Inspection Reports for Mother Hull Home

125 E 23rd St, Kearney, NE 68847, United States, NE, 68847

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Deficiencies (last 9 years)

Deficiencies (over 9 years) 9.6 deficiencies/year

Deficiencies are regulatory violations found during state inspections.

129% worse than Nebraska average
Nebraska average: 4.2 deficiencies/year

Deficiencies per year

24 18 12 6 0
2011
2012
2013
2014
2015
2016
2017
2018
2019

Census

Latest occupancy rate 52 residents

Based on a August 2018 inspection.

Census over time

40 45 50 55 60 65 Jan 1970 Apr 2012 Jul 2014 Jun 2016 Jul 2017 Aug 2018
Inspection Report Renewal Capacity: 58 Deficiencies: 0 Feb 25, 2019
Visit Reason
The document is a renewal application and certification for the nursing home license of Mother Hull Home, verifying licensure through the indicated renewal date.
Findings
The documents confirm that Mother Hull Home meets statutory requirements for SNF/NF dual certification and is licensed for 58 beds. The occupancy permit issued by the Nebraska State Fire Marshal also approves the facility for 58 beds.
Report Facts
Number of beds to be relicensed: 58 Maximum occupancy: 58
Employees Mentioned
NameTitleContext
Stephanie SimmonsAdministratorNamed in Nursing Home Licensure Renewal Application
Kristina RobertsDirector of NursingNamed in Nursing Home Licensure Renewal Application
Anita SmithPresident of CorporationNamed as Board of Directors member
Brenda SmithSecretaryNamed as Board of Directors member
Inspection Report Annual Inspection Census: 52 Deficiencies: 15 Aug 14, 2018
Visit Reason
Annual inspection survey conducted to assess compliance with Medicare/Medicaid regulations, Life Safety Code, and other regulatory requirements for Mother Hull Home nursing facility.
Findings
The facility was found not in compliance with several regulatory requirements including failure to issue timely Medicare Non-Coverage notices, failure to notify Ombudsman of resident transfers, inaccurate MDS coding, incomplete PASRR screening, incomplete care plans, medication administration errors, food safety violations, and deficiencies in life safety code compliance such as delayed egress door issues and emergency lighting failures.
Severity Breakdown
SS=D: 13 SS=E: 1 SS=F: 1
Deficiencies (15)
DescriptionSeverity
Failed to issue Notice of Medicare Non-Coverage to Resident 37 before service discontinuation.SS=D
Failed to notify Ombudsman when Resident 15 was transferred to hospital.SS=D
Failed to issue notice of bed hold policy to Resident 15 upon hospital transfer.SS=D
Failed to code MDS consistent with Resident 24's diagnoses (manic depression).SS=D
Failed to complete PASRR screening for Resident 39.SS=D
Failed to develop care plans reflecting fall risk for Resident 8 and urinary tract infection for Resident 42.SS=D
Failed to revise care plans for Resident 2 and Resident 23 to reflect current treatment and significant changes.SS=D
Medication administration error: Medication aide pre-set medications administered by nurse, violating professional standards (Resident 252).SS=D
Failed to follow standard practice for instilling liquids into feeding tube (Resident 252).SS=D
Medications not labeled according to physician's orders for Residents 28 and 36.SS=D
Failed to implement antibiotic stewardship program regarding prophylactic antibiotic use for Resident 28.SS=D
Delayed egress exit door in North Wing did not unlock with less than 15 pounds of force.SS=D
Battery backup emergency light in South Wing failed to operate during test.SS=D
Corridor door to Oxygen Transfilling Room did not positively latch.SS=E
Diesel fuel for emergency generator was not tested annually for quality.SS=F
Report Facts
Facility census: 52 Deficiencies cited: 15 Force applied to delayed egress door: 30 Levemir insulin dose: 40 Pantoprazole administration time: 6
Employees Mentioned
NameTitleContext
RN-BRegistered NurseNamed in medication administration and feeding tube liquid instillation deficiencies
MA-CMedication AideNamed in medication administration deficiency
DONDirector of NursingInterviewed regarding multiple deficiencies including care plans, medication administration, and antibiotic stewardship
Administrator AAdministratorInterviewed regarding delayed egress door and emergency lighting deficiencies
Social Service DirectorInterviewed regarding PASRR screening and Ombudsman notification deficiencies
Dietary ManagerInterviewed regarding food safety deficiencies
Inspection Report Complaint Investigation Census: 49 Capacity: 54 Deficiencies: 22 Jul 17, 2017
Visit Reason
An unannounced visit was conducted to investigate a complaint and annual survey at Mother Hull Home on July 17-20, 2017, triggered by allegations of insufficient staffing, inadequate bathing opportunities, and failure to follow the plan of care to prevent loss of personal items.
Findings
The facility was found to be in violation for insufficient staffing affecting bathing and call light response, failure to honor resident bathing preferences, failure to maintain resident privacy during blood pressure checks, failure to maintain dignity and respect for residents, housekeeping deficiencies, incomplete comprehensive assessments, failure to follow care plans for pressure sore treatment, food safety violations, infection control lapses, and multiple life safety code violations including emergency lighting, hazardous area enclosures, sprinkler system impairments, fire extinguisher placement, corridor door latching, fire drills, and electrical safety.
Complaint Details
The complaint investigation was triggered by allegations that the facility failed to ensure sufficient staffing, failed to provide sufficient bathing opportunities, and failed to follow the plan of care to prevent loss of personal items. The facility was found in violation for staffing and bathing issues but was found in compliance regarding loss of personal items.
Severity Breakdown
SS=F: 6 SS=E: 8 SS=D: 6
Deficiencies (22)
DescriptionSeverity
Facility failed to ensure sufficient staffing to meet resident bathing preferences and call light response.
Facility failed to maintain resident privacy by checking blood pressure readings in the dining room visible to others.SS=E
Facility failed to maintain resident dignity and respect by delayed response to call lights causing incontinence.SS=D
Facility failed to honor resident bathing preferences for 4 sampled residents.SS=E
Facility failed to maintain housekeeping standards; floors were dingy and ceiling vents dirty in multiple resident rooms.SS=E
Facility failed to code MDS correctly for resident eating status.SS=D
Facility failed to provide services by qualified persons per care plan; pressure sore interventions not followed for Resident 25.SS=D
Facility failed to provide treatment and services to prevent and heal pressure sores for Resident 25.SS=D
Facility failed to ensure a safe environment by leaving unsecured liquid oxygen containers in hallways.SS=E
Facility failed to provide sufficient 24-hour nursing staff to meet resident needs and preferences.SS=E
Facility failed to ensure food was prepared and served in a sanitary manner; undated sliced cheese and improper hand hygiene observed.SS=F
Facility failed to ensure expired medications and medical supplies were not available for use.SS=D
Facility failed to implement infection control practices including hand hygiene between residents, covering linens during transport, and cleaning items during dressing changes.SS=D
Facility failed to maintain kitchen overhead light fixtures in a clean manner.SS=F
Facility failed to document duration of monthly emergency lighting battery backup tests.SS=D
Facility failed to provide smoke resistant enclosure for hazardous areas; landscaping storage room door did not positively latch.SS=D
Facility failed to conduct monthly visual inspections of kitchen range hood suppression system components.SS=F
Facility failed to install fire extinguishers properly; some extinguishers were mounted too high, lacked proper rating, or lacked placards.SS=D
Facility failed to provide corridor doors that positively latch in the door frame, allowing smoke migration.SS=E
Facility failed to conduct fire drills quarterly under varying conditions spaced at least one hour apart on each shift.SS=F
Facility failed to exercise emergency generator at 30% capacity during monthly load testing and failed to conduct annual load bank test.SS=F
Facility allowed an electrical cord to pass through a door frame, creating a fire hazard.SS=E
Report Facts
Deficiencies cited: 21 Facility census: 49 Licensed capacity: 54 Residents affected by privacy violation: 3 Residents affected by dignity violation: 1 Residents affected by bathing preference violation: 4 Residents affected by housekeeping violation: 10 Residents affected by pressure sore care violation: 1 Rooms with unsecured oxygen containers: 6 Fire drills conducted less than 1 hour apart: 2 Fire extinguisher height: 64 Fire extinguisher rating: 1
Employees Mentioned
NameTitleContext
Stephanie SimmonsAdministratorNamed in complaint investigation and correspondence
Eve LewisProgram ManagerSigned complaint investigation letter
Don FritzAssistant State Fire MarshalSigned waiver request approval
RN-ERegistered NurseObserved during dressing change with infection control lapses
LPN-ALicensed Practical NurseObserved during medication administration with hand hygiene lapses
Cook CCookObserved handling food unsanitarily
Cook DCookObserved handling food unsanitarily
RN-GRegistered NurseObserved assisting residents without hand hygiene
DA-FDietary AideObserved serving food without hand hygiene
Maintenance AMaintenance DirectorInterviewed regarding fire safety and maintenance issues
Administrator AAdministratorInterviewed regarding fire safety and maintenance issues
Dietary ManagerDietary ManagerInterviewed regarding food safety and sanitation issues
DONDirector of NursingInterviewed regarding care plan and staffing issues
Inspection Report Complaint Investigation Census: 55 Deficiencies: 2 Sep 14, 2016
Visit Reason
An unannounced visit was conducted to investigate a complaint at Mother Hull Home regarding failure to immediately report allegations of neglect and other resident rights concerns.
Findings
The facility was found to be in violation for failing to immediately report an allegation of neglect related to an unwitnessed fall of Resident 48. The facility was found in compliance regarding residents' rights to direct their care and choices on bathing. Additionally, the facility failed to assess the effectiveness of pain medication for Resident 48.
Complaint Details
The complaint alleged the facility failed to immediately report allegations of neglect, failed to allow residents to exercise their rights and direct their care, and failed to allow residents choices on bathing. The neglect allegation was substantiated with a violation found; the other allegations were found to be in compliance.
Severity Breakdown
SS=D: 2
Deficiencies (2)
DescriptionSeverity
Failure to immediately report allegations of neglect for Resident 48's unwitnessed fall.SS=D
Failure to assess the effectiveness of pain medication for Resident 48.SS=D
Report Facts
Facility census: 55 Deficiency completion date: Oct 7, 2016 Deficiency completion date: Oct 21, 2016
Employees Mentioned
NameTitleContext
Stephanie SimmonsAdministratorNamed as facility administrator during the investigation and interview.
Eve LewisProgram Manager - Office of LTC Facilities - Licensure Unit - Division of Public Health - DHHSSigned the letter communicating the complaint investigation results.
DON (Director of Nurses)Director of NursesInterviewed regarding failure to assess effectiveness of pain medication.
Inspection Report Routine Census: 51 Capacity: 58 Deficiencies: 14 Jun 21, 2016
Visit Reason
Routine state survey inspection of Mother Hull Home to assess compliance with licensure and regulatory requirements including resident care, safety, and facility operations.
Findings
The survey identified multiple deficiencies including failure to complete registry checks for new employees, failure to honor resident preferences for bathing and wake times, inadequate care planning for high risk medications and conditions, medication administration errors, improper infection control practices, unsafe equipment maintenance, fire safety code violations, and staffing information posting issues.
Severity Breakdown
SS=F: 6 SS=E: 3 SS=D: 5 SS=C: 1
Deficiencies (14)
DescriptionSeverity
Failed to complete APS and CPC registry checks for one employee prior to unsupervised work.
Failed to honor resident preferences for wake time and bathing for multiple residents.SS=D
Failed to maintain sanitary conditions including improper handling of food service items and hand hygiene.SS=F
Failed to develop comprehensive care plans addressing diabetic condition and monitoring for complications of high risk medications for several residents.SS=D
Medication administration errors including failure to administer medication at correct times.SS=D
Failed to post nurse staffing information in a public and accessible location.SS=C
Failed to maintain assist bars around toilets in safe condition with secure caps.SS=D
Failed to perform hand hygiene between residents during insulin administration and dressing changes.SS=E
Failed to maintain fire safety code requirements including positive latching of hazardous area doors and sealing penetrations.SS=F
Failed to provide complete fire alarm inspection reports as required.SS=F
Kitchen stove pilot light failed to remain lit, risking gas leak and flash fire.SS=D
Failed to provide remote manual stop for emergency generator outside enclosure.SS=F
Failed to conduct required monthly emergency generator tests with complete documentation.SS=F
Improper use of electrical equipment including non-approved power taps and damaged cords in resident rooms.SS=E
Report Facts
Facility census: 51 Total licensed capacity: 58 Medication error rate: 7 Number of residents affected by registry check failure: 1 Number of residents affected by unsafe assist bars: 3 Number of residents affected by infection control failure: 5
Employees Mentioned
NameTitleContext
NA-FNurse AideFailed to complete APS and CPC registry checks prior to unsupervised work
LPN-KLicensed Practical NurseObserved failing to perform hand hygiene between residents and improper dressing change technique
AdministratorConfirmed registry check process and fire safety deficiencies
SDCStaff Development CoordinatorProvided information on registry check process and hand hygiene training
DONDirector of NursingConfirmed care plan deficiencies and medication side effect monitoring failures
Dietary ManagerRe-educated staff on food handling and hand hygiene
Maintenance PersonConfirmed assist bar and fire safety door deficiencies
Inspection Report Complaint Investigation Census: 48 Deficiencies: 8 Jul 20, 2015
Visit Reason
An unannounced visit was conducted to investigate a complaint and annual survey at Mother Hull Home from July 20, 2015 to July 23, 2015. The complaint alleged the facility failed to assess and monitor skin for breakdown.
Findings
The complaint investigation found that the facility failed to complete and document an assessment between a resident's fall and complaints of severe pain, violating Federal tag F309 and State Licensure tag 175 NAC 12-006.09D. Additional deficiencies included failure to educate residents on complaint rights, housekeeping and maintenance issues, medication errors, expired medications, and fire safety code violations.
Complaint Details
The complaint alleged the facility failed to assess and monitor skin for breakdown. The investigation substantiated this allegation with findings of missing assessments and documentation between a resident's fall and complaints of severe pain.
Severity Breakdown
F: 4 E: 1 D: 3
Deficiencies (8)
DescriptionSeverity
Failure to assess and monitor skin for breakdown between fall and complaints of severe pain.
Failure to educate residents on their rights to file complaints to the State Agency.F
Failure to maintain a clean and comfortable environment including unclean bathroom vents, stained carpets, broken drywall, and unclean bathroom floors.E
Medication error rate exceeded 5% with errors in medication patch application and fluid volume for medication administration.D
Failure to ensure residents were free of significant medication errors, specifically a resident with a Nitroglycerin patch left on longer than prescribed.D
Failure to properly label, store, and ensure medications were not expired, including expired Novolog insulin found on medication cart.D
Fire rated doors between rooms 21 and 22 and in the northwest stairwell basement did not close properly, risking fire and smoke spread.F
Failure to conduct fire drills at varying times and conditions on all shifts, limiting staff preparedness.F
Report Facts
Facility census: 48 Medication error rate: 8 Number of residents affected by housekeeping deficiencies: 9 Fire drills: 4
Employees Mentioned
NameTitleContext
Vicki LepantRegistered NurseInvestigator conducting complaint and annual survey
Betty SmithRegistered NurseInvestigator conducting complaint and annual survey
Eve LewisProgram Manager - Office of LTC Facilities - Licensure UnitAuthor of complaint investigation letter
RN-BRegistered NurseInvolved in medication error with Nitroglycerin patch
DONDirector of NursingReviewed medication errors and implemented corrective actions
Maintenance DirectorInterviewed regarding housekeeping and fire door deficiencies
AdministratorInterviewed regarding resident council and housekeeping issues
LPN-ALicensed Practical NurseConfirmed expired Novolog insulin on medication cart
Maintenance AConfirmed fire door and fire drill findings
Inspection Report Annual Inspection Census: 51 Deficiencies: 6 Jul 23, 2014
Visit Reason
An unannounced visit was conducted to investigate a complaint and annual survey at Mother Hull Home from July 16, 2014 to July 23, 2014. The investigation included review of resident records, observation of care and services, and interviews with residents, family members, and staff.
Findings
The facility was found to be in compliance with fall intervention changes and timely submission of investigations. However, deficiencies were identified including failure to update a resident's care plan after hospitalization for suicidal ideation, inadequate monitoring and protection of skin tears for two residents, failure to try non-medication interventions before administering antianxiety medication for one resident, failure to sanitize a sit to stand lift between resident use, failure to ensure proper closing of fire rated doors, and failure to have fire alarm tested every 6 months.
Complaint Details
The visit was complaint-related and annual survey combined. Allegations included failure to change fall interventions after residents identified at risk for falls, failure to submit investigations within 5 working days, and failure to notify POA/family of changes in condition. The facility was found compliant with fall interventions and investigation submission but did fail to notify POA/family in one case.
Severity Breakdown
SS=E: 1 SS=F: 1
Deficiencies (6)
DescriptionSeverity
Failed to review and revise one resident's care plan regarding behaviors and antipsychotic medication adjustment following hospitalization for suicidal ideation.
Skin tears identified for two residents with no documentation of monitoring or protective coverings.
Failed to ensure non-medication interventions were tried before antianxiety medications were given for one resident.
Failed to sanitize a sit to stand lift between resident use, risking infection spread.
Failed to ensure proper closing of fire rated doors between West Hall and Activities Lounge.SS=E
Failed to have fire alarm tested and inspected every 6 months as required by NFPA 72.SS=F
Report Facts
Facility census: 51 Skin tear size: 7 Medication doses: 0.25 Fire alarm last tested: Jan 4, 2014
Employees Mentioned
NameTitleContext
Stephanie SimmonsAdministratorNamed in complaint letter and plan of correction
Jean ObermierRegistered NurseSurveyor conducting investigation
Frances ProkopRegistered NurseSurveyor conducting investigation
Susan GriepenstrohRegistered NurseSurveyor conducting investigation
Nancy HauschildNutrition/dietitianSurveyor conducting investigation
Eve LewisProgram Manager, Office of Long Term Care FacilitiesSigned complaint letter
Maintenance AConfirmed fire door and fire alarm deficiencies
NA-ANursing AssistantObserved transferring resident and failure to sanitize lift
NA-BNursing AssistantObserved transferring resident and failure to sanitize lift
LPN-CLicensed Practical NurseConfirmed lift sanitizing policy
Inspection Report Routine Census: 50 Deficiencies: 1 May 23, 2013
Visit Reason
Routine inspection to assess compliance with regulations governing licensure of skilled nursing facilities, nursing facilities, and intermediate care facilities.
Findings
The facility failed to ensure two residents requiring assistance with dining received adequate help to maintain good nutrition and hydration. Observations and record reviews showed inconsistent assistance during meals for Residents 20 and 47.
Severity Breakdown
SS=D: 1
Deficiencies (1)
DescriptionSeverity
Failed to ensure two residents requiring assistance with dining received adequate help to maintain good nutrition and hydration.SS=D
Report Facts
Facility census: 50 Resident 20 meal consumption: 75 Resident 47 meal consumption: 25
Employees Mentioned
NameTitleContext
Licensed Practical Nurse (LPN) AObserved assisting Resident 20 during dining
Registered Nurse (RN) FAssisted Resident 20 during dining
Nursing Assistant (NA) JAssisted Residents 20 and 47 during dining
Nursing Assistant (NA) KObserved during dining service for Resident 20 and 47
Nursing Assistant (NA) LAssisted Resident 20 and 47 during dining
Nursing Assistant (NA) MAssisted Resident 47 during dining
Director of Nursing (DON)Interviewed regarding dining assistance staffing
Inspection Report Annual Inspection Census: 55 Deficiencies: 12 Apr 19, 2012
Visit Reason
The facility underwent an annual survey inspection to assess compliance with regulatory requirements including resident care, safety, and facility maintenance.
Findings
The inspection identified multiple deficiencies including failure to provide appropriate resident care (dressing, activity assistance, care planning), maintenance issues (uncleanable surfaces, electrical hazards), fire safety code violations (smoke partitions, sprinkler system inconsistencies), and failure to maintain proper housekeeping and equipment inspections.
Severity Breakdown
SS=E: 6 SS=D: 6
Deficiencies (12)
DescriptionSeverity
Failure to provide care necessary to assist Resident 12 with appropriate dressing/appearance.SS=D
Failure to provide assistance for Resident 62 to attend an activity.SS=D
Failure to maintain housekeeping and maintenance services including repair of doors, gaps in bathroom flooring, and cleaning window frames.SS=E
Failure to develop comprehensive care plans reflecting current physical status, needs, and behavioral issues for multiple residents.SS=E
Failure to periodically review and revise care plan related to Unno boots applied by physician for Resident 62.SS=D
Failure to provide services by qualified persons in accordance with each resident's written plan of care, including call light placement for Resident 64.SS=D
Failure to provide smoke resistive partition between Beauty Shop and Exit Corridor allowing potential smoke migration.SS=E
Failure to provide smoke resistive partition between Laundry Room and Exit Corridor allowing potential smoke migration.SS=D
Failure to install automatic sprinkler system in accordance with NFPA 13; mixed sprinkler head types in smoke compartments.SS=E
Failure to inspect 3 of 8 sampled fire extinguishers monthly.SS=E
Failure to provide approved method to return Kitchen Range to approved location under suppression system.SS=E
Failure to use electrical wiring in accordance with NFPA 70; exposed wires from wall outlet in Resident Room 21.SS=D
Report Facts
Facility census: 55 Deficiency count: 12
Employees Mentioned
NameTitleContext
Stephanie SimmonsAdministratorNamed in Plan of Correction and Informal Dispute Resolution documents
Lee MarshallDirector of NursingNamed in Informal Dispute Resolution conference
Eve LewisAdministratorSigned Informal Dispute Resolution letter
Kimberly A. DivisRN, NSSCSigned Informal Dispute Resolution letter
Inspection Report Annual Inspection Census: 52 Capacity: 58 Deficiencies: 6 Mar 23, 2011
Visit Reason
The inspection was conducted as an annual survey to assess compliance with regulatory standards for licensure and certification of the nursing facility.
Findings
The facility was found deficient in multiple areas including medication administration, free of accident hazards, food procurement and sanitation, pharmaceutical services, infection control, and life safety code compliance. Deficiencies included failure to obtain physician orders prior to medication administration, unsecured hazardous chemicals, improper food storage and handling, medication errors, inadequate hand hygiene, and fire safety violations.
Severity Breakdown
Level D: 2 Level E: 3 Level F: 1
Deficiencies (6)
DescriptionSeverity
Failure to ensure physician orders for medications were obtained prior to administration.Level D
Failure to secure potentially hazardous chemicals in unlocked storage areas.Level E
Failure to ensure food was procured, stored, and served under sanitary conditions.Level F
Failure to provide pharmaceutical services including accurate medication administration and documentation.Level E
Failure to maintain an effective infection control program including hand hygiene and prevention of disease transmission.Level E
Failure to meet NFPA 101 Life Safety Code standards including hazardous storage and electrical wiring issues.Level D
Report Facts
Facility census: 52 Total capacity: 58 Survey sample size: 13 Residents affected by medication order deficiency: 1 Residents affected by hazardous chemical storage deficiency: 5 Residents affected by medication administration errors: 6 Residents affected by infection control deficiency: 7 Residents affected by life safety code deficiency: 19
Employees Mentioned
NameTitleContext
Stephanie SimmonsAdministratorSigned the report and plan of correction
RN FRegistered NurseNamed in medication order deficiency and staff education
RN MRegistered NurseNamed in medication administration deficiencies and education
Cook ANamed in food handling and hand hygiene deficiencies
Cook DNamed in food handling and hand hygiene deficiencies
Dietary ManagerNamed in food service deficiencies and staff education
Maintenance SupervisorNamed in life safety code deficiencies related to fire safety and electrical issues
Notice Capacity: 58 Deficiencies: 0 APP2016
Visit Reason
This document serves as a licensure renewal application and verification for the Mother Hull Home nursing facility, confirming the renewal of the SNF/NF dual certification and occupancy permit.
Findings
The documents confirm that Mother Hull Home meets statutory requirements for licensure renewal and occupancy with a licensed capacity of 58 beds. No inspection findings or deficiencies are reported.
Report Facts
Licensed capacity: 58
Employees Mentioned
NameTitleContext
Stephanie SimmonsAdministratorNamed in Nursing Home Licensure Renewal Application.
April GneitingDirector of NursingNamed in Nursing Home Licensure Renewal Application.
Anita SmithPresidentNamed as President in ownership certification and Board of Directors list.
Brenda J SmithSecretaryNamed as Secretary in ownership certification and Board of Directors list.
Notice Capacity: 58 Deficiencies: 0 APP2017
Visit Reason
This document serves as verification that the SNF/NF dual certification license for Mother Hull Home is renewed and valid through the indicated expiration date. It also includes the occupancy permit issued by the Nebraska State Fire Marshal confirming the maximum occupancy of 58 beds.
Findings
The documents confirm that Mother Hull Home meets statutory requirements for licensure renewal and fire safety occupancy standards with no deficiencies or violations noted.
Report Facts
Licensed beds: 58 Renewal fee: 1550
Employees Mentioned
NameTitleContext
April QuiringDirector of NursingNamed in licensure renewal application
Stephanie SimmonsAdministratorNamed in licensure renewal application
Anita SmithPresident of Mother Hull Home CorporationNamed in Board of Directors and corporate leadership
Monte StandageChairmanNamed in Board of Directors and corporate leadership
Randy HaysVice-ChairmanNamed in Board of Directors and corporate leadership
Brenda SmithSecretaryNamed in Board of Directors and corporate leadership
Notice Census: 51 Capacity: 58 Deficiencies: 0 APP2018
Visit Reason
This document serves as a licensure renewal application and verification of the facility's SNF/NF dual certification and licensed capacity.
Findings
The documents confirm the facility's licensure renewal status, licensed bed capacity, occupancy permit, and ownership information without reporting any inspection findings or deficiencies.
Report Facts
Licensed Beds: 58 Current Census: 51 Renewal Fees: 1550
Employees Mentioned
NameTitleContext
Stephanie SimmonsAdministratorNamed in the Nursing Home Licensure Renewal Application.
Kristina RobertsDirector of Nursing, R.N.Named in the Nursing Home Licensure Renewal Application.
Anita SmithPresident of CorporationListed as a member of the Mother Hull Home Board of Directors.
Monte StandageChairmanListed as a member of the Mother Hull Home Board of Directors.
Randy HaysVice-ChairmanListed as a member of the Mother Hull Home Board of Directors.
Brenda SmithSecretaryListed as a member of the Mother Hull Home Board of Directors.
Notice Capacity: 58 Deficiencies: 0 APP2020
Visit Reason
This document serves as a licensure renewal application and certification for Mother Hull Home, verifying that the facility's SNF/NF dual certification is licensed through the indicated renewal date.
Findings
The document confirms the renewal of the facility's license and includes ownership information, board of directors, and occupancy permit details. No inspection findings or deficiencies are reported.
Report Facts
Total licensed beds: 58 License expiration date: Mar 31, 2021 Maximum occupancy: 58
Employees Mentioned
NameTitleContext
Kristina RobertsDirector of NursingNamed in the renewal application on page 2
Stephanie SimmonsAdministratorNamed in the renewal application on page 2
Inspection Report Renewal Capacity: 58 Deficiencies: 0 APP2021
Visit Reason
This document is a Nursing Home Licensure Renewal Application for Mother Hull Home, indicating the facility is applying to renew its license for 58 beds.
Findings
The document confirms the facility's licensure renewal status and includes ownership and accreditation information, with no inspection findings or deficiencies reported.
Report Facts
Total licensed beds: 58
Employees Mentioned
NameTitleContext
Stephanie SimmonsAdministratorNamed in the Nursing Home Licensure Renewal Application
Kristina RobertsDirector of Nursing, RNNamed in the Nursing Home Licensure Renewal Application
Notice Capacity: 58 Deficiencies: 0 APP2022
Visit Reason
The document serves as a renewal application for the nursing home license of Mother Hull Home and includes related licensing and occupancy permit information.
Findings
The documents verify that Mother Hull Home meets statutory requirements for licensure renewal, with a licensed capacity of 58 beds, and includes certification and occupancy permits.
Report Facts
Licensed capacity: 58 Renewal expiration date: Mar 31, 2022 Renewal license fee: 1550
Employees Mentioned
NameTitleContext
Stephanie SimmonsAdministratorNamed on the Nursing Home Licensure Renewal Application.
Kristina RobertsDirector of NursingNamed on the Nursing Home Licensure Renewal Application.
Anita SmithPresident of Mother Hull Home CorporationNamed in Board of Directors and signed renewal application.
Brenda SmithSecretaryNamed in Board of Directors and signed renewal application.
Mark ManchesterDeputy State Fire MarshalSigned Nebraska State Fire Marshal Occupancy Permit.
Notice Capacity: 58 Deficiencies: 0 APP2023
Visit Reason
This document serves to verify the license renewal status of Mother Hull Home and includes the Nursing Home Licensure Renewal Application for the facility.
Findings
The document confirms that Mother Hull Home meets statutory requirements for licensure renewal as a skilled nursing facility with a licensed capacity of 58 beds.
Report Facts
Licensed beds: 58
Employees Mentioned
NameTitleContext
Stephanie SimmonsAdministratorNamed in the Nursing Home Licensure Renewal Application.
Kristina RobertsDirector of Nursing, RNNamed in the Nursing Home Licensure Renewal Application.
Anita SmithAuthorized RepresentativeSigned the Nursing Home Licensure Renewal Application.
Notice Capacity: 58 Deficiencies: 0 APP2024
Visit Reason
This document serves as a renewal application for the nursing home license of Mother Hull Home, verifying licensure through the indicated expiration date and providing related occupancy and ownership information.
Findings
The documents confirm that Mother Hull Home meets statutory requirements for licensure renewal, with no inspection findings or deficiencies noted.
Report Facts
Total licensed beds: 58 Renewal license fees: 1550
Employees Mentioned
NameTitleContext
Stephanie SimmonsAdministratorNamed on the Nursing Home Licensure Renewal Application
Kristina RobertsDirector of Nursing, RNNamed on the Nursing Home Licensure Renewal Application
Notice Capacity: 58 Deficiencies: 0 APP2025
Visit Reason
This document serves as a renewal application for the nursing home license of Mother Hull Home, verifying licensure through the indicated expiration date and providing occupancy permit details.
Findings
The documents confirm the facility's licensure renewal status, ownership, bed capacity, and occupancy permit compliance with state fire marshal codes.
Report Facts
Licensed beds: 58 Renewal license expiration date: 2025 Occupancy permit date issued: 2023
Employees Mentioned
NameTitleContext
Stephanie SimmonsAdministratorNamed in the Nursing Home Licensure Renewal Application.
Kristina RobertsDirector of NursingNamed in the Nursing Home Licensure Renewal Application.
Monte StandageAuthorized RepresentativeSigned the Nursing Home Licensure Renewal Application and listed as Chairman of the Board.

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