Inspection Reports for
Country View Assisted Living
811 EAST 14TH STREET, WAYNE, NE, 68787
Back to Facility ProfileDeficiencies (last 4 years)
Deficiencies (over 4 years)
0.5 deficiencies/year
Deficiencies are regulatory findings recorded during state inspections.
88% better than Nebraska average
Nebraska average: 4.2 deficiencies/yearDeficiencies per year
4
3
2
1
0
Inspection Report
Renewal
Capacity: 32
Deficiencies: 0
Date: Apr 3, 2025
Visit Reason
The document is a renewal application and license verification for Country View Assisted Living facility, confirming the facility's licensure status and renewal of its assisted-living license.
Findings
The facility is licensed as an assisted-living facility with a total capacity of 32 beds. The renewal application was completed and signed by authorized representatives on April 3, 2025. An occupancy permit was issued with a maximum occupancy of 32 beds.
Report Facts
Total licensed beds: 32
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Martin Brown | Administrator | Named in renewal application |
| Soon Burnam | Authorized Representative | Signed renewal application |
| Ami Sato | Authorized Representative | Signed renewal application |
| Tara Helenthal | President | Officer of Lindahl Healthcare, Inc., corporate organization chart |
| Soon Burnam | Secretary | Officer of Lindahl Healthcare, Inc., corporate organization chart |
| Ami Sato | Treasurer | Officer of Lindahl Healthcare, Inc., corporate organization chart |
| Dave Jorgensen | Director | Officer of Lindahl Healthcare, Inc., corporate organization chart |
| Barry Port | Manager | Officer of Gateway Healthcare, LLC, corporate organization chart |
| Spencer Burton | President | Officer of The Ensign Group, Inc., corporate organization chart |
| Barry Port | CEO | Officer of The Ensign Group, Inc., corporate organization chart |
Inspection Report
Renewal
Capacity: 32
Deficiencies: 0
Date: Apr 4, 2022
Visit Reason
The document is a renewal application and license verification for Country View Assisted Living facility to continue its operation as an assisted-living facility.
Findings
The documents confirm that Country View Assisted Living meets statutory requirements for licensure renewal. The renewal application includes ownership and corporate organization details, and the occupancy permit confirms a maximum capacity of 32 beds.
Report Facts
Total licensed beds: 32
Renewal license expiration date: Apr 30, 2023
Occupancy permit date issued: Jun 22, 2021
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Rachael Hurley | Administrator | Named as the facility administrator on the renewal application. |
| Soon Burnam | Authorized Representative | Signed the renewal application as an authorized representative. |
| Craig Fitch | Authorized Representative | Signed the renewal application as an authorized representative and listed as Secretary in corporate organization. |
| Tara Helenthal | President | Listed as President of Lindahl Healthcare, Inc., the ownership corporation. |
| Spencer Burton | Director and President | Listed as Director of Country View Assisted Living and President of Gateway Healthcare, Inc. |
| Barry Port | Director and CEO | Listed as Director of Gateway Healthcare, Inc. and CEO of The Ensign Group, Inc. |
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Apr 12, 2018
Visit Reason
An unannounced visit was conducted to investigate a complaint and perform the annual survey at Country View Assisted Living on April 11-12, 2018.
Complaint Details
The complaint alleged that the facility failed to ensure residents were not beyond the level of care provided. The complaint was not substantiated as the facility ensured residents were appropriate for assisted living.
Findings
The facility was found to be in compliance with regulations governing assisted living facilities. Residents were appropriate for the level of care provided, and no complex nursing interventions were observed. Residents reported satisfaction with the assistance provided.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Dan Taylor | RN, Training Coordinator | Signed the inspection and complaint investigation report. |
| Kay Reeves | Nutrition/dietitian | Conducted the compliance inspection at the facility. |
Inspection Report
Complaint Investigation
Census: 10
Deficiencies: 2
Date: Aug 7, 2012
Visit Reason
The inspection was conducted following a complaint investigation regarding noncompliance with licensure regulations for Assisted-Living Facilities, specifically related to resident grievances and record confidentiality.
Complaint Details
The complaint investigation was substantiated based on observations, record review, and staff and resident interviews indicating unresolved grievances about cold food and unsecured resident records.
Findings
The facility failed to establish and implement a process to address and resolve resident grievances concerning food temperatures, with multiple meals served below required temperatures. Additionally, resident records were stored in an unlocked cabinet accessible to unauthorized persons, compromising confidentiality.
Deficiencies (2)
Failure to address and resolve resident grievances related to food temperatures, with multiple hot food items served below 140 degrees Fahrenheit.
Failure to store resident records in a manner assuring confidentiality and restricting access to authorized persons only.
Report Facts
Facility census: 10
Sample size: 4
Breakfast meals recorded: 36
Noon meals recorded: 33
Evening meals recorded: 36
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Patricia Wolfe | Registered Nurse | Surveyor who conducted the inspection |
| Pamela Albin | Administrator | Named in Plan of Correction response |
Notice
Capacity: 32
Deficiencies: 0
Date: APP2016
Visit Reason
The document serves as a licensure renewal application and verification for Country View Assisted Living, confirming the facility's licensed status and capacity.
Findings
The documents confirm the facility meets statutory requirements for assisted living licensure renewal and include ownership information, occupancy permit, and organizational charts.
Report Facts
Total licensed beds: 32
Renewal fees: 950
Renewal fees: 1450
Renewal fees: 1650
Renewal fees: 1950
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Robert Pyper | Administrator | Named as the facility administrator on the renewal application. |
| Soon Burnam | Treasurer | Listed as an officer of Lindahl Healthcare, Inc. and Gateway Healthcare, Inc. |
| Beverly Wittekind | Secretary | Listed as an officer of Lindahl Healthcare, Inc. and Gateway Healthcare, Inc. |
| Michael Clegg | President | Listed as an officer of Lindahl Healthcare, Inc. and Gateway Healthcare, Inc. |
| Christopher Christensen | Director and President and CEO | Listed as an officer of Lindahl Healthcare, Inc., Gateway Healthcare, Inc., and The Ensign Group, Inc. |
| Beverly Wittekind | Authorized Representative | Signed the renewal application. |
| Soon Burnam | Authorized Representative | Signed the renewal application. |
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