Deficiencies per Year
4
3
2
1
0
Unclassified
Inspection Report
Renewal
Capacity: 44
Deficiencies: 0
Mar 11, 2025
Visit Reason
The document is a renewal application and certification for the assisted-living facility license of Homestead of Kearney, verifying licensure through the indicated renewal date.
Findings
The facility is licensed as an assisted-living facility with a total of 44 beds. The renewal application was completed and signed by authorized representatives on 2025-03-11. The Nebraska State Fire Marshal issued an occupancy permit for 44 beds on 2023-12-11.
Report Facts
Total number of beds to be relicensed: 44
Renewal license expiration date: Apr 30, 2026
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Gwendolyn Jacobitz | Administrator | Named on renewal application form |
| James A. Klausman | Authorized Representative | Signed renewal application on 3/11/2025 |
| Floyd C. Eaton Jr. | Authorized Representative | Signed renewal application on 3/11/2025 |
Inspection Report
Renewal
Capacity: 44
Deficiencies: 0
Mar 19, 2024
Visit Reason
The document is a renewal application and certification for the assisted-living facility license of Homestead of Kearney.
Findings
The facility is licensed as an assisted-living facility with a total licensed capacity of 44 beds. The renewal application certifies compliance with applicable rules and regulations.
Report Facts
Total licensed beds: 44
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Gwendolyn Jacobitz | Administrator | Named in the renewal application as the facility administrator. |
| James A. Klausman | Authorized Representative | Signed the renewal application on 3/19/2024. |
| Floyd C. Eaton Jr. | Authorized Representative | Signed the renewal application on 3/19/2024. |
Inspection Report
Renewal
Capacity: 44
Deficiencies: 0
Apr 1, 2019
Visit Reason
This document serves as the renewal application and license verification for the assisted-living facility Midwest Homestead of Kearney, confirming compliance with statutory requirements for license renewal.
Findings
The facility is licensed as an assisted-living facility with a total capacity of 44 beds. The renewal application was submitted and signed by authorized representatives, and the occupancy permit was issued by the Nebraska State Fire Marshal on 2018-05-08.
Report Facts
Total licensed beds: 44
Renewal expiration date: Apr 30, 2020
Renewal application date: Apr 1, 2019
Occupancy permit date: May 8, 2018
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jennifer Bauer | Administrator | Named as facility administrator in renewal application |
| James A. Klausman | Authorized Representative | Signed renewal application as authorized representative |
| Floyd C. Eaton Jr. | Authorized Representative | Signed renewal application as authorized representative |
| Todd Wright | Deputy State Fire Marshal | Inspected facility and issued occupancy permit |
Notice
Capacity: 44
Deficiencies: 0
Mar 19, 2018
Visit Reason
This document serves as the licensure renewal application and verification for the assisted-living facility Midwest Homestead of Kearney, including confirmation of total licensed beds and occupancy permit.
Findings
The facility is licensed as an assisted-living facility with a total licensed capacity of 44 beds. The occupancy permit was issued on 2017-04-21 by the Nebraska State Fire Marshal.
Report Facts
Renewal fee: 1650
Total licensed beds: 44
Occupancy permit date: Apr 21, 2017
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Stacie Brueggeman | Administrator | Named as facility administrator on renewal application |
| James A. Klausman | Authorized Representative | Signed renewal application as authorized representative |
| Floyd C. Eaton, Jr. | Authorized Representative | Signed renewal application as authorized representative |
| Todd Wright | Deputy State Fire Marshal | Inspected facility and issued occupancy permit |
Inspection Report
Complaint Investigation
Deficiencies: 0
Mar 30, 2016
Visit Reason
An unannounced visit was conducted to investigate a complaint at Midwest Covenant Home on March 30-31, 2016, by representatives of the Department of Health and Human Services Division of Public Health.
Findings
The investigation found no violations related to the allegations concerning operational food equipment, meal quality, timely submission of investigations, resident abuse protection, dignity and respect of residents, reporting of abuse allegations, and sufficient staffing. No concerns were identified in any of these areas.
Complaint Details
The visit was complaint-related with multiple allegations including failure to have operational food equipment, failure to ensure meals are attractive and palatable, failure to submit investigations within 5 working days, failure to protect residents from abuse, failure to treat residents with dignity and respect, failure to report allegations of abuse, and failure to ensure sufficient staffing. All allegations were found unsubstantiated with no violations.
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
Renewal
Capacity: 44
Deficiencies: 0
Mar 21, 2016
Visit Reason
The document is a licensure renewal application and verification for the assisted-living facility Midwest Homestead of Kearney, confirming the facility's license renewal and compliance with statutory requirements.
Findings
The documents confirm the facility's licensure renewal with a total licensed capacity of 44 beds and no indication of deficiencies or violations.
Report Facts
Total licensed beds: 44
Renewal fee: 950
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Stacie Brueggeman | Administrator | Named as the facility administrator in the renewal application |
| James Klausman | Authorized Representative | Signed the renewal application as authorized representative |
| Floyd Charles Eaton Jr. | Authorized Representative | Signed the renewal application as authorized representative |
Inspection Report
Routine
Deficiencies: 0
Mar 17, 2015
Visit Reason
The inspection was conducted as a Compliance Inspection to assess the facility's adherence to 175 NAC 4 – 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 |
|---|---|---|
| Vicki Lepant | Registered Nurse | Conducted the Compliance Inspection |
| Ronda Gunther | Registered Nurse | Conducted the Compliance Inspection |
| Betty Smith | Registered Nurse | Conducted the Compliance Inspection |
Inspection Report
Complaint Investigation
Census: 30
Deficiencies: 1
Dec 12, 2013
Visit Reason
An unannounced complaint investigation was conducted at Midwest Homestead Of Kearney on December 12, 2013, to investigate allegations related to grievances/complaints, resident retention criteria, and medication administration according to practitioner's orders.
Findings
The facility was found to be in compliance with allegations regarding grievances/complaints and resident retention criteria. However, the facility failed to administer medications according to practitioner's orders, with two records showing medications were not administered as prescribed.
Complaint Details
The complaint investigation was triggered by allegations that the facility failed to address grievances/complaints, failed to ensure residents meet retention criteria, and failed to administer medications according to practitioner's orders. The first two allegations were found to be in compliance, while the medication administration allegation was substantiated with related deficiency cited at 175 NAC 4-006.09B.
Deficiencies (1)
| Description |
|---|
| Facility failed to administer medications according to practitioner's orders as evidenced by two records during the complaint investigation. |
Report Facts
Facility census: 30
Records reviewed: 4
Medication administration errors: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sally Nichols | Registered Nurse | Surveyor who conducted the complaint investigation |
| Ashley Schroeder | Executive Director | Named in response letter addressing the findings |
| Eve Lewis | Program Manager | Author of the complaint investigation report and correspondence |
Notice
Capacity: 44
Deficiencies: 0
APP2017
Visit Reason
This document serves as a licensure renewal verification and occupancy permit for Midwest Homestead of Kearney, confirming the facility's license renewal and maximum occupancy.
Findings
The facility is licensed as an assisted-living facility with a total licensed capacity of 44 beds. An occupancy permit was issued by the Nebraska State Fire Marshal on 2016-04-25.
Report Facts
Total licensed beds: 44
Renewal fee: 950
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Stacie Brueggeman | Administrator | Named as facility administrator on renewal application |
| James Klausman | President | Named as member and president of Midwest Homestead of Kearney Operations, LLC |
| Floyd Charles Eaton Jr. | Vice President | Named as member and vice president of Midwest Homestead of Kearney Operations, LLC |
| Todd Wright | Deputy State Fire Marshal | Inspected and approved the occupancy permit |
Notice
Capacity: 44
Deficiencies: 0
APP2020
Visit Reason
The document serves as a renewal application for the assisted-living facility license and includes an occupancy permit indicating the maximum occupancy of the facility.
Findings
The documents certify that Midwest Homestead of Kearney meets statutory requirements as an assisted-living facility and is licensed through the expiration date. The occupancy permit confirms a maximum capacity of 44 beds.
Report Facts
Total licensed beds: 44
Renewal license fees: 1650
Occupancy permit issue date: Nov 21, 2019
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Gwendolyn Jacobitz | Administrator | Named as the facility administrator in the renewal application. |
| James A. Klausman | Authorized Representative | Signed the renewal application as an authorized representative. |
| Floyd C. Eaton Jr. | Authorized Representative | Signed the renewal application as an authorized representative. |
| Todd Wright | Deputy State Fire Marshal | Inspected the facility for the occupancy permit. |
Notice
Capacity: 44
Deficiencies: 0
APP2021
Visit Reason
This document set serves as a renewal application for the assisted-living facility license for Homestead of Kearney, including verification of licensure and occupancy permit.
Findings
The documents confirm that Homestead of Kearney is licensed as an assisted-living facility with a total licensed capacity of 44 beds and holds a valid occupancy permit issued on 12/1/2020.
Report Facts
Total licensed beds: 44
Renewal application date: Mar 30, 2021
Occupancy permit issue date: Dec 1, 2020
Notice
Capacity: 44
Deficiencies: 0
APP2022
Visit Reason
This document serves as a renewal application for the assisted-living facility license for Homestead of Kearney and includes related licensing and occupancy permit information.
Findings
The documents certify that Homestead of Kearney meets statutory requirements as an assisted-living facility and holds a valid occupancy permit for 44 beds.
Report Facts
Total licensed beds: 44
Renewal application date: 2022
Occupancy permit issue date: 2021
Notice
Capacity: 44
Deficiencies: 0
APP2023
Visit Reason
This document serves as a renewal application and verification of licensure for the assisted-living facility Homestead of Kearney.
Findings
The documents confirm the facility meets statutory requirements for licensure renewal and includes an occupancy permit certifying a maximum capacity of 44 beds.
Report Facts
Total licensed beds: 44
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