Inspection Reports for
Brookestone of Papillion
610 South Polk Street, PAPILLION, NE, 68046
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Inspection Report — Oct 31, 2023
Renewal State
Date: Oct 31, 2023
Visit Reason
The document is related to the renewal of the nursing home license for Brookestone of Papillion, confirming the facility's licensure and capacity.
Findings
The documents confirm that Brookestone of Papillion meets statutory requirements for licensure as a Skilled Nursing Facility and Nursing Facility dual certification. The renewal application and occupancy permit indicate the facility is licensed for 110 beds.
Report Facts
Number of beds to be relicensed: 110
Maximum Occupancy: 110
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Ashley Walters | Administrator | Named on the Nursing Home Licensure Renewal Application |
| Michele Tordoff | Director of Nursing | Named on the Nursing Home Licensure Renewal Application |
| Brian Stuhr | Authorized Representative / Treasurer | Signed the Nursing Home Licensure Renewal Application |
| Glenn Van Ekeren | Authorized Representative / President | Signed the Nursing Home Licensure Renewal Application |
| Ty Hernes | Deputy State Fire Marshal | Inspected the facility and approved the Occupancy Permit |
Inspection Report — Feb 18, 2022
Renewal State
Date: Feb 18, 2022
Visit Reason
The document is a Nursing Home Licensure Renewal Application for Papillion Manor, indicating the facility is applying to renew its license for continued operation.
Findings
The document certifies that Papillion Manor meets statutory requirements for licensure renewal as a Skilled Nursing Facility with specified services including occupational therapy, physical therapy, and speech therapy.
Report Facts
Number of beds to be relicensed: 110
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Ashley Walters | Administrator | Named in Nursing Home Licensure Renewal Application |
| Maureen Blaylock | Director of Nursing | Named in Nursing Home Licensure Renewal Application |
| Brian Stuhr | Authorized Representative | Signed Nursing Home Licensure Renewal Application |
| Glenn Van Ekeren | Authorized Representative | Signed Nursing Home Licensure Renewal Application |
Notice — Feb 1, 2016
State
Date: Feb 1, 2016
Visit Reason
The letter serves to amend the Health Insurance Benefits Agreement to reflect changes in the certified bed locations and counts effective March 1, 2016, as requested by the facility.
Findings
The agreement updates the certified bed locations within the facility, maintaining a total of 110 Medicare certified beds with some room bed counts adjusted.
Report Facts
Total certified beds: 110
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Eve Lewis | Program Manager | Signed the letter as Program Manager, Office of Long Term Care Facilities |
Notice — APP2019
State
Date: APP2019
Visit Reason
This document serves to verify that Papillion Manor's SNF/NF dual certification license is valid through the indicated renewal date and includes the occupancy permit issued by the Nebraska State Fire Marshal.
Findings
The documents confirm that Papillion Manor meets statutory requirements for licensure as a skilled nursing facility/nursing facility and has an occupancy permit for 110 beds issued on 2018-05-31. No inspection findings or deficiencies are reported.
Report Facts
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Linnea Detrick | Administrator | Named as facility administrator on relicensing application. |
| Maureen Blaylock | Director of Nursing | Named as Director of Nursing on relicensing application. |
| Jack D. Vetter | Chairman of the Board and CEO | Listed as Chairman of the Board and CEO of parent corporation Vetter Senior Living. |
| Glenn Van Ekeren | President | Listed as President of parent corporation Vetter Senior Living. |
| Eldora D. Vetter | Secretary | Listed as Secretary of parent corporation Vetter Senior Living. |
| Brian Stuhr | Treasurer | Listed as Treasurer of parent corporation Vetter Senior Living. |
| Heath Boddy | Listed as a director/officer of Vetter Senior Living. |
Document — APP2020
State
Date: APP2020
Visit Reason
The document set pertains to the renewal of the nursing home license for Papillion Manor, including submission of the renewal application and verification of licensure status.
Findings
No inspection findings or deficiencies are reported in these documents. The materials confirm licensure renewal, ownership information, and occupancy permit details.
Report Facts
Renewal application date: 2020
Occupancy permit issue date: 2019
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Linnea Detrick | Administrator | Named on renewal application |
| Maureen Blaylock | Director of Nursing | Named on renewal application |
| Jack D. Vetter | Chairman of the Board and CEO | Named as authorized representative and corporate officer |
| Glenn Van Ekeren | President | Named as authorized representative and corporate officer |
Report — February 20, 2025
CMS
February 20, 2025
Report — November 19, 2024
CMS
November 19, 2024
Report — September 4, 2024
CMS
September 4, 2024
Report — November 2, 2023
CMS
November 2, 2023
Report — November 8, 2022
CMS
November 8, 2022
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