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Petersburg Medical Center Home

(907) 772-571615 N 12TH Street Room 117, Petersburg, AK 99833
CMS Certification Number 027009 · Non-Profit · Medicare-certified since 07/21/1987
14deficiencies since 2018
0serious
3inspections
2CMS quality stars
Data from CMS inspection reports (Form 2567), 2018-01-02 to 2026-10-15, downloaded 2026-10-21; CMS agency list file dated 2026-09-21. What the labels mean

Inspection 2025-05-29

· Recertification · 2 deficiencies · CMS source report (PDF)
Minor Plan Of Care Must Include The Following

The agency failed to ensure the plan of care (POC) included all supplies and equipment required and all medication and treatments ordered for 1 of 3 home visits observed (#3).

Source: CMS Form 2567, inspection 2025-05-29, tag G0574 · view on CMS
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Minor Preparing Clinical Notes

The agency failed to ensure complete clinical notes for 1 of 6 active records reviewed (#3).

Source: CMS Form 2567, inspection 2025-05-29, tag G0716 · view on CMS
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Inspection 2021-12-10

· Complaint, Recertification · 1 deficiencies · CMS source report (PDF)
Minor Preparing Clinical Notes

The agency failed to ensure a licensed nurse had completed clinical notes to identify the medication administration specifics completed by the skilled nurse for 1 of 1 records reviewed with Intramuscular medication administration (#1).

Source: CMS Form 2567, inspection 2021-12-10, tag G0716 · view on CMS
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Inspection 2018-11-09

· Recertification · 11 deficiencies · CMS source report (PDF)
Moderate Hha Comprehensive Assessment In Disaster

The facility failed to ensure emergency preparedness was part of the comprehensive patient assessment for 7 out of 7 patient charts reviewed.

Source: CMS Form 2567, inspection 2018-11-09, tag E0017 · view on CMS
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Moderate Homebound Hha/Hospice Inform Ep Officials

The facility emergency preparedness plan failed to include notification procedures to inform State officials during times of patient evacuation.

Source: CMS Form 2567, inspection 2018-11-09, tag E0019 · view on CMS
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Moderate Hha- Procedures For Follow Up Staff/Pts.

The facility Emergency Preparedness (EP) plan failed to established written policies and/or procedures to ensure follow up with on-duty staff and patients to determine services would continue or would be provided, in the event there is an interruption in services during or due to an emergency.

Source: CMS Form 2567, inspection 2018-11-09, tag E0021 · view on CMS
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Moderate Policies/Procedures For Medical Documentation

The facility failed to ensure written policies and/or procedures were established to ensure a system of medical documentation that preserves patient information, protected confidentiality of patient information, and secured and maintained availability of records during times of emergency.

Source: CMS Form 2567, inspection 2018-11-09, tag E0023 · view on CMS
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Moderate Policies/Procedures-Volunteers And Staffing

The facility failed to ensure written policies and/or procedures were established to address the use of volunteers or other emergency staffing strategies, included the process and role for integration of State and Federally designated health care professionals to address surge needs during an…

Source: CMS Form 2567, inspection 2018-11-09, tag E0024 · view on CMS
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Moderate Emergency Officials Contact Information

The facility failed to include contact information for the State of Alaska-Emergency Preparedness staff in the emergency communication plan.

Source: CMS Form 2567, inspection 2018-11-09, tag E0031 · view on CMS
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Moderate Methods For Sharing Information

The facility failed to include in their Emergency Preparedness plan (EP) a communication plan consisting of the following; 1) a method for sharing information and medical documentation for patients under the [facility's] care, as necessary, with other health providers to maintain the continuity of…

Source: CMS Form 2567, inspection 2018-11-09, tag E0033 · view on CMS
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Moderate Integrated Ep Program

The facility failed to include as part of the integrated health care system, contact information in the communication plan for the State of Alaska, Emergency Preparedness staff during times of evacuation or emergency.

Source: CMS Form 2567, inspection 2018-11-09, tag E0042 · view on CMS
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Moderate Administrator Must:

The facility failed to ensure the administrator was appointed by the governing body.

Source: CMS Form 2567, inspection 2018-11-09, tag G0944 · view on CMS
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Minor Contact Info Federal/State-Funded Entities

The facility failed to ensure all the required names, addresses, and telephone numbers for Federally-funded and state-funded entities that service the area was provided to 7 patients out of 7 records reviewed.

Source: CMS Form 2567, inspection 2018-11-09, tag G0446 · view on CMS
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Minor Administrator Appointed By Governing Body

The facility failed to ensure when the administrator is not available, a pre-designated person, who is authorized in writing by the administrator and governing body, assumes the same responsibility and obligations as the administrator.

Source: CMS Form 2567, inspection 2018-11-09, tag G0946 · view on CMS
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