Inspection Reports for
Country Lane Retirement Village
1203 EAST HYNES AVE, NEILL, NE, 68763
Back to Facility Profile5 Reports
Inspection Report — Jul 13, 2020
Complaint Investigation
Date: Jul 13, 2020
Visit Reason
An unannounced visit was conducted to investigate a complaint alleging the facility failed to protect residents from infection.
Complaint Details
The complaint alleged the facility failed to protect residents from infection. The investigation found the allegation unsubstantiated as the facility was in compliance with infection prevention regulations.
Findings
The facility was found to have protected residents from infections through completed screening logs, updated infection prevention policies, knowledgeable staff, and implemented infection control interventions. The facility was in compliance with relevant regulations.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Connie Vogt | Program Manager | Signed the report as Program Manager - Office of LTC Facilities - Licensure Unit - Division of Public Health |
Inspection Report — Nov 8, 2017
Original Licensing
Date: Nov 8, 2017
Visit Reason
The document is related to the original licensing and issuance of an Assisted Living Facility license for Country Lane Retirement Village, including Alzheimer's Memory Care endorsement.
Findings
The facility was inspected and found to be in compliance with applicable regulations, including Life Safety Code compliance. The license was issued for 30 beds with an Alzheimer's Memory Care endorsement for 18 beds.
Report Facts
Licensed beds: 30
Memory care beds: 18
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Alisha Schroeder | Administrator | Named as facility administrator and contact for licensing and memory care endorsement. |
| Thomas L. Williams | Chief Medical Officer, Director, Division of Public Health | Signed licensing documents and letters. |
| Dan Taylor | RN | Contact person for licensing questions. |
| Sarah Sidak | Zoning Administrator | Provided zoning confirmation letter. |
| Jeff Edgar | Deputy State Fire Marshal | Conducted life safety inspection. |
Inspection Report — Nov 8, 2017
Routine
Date: Nov 8, 2017
Visit Reason
The inspection was conducted as a Compliance Inspection to assess the facility's adherence to the Regulations Governing Licensure of Assisted-Living Facilities.
Findings
The facility was found in compliance with the applicable regulations, and the results of the Compliance Inspection were commendable.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Dan Taylor | Training Coordinator | Signed the letter acknowledging the results of the Compliance Inspection. |
Notice — APP2023
Date: APP2023
Visit Reason
The documents pertain to the renewal of the assisted-living facility license for Country Lane Retirement Village, including verification of licensure, renewal application, and occupancy permit.
Findings
The facility meets statutory requirements for assisted-living licensure with a licensed capacity of 30 beds and a special population designation for Alzheimer's/Special Care Unit with 12 beds. The occupancy permit was issued on 2023-02-17. No deficiencies or inspection findings are reported.
Report Facts
Special care unit beds: 12
Occupancy permit date: Feb 17, 2023
Renewal license fees: 950
Renewal license fees: 1450
Renewal license fees: 1650
Renewal license fees: 1950
Monthly private MC suite price: 5725
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Barbara Jackson | Administrator | Named as administrator and authorized representative on renewal application and Alzheimer's special care unit endorsement application |
| Mark Holtkamp | Owner | Named as owner of Country Lane Retirement Village |
| Robert Folck | Deputy State Fire Marshal | Inspected facility and approved occupancy permit |
Document — APP2025
Date: APP2025
Visit Reason
The documents serve to verify and renew the assisted-living facility license for Country Lane Retirement Village, including renewal of Alzheimer's Memory Care Endorsement and occupancy permit validation.
Findings
No inspection findings or deficiencies are reported; the documents confirm licensure status, renewal application details, ownership, occupancy permit, and Alzheimer's special care unit endorsement.
Report Facts
Total licensed beds: 30
Occupancy permit date issued: Feb 7, 2025
Renewal license expiration date: Apr 30, 2026
Unit rate: 6155
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kylie Debus | Administrator | Named on renewal application and Alzheimer's endorsement application. |
| Mark Holtkamp | Owner | Named on renewal application and ownership list. |
| Nicholas Lensch | Regional Operations Director | Named on Alzheimer's endorsement application and ownership list. |
| Samantha Greene | Senior Living Solutions | Named as authorized representative signing Alzheimer's endorsement application. |
| Allison Law | Asset Manager | Named on ownership list. |
| Carol Gasper | Named as representative of Senior Living Solutions on ownership list. | |
| Morgan Brunscheen | Named as representative of Senior Living Solutions on ownership list. |
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