Mirage Post Acute
Inspection Findings
F-Tag F0584
F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
possible.1. Staff provides person-centered care that emphasizes the residents' comfort, independence and personal needs and preferences.2. The facility staff and management maximizes, to the extent possible, the characteristics of the facility that reflect a personalized, homelike setting. These characteristics include:a. clean, sanitary and orderly environment;b. comfortable (minimum glare) yet adequate (suitable to the task) lighting;c. inviting colors and decor;d. personalized furniture and room arrangements;e. clean bed and bath linens that are in good condition;f. pleasant, neutral scents;g. plants and flowers, where appropriate;h. comfortable and safe temperatures; [NAME]. comfortable sound levels. The DON stated homelike environment means room was clean and organized. The DON stated the facility's P&P indicated to have a safe, clean, and comfortable environment. The DON stated Resident 7's leaking room with containers was not a homelike environment. The DON stated Resident 8's room being too cold was also not a homelike environment. The DON stated the facility P&P was not followed.
Event ID:
Facility ID:
If continuation sheet
Printed: 04/13/2026 Form Approved OMB No. 0938-0391
Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
11/24/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Mirage Post Acute
44445 15th St W Lancaster, CA 93534
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F-Tag F0656
F 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
possible.During a concurrent interview, and record review on 11/21/2025, at 3:43 p.m., with the Minimum Data Set Nurse Assistant (MDSA), Resident 7's Care Plan dated 11/21/2025, regarding refusal of care was reviewed. The Care Plan indicated the following interventions:-encourage active participation of care-Inform of risks and ramifications (a consequence of an action or event) of continued noncompliance.- Monitor the effectiveness of safety equipment.MDSA stated the care plan was generalized and did not indicate hourly rounding to check and observe for the progression of leaks if improving or not and to check if Resident 7 was safe and feels safe inside the room. MDSA stated the care plan should be individualized to address resident safety inside a room that had a leaking ceiling.During an interview on 11/21/2025, at 4:12 p.m., with the Director of Nursing (DON), the DON stated Resident 7's Care Plan should be person centered or individualized to address her (Resident 7) safety inside the room that had a leaking ceiling.During a concurrent interview, and record review on 11/24/2025, at 11:09 a.m., with the DON, facility's policy and procedure (P&P), titled, Homelike Environment dated 2001, and last reviewed on 7/24/2025, the P&P indicated, Staff provides person-centered care that emphasizes the residents' comfort, independence and personal needs and preferences. The DON stated Resident 7's Care Plan should have an intervention that Resident 7 was being checked hourly to check for her (Resident 7) safety. The DON stated without the person-centered care plan, there might be a delay in room change and placing Resident 7's safety at risk.
The DON stated the P&P for person-centered care was not followed.During a record review of facility's P&P, titled, Comprehensive Person-Centered Care Plans, dated 2001, and last reviewed on 3/2025, the P&P indicated, A comprehensive, person-centered care plan that includes measurable objectives and timetables to meet the resident's physical, psychosocial and functional needs is developed and implemented for each resident.6. The comprehensive, person-centered care plan: a. includes measurable objectives and timeframes; b. describes the services that are to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being, including: (1) services that would otherwise be provided for the above, but are not provided due to the resident exercising his or her rights, including the right to refuse treatment; .9. When possible, interventions address the underlying source(s) of the problem area(s), not just symptoms or triggers.
Event ID:
Facility ID:
If continuation sheet
Printed: 04/13/2026 Form Approved OMB No. 0938-0391
Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
11/24/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Mirage Post Acute
44445 15th St W Lancaster, CA 93534
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F-Tag F0689
F 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some
FORM CMS-2567 (02/99) Previous Versions Obsolete
not provide proper care or meet the residents' (Residents 2, 3, and 4) needs by not changing their room when the ceiling was leaking with rainwater. This failure meant residents were not comfortable or safe in their rooms.During a review of the facility policy and procedure titled, Homelike Environment, last review date of 11/6/2025, the policy and procedure indicated, Residents are provided with a safe, clean, comfortable and homelike environment The facility staff and management maximize to the extent possible,
the characteristics of the facility that reflect a personalized, homelike setting. These characteristics include: a. Clean, sanitary and orderly environment
Event ID:
Facility ID:
If continuation sheet
Printed: 04/13/2026 Form Approved OMB No. 0938-0391
Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
11/24/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Mirage Post Acute
44445 15th St W Lancaster, CA 93534
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F-Tag F0880
Federal health inspectors cited MIRAGE POST ACUTE in LANCASTER, CA for a deficiency under regulatory tag F-F0880 during a complaint investigation conducted on 2025-11-24.
Category: Infection Control Deficiencies
The facility was found deficient in the following area: Provide and implement an infection prevention and control program.
Scope/Severity Level G: isolated, actual harm that is not immediate jeopardy.
Actual harm to residents was documented as a result of this deficiency.
This was one of 4 deficiencies cited during this inspection of MIRAGE POST ACUTE.
Correction Status: Deficient, Provider has no plan of correction.
MIRAGE POST ACUTE in LANCASTER, CA inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
Frequently Asked Questions
- What is an F-tag violation?
- F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
- Were these violations corrected?
- Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
- How often do nursing home inspections happen?
- CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
- What should families do about these violations?
- Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in LANCASTER, CA, (5) Report new concerns to state authorities.
- Where can I see the full inspection report?
- Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from MIRAGE POST ACUTE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.