Inspection Reports for Arbor Care Centers – Ord, LLC
220 South 26th Street, NE, 68862
Back to Facility ProfileDeficiencies (last 11 years)
Deficiencies (over 11 years)
8.1 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
93% worse than Nebraska average
Nebraska average: 4.2 deficiencies/yearDeficiencies per year
32
24
16
8
0
Census
Latest occupancy rate
34 residents
Based on a March 2018 inspection.
This facility has shown a decline in demand based on occupancy rates.
Census over time
Inspection Report
Renewal
Capacity: 60
Deficiencies: 0
Mar 24, 2025
Visit Reason
The document is a Nursing Home Licensure Renewal Application and related certification materials for Arbor Care Centers - Ord, LLC, indicating the facility's license renewal process.
Findings
The documents certify that Arbor Care Centers - Ord, LLC meets statutory requirements for licensure renewal as a Skilled Nursing Facility with 60 licensed beds. The renewal application includes facility details, ownership information, and certifications signed by authorized representatives.
Report Facts
Number of beds to be relicensed: 60
Renewal license expiration date: 2026
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Wendy Bronson | Administrator | Named in the Nursing Home Licensure Renewal Application. |
| Cindy Horky | Director of Nursing | Named in the Nursing Home Licensure Renewal Application. |
| Aaron Klaasmeyer | Authorized Representative | Signed the renewal application on 3/24/2025. |
| Linda Klaasmeyer | Authorized Representative | Signed the renewal application on 3/24/2025. |
Notice
Capacity: 60
Deficiencies: 0
Mar 26, 2021
Visit Reason
The document serves as a renewal application for the nursing home license and includes certification of licensure and a temporary occupancy permit.
Findings
The documents verify that Arbor Care Centers - Ord, LLC meets statutory requirements for licensure renewal and has a temporary occupancy permit with a maximum occupancy of 60 beds.
Report Facts
Total licensed beds: 60
Inspection Report
Annual Inspection
Census: 34
Deficiencies: 30
Mar 21, 2018
Visit Reason
An unannounced visit was conducted to investigate a complaint and annual survey at Valley View Senior Village to assess compliance with regulatory requirements and resident care standards.
Findings
The facility was found to have multiple deficiencies including failure to complete required background checks, incomplete admission documentation, improper diet preparation, failure to protect resident rights, medication administration errors, inadequate infection control practices, deficient emergency preparedness plans, and fire safety code violations.
Complaint Details
The visit was triggered by a complaint investigation regarding allegations of failure to submit investigations timely and failure to provide requested personal medical information within required timeframes. The facility was found to be in compliance with these specific allegations.
Severity Breakdown
SS=F: 11
SS=E: 9
SS=D: 6
: 3
Deficiencies (30)
| Description | Severity |
|---|---|
| Failed to provide Nurse Aide Registry verification for adverse findings for one newly hired employee. | — |
| Failed to ensure admission history and physical examinations were completed within required timeframes for sampled residents. | — |
| Failed to inventory resident possessions at time of admission for one resident. | — |
| Residents on pureed diets were served incorrect menu items and personal information was posted inappropriately in a resident's room. | SS=D |
| Failed to ensure a resident was safe to self-administer medications and to keep medications at bedside. | SS=D |
| Failed to issue Advanced Beneficiary Notice (ABN) to Medicaid-eligible residents when Medicare A benefits were discontinued. | SS=D |
| Failed to maintain a safe, clean, comfortable, and homelike environment including marred walls, dirty bathroom vents, missing closet doors, and dead bugs in light fixtures. | SS=D |
| Failed to follow facility policy for screening employees for abuse prior to employment. | — |
| Failed to accurately code Minimum Data Set (MDS) assessments to reflect resident status. | SS=E |
| Failed to develop individualized and person-centered care plans reflecting resident behaviors and current status. | SS=D |
| Failed to ensure residents were free from interference, coercion, discrimination, and reprisal in exercising rights. | SS=D |
| Failed to ensure residents received care and treatment to prevent and heal pressure ulcers including proper assessments, clean technique, repositioning, and nutritional supplements. | SS=E |
| Failed to ensure medication error rate was less than 5%, including errors in medication administration and documentation. | SS=D |
| Failed to ensure residents receiving rapid acting insulin were given food or drink within 5-10 minutes of administration. | SS=D |
| Failed to ensure expired medications were removed from emergency medication box. | SS=D |
| Failed to ensure pharmacist reported irregularities and recommendations to attending physician and facility staff and that these were acted upon. | SS=E |
| Failed to ensure psychotropic medications were used appropriately including gradual dose reductions and clinical rationale for PRN use. | SS=E |
| Failed to ensure medication orders were dated by physicians. | SS=D |
| Failed to ensure facility had accurate facility assessment reflecting resident population needs and staff competencies. | SS=E |
| Failed to establish an infection prevention and control program that prevents cross contamination and ensures proper hand hygiene and equipment cleaning. | SS=E |
| Failed to establish an antibiotic stewardship program with protocols and monitoring. | SS=E |
| Failed to ensure resident call light system was functioning and residents had correct call lights. | SS=F |
| Failed to provide adequate lighting in the dining room. | SS=F |
| Failed to provide a safe, functional, sanitary, and comfortable environment including clean light fixtures, marred walls, and clean exhaust fans. | SS=F |
| Failed to ensure bathroom ventilation was adequate for multiple resident rooms. | SS=D |
| Failed to maintain sprinkler heads free of paint and ceiling holes near sprinkler heads. | SS=F |
| Failed to conduct fire drills quarterly on all shifts. | SS=F |
| Failed to inspect emergency generator weekly, test monthly under load, and test diesel fuel annually. | SS=F |
| Failed to ensure electrical wiring and equipment were used safely including missing junction box cover and improper use of extension cords and power strips. | SS=E |
| Failed to store compressed gas cylinders properly restrained to prevent tipping. | SS=D |
Report Facts
Deficiencies cited: 34
Medication errors observed: 3
Residents affected by pureed diet error: 4
Residents with marred walls and doors: 10
Residents with bathroom vents not working: 7
Fire drills documented: 1
Expired medications in emergency box: 11
Residents with pressure ulcers reviewed: 4
Residents with missing admission H/P: 3
Residents with missing possessions inventory: 1
Residents with missing or undated physician orders: 4
Residents with missing ABN forms: 2
Residents with missing Nurse Aide Registry verification: 1
Residents with pressure ulcer infection: 1
Residents with medication self-administration issues: 1
Residents with missing or undated MDS assessments: 3
Residents with missing or incomplete care plans: 6
Residents with wandering/elopement risk missing care plan: 1
Residents with missing or undated physician visit notes: 2
Residents with missing or incomplete infection control practices: 5
Residents with missing or improper medication labeling: 1
Residents with medication administration errors: 2
Residents with missing or incomplete antibiotic stewardship program: 34
Residents with missing or incomplete emergency preparedness policies: 34
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| RN-C | Registered Nurse | Named in infection control and dressing change deficiencies including failure to change gloves and hand hygiene |
| LPN-G | Licensed Practical Nurse | Named in medication self-administration and infection control deficiencies |
| MA-D | Medication Aide | Named in medication administration and documentation deficiencies |
| Hskp-J | Housekeeper | Named in housekeeping and linen handling deficiencies |
| BOM | Business Office Manager | Named in Nurse Aide Registry verification deficiency |
| ADM | Administrator | Named in multiple deficiencies related to facility management and compliance |
| DON | Director of Nursing | Named in multiple deficiencies related to nursing care, medication, infection control, and emergency preparedness |
| DM-H | Dietary Manager | Named in dietary and menu deficiencies |
| RD-P | Registered Dietician | Named in dietary and menu deficiencies |
Inspection Report
Complaint Investigation
Deficiencies: 0
Dec 12, 2017
Visit Reason
An unannounced visit was conducted to investigate a complaint at Valley View Senior Village regarding allegations of abuse, inappropriate transfers, failure to implement fall interventions, and failure to identify change in condition.
Findings
The investigation found the facility to be in compliance with all related regulatory requirements for each allegation, including abuse prevention, appropriate resident transfers, implementation of fall interventions, and identification of change in condition. No citations were issued.
Complaint Details
The complaint allegations included failure to ensure residents are free from abuse, failure to provide appropriate transfer services, failure to implement care planned fall interventions, and failure to identify change in condition. The facility was found compliant with all allegations and no citations were issued.
Report Facts
Resident care plans reviewed: 6
Fall incidents: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Dan Taylor | RN, Training Coordinator | Signed the report as Training Coordinator, Office of LTC Facilities - Licensure Unit |
Inspection Report
Annual Inspection
Census: 33
Capacity: 60
Deficiencies: 14
Feb 28, 2017
Visit Reason
Annual inspection of Valley View Senior Village to assess compliance with healthcare facility regulations including medication administration, dietary services, food safety, life safety, and fire safety.
Findings
The facility was found deficient in several areas including expired medication administration, lack of certified dietary manager, unsanitary kitchen ventilation covers, life safety code violations such as courtyard gate egress, fire alarm system deficiencies, emergency lighting, fire extinguisher placement, electrical hazards, and incomplete fire evacuation procedures.
Severity Breakdown
SS=F: 10
SS=E: 1
SS=D: 2
Deficiencies (14)
| Description | Severity |
|---|---|
| Expired Novolog insulin was administered to Resident 35 beyond the 28-day expiration after opening. | SS=D |
| Facility failed to employ a Certified Dietary Manager or full-time Dietitian. | SS=F |
| Ceiling ventilation covers in the kitchen were dirty with dust buildup. | SS=F |
| Courtyard gate within means of egress required more than one motion to open. | SS=F |
| Smoke detection not installed to release magnetically held open doors in hazard area. | SS=E |
| Dining room lacked emergency lighting providing 5 ft-candles illumination during power loss. | SS=F |
| Facility failed to conduct monthly visual inspection of kitchen range hood fire suppression system. | SS=D |
| Fire alarm panel lacked a smoke detector for early fire notification. | SS=F |
| Fire alarm system smoke detector sensitivity testing not conducted every other year. | SS=F |
| Kitchen Class K fire extinguisher lacked required placard and fire extinguishers were mounted too high. | SS=F |
| Corridor doors (Family Room) lacked positive latching devices allowing potential smoke spread. | SS=F |
| Fire evacuation plan lacked procedures for evacuating residents in immediate sleeping areas. | SS=F |
| Emergency generator lacked a remote manual stop station. | SS=F |
| Electrical hazards including open junction box without cover, pinched cords, broken outlets, and use of flexible cords in lieu of permanent wiring. | SS=F |
Report Facts
Facility census: 33
Total licensed capacity: 60
Expired insulin doses administered: 17
Fire extinguisher mounting height: 67
Fire extinguisher mounting height: 68.5
Fire extinguisher mounting height: 65
Fire extinguisher mounting height: 63
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Lisa Woithalewicz | Administrator | Confirmed dietary manager was not certified and acknowledged electrical hazards and fire safety deficiencies |
| James M. Tharp | Maintenance Manager | Responsible for monitoring fire safety equipment, electrical work, and corrective actions |
| Director of Nursing | Interviewed regarding expired medication and dietary services | |
| Licensed Practical Nurse (LPN)-A | Observed administering expired insulin | |
| Dietary Manager | Interviewed regarding certification status and kitchen sanitation | |
| Consultant Dietician | Interviewed regarding dietary staffing | |
| Maintenance Director | Interviewed regarding cleaning of kitchen ventilation covers |
Inspection Report
Complaint Investigation
Deficiencies: 0
Dec 7, 2016
Visit Reason
An unannounced visit was conducted to investigate a complaint at Valley View Senior Village regarding allegations of failure to protect residents from injury and misappropriation.
Findings
The facility was found to have protected residents from injury and misappropriation, with no violations identified after review of records, observations, and interviews.
Complaint Details
The complaint alleged failure to protect residents from injury and misappropriation. Both allegations were unsubstantiated as no violations or concerns were identified.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Eve Lewis | Program Manager | Signed the report as Program Manager - Office of LTC Facilities - Licensure Unit - Division of Public Health - DHHS |
Inspection Report
Complaint Investigation
Census: 27
Deficiencies: 2
Jul 7, 2016
Visit Reason
An unannounced visit was conducted to investigate a complaint at Valley View Senior Village on July 6-7, 2016, regarding allegations of insufficient staffing, malfunctioning call light system, incomplete charting, and untimely laboratory values.
Findings
The facility was found to have sufficient staffing, complete and accurate charting, and timely lab value collection. However, the facility failed to ensure the call light system was in working condition, with multiple call lights malfunctioning and no preventative maintenance program in place, affecting potentially all residents.
Complaint Details
The complaint alleged insufficient staffing, malfunctioning call light system, incomplete charting, and untimely lab values. The investigation substantiated the call light system malfunction but found no violations related to staffing, charting, or lab values.
Severity Breakdown
Level F: 1
Level E: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Failure to provide a preventative maintenance program for the call light system, resulting in multiple call lights malfunctioning. | Level F |
| Failure to provide a working call light system for all residents, with six call lights not functioning during the audit. | Level E |
Report Facts
Facility census: 27
Malfunctioning call lights: 6
Call lights malfunctioning: 25
Call lights malfunctioning: 60
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Randy Kozeal | Administrator | Named in relation to notification of call light system malfunction |
| Eve Lewis | Program Manager - Office of LTC Facilities - Licensure Unit - Division of Public Health - DHHS | Signed letter regarding complaint investigation findings |
Inspection Report
Complaint Investigation
Census: 30
Deficiencies: 1
May 5, 2016
Visit Reason
An unannounced visit was conducted to investigate a complaint that residents have been identified at risk for falls and the facility fails to follow the plan of care when residents have been identified at risk for falls.
Findings
The facility was found to follow the plan of care when residents were identified at risk for falls. However, the facility failed to notify a resident's Primary Care Provider of a significant change in condition after a fall, which had the potential to affect the resident's health. The resident's condition declined and the PCP was not promptly notified.
Complaint Details
The complaint alleged that residents have been identified at risk for falls and the facility fails to follow the plan of care when residents have been identified at risk for falls. The investigation found no violation related to falls risk care but identified a deficiency in failure to notify the PCP of a significant change in condition for Resident 1 after a fall.
Severity Breakdown
SS=D: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to notify a resident's Primary Care Provider of a change in condition after a fall. | SS=D |
Report Facts
Facility census: 30
Deficiency count: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Brenda Keefe | Administrator | Named as recipient of the complaint investigation letter |
| Eve Lewis | Program Manager, Office of LTC Facilities - Licensure Unit | Signed the complaint investigation letter |
Inspection Report
Renewal
Capacity: 60
Deficiencies: 0
Mar 31, 2016
Visit Reason
The document is related to the renewal of the nursing home license for Valley View Senior Village, verifying licensure through the indicated renewal date.
Findings
The documents confirm that Valley View Senior Village meets statutory requirements for licensure renewal as a Skilled Nursing Facility with 60 beds. The renewal application and occupancy permit support the facility's compliance with licensing standards.
Report Facts
Number of beds to be relicensed: 60
Renewal fees: 1550
Renewal fees: 1750
Maximum Occupancy: 60
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Brenda Keefe | Administrator | Named on Nursing Home Licensure Renewal Application and email correspondence |
| Melanie Hansen | Director of Nursing | Named on Nursing Home Licensure Renewal Application |
| Randy L. Kozeal | CEO | Named in email correspondence regarding ownership/control |
| Merlin Brenden | CFO | Named in email correspondence regarding ownership/control |
Inspection Report
Annual Inspection
Census: 30
Deficiencies: 10
Nov 17, 2015
Visit Reason
An unannounced visit was conducted to investigate a complaint and annual survey at Valley View Senior Village on November 16-19, 2015, by representatives of the Department of Health and Human Services Division of Public Health.
Findings
The facility was found to be in compliance with complaint allegations related to staffing, bladder elimination care, and discharge notice. However, multiple life safety code deficiencies were identified including missing exit signs, unsealed smoke barrier penetrations, missing sprinkler coverage, obstructed fire extinguisher access, unmaintained smoke detectors, inadequate fire drill timing, and improper electrical equipment use.
Complaint Details
The complaint allegations investigated included insufficient staffing, failure to provide care and treatment for bladder elimination, and failure to give appropriate notice of discharge. The facility was found to be in compliance with all these allegations.
Severity Breakdown
F: 5
E: 3
D: 2
Deficiencies (10)
| Description | Severity |
|---|---|
| Failed to post exit signs so two exits from the Exterior Courtyard, 300, 400, 500 and 700 Wings were visible for 4 of 7 smoke compartments. | F |
| Failed to seal smoke barrier penetrations throughout the facility in 7 of 7 smoke barriers. | F |
| Failed to provide smoke resistive barriers for the Laundry and Atrium Furnace Room for 1 of 7 smoke compartments. | E |
| Failed to conduct fire drills quarterly for 3 of 3 shifts with varying times. | F |
| Laundry Heat Detector had been painted over and not replaced for 1 of 7 smoke compartments. | D |
| Failed to provide automatic fire sprinkler coverage in Restorative Care Fire Sprinkler Closet and Atrium Closet for 2 of 7 smoke compartments. | F |
| Fire extinguisher in Sunshine Circle was obstructed by a table preventing unobstructed access. | E |
| Non-required battery operated single station smoke detectors were installed in Resident Room 308 and Biohazard Room 306 and were not maintained or tested weekly. | D |
| Failed to document emergency generator monthly testing at 30% load capacity. | F |
| Used electrical wiring and equipment not listed for use in Resident Rooms 308, 408, 503, and 702 including power strips and extension cords. | E |
Report Facts
Facility census: 30
Fire drills: 3
Smoke barriers: 7
Smoke compartments: 7
Residents affected: 12
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Maintenance A | Acknowledged deficiencies related to exit signs, smoke barrier penetrations, fire drills, heat detectors, sprinkler coverage, fire extinguisher obstruction, smoke detectors, and electrical equipment | |
| Randy Kozeal | Administrator | Facility administrator addressed in complaint investigation letter |
| Eve Lewis | Program Manager - Office of LTC Facilities - Licensure Unit - Division of Public Health - DHHS | Signed complaint investigation letter |
Inspection Report
Annual Inspection
Census: 27
Deficiencies: 3
Nov 20, 2014
Visit Reason
The inspection was conducted as an annual survey to assess compliance with regulatory requirements for a skilled nursing facility.
Findings
The facility was found deficient in housekeeping and maintenance services related to bath safety belts, medication management including duplicate antibiotic therapy and inadequate monitoring of antipsychotic drug side effects, and life safety code violations related to sprinkler head clearance.
Severity Breakdown
Level D: 1
Level E: 2
Deficiencies (3)
| Description | Severity |
|---|---|
| Failed to provide bath safety belts with a cleanable surface on the lift chair for the whirlpool tub, exposing inner fibers and creating an uncleanable surface. | Level D |
| Failed to ensure one resident did not receive duplicate antibiotic therapy resulting in an adverse reaction and failed to monitor two residents receiving antipsychotic medication for adverse reactions related to involuntary movements. | Level E |
| Failed to maintain the automatic sprinkler system to assure reliable operating condition; items stored closer than the required 18 inches of clearance below a sprinkler head in room 305. | Level E |
Report Facts
Facility census: 27
Facility census: 29
Residents affected: 1
Residents affected: 5
Residents affected: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Maintenance A | Confirmed items stored too close to sprinkler head | |
| Director of Nursing | DON | Acknowledged lack of monitoring for involuntary movements related to antipsychotic use |
| Pharmacist Consultant | Reported on antibiotic use and monitoring of antipsychotic side effects | |
| Patient Care Coordinator | Confirmed duplicate antibiotic therapy and adverse reactions | |
| Nurses Aid / Bath Aid A | Interviewed about resident bathing and bath belt use |
Inspection Report
Complaint Investigation
Census: 29
Deficiencies: 0
Aug 14, 2014
Visit Reason
An unannounced visit was conducted to investigate a complaint at Valley County Health System Long Term Care regarding allegations of inadequate time at meals, failure to provide medications according to the Five Rights, failure to provide interventions to prevent weight loss, and failure to ensure residents are not chemically restrained.
Findings
The facility was found to allow adequate time at meals, provide medications in accordance with the Five Rights with less than 5 percent error rate, and provide interventions to prevent weight loss. Residents were confirmed to be free from chemical restraints. No violations were identified related to the allegations.
Complaint Details
The complaint alleged inadequate time at meals, failure to provide medications according to the Five Rights, failure to provide interventions to prevent weight loss, and failure to ensure residents are not chemically restrained. All allegations were found unsubstantiated based on observations, record reviews, and staff interviews.
Report Facts
Facility census: 29
Medication error rate: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Travis Castner | Registered Nurse | Conducted the complaint investigation |
| Daniel Woodward | Registered Nurse | Conducted the complaint investigation |
| Eve Lewis | Program Manager | Signed the report correspondence |
Inspection Report
Annual Inspection
Census: 31
Deficiencies: 8
Aug 14, 2013
Visit Reason
Annual inspection to assess compliance with federal and state regulations governing skilled nursing facilities, including care plans, infection control, pharmaceutical services, and life safety code standards.
Findings
The facility was found deficient in multiple areas including failure to develop comprehensive care plans for residents, improper food handling practices risking food borne illness, expired and mislabeled medications, inadequate infection control practices such as failure to use gloves during insulin administration, lack of written agreements for physical therapy services, and life safety code violations including doors not latching properly and improper installation of alcohol-based hand rub dispensers.
Severity Breakdown
SS=D: 5
SS=E: 1
SS=F: 3
Deficiencies (8)
| Description | Severity |
|---|---|
| Failure to develop a comprehensive care plan for Resident 34's skin condition. | SS=D |
| Failure to prevent potential food borne illness due to improper hand washing by dietary staff. | SS=F |
| Expired medication administered to Resident 27 and mislabeled medication for Resident 30. | SS=D |
| Failure to use gloves during insulin administration to Resident 26, risking infection spread. | SS=D |
| Lack of written agreement for physical therapy services provided outside the facility. | SS=D |
| Door to room 702 did not close and latch tightly, compromising corridor protection. | SS=E |
| Doors to Multi-Purpose room and clean utility room did not close tightly, compromising smoke resistance. | SS=F |
| Alcohol-based hand rub dispenser installed too close to an ignition source in the Atrium. | SS=F |
Report Facts
Facility census: 31
Deficiency count: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Don Fritz | Director of Nursing | Interviewed regarding medication labeling and care plan deficiencies; signed plan of correction |
| Larry Paskevil | Director - Support Services | Signed plan of correction related to life safety code deficiencies |
| RN B | Registered Nurse | Acknowledged expired medication and labeling issues |
| LPN A | Licensed Practical Nurse | Observed not using gloves during insulin administration |
| Cook D | Observed improper hand washing and handling of soiled items | |
| Maintenance A | Confirmed door and hand rub dispenser deficiencies |
Inspection Report
Annual Inspection
Census: 41
Deficiencies: 13
Jun 7, 2012
Visit Reason
The inspection was conducted as an annual survey to assess compliance with federal and state regulations governing skilled nursing facilities, including resident rights, dignity, care planning, fall prevention, infection control, and life safety code compliance.
Findings
The facility was found deficient in multiple areas including improper use of physical restraints, lack of respect and dignity in resident care, inadequate activities programming, incomplete care plans, failure to implement fall prevention interventions, delayed call light responses, pressure ulcer management deficiencies, unsafe environmental conditions, and lapses in infection control practices.
Severity Breakdown
SS=G: 2
SS=F: 1
SS=E: 4
SS=D: 5
Deficiencies (13)
| Description | Severity |
|---|---|
| Failed to identify and prevent use of physical restraint for one resident (Resident 19) using a recliner footrest as a restraint. | SS=D |
| Failed to ensure residents were treated with respect and dignity related to dining services and staff interactions for multiple residents. | SS=E |
| Failed to provide evening activities accessible for one resident (Resident 2) who voiced a desire to attend. | SS=D |
| Failed to develop a comprehensive care plan related to bruising for one resident (Resident 24). | SS=D |
| Failed to implement fall prevention interventions for one resident (Resident 19) with multiple falls and a fracture. | SS=D |
| Failed to answer call lights in a timely manner for four residents (Residents 2, 26, 32, 47). | SS=E |
| Failed to prevent development and properly treat a pressure ulcer for one resident (Resident 44). | SS=G |
| Failed to ensure resident environment was free of accident hazards; oxygen used under a heat source and fall prevention interventions not revised for Resident 19. | SS=G |
| Failed to provide sufficient fluid intake and reasonable access to fluids between meals for one resident (Resident 47). | SS=D |
| Failed to follow up on pharmacist's recommendation for antihistamine eye drops for one resident (Resident 2). | SS=D |
| Failed to ensure hand hygiene before and after resident contact for two residents (Residents 2 and 19). | SS=E |
| Double doors to Multi Purpose room did not latch tightly as required by life safety code. | SS=E |
| Door to oxygen storage room lacked an automatic door closure as required by life safety code. | SS=F |
Report Facts
Facility census: 41
Residents on sample: 17
Call light response times: 72.9
Bruise size: 33
Bruise size: 13
Pressure ulcer size: 3.5
Pressure ulcer size: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ashley Woodward | CEO | Signed plan of correction documents |
| Larry L. Proskocil | Director - Support Services | Responsible for maintenance corrections and monitoring door closures |
Inspection Report
Annual Inspection
Census: 38
Deficiencies: 7
May 4, 2011
Visit Reason
Annual inspection of Valley County Health System Long Term Care to assess compliance with licensure regulations and life safety codes.
Findings
The facility was found deficient in multiple areas including failure to report allegations of resident mistreatment, inadequate implementation of individualized toileting plans and pericare, failure to sanitize mechanical lifts between residents, and several life safety code violations such as improper fire door separation, confusing exit signage, overdue sprinkler system inspection, and use of non-hospital grade power strips.
Severity Breakdown
SS=D: 1
SS=E: 2
SS=F: 4
Deficiencies (7)
| Description | Severity |
|---|---|
| Failure to report allegations of mistreatment by two residents to the State Agency. | SS=D |
| Failure to implement individualized toileting plan and proper pericare to prevent urinary tract infections for two residents. | SS=E |
| Failure to sanitize mechanical lifts between resident use, risking cross contamination. | SS=E |
| Failure to maintain a two-hour fire barrier separation between health care occupancy and business occupancy due to door gap. | SS=F |
| Exit signage was confusing and did not properly indicate direction to exit. | SS=F |
| Automatic sprinkler system overdue for required 5-year internal inspection. | SS=F |
| Electrical wiring and equipment not installed in accordance with NFPA 70; use of non-hospital grade power strips. | SS=F |
Report Facts
Facility census: 38
Residents sampled: 10
Residents non-sampled: 4
Residents affected by mechanical lift deficiency: 7
Facility census: 36
Inspection Report
Complaint Investigation
Census: 43
Deficiencies: 1
Oct 20, 2010
Visit Reason
The inspection was conducted due to a complaint investigation regarding failure to protect female residents from potential sexual abuse by a male resident.
Findings
The facility failed to implement adequate interventions to protect female residents from inappropriate physical contact by a male resident. Multiple events of inappropriate behavior were documented, and interventions were either insufficient or not evaluated after incidents.
Complaint Details
The complaint investigation was substantiated as the facility failed to protect female residents (Residents 2, 3, and 4) from sexual abuse by Resident 1. The report identifies three separate events of inappropriate physical contact by Resident 1 toward female residents over a two-week period.
Severity Breakdown
SS=E: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to protect female residents from verbal, sexual, physical, and mental abuse, corporal punishment, and involuntary seclusion. | SS=E |
Report Facts
Facility census: 43
Sample size: 4
Dates of events: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Joyce Howard | Administrator | Signed the plan of correction on 11-11-10 |
| Director of Nursing | Interviewed and involved in review of care plans and interventions | |
| Social Service Designee | Interviewed and involved in review of care plans and interventions |
Notice
Capacity: 60
Deficiencies: 0
APP2017
Visit Reason
This document serves as verification of the renewal of the SNF/NF dual certification license for Valley View Senior Village and provides ownership/control information.
Findings
The facility is licensed as a skilled nursing facility with a total licensed capacity of 60 beds. Ownership is held by Valley View Senior Village, LLC, with Randy L. Kozeal as President holding 60% ownership and Merlin Brenden as Member holding 40%.
Report Facts
Licensed beds: 60
Ownership percentage: 60
Ownership percentage: 40
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Lisa Woitalewicz | Administrator | Named in licensure renewal application |
| Steven Roy | Director of Nursing | Named in licensure renewal application |
| Randy L. Kozeal | NHA, President | Named as owner and President in ownership/control letter |
| Merlin Brenden | Member | Named as owner and Member in ownership/control letter |
Document
Capacity: 60
Deficiencies: 0
APP2018
Visit Reason
The documents serve to renew the nursing home license for Valley View Senior Village and to apply for Alzheimer's Special Care Unit endorsement and memory care services.
Findings
No inspection findings or deficiencies are reported. The documents include licensing renewal, certification of services, and administrative correspondence confirming application receipt and payment.
Report Facts
Licensed beds: 60
Renewal fee: 1750
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Silvester Juanes | Administrator | Named as facility administrator on the Nursing Home Licensure Renewal Application and Alzheimer's Special Care Unit Disclosure. |
| Donna Jobman | Staff Assistant II | Named in correspondence regarding licensing renewal and Alzheimer's services. |
| Randy L. Kozeal | Named as contact person for Midwest LTC and in correspondence related to licensing. |
Document
Capacity: 60
Deficiencies: 0
APP2019
Visit Reason
The documents serve to renew the nursing home license, verify occupancy capacity, and disclose information related to the Alzheimer's Special Care Unit at Valley View Senior Village.
Findings
The documents confirm the facility's licensure renewal status, licensed bed capacity of 60, and provide detailed information about the Alzheimer's Special Care Unit including staffing, care philosophy, and facility features.
Report Facts
Licensed bed capacity: 60
Alzheimer's Special Care Unit endorsed capacity: 10
Renewal expiration date: 2019
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Cindy M. Tapphorn | Administrator | Named as facility administrator on renewal application and Alzheimer's unit disclosure |
| Susan Vlach | Director of Nursing | Named as Director of Nursing on renewal application |
| Randy L. Kozeal | Owner/Authorized Representative | Named as facility owner and authorized representative signing renewal and Alzheimer's unit disclosure |
| Jennifer Rasmuson | Certified Dementia Practitioner | Named as staff providing dementia training in Alzheimer's unit disclosure |
Notice
Capacity: 60
Deficiencies: 0
APP2020
Visit Reason
This document serves as a renewal application and verification of licensure for Valley View Senior Village, including occupancy permit and ownership information.
Findings
The documents confirm that Valley View Senior Village meets statutory requirements for licensure as a Skilled Nursing Facility/Nursing Facility dual certification, with a licensed capacity of 60 beds and approved occupancy by the State Fire Marshal.
Report Facts
Licensed beds: 60
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jodi Dethlefs | Administrator | Named on the Nursing Home Licensure Renewal Application. |
| Stephanie Jensen | Director of Nursing | Named on the Nursing Home Licensure Renewal Application. |
| Randy L. Kozeal | President/Owner | Signed ownership certification and control list for the facility. |
Notice
Capacity: 60
Deficiencies: 0
APP2022
Visit Reason
This document serves to verify the renewal of the SNF/NF dual certification license for Arbor Care Centers - Ord, LLC and includes the nursing home licensure renewal application and occupancy permit.
Findings
The documents confirm the facility meets statutory requirements for licensure renewal and has a maximum occupancy of 60 beds as per the occupancy permit.
Report Facts
Total licensed beds: 60
Renewal licensure fee: 1750
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Roger Bayliff | Director of Nursing | Named on the Nursing Home Licensure Renewal Application. |
| Timeree Andreasen | Administrator | Named on the Nursing Home Licensure Renewal Application. |
Notice
Capacity: 60
Deficiencies: 0
APP2023
Visit Reason
This document serves as a Nursing Home Licensure Renewal Application for Arbor Care Centers - Ord, LLC, including verification of licensure and occupancy permit information.
Findings
The documents confirm the facility's licensure renewal status, the number of beds to be relicensed, and the maximum occupancy as per the fire marshal's permit. No inspection findings or deficiencies are reported.
Report Facts
Total licensed beds: 60
Document
Capacity: 60
Deficiencies: 0
APP2024
Visit Reason
This document serves as a Nursing Home Licensure Renewal Application for Arbor Care Centers - Ord, LLC, including verification of licensure and occupancy permits.
Findings
The documents confirm the facility's licensure renewal status, licensed bed capacity, and occupancy permit approval by the State Fire Marshal.
Report Facts
Licensed beds: 60
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Melissa VanDeWalle | Administrator | Named in the Nursing Home Licensure Renewal Application |
| Faith Weaver | Director of Nursing | Named in the Nursing Home Licensure Renewal Application |
| Aaron Klaasmeyer | Authorized Representative | Signed the Nursing Home Licensure Renewal Application |
| Kenneth Klaasmeyer | Authorized Representative | Signed the Nursing Home Licensure Renewal Application |
Notice
Deficiencies: 0
DAN032118
Visit Reason
This document serves as a Notice of Disciplinary Action issued to Valley View Senior Village due to violations of licensure regulations, including a prohibition on admitting new residents until compliance is demonstrated and placement of the facility's license on probation for 180 days starting April 26, 2018.
Findings
The facility was found in violation of multiple licensure regulations related to resident care, medication management, staff training, and facility maintenance. A Plan of Correction and biweekly reporting on residents with pressure sores were required. A revisit on May 16, 2018 confirmed correction of the referenced violation, terminating the admission prohibition but continuing probation.
Report Facts
Probation period (days): 180
Date prohibition on admissions ends: Prohibition ended after compliance demonstrated on May 16, 2018
Report submission frequency (days): 14
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Dan Taylor | RN, Interim Program Manager - Office of LTC Facilities - Licensure Unit - Division of Public Health - DHHS | Signed letter confirming correction of violations and termination of admission prohibition |
Notice
Deficiencies: 0
DAN060712
Visit Reason
This Notice of Disciplinary Action was issued to place the nursing facility license on probation for 90 days beginning July 11, 2012, due to failure to implement interventions to prevent pressure sores and injuries from accidents.
Findings
The facility failed to implement required processes and interventions to prevent pressure sores and accidents, as evidenced by violations documented in the CMS-2567 Report dated June 26, 2012.
Report Facts
Probation period length: 90
Probation start date: July 11, 2012
Notice mailing date: June 26, 2012
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Joann Schaefer | Chief Medical Officer, Director, Division of Public Health | Signed the Notice of Disciplinary Action |
| Helen L. Meeks | Administrator, Licensure Unit | Signed the Notice of Disciplinary Action |
| Linda Stenvers | Staff Assistant II | Certified mailing of the Notice |
| Eve Lewis | Administrator, Long Term Care Facilities, Licensure Unit, Division of Public Health | Recipient of reports and author of follow-up letter dated October 29, 2012 |
| William Sugg | Administrator | Facility administrator addressed in the follow-up letter |
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