Based on record review and interview, the facility failed to ensure training for one-on-one observation (a close and consistent observation, in line of sight, of a resident who is an imminent risk of harming self or others) was provided to direct care staff. This failed practice placed all residents (based on a census of 96) at risk for improper or inconsistent observation which could lead to self-harm, harm to others, suicide attempt, or completed suicide. Findings: Record review on 6/3-5/24 revealed the facility had no policy, procedure, or protocol for when a resident expressed suicidal ideation, to include initiation of one-on-one observations for safety. …
F949 citations in Alaska
Administration Deficiencies
Provide behavior health training consistent with the requirements and as determined by a facility assessment.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2024
Alaska cites F949 more often than its own record predicts
9.53 times the share F949 takes of citations nationally.
Of every deficiency written in Alaska in 2024, this is the portion that was F949.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Alaska surveyors wrote
F949 findings written in Alaska, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
The short window
Recent years
| Year | Share of Alaska citations | vs expected |
|---|---|---|
| 2023 | 0.73% | 13.47× |
| 2024 | 0.78% | 9.53× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Alaska surveyors cite →
Deficiency Index is independent and is not affiliated with, endorsed by, or approved by CMS, Medicare, or any government agency. About this data · Report a correction