HAVEN HEALTH GREEN VALLEY, LLC
150 NORTH LA CANADA DRIVE
GREEN VALLEY, AZ, 85614
5206250178
CCN: 035073
3
Overall2
Health3
Staffing5
QualitySpecial FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
OIG Federal Exclusion Matches (2)
This facility's name matches one or more entities on the OIG List of Excluded Individuals/Entities (LEIE). Excluded parties are prohibited from participation in Medicare and Medicaid programs.
APACHE HEALTH LLC
1128a1
Excluded 2024-10-20
PARADISE VALLEY GROUP HOME LLC
1128a1
Excluded 2026-04-20
Ownership
| Name | Role | % |
|---|---|---|
| HAVEN HEALTH GROUP LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| ROBERTSON, BRETT | 5% OR GREATER DIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| SAMUELIAN, ROBERT | 5% OR GREATER DIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| SAMUELIAN, SPENCER | 5% OR GREATER DIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| SAMUELIAN, STEPHEN | 5% OR GREATER DIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| WEST, CHRISTIAN | 5% OR GREATER DIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED |
| HAVEN HEALTH PROPERTIES LLC | 5% OR GREATER MORTGAGE INTEREST | NOT APPLICABLE |
| HAVEN GREEN VALLEY REAL ESTATE LLC | 5% OR GREATER MORTGAGE INTEREST | NOT APPLICABLE |
| MUIR, MARK | CONTRACTED MANAGING EMPLOYEE | NOT APPLICABLE |
| SEASTRAND, JASON | CONTRACTED MANAGING EMPLOYEE | NOT APPLICABLE |
| SHAH, VIRAG | CONTRACTED MANAGING EMPLOYEE | NOT APPLICABLE |
| ESPINOSA, STEPHANIE | CORPORATE OFFICER | NOT APPLICABLE |
| FRAGOSO, LINDSAY | CORPORATE OFFICER | NOT APPLICABLE |
| SAMUELIAN, ROBERT | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| SAMUELIAN, SPENCER | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| SAMUELIAN, STEPHEN | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| SEASTRAND, JASON | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| SHAH, VIRAG | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| WEST, CHRISTIAN | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| EAGLEN, ROBYN | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| FRAGOSO, LINDSAY | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| HATCH, BRANDON | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| MUIR, MARK | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| ROBERTSON, BRETT | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| HEALTH GROUP MANAGEMENT LLC | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| ESPINOSA, STEPHANIE | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| EAGLEN, ROBYN | W-2 MANAGING EMPLOYEE | NOT APPLICABLE |
| HATCH, BRANDON | W-2 MANAGING EMPLOYEE | NOT APPLICABLE |
Health Deficiencies (35)
2024-05-23 · Health
D
F790 · Quality of Life and Care Deficiencies
Provide routine and 24-hour emergency dental care for each resident.
D
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
E
F680 · Quality of Life and Care Deficiencies
Ensure the activities program is directed by a qualified professional.
D
F658 · Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
D
F645 · Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
D
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
E
F584 · Resident Rights Deficiencies
Honor 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.
D
F583 · Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
D
F578 · Resident Rights Deficiencies
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
2024-04-09 · Health
D
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
2023-01-13 · Health
E
F790 · Quality of Life and Care Deficiencies
Provide routine and 24-hour emergency dental care for each resident.
E
F758 · Pharmacy Service Deficiencies
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.
E
F756 · Pharmacy Service Deficiencies
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
E
F755 · Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
E
F726 · Nursing and Physician Services Deficiencies
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
D
F686 · Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
D
F685 · Quality of Life and Care Deficiencies
Assist a resident in gaining access to vision and hearing services.
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
F661 · Resident Assessment and Care Planning Deficiencies
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
D
F658 · Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
D
F657 · Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
D
F644 · Resident Assessment and Care Planning Deficiencies
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
D
F582 · Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
D
F578 · Resident Rights Deficiencies
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
D
F552 · Resident Rights Deficiencies
Ensure that residents are fully informed and understand their health status, care and treatments.
2021-10-28 · Health
E
F886 · Infection Control Deficiencies
Perform COVID19 testing on residents and staff.
E
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
F770 · Administration Deficiencies
Provide timely, quality laboratory services/tests to meet the needs of residents.
E
F761 · Pharmacy Service Deficiencies
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.
D
F695 · Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
D
F692 · Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
D
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
F657 · Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
D
F655 · Resident Assessment and Care Planning Deficiencies
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
D
F637 · Resident Assessment and Care Planning Deficiencies
Assess the resident when there is a significant change in condition
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day3.68
3.34
RN Hrs/Resident/Day0.54
0.44
LPN Hrs/Resident/Day0.81
0.84
CNA Hrs/Resident/Day2.33
2.06
PT Hrs/Resident/Day0.12
0.07
Data as of 2026-03-01