Nursing Care Index

Lake Pleasant Post Acute Rehabilitation Center

Peoria, Maricopa County, Arizona · CCN 035111 · For-profit (LLC) · part of The Ensign Group (342 facilities, chain average 3.2 stars)

CMS rates Lake Pleasant Post Acute Rehabilitation Center 4 of 5 overall as of August 2026. 128 certified beds, 102 residents a day on average. 20 citations on record from the current inspection cycles; no fines on record.

CMS’s ratings

The Five-Star Quality Rating System, as CMS publishes it. Where CMS gives no rating, the reason CMS gives is printed instead.

Overall★★★★☆ 4 of 5
Health inspections★★★☆☆ 3 of 5
Staffing★★☆☆☆ 2 of 5
Quality measures★★★★★ 5 of 5
Quality: long-stay / short-stay5 / 5 of 5

Staffing

Total nurse staffing3.32261 hours per resident per day
Registered nurses0.59208 hours per resident per day
Weekend total2.91525 hours per resident per day
Nursing staff turnover50% (registered nurses 61.1%)
Administrators who left0

Citations from health inspections

Each is a finding by a state surveyor on the date shown, in CMS’s words. The severity is CMS’s scope-and-severity grid, spelled out: harm on the left, how widespread on the right.

SurveyFindingSeverityStatus
2026-02-26
complaint survey
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Resident Rights Deficiencies · tag F0628
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-04-15
2026-02-26 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · tag F0812
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-04-15
2026-02-26 Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · tag F0641
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-15
2026-02-26 Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · tag F0684
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-15
2026-02-26 Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies · tag F0695
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-15
2024-05-10 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · tag F0550
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-06-24
2024-05-10 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · tag F0812
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-06-24
2024-05-10 Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Resident Rights Deficiencies · tag F0582
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-06-24
2024-05-10 Provide appropriate care/assistance for a resident with a prosthesis.
Quality of Life and Care Deficiencies · tag F0696
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-06-24
2024-05-10 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-06-24
2024-01-17
complaint survey
Provide enough food/fluids to maintain a resident's health.
Quality of Life and Care Deficiencies · tag F0692
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-03-01
2023-12-13
complaint survey
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0609
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-01-19
2023-12-13
complaint survey
Respond appropriately to all alleged violations.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0610
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-01-19
2023-01-26 Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning Deficiencies · tag F0658
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-03-05
2023-01-26 Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Nursing and Physician Services Deficiencies · tag F0725
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-03-05
2023-01-26 Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Pharmacy Service Deficiencies · tag F0758
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-03-05
2023-01-26 Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Resident Rights Deficiencies · tag F0580
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-03-05
2023-01-26 Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies · tag F0677
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-03-05
2023-01-26 Assist a resident in gaining access to vision and hearing services.
Quality of Life and Care Deficiencies · tag F0685
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-03-05
2023-01-26 Ensure each resident’s drug regimen must be free from unnecessary drugs.
Pharmacy Service Deficiencies · tag F0757
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-03-05

Fines and payment denials

No fines or payment denials on record since 2023.

Who owns and runs it

Every owner, officer and manager CMS lists, as filed. These are the names in CMS’s ownership record; anyone named in the ownership record can ask about it on the about page.

NameRoleShareSince
Ensign Services Inc.
Organization
adp of the snf2015-07-01
Sun Grove Village Care Center, LLC
Organization
adp of the snf1995-10-23
Hill, Sean
Individual
adp of the snf2015-07-01
Nagle, Craig
Individual
adp of the snf2025-05-15
Peterson, Forrest
Individual
corporate director2019-01-01
Burnam, Soon
Individual
corporate officer2015-07-01
Fischbeck, Courtney
Individual
corporate officer2025-01-01
Keetch, Chad
Individual
corporate officer2011-03-01
Sato, Ami
Individual
corporate officer2024-09-09
Port, Barry
Individual
individual is an owner, partner or trustee of any adp of the snf2025-08-06
Hill, Sean
Individual
managing control - governing body2015-07-01
Nagle, Craig
Individual
managing control - governing body2025-05-15
Hill, Sean
Individual
operational/managerial control2015-07-01
Nagle, Craig
Individual
operational/managerial control2025-05-15

What changed

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Source: Centers for Medicare & Medicaid Services, Provider Data Catalog (public domain), files dated 2026-08-01. Ratings are CMS’s; citations are state surveyors’ findings; nothing here is estimated or a recommendation. Every nursing home in Maricopa County.