Inspection Reports for Hillcrest Country Estates Cottages

The document is a Nursing Home Licensure Renewal Application for Hillcrest Country Estates-Cottages, indicating the facility is renewing its license to operate as a Skilled Nursing Facility.

The document certifies that the facility meets statutory requirements for licensure renewal as a Skilled Nursing Facility with specified special care and treatment services including physical therapy, speech therapy, and occupational therapy.

The document is a Nursing Home Licensure Renewal Application and related licensing and occupancy permit documents for Hillcrest Country Estates-Cottages, indicating the renewal of the facility's license.

The documents certify that Hillcrest Country Estates-Cottages meets statutory requirements for skilled nursing facility licensure and include multiple occupancy permits for various buildings within the facility, specifying maximum occupancy limits.

An offsite investigation was conducted to investigate a complaint that the facility failed to implement CMS directives related to COVID-19.

The facility followed CMS protocol for COVID-19 prevention, implemented interventions for staff and resident protection, and was found to be in compliance with relevant regulatory requirements.

The complaint alleged that the facility failed to implement CMS directives related to COVID-19. The investigation found the allegation unsubstantiated as the facility was compliant.

An unannounced visit was conducted to investigate a complaint at Hillcrest Country Estates-Cottages on February 27, 2019, regarding fall interventions, emergency care, and notification of administrative staff changes.

The facility was found compliant with fall interventions and prompt emergency care but failed to notify the department of changes in the Director of Nursing within five working days, resulting in a deficiency citation.

The complaint alleged failure to use fall interventions to prevent injuries, failure to ensure prompt emergency care, and failure to notify the department of administrative staff changes. The first two allegations were found to be in compliance; the third was substantiated.

An unannounced visit was conducted to investigate a complaint at Hillcrest Country Estates-Cottages on November 15, 2018, regarding failure to identify change in condition, failure to investigate causal factors in falls, and failure to provide medications according to the five rights.

The facility was found to be in compliance with regulations for all allegations: changes in condition were identified and documented, causal factors in falls were investigated, and medications were provided according to the five rights of medication administration.

The complaint alleged failure to identify change in condition, failure to investigate causal factors in falls, and failure to provide medications according to the five rights. The facility was found to be in compliance with all these allegations.

An unannounced visit was conducted to investigate a complaint at Hillcrest Country Estates-Cottages on October 24-25, 2018, by representatives of the Department of Health and Human Services Division of Public Health. The investigation included review of resident records, observation of care and services, and interviews with residents, family members, and staff.

The facility was found to be in compliance with all regulatory requirements related to medication administration, following practitioner's orders, housekeeping and maintenance, psychosocial activities, equipment maintenance, odor prevention, and timely reporting of injuries requiring treatment.

The complaint alleged failures in medication administration, following practitioner's orders, housekeeping and maintenance, psychosocial activities, equipment maintenance, odor prevention, and injury reporting. The investigation found the facility compliant in all these areas.

An unannounced visit was conducted to investigate a complaint at Hillcrest Country Estates-Cottages on September 5-6, 2018, regarding allegations of residents being left in soiled clothing, inadequate housekeeping to prevent odors, and insufficient staffing to care for residents.

The investigation found the facility was in compliance with regulations: residents were not left in soiled clothing, the housekeeping program was adequate with no odors detected, and staffing levels were sufficient to meet resident needs.

The complaint alleged the facility failed to ensure residents were not left in soiled clothing, failed to have an adequate housekeeping program to prevent odors, and failed to ensure sufficient staffing. All allegations were found to be unsubstantiated with the facility in compliance at the time of the survey.

An unannounced visit was conducted to investigate a complaint and annual survey at Hillcrest Country Estates-Cottages from July 5, 2018 to July 18, 2018 by representatives of the Department of Health and Human Services Division of Public Health.

The facility failed to submit investigations within 5 working days for 2 residents, failed to provide care and services according to practitioner's orders, failed to provide care and treatment to prevent skin breakdown, failed to provide fluids as ordered, and failed to complete ordered lab testing. Other allegations were found to be in compliance.

The complaint investigation included allegations of failure to submit investigations timely, insufficient staffing, failure to provide care and services for repositioning, failure to provide 3 meals per day, failure to ensure staff credentials, failure to address grievances, failure to notify responsible parties of changes in condition, failure to provide care according to orders, failure to prevent skin breakdown, failure to provide assistance for eating/hydration, overmedication, failure to provide fluids as ordered, failure to ensure interdisciplinary team presence at careplan meetings, failure to complete ordered lab testing, and failure to provide medications as ordered. Some allegations were substantiated with deficiencies cited, others were found in compliance.

The letter acknowledges the increase in the number of licensed beds at Hillcrest Country Estates-Cottages Skilled Nursing Facility, effective July 1, 2018, due to the transfer of 60 beds from another facility.

The letter confirms the increase in licensed beds from 126 to 186 beds at the facility, with no inspection findings or deficiencies noted.

The document package relates to the renewal and change of ownership of the skilled nursing facility license for Hillcrest Country Estates-Cottages, including initial licensing for the new corporation HCE-Cottages LLC effective April 1, 2018.

The documents confirm licensure issuance, renewal, and change of ownership from Hillcrest Development Company LLC to HCE-Cottages LLC. The facility is licensed for 126 beds, with no deficiencies or violations noted in the materials provided. Fire marshal occupancy permits for cottages with capacities of 13 and 22 beds are included.

An unannounced visit was conducted to investigate a complaint survey at Hillcrest Country Estates on August 14-15, 2017, by representatives of the Department of Health and Human Services Division of Public Health. The investigation focused on allegations that the facility failed to report falls with injury and failed to ensure care planned fall interventions were in place.

The facility failed to report falls with injury for 1 of 4 residents reviewed and failed to ensure care planned fall interventions were in place to prevent falls for 2 of 4 residents reviewed. The failures were confirmed through record reviews and staff interviews, and were violations of state regulations.

The complaint alleged that the facility failed to report falls with injury and failed to ensure care planned fall interventions were in place. The investigation substantiated these allegations based on record reviews and interviews.

The notice was issued to inform Hillcrest Country Estates of disciplinary action placing their nursing home license on probation for 90 days due to violations related to failure to identify and prevent pressure sores.

The facility was found in violation of multiple licensure regulations, including failure to identify pressure sores and implement interventions to prevent worsening, as detailed in the CMS-2567 report dated May 22, 2017.

An unannounced visit was conducted to investigate a complaint and annual survey at Hillcrest Country Estates on May 1, 2017-May 4, 2017, by representatives of the Department of Health and Human Services Division of Public Health.

The facility was found to have multiple deficiencies including failure to implement or follow the plan of care, failure to ensure staff had required credentials, failure to ensure security of narcotic medications, failure to prevent skin breakdown, failure to ensure proper hand washing, failure to accommodate resident choices regarding bathing and wake times, failure to provide an activity program meeting resident needs, failure to employ a qualified activity professional, failure to code terminal illness correctly in MDS, failure to develop comprehensive care plans for multiple residents, failure to provide necessary treatment for pressure ulcers, failure to evaluate unnecessary drug use, failure to maintain nutritive value of pureed food, failure to follow PASRR recommendations, failure to maintain infection control practices, and several life safety code violations related to fire alarm and sprinkler systems and oxygen cylinder storage.

The visit was complaint-related with allegations including failure to implement or follow the plan of care, failure to ensure residents are treated with dignity and respect, failure to ensure appropriate housekeeping and maintenance, failure to ensure staff have required credentials, failure to ensure prompt response to calls for assistance, failure to ensure sufficient staffing, failure to ensure necessary supplies are available, failure to provide care and services as ordered by practitioner, failure to allow appropriate parties access to medical records, failure to ensure security of narcotic medications, failure to provide care and treatment to prevent skin breakdown, failure to have physician orders for treatments, failure to provide care and services for bowel and bladder elimination, failure to provide oral care as required, failure to ensure meals are attractive and palatable, failure to ensure proper hand washing, failure to ensure residents were supervised, and failure to ensure staff can identify care concerns without retribution.

An unannounced visit was conducted to investigate a complaint alleging the facility failed to ensure residents are free from abuse and failed to report allegations of abuse.

The investigation found that the facility ensured residents were free from abuse and did not fail to report allegations of abuse; therefore, no violations were identified related to these allegations.

The complaint alleged the facility failed to ensure residents were free from abuse and failed to report allegations of abuse. Both allegations were found to be unsubstantiated.

An unannounced visit was conducted to investigate a complaint alleging the facility failed to ensure residents' safety during transport.

The facility ensured residents' safety during transport; observations showed residents were transported in wheelchairs with foot pedals in place, staff were knowledgeable about their use, and staff had been educated on this safety measure. The facility was determined to be in compliance with related regulatory requirements.

The complaint alleged failure to ensure residents' safety during transport. The complaint was found to be unsubstantiated as the facility was compliant.

An unannounced visit was conducted to investigate a complaint alleging the facility failed to use fall interventions to prevent injuries.

The facility implemented interventions to prevent falls but was cited for failure to evaluate a resident's condition after a fall and failure to complete skin treatment and monitoring for residents. Specifically, Resident 1 did not have complete follow-up evaluations or wound treatment documented, and Resident 2 lacked weekly skin assessments.

The complaint alleged the facility failed to use fall interventions to prevent injuries. The investigation found the facility was in compliance with fall interventions but cited deficiencies related to follow-up evaluations and skin treatment after falls.

An unannounced visit was conducted to investigate a complaint and annual survey at Hillcrest Country Estates on May 9, 2016-May 17, 2016, by representatives of the Department of Health and Human Services Division of Public Health.

The facility was found to be in compliance with most allegations related to complaint investigations. Deficiencies were cited related to criminal background checks, notification of changes, care planning, nutrition, pressure sore prevention, immunizations, food handling, medication storage, and life safety code violations including emergency lighting and generator testing.

The visit was complaint-related and included allegations that the facility failed to submit investigations when completed, failed to report injuries of unknown origin, and failed to follow resident/family directions for care planning. All allegations were found to have no violations.

An unannounced visit was conducted to investigate a complaint regarding medication administration, pain management, food form, dining assistance, weight loss interventions, and personal hygiene at Hillcrest Country Estates.

The investigation found no violations; the facility complied with practitioner's medication orders, assisted with pain management and personal hygiene, ensured food form met resident needs, provided dining assistance, and implemented interventions to prevent weight loss.

The complaint alleged failures in medication administration, pain management, food form appropriateness, dining assistance, weight loss prevention, and personal hygiene assistance. All allegations were found to be unsubstantiated.

An unannounced visit was conducted to investigate a complaint regarding failure to notify practitioner of change in condition and failure to administer medications according to practitioner's orders.

The facility was found to be in compliance with notification of practitioner of change in condition. However, the facility failed to administer medications according to practitioner's orders for two residents, but self-corrected by providing education and competency testing to staff and implementing weekly audits.

The complaint alleged failure to notify practitioner of change in condition and failure to administer medications according to practitioner's orders. The notification allegation was not substantiated; the medication administration allegation was substantiated with corrective actions taken.

An unannounced visit was conducted to investigate a complaint that the facility fails to change fall interventions after residents have been identified at risk for falls.

The facility did change fall interventions after residents were identified at risk for falls, including adding new interventions to care plans and providing staff education. However, the facility was found noncompliant for failing to submit an investigation report to the state agency within 5 working days for one resident's fall incident.

The complaint alleged the facility fails to change fall interventions after residents have been identified at risk for falls. The investigation found the facility did change interventions but failed to timely submit the investigation report to the state agency.

Routine inspection of Hillcrest Country Estates to assess compliance with regulatory requirements including care planning, medication management, and life safety code standards.

The facility failed to develop comprehensive care plans addressing antipsychotic medication use for certain residents and did not adequately monitor or document target behaviors related to antipsychotic drug use. Additionally, fire safety deficiencies were identified including failure of a housekeeping door to latch properly, fire drills not conducted at varied times on all shifts, and generator testing deficiencies.

An unannounced visit was conducted to investigate a complaint regarding the facility's failure to maintain an emergency call system, ensure prompt call notifications, identify changes in condition, and utilize fall interventions to prevent injuries.

The facility was found to be in compliance with emergency call system maintenance, prompt call notification, and identification of changes in condition. However, the facility failed to evaluate potential causal factors for falls and implement interventions to prevent falls for one sampled resident, violating regulatory requirements.

The complaint alleged failure to maintain emergency call system, failure to ensure call notifications are answered promptly, failure to identify change in condition, and failure to utilize fall interventions to prevent injuries. The facility was found compliant with the first three allegations but deficient in fall interventions.

An unannounced visit was conducted to investigate a complaint and annual survey at Hillcrest Country Estates from January 6, 2014 to January 9, 2014.

The facility failed to ensure nursing personnel performed hand hygiene as required during resident transfers and medication administration, potentially affecting two residents. The facility was found to be in compliance regarding reporting falls with significant injuries.

The complaint alleged the facility failed to report all falls with significant injuries. The investigation found the facility did report all such falls and was in compliance with reporting requirements.

The inspection was conducted as a routine survey to assess compliance with Nebraska Administrative Code regulations governing licensure of skilled nursing facilities, nursing facilities, and intermediate care facilities.

The facility was found deficient in two areas: failure to implement an intervention to evaluate potential causal factors for falls for one resident, and failure to inventory resident possessions at time of admission for two residents. The facility had a total census of 102 residents at the time of inspection.

Routine state inspection of Hillcrest Country Estates to assess compliance with licensure regulations and life safety codes.

Multiple deficiencies were identified including failure to develop and revise comprehensive care plans for residents with behavioral issues, failure to evaluate wheelchair positioning, improper food handling and temperature control, expired laboratory vials and improper storage, fire safety code violations including inadequate fire drills, sprinkler system maintenance issues, oxygen storage and signage deficiencies, electrical panel access obstruction, and use of flammable materials near kitchen stove.

Routine inspection to assess compliance with Nebraska regulations governing licensure of skilled nursing facilities, nursing facilities, and intermediate care facilities.

The facility failed to maintain sanitary food storage and preparation conditions, including undated and unsealed dry food products, unclean kitchen surfaces and cookware, improper utensil storage, and damaged freezer equipment. Additionally, the chronological resident register was incomplete regarding dental information. Life safety code deficiencies included obstructed egress, missing oxygen use signage, and unsecured emergency generator gas supply valves.

The document serves as a license renewal application for Hillcrest Country Estates Skilled Nursing Facility and includes occupancy permits issued by the Nebraska State Fire Marshal.

The documents confirm the renewal of the skilled nursing facility license and provide occupancy permits for multiple facility locations with specified maximum bed capacities.

The document is a license renewal application for Hillcrest Country Estates Skilled Nursing Facility, including renewal fee payment and ownership information.

The documents include multiple occupancy permits issued by the Nebraska State Fire Marshal for various facility locations, confirming maximum occupancy limits and compliance with fire safety codes.

The documents include a license renewal application for Hillcrest Country Estates-Cottages skilled nursing facility and multiple occupancy permits issued by the fire marshal for various cottages within the facility.

The documents confirm the facility's license renewal application, ownership details, and the maximum licensed bed capacity for each cottage. Fire marshal occupancy permits specify maximum occupancy limits for each cottage, ranging from 13 to 24 beds.

The document serves as a licensure renewal application for Hillcrest Country Estates-Cottages, including ownership, accreditation, and facility information, along with occupancy permits and facility layout plans.

The documents verify that the facility meets statutory requirements for skilled nursing licensure and provide details on licensed bed capacity, ownership, and facility layout. No inspection findings or deficiencies are reported.

The documents serve to verify licensing status, ownership information, and occupancy permits for Hillcrest Country Estates-Cottages and its associated skilled nursing facilities.

No inspection findings or deficiencies are reported. The documents primarily confirm licensing renewal, ownership disclosures, and fire marshal occupancy permits with maximum bed capacities for various buildings and cottages.

The document serves as a renewal application for the nursing home license of Hillcrest Country Estates-Cottages, including information about the facility, ownership, and licensure details.

No inspection findings or deficiencies are reported in this document. It primarily contains administrative and licensing information.

This document serves as a licensure renewal application for Hillcrest Country Estates-Cottages skilled nursing facility and includes related occupancy permits and organizational charts.

The documents confirm licensure renewal status, ownership structure, and maximum occupancy limits for multiple buildings within the Hillcrest Country Estates-Cottages facility complex. Fire Marshal occupancy permits specify maximum bed counts for each building.

This document serves as a Notice of Disciplinary Action placing the facility on probation for 90 days starting June 15, 2016, due to violations related to pressure sores and unplanned weight loss, and a subsequent Modification of Disciplinary Action eliminating the probation and reporting requirements for pressure sores but continuing those for weight loss.

The facility was found in violation for failure to evaluate causal factors and implement interventions for pressure sores and significant weight loss. The probation was modified to remove requirements related to pressure sores after an informal conference determined no actual harm occurred, but weight loss issues remain.