The Peaks Health & Rehabilitation
3150 North Winding Brook Road, Flagstaff, AZ 86001
The Peaks Health & Rehabilitation is a nursing home in Flagstaff, Arizona. This page lists the citations, fines and star ratings that CMS publishes for it. Each one has a date and a link to CMS.
At a glance
- CMS overall star rating3 of 5
- Last standard health inspectionFebruary 12, 2026 (8 months ago)
- Health citations since September 22, 202317 (Arizona average 21)
- Fines in the past three yearsNone listed by CMS
- CMS flagsNone listed by CMS
Get an email when CMS publishes something new about this home
One email per CMS update, only when something changed: a new citation, a fine, a star rating change, a new owner. Early access follows one home per address.
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CMS flags
CMS does not list this home as a Special Focus Facility or a candidate. CMS does not show an abuse icon for it. CMS lists no change of ownership in the past 12 months.
Inspections, fines and changes
This list shows every citation and fine in CMS's current data, which covers about the last three years. It also shows changes CMS made to this home's ratings and records.
CMS update of October 8, 2026
Star rating
The CMS overall star rating changed from 2 of 5 to 3 of 5.
Star rating
The CMS health inspection star rating changed from 2 of 5 to 3 of 5.
Health inspection on February 12, 2026
3 citationsCMS lists this as a standard inspection.
Show the 3 citations
Citation F0812. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
CMS lists it as corrected on March 14, 2026.
Citation F0689. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
CMS lists it as corrected on March 14, 2026.
Citation F0761. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
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.
CMS lists it as corrected on March 14, 2026.
CMS has cited this home for F0761 2 times since 2024.
Fire safety inspection on February 12, 2026
2 citationsCMS lists this as a standard inspection.
Show the 2 citations
Citation K0353. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Inspect, test, and maintain automatic sprinkler systems.
CMS lists it as corrected on May 15, 2026.
Citation K0372. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
CMS lists it as corrected on May 15, 2026.
CMS update of July 30, 2025
Staffing
Total nurse staffing reported to CMS went from 5.9 to 4.4 hours per resident per day.
Health inspection on July 10, 2025
1 citationCMS lists this as a complaint inspection.
Show the 1 citation
Citation F0609. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
CMS lists it as corrected on September 5, 2025.
CMS has cited this home for F0609 2 times since 2024.
CMS update of April 30, 2025
Star rating
The CMS overall star rating changed from 3 of 5 to 2 of 5.
Star rating
The CMS health inspection star rating changed from 3 of 5 to 2 of 5.
CMS update of February 26, 2025
Star rating
The CMS quality measures star rating changed from 3 of 5 to 4 of 5. CMS changed how it scores this rating for many homes at once.
Health inspection on January 29, 2025
1 citationCMS lists this as a complaint inspection.
Show the 1 citation
Citation F0842. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
CMS lists it as corrected on March 28, 2025.
Health inspection on November 7, 2024
11 citationsCMS lists this as a standard inspection and a complaint inspection.
Show the 11 citations
Citation F0658. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Ensure services provided by the nursing facility meet professional standards of quality.
CMS lists it as corrected on December 13, 2024.
Citation F0759. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Ensure medication error rates are not 5 percent or greater.
CMS lists it as corrected on December 13, 2024.
Citation F0761. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
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.
CMS lists it as corrected on December 13, 2024.
Citation F0554. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Allow residents to self-administer drugs if determined clinically appropriate.
CMS lists it as corrected on December 13, 2024.
Citation F0607. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
CMS lists it as corrected on December 13, 2024.
Citation F0609. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
CMS lists it as corrected on December 13, 2024.
Citation F0610. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Respond appropriately to all alleged violations.
CMS lists it as corrected on December 13, 2024.
Citation F0656. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
CMS lists it as corrected on December 13, 2024.
Citation F0657. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
CMS lists it as corrected on December 13, 2024.
Citation F0755. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
CMS lists it as corrected on December 13, 2024.
Citation F0883. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Develop and implement policies and procedures for flu and pneumonia vaccinations.
CMS lists it as corrected on December 13, 2024.
Fire safety inspection on November 7, 2024
1 citationCMS lists this as a standard inspection.
Show the 1 citation
Citation K0341. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Install a fire alarm system that can be heard throughout the facility.
CMS lists it as corrected on November 18, 2024.
CMS update of October 30, 2024
Star rating
The CMS quality measures star rating changed from 4 of 5 to 3 of 5.
CMS update of July 31, 2024
Star rating
The CMS staffing star rating changed from 3 of 5 to 4 of 5. CMS changed how it scores this rating for many homes at once.
CMS update of June 26, 2024
Ownership
CMS lists this home under a new chain.
CMS update of April 25, 2024
Star rating
The CMS overall star rating changed from 2 of 5 to 3 of 5.
Star rating
The CMS staffing star rating changed from 1 of 5 to 3 of 5.
CMS update of January 31, 2024
Star rating
The CMS health inspection star rating changed from 2 of 5 to 3 of 5.
Star rating
The CMS staffing star rating changed from 4 of 5 to 1 of 5.
Health inspection on September 22, 2023
1 citationCMS lists this as a standard inspection.
Show the 1 citation
Citation F0947. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
CMS lists it as corrected on November 15, 2023.
Fire safety inspection on September 22, 2023
18 citationsCMS lists this as a standard inspection.
Show the 18 citations
Citation E0004. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Develop and maintain an Emergency Preparedness Program (EP).
CMS lists it as corrected on October 16, 2023.
Citation E0006. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Conduct risk assessment and an All-Hazards approach.
CMS lists it as corrected on October 16, 2023.
Citation E0007. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Address patient/client population and determine types of services needed.
CMS lists it as corrected on October 16, 2023.
Citation E0020. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Establish policies and procedures including evacuation.
CMS lists it as corrected on October 16, 2023.
Citation E0030. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
List the names and contact information of those in the facility.
CMS lists it as corrected on October 16, 2023.
Citation E0035. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Provide family notifications of emergency plan.
CMS lists it as corrected on October 16, 2023.
Citation E0039. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Conduct testing and exercise requirements.
CMS lists it as corrected on October 16, 2023.
Citation K0711. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Provide a written emergency evacuation plan.
CMS lists it as corrected on October 16, 2023.
Citation K0712. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Have simulated fire drills held at unexpected times.
CMS lists it as corrected on October 16, 2023.
Citation K0761. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
CMS lists it as corrected on October 16, 2023.
Citation K0927. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Have proper fire barriers, ventilation and signs for the transfilling of oxygen.
CMS lists it as corrected on October 16, 2023.
Citation K0211. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Keep aisles, corridors, and exits free of obstruction in case of emergency.
CMS lists it as corrected on October 16, 2023.
Citation K0342. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Have a complete alarm system manually initiated and initiated by fire sprinkler system connection.
CMS lists it as corrected on October 16, 2023.
Citation K0363. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Install corridor and hallway doors that block smoke.
CMS lists it as corrected on October 16, 2023.
Citation K0521. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
CMS lists it as corrected on October 16, 2023.
Citation K0914. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
CMS lists it as corrected on October 16, 2023.
Citation K0920. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Ensure proper usage of power strips and extension cords.
CMS lists it as corrected on October 16, 2023.
Citation K0921. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Ensure that testing and maintenance of electrical equipment is performed.
CMS lists it as corrected on October 16, 2023.
CMS star ratings
- 3 of 5CMS overall star rating
- 3 of 5CMS health inspection star rating
- 4 of 5CMS staffing star rating
- 4 of 5CMS quality measures star rating
Facts from CMS
- Phone
- (928) 774-7106
- Last standard health inspection
- February 12, 2026 (8 months ago)
- Certified beds
- 58
- Residents per day, on average
- 40.3
- Ownership type
- Non profit - Other
- Legal business name
- Northern Arizona Senior Living Community, LLC
- Chain
- The Goodman Group
- Takes part in
- Medicare and Medicaid
Fewer health citations than the Arizona average (17 vs 21).
Owners and managers
CMS lists these owners and managers for this home. Names are as CMS writes them.
- NORTHERN ARIZONA HEALTHCARE CORPORATION5% or greater direct ownership interest · no percentage provided · since 12/24/1997
- NORTHERN ARIZONA SENIOR LIVING COMMUNITY, LLC5% or greater direct ownership interest · no percentage provided · since 02/15/2017
- THE GOODMAN FAMILY OPERATING FOUNDATION5% or greater direct ownership interest · no percentage provided · since 01/01/2024
- NORTHERN ARIZONA HEALTHCARE CORPORATIONOperational/managerial control · not applicable · since 12/24/1997
- NORTHERN ARIZONA SENIOR LIVING COMMUNITY, LLCOperational/managerial control · not applicable · since 02/15/2017
Questions
When was The Peaks Health & Rehabilitation last inspected?
CMS lists February 12, 2026 as the date of its most recent standard health inspection.
How many citations (violations) does The Peaks Health & Rehabilitation have?
CMS lists 17 health citations since September 22, 2023. CMS also calls these deficiencies.
Has The Peaks Health & Rehabilitation been fined?
CMS lists no fines for this home in the past three years.
What is the CMS star rating of The Peaks Health & Rehabilitation?
Its CMS overall star rating is 3 of 5.
Is The Peaks Health & Rehabilitation a Special Focus Facility?
No. CMS does not list it as a Special Focus Facility or a candidate.