide for the safe, appropriate administration of IV fluids for a resident when needed.ENoDeficient, Provider has date of correction15 May 2024
18 April 2024HealthF 0726Nursing and Physician Services DeficienciesEnsure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.FNoDeficient, Provider has date of correction15 May 2024
18 April 2024HealthF 0802Nutrition and Dietary DeficienciesProvide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.FNoDeficient, Provider has date of correction14 May 2024
18 April 2024HealthF 0812Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.FNoDeficient, Provider has date of correction13 May 2024
18 April 2024HealthF 0813Nutrition and Dietary DeficienciesHave a policy regarding use and storage of foods brought to residents by family and other visitors.FNoDeficient, Provider has date of correction20 April 2024
18 April 2024HealthF 0908Environmental DeficienciesKeep all essential equipment working safely.FNoDeficient, Provider has date of correction15 May 2024

From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.

Penalties

Not yet extracted for this facility.

Care Compare provider information

FieldAs filed
Provider TypeMedicare
Ownership TypeFor profit - Limited Liability company
Legal Business NameLegal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid Services2022-04-04
Provider Resides in HospitalN
Continuing Care Retirement CommunityN
UrbanY
County/ParishSan Juan
Telephone Number7879992959
Provider Changed Ownership in Last 12 MonthsN
With a Resident and Family CouncilNone
Automatic Sprinkler Systems in All Required AreasYes
Number of Certified Beds22
Average Number of Residents per Day22.3
Overall Rating4
Health Inspection Rating3
Processing Date2026-08-01

From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.

Every change on this record

How to read this report

Every figure is printed as the CMS file it came from printed it. Each cost-report figure carries the worksheet, line and column of form CMS-2540 it was read from, so a reader holding the same public file can go to that cell; each Care Compare and Medicare enrollment section names its file and the date CMS stamped on it.

A figure the filing does not carry is left out, and so is a figure whose value the filing’s own arithmetic contradicts. Net income is printed with what the form’s own arithmetic shows about it — plainly where it follows from the lines above it, and, where it does not, beside what the form’s own lines leave unaccounted for. An ownership field left empty carries the dated sentence on CMS’s pause of the expanded Form CMS-855A disclosure. A source that holds nothing for this facility says so in its section.

This report carries no percentile and no score, and it does not place this facility above or below another. The five facilities above are the one comparison it draws: the nearest certified bed counts in the same state at the same fiscal year, listed by name. Nurse staffing is printed in its own section, on its own page, apart from the cost-report figures.

How to cite this report

Velarion Records, ALTERNATIVE HEALTHCARE SOLUTIONS LLC — facility record report, CMS certification number 405000. https://velarionrecords.com/facility/405000/report.

Published by VELARIONAI LLC · Andrew Richardson, founder. Corrections: hello@velarionrecords.com, quoting certification number 405000. Velarion Records publishes these records as filed.

Nurse staffing, quarter by quarter

Hours this facility reported to CMS’s Payroll-Based Journal, one row per quarter, oldest first, each with how its figures are derived and the file it came from.

Nurse staffing hours by quarter
QuarterQuarter endedDays reportedResident daysRegistered nurse hoursLicensed practical nurse hoursNurse aide hoursTotal nurse hours
2023Q230 June 2023911,0707,039.252,460.2509,499.5
2023Q330 September 2023921,1637,666.52,516.5010,183
2023Q431 December 2023921,1867,7162,857.5010,573.5
2024Q131 March 2024918147,2322,326.509,558.5
2024Q230 June 2024911,0327,1291,87609,005
2024Q330 September 2024921,4967,0672,87009,937
2024Q431 December 2024921,0387,0902,26609,356
2025Q131 March 2025901,2047,1021,78208,884
2025Q230 June 2025911,1467,1901,540.508,730.5
2025Q330 September 2025921,3938,5731,104.509,677.5
2025Q431 December 2025921,6577,5921,35808,950
2026Q131 March 2026902,0047,9161,18109,097
Nurse staffing hours per resident day by quarter
QuarterRegistered nurse hours per resident dayLicensed practical nurse hours per resident dayNurse aide hours per resident dayTotal nurse hours per resident day
2023Q26.5787382.29929908.878037
2023Q36.5920032.16380108.755804
2023Q46.5059022.40935908.915261
2024Q18.8845212.858108011.742629
2024Q26.9079461.81782908.725775
2024Q34.723931.91844906.64238
2024Q46.8304432.18304409.013487
2025Q15.8986711.48006607.378738
2025Q26.2739971.34424107.618237
2025Q36.1543430.79289306.947236
2025Q44.5817740.81955305.401328
2026Q13.95010.58932104.539421

How each quarter is derived, and its file

  • 2023Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-06-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-06-01.csv
  • 2023Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-09-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-09-01.csv
  • 2023Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-12-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-12-01.csv
  • 2024Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-01-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-01-01.csv
  • 2024Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-04-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-04-01.csv
  • 2024Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-09-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-09-01.csv
  • 2024Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-12-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-12-31.csv
  • 2025Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-01-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-01-01.csv
  • 2025Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-04-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-04-01.csv
  • 2025Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-07-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-07-01.csv
  • 2025Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-10-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-10-01.csv
  • 2026Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2026-01-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2026-01-01.csv

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