| General |
| City |
| Omaha |
Wayne |
| State attribute explanation |
| Ne |
Ne |
| Street |
| 4102 Woolworth Avenue |
811 East 14th Street |
| Zip Code |
| 68,105 |
68,787 |
| Phone |
| 4,024,447,314 |
4,023,751,922 |
|
Overall Star Rating |
| 5 |
2 |
|
Health Inspections Star Rating |
| 5 |
1 |
|
Nurse Staffing Star Rating |
| 5 |
4 |
|
Quality Measures Star Rating |
| 3 |
2 |
|
RN Only Star Rating |
| 5 |
5 |
|
Number of Certified Beds |
| 254 |
60 |
| Total Number of Residents |
| 226 |
40 |
|
Percent of Occupied Beds |
| 89 % |
67 % |
| Health Survey Date |
| 7/13/2011 |
9/22/2011 |
| Fire Survey Date |
| 7/25/2011 |
9/15/2011 |
| Sprinkler Status |
| Fully Sprinklered |
Fully Sprinklered |
| Program Participation |
| Medicare And Medicaid |
Medicare And Medicaid |
| Type of Ownership |
| Government - County |
For Profit - Corporation |
| Located Within a Hospital? |
| No |
No |
| Multi Nursing Home Ownership? |
| No |
Yes |
| Resident and Family Councils |
| Resident |
Resident |
| Continuing Care Retirement Community? |
| No |
No |
| Quality Indicator Survey? |
| No |
Yes |
| Special Focus Facility? |
| No |
No |
| Civil Money Penalty Count |
| 1 |
75.2 |
| Total Enforcement Actions Count |
| 3 |
1 |
| # of deficiencies |
| 1 |
11 |
|
| Staff Information |
| Number of Residents |
| 226 |
40 |
| Number of RN Hours Per Resident Per Day |
| 0.85 |
0.91 |
| Number of LPN/LVN Hours Per Resident Per Day |
| 0.78 |
0.43 |
| Total Number of Licensed Staff Hours Per Resident Per Day |
| 1.63 |
1.34 |
| Number of CNA Hours Per Resident Per Day |
| 0.02 |
0.03 |
| Number Therapy Hours Per Resident Per Day |
| 0.02 |
0.03 |
| Environmental Deficiencies |
| Deficiency #1 |
|
Scope: Fewlevel Of Harm: 3deficiency: Make Sure That The Nursing Home Area Is Free From Accident Hazards And Risks And Provides Supervision To Prevent Avoidable Accidents.survey Date: 09/22/2011date Of Correction: 10/21/2011 |
| Deficiency #2 |
|
Scope: Somelevel Of Harm: 2deficiency: Make Sure That The Nursing Home Area Is Safe, Easy To Use, Clean And Comfortable For Residents, Staff And The Public.survey Date: 06/16/2009date Of Correction: 07/22/2009 |
| Deficiency #3 |
|
Scope: Somelevel Of Harm: 2deficiency: Provide Housekeeping And Maintenance Services.survey Date: 06/16/2009date Of Correction: 07/22/2009 |
| Deficiency #4 |
|
Scope: Somelevel Of Harm: 1deficiency: Provide A Safe, Clean, Comfortable And Homelike Environment.survey Date: 06/16/2009date Of Correction: 07/22/2009 |
| Mistreatment Deficiencies |
| Deficiency #1 |
|
Scope: Fewlevel Of Harm: 3deficiency: Protect Each Resident From All Abuse, Physical Punishment, And Being Separated From Others.survey Date: 11/29/2010date Of Correction: 01/25/2011 |
| Resident Rights Deficiencies |
| Deficiency #1 |
|
Scope: Fewlevel Of Harm: 2deficiency: Immediately Tell The Resident, The Resident's Doctor And A Family Member Of The Resident Of Situations (injury/decline/room, Etc.) That Affect The Resident.survey Date: 09/22/2011date Of Correction: 10/21/2011 |
| Deficiency #2 |
|
Scope: Fewlevel Of Harm: 2deficiency: Immediately Tell The Resident, The Resident's Doctor And A Family Member Of The Resident Of Situations (injury/decline/room, Etc.) That Affect The Resident.survey Date: 11/29/2010date Of Correction: 01/25/2011 |
| Quality Care Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: Properly Care For Residents Needing Special Services, Including: Injections, Colostomy, Ureostomy, Ileostomy, Tracheostomy Care, Tracheal Suctioning, Respiratory Care, Foot Care, And Prostheses.survey Date: 07/13/2011date Of Correction: 08/26/2011 |
Scope: Somelevel Of Harm: 2deficiency: Make Sure That Residents With Reduced Range Of Motion Get Proper Treatment And Services To Increase Range Of Motion.survey Date: 06/16/2009date Of Correction: 07/22/2009 |
| Resident Assessment Deficiencies |
| Deficiency #1 |
|
Scope: Somelevel Of Harm: 2deficiency: Develop A Complete Care Plan That Meets All Of A Resident's Needs, With Timetables And Actions That Can Be Measured.survey Date: 09/22/2011date Of Correction: 10/21/2011 |
| Deficiency #2 |
|
Scope: Fewlevel Of Harm: 2deficiency: Allow The Resident The Right To Participate In The Planning Or Revision Of The Resident's Care Plan.survey Date: 11/29/2010date Of Correction: 01/25/2011 |
| Nutrition and Dietary Deficiencies |
| Deficiency #1 |
|
Scope: Somelevel Of Harm: 2deficiency: Store, Cook, And Serve Food In A Safe And Clean Way.survey Date: 06/16/2009date Of Correction: 07/22/2009 |
| Quality Measures Q1 |
| Percent of long-stay residents who received an antipsychotic medication |
| 35.5 % |
25.6 (78.1) |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 7.6 % |
|
| Percent of long-stay residents who self-report moderate to severe pain |
| 13.9 / 15.3 |
|
| Percent of long-stay high-risk residents with pressure ulcers |
| 6.7 % |
|
| Percent of long-stay residents who lose too much weight |
| 6.2 % |
23.1 % |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 30.1 % |
|
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 1.8 % |
75.2 % |
| Percent of long-stay residents with a urinary tract infection |
| 5.7 % |
2.6 / 3 |
| Percent of long-stay residents who have depressive symptoms |
| 13.2 % |
5 % |
| Percent of long-stay residents who were physically restrained |
| 75.2 % |
75.2 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 90.5 % |
|
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 85.2 % |
|
| Percent of short-stay residents who newly received an antipsychotic medication |
| 2 |
1 |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 5.3 % |
5 % |
| Quality Measures Q3 |
| Percent of long-stay residents who received an antipsychotic medication |
| 37 % |
21.8 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 9.2 % |
1.7 % |
| Percent of long-stay residents who self-report moderate to severe pain |
| 12.6:1 |
22 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 5.2 % |
11.6:1 |
| Percent of long-stay residents who lose too much weight |
| 5.1 % |
15.3 % |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 32.2 % |
50 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 2.4 % |
2 % |
| Percent of long-stay residents with a urinary tract infection |
| 6.8 % |
5.9 % |
| Percent of long-stay residents who have depressive symptoms |
| 11.7 % |
4.1 % |
| Percent of long-stay residents who were physically restrained |
| 75.2 % |
75.2 % |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 5.8 % |
27.7 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 25 % |
30.6 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 82.5 % |
77.8 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 83.8 % |
77.8 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 3.8 % |
2.8 % |