Inspection Reports for Ponderosa Villa
755 First Street, Crawford, NE 69339, NE, 69339
Back to Facility ProfileDeficiencies (last 10 years)
Deficiencies (over 10 years)
6.3 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
50% worse than Nebraska average
Nebraska average: 4.2 deficiencies/yearDeficiencies per year
12
9
6
3
0
Census
Latest occupancy rate
27 residents
Based on a October 2018 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Census over time
Inspection Report
Renewal
Capacity: 35
Deficiencies: 0
Date: Apr 10, 2025
Visit Reason
The document is a Nursing Home Licensure Renewal Application and related certification and occupancy permit for Ponderosa Villa, indicating the facility's license renewal process and compliance with state requirements.
Findings
The documents verify that Ponderosa Villa meets statutory requirements for licensure renewal as a skilled nursing facility with dual certification for SNF/NF, including occupational, physical, and speech therapy services. The occupancy permit confirms a maximum capacity of 35 beds.
Report Facts
Renewal license fee: 1550
Total licensed capacity: 35
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kathy Bishop | Provisional Administrator | Named on Nursing Home Licensure Renewal Application |
| Yulija Brown | Director of Nursing | Named on Nursing Home Licensure Renewal Application |
| Rhonda Schoenemann | Authorized Representative | Signed Nursing Home Licensure Renewal Application and Board Chair |
Inspection Report
Renewal
Capacity: 35
Deficiencies: 0
Date: Mar 30, 2022
Visit Reason
This document is a Nursing Home Licensure Renewal Application and renewal certification for Ponderosa Villa, verifying the facility's license renewal and compliance with statutory requirements.
Findings
The document certifies that Ponderosa Villa meets statutory requirements for SNF/NF dual certification and includes renewal of the nursing home license for 35 beds. It also includes an occupancy permit confirming the licensed bed capacity.
Report Facts
Licensed beds: 35
Renewal application date: Mar 30, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stacie Jones | PNH Administrator | Signed renewal application as authorized representative |
| Connie Shell | Mayor | Signed renewal application as authorized representative |
Inspection Report
Complaint Investigation
Census: 27
Deficiencies: 1
Date: Oct 3, 2018
Visit Reason
An unannounced visit was conducted to investigate a complaint regarding incomplete assessments and resident safety from adverse behaviors at Ponderosa Villa.
Complaint Details
The complaint alleged incomplete assessments and failure to protect residents from adverse behaviors. The assessment allegation was found in compliance. The safety allegation was substantiated with findings of recurrent sexual abuse incidents involving two residents.
Findings
The facility was found compliant with assessment completion but failed to ensure residents were safe from recurrent resident-to-resident sexual abuse. Deficiencies were cited related to failure to implement interventions to protect a resident from abuse.
Deficiencies (1)
Failure to ensure interventions were in place to protect one resident from recurrent episodes of resident-to-resident sexual abuse.
Report Facts
Facility census: 27
Sampled residents: 7
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Connie Vogt | Program Manager - Office of LTC Facilities - Licensure Unit - Division of Public Health - DHHS | Signed the complaint investigation letter |
| Stephanie Huffman | Administrator | Facility administrator addressed in the report |
Inspection Report
Annual Inspection
Census: 21
Capacity: 35
Deficiencies: 10
Date: Mar 13, 2018
Visit Reason
An unannounced visit was conducted to investigate a complaint and annual survey at Ponderosa Villa on March 13-15, 2018, by representatives of the Department of Health and Human Services Division of Public Health.
Complaint Details
The complaint alleged insufficient staffing. The investigation revealed no issues related to insufficient staffing and the facility was found to be in compliance with related regulatory requirements.
Findings
The facility was found to be in compliance with staffing requirements during the complaint investigation. Several deficiencies were identified related to resident care, medication management, food safety, infection control, and life safety code compliance, with corrective actions planned or implemented.
Deficiencies (10)
Failed to ensure decline in bladder continence was identified and assessed for one resident.
Failed to ensure residents' medication regimens were free of unnecessary psychotropic medications for three residents.
Failed to test chemical disinfecting and sanitization solution in dishwasher with test strips.
Failed to ensure infection control program included tracking and controlling employee illnesses.
Failed to provide access to a key to unlock the gate on the patio outside the dining room.
Failed to provide a door that would close and latch automatically between kitchen and dining room.
Failed to provide safe access to a public way leading from the patio area adjacent to the dining room.
Failed to provide a smoke detection device interconnected to the facility fire alarm system in the phone sitting area open to the corridor.
Failed to maintain fire sprinklers in the 100 corridor and laundry area free of lint buildup.
Failed to prevent use of a power strip not listed for use in patient care vicinity in resident room.
Report Facts
Facility census: 21
Total licensed capacity: 35
Number of sampled residents: 12
Deficiency completion dates: Apr 19, 2018
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Dan Taylor | RN, Training Coordinator, Office of LTC Facilities - Licensure Unit | Signed complaint investigation letter |
| Stephanie Huffman | Administrator | Facility administrator named in complaint letter and documents |
| RN - A | Registered Nurse, Acting MDS Coordinator | Interviewed regarding continence assessment deficiency |
| RN-C | Registered Nurse | Interviewed regarding psychotropic medication use |
| Director of Nursing | DON | Interviewed regarding medication and infection control deficiencies |
| Maintenance Personnel A | Interviewed regarding fire safety deficiencies |
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Oct 17, 2017
Visit Reason
An unannounced visit was conducted to investigate a complaint at Ponderosa Villa on October 17, 2017, by representatives of the Department of Health and Human Services Division of Public Health.
Complaint Details
The complaint included allegations that the facility failed to ensure residents are transferred to prevent discomfort, failed to submit investigations within 5 working days, and failed to assist residents with pain management. All allegations were investigated and found to be unsubstantiated with the facility in compliance.
Findings
The investigation addressed three allegations regarding resident transfers, submission of investigations, and pain management. The facility was found to be in compliance with regulatory requirements for all allegations after review of records, observations, and interviews with residents and staff.
Report Facts
Sample size for mechanical lift transfers: 4
Sample size for pain management: 6
Number of residents interviewed for transfer allegation: 1
Number of residents interviewed for investigation submission allegation: 3
Number of residents interviewed for pain management allegation: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Eve Lewis | RNC, Program Manager | Signed the report as Program Manager - Office of LTC Facilities - Licensure Unit - Division of Public Health - DHHS |
Inspection Report
Annual Inspection
Census: 25
Capacity: 49
Deficiencies: 9
Date: Feb 14, 2017
Visit Reason
Annual inspection of Wakefield Health Care Center to assess compliance with regulatory requirements including resident safety, food sanitation, infection control, and life safety codes.
Findings
The facility was found deficient in multiple areas including failure to assess resident competency for motorized wheelchair use, unsanitary food handling and storage practices, inadequate infection control with improper glove use and hand hygiene, life safety code violations related to hazardous area enclosures, fire alarm system documentation, sprinkler head maintenance, obstructed fire extinguishers, lack of remote manual stop switch for emergency generator, and unsafe electrical power strip use.
Deficiencies (9)
Facility failed to assess Resident 12's ability to safely operate a motorized wheelchair, despite repeated safety violations.
Food items were not disposed of within specified timeframes; serving utensils improperly stored and not air dried; ventilation hood soiled; nursing staff touched ready-to-eat food with bare hands.
Facility staff failed to remove gloves and wash hands at appropriate intervals during care for 5 residents.
Hazardous areas were not properly enclosed with self-closing doors and positive latches, allowing potential smoke and fire migration.
Annual fire alarm system inspection documentation was incomplete and lacked required details.
Corroded and painted fire sprinkler heads were observed, risking sprinkler system failure.
Fire extinguishers in dining room and kitchen were obstructed, preventing ready access.
Facility lacked a remote manual stop switch for the emergency generator outside the generator room.
Power strips were daisy chained in offices, creating electrical hazards.
Report Facts
Facility census: 25
Total licensed capacity: 49
Sample size: 18
Number of residents affected by infection control deficiency: 5
Number of residents affected by electrical hazard: 18
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Nov 14, 2016
Visit Reason
An unannounced visit was conducted to investigate a complaint regarding the facility's failure to evaluate causal factors for falls.
Complaint Details
The complaint alleged that the facility fails to evaluate causal factors for falls. The allegation was investigated and found to be unsubstantiated.
Findings
The investigation included review of resident records, observations, and interviews with residents, family, and staff. The facility was found in compliance with regulatory requirements, with no violations or citations.
Report Facts
Residents sampled: 3
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
Annual Inspection
Census: 25
Deficiencies: 2
Date: Mar 14, 2016
Visit Reason
An unannounced visit was conducted to investigate an annual survey at Ponderosa Villa on March 14-15, 2016, by representatives of the Department of Health and Human Services Division of Public Health.
Findings
The facility was investigated for allegations related to residents not being appropriately dressed and not having access to their possessions; no violations were found for these allegations. Deficiencies were identified related to dignity and respect for one resident with an incontinent pad visible to others, and failure to provide required liability notices when Medicare A benefits were discontinued for another resident.
Deficiencies (2)
Facility failed to ensure that one resident was treated with respect and dignity by not ensuring that an incontinence pad was not in full view of other residents in the dining room.
Facility failed to provide written evidence that required liability notices were issued when Medicare A benefits were discontinued for one sampled resident.
Report Facts
Facility census: 25
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Huffman | Administrator | Named in relation to investigation and interviews |
| Eve Lewis | Program Manager - Office of LTC Facilities - Licensure Unit - Division of Public Health - DHHS | Signed the inspection report letter |
| Social Services Director | Interviewed regarding Medicare A benefits discontinuation for Resident 26 |
Inspection Report
Complaint Investigation
Census: 27
Deficiencies: 0
Date: Jul 9, 2015
Visit Reason
An unannounced visit was conducted to investigate complaints regarding failure to protect residents from abuse and improper use of physical restraints at Ponderosa Villa.
Complaint Details
The investigation was complaint-driven, focusing on allegations that the facility failed to protect residents from abuse and failed to ensure physical restraints were used according to physician orders. The facility was not cited for either allegation. The alleged perpetrator related to the restraint incident was referred to licensure investigations.
Findings
The investigation found that the facility had developed and implemented abuse neglect procedures and was not cited regarding the abuse allegation. An incident of physical restraint without a physician's order occurred but was addressed promptly with removal of the restraint and referral of the alleged perpetrator to licensure investigations. No current residents were physically restrained and the facility was not cited.
Report Facts
Facility census: 27
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Dan Taylor | RN, Training Coordinator, Licensure Unit | Signed the report as the Training Coordinator for the Licensure Unit |
Inspection Report
Annual Inspection
Census: 25
Capacity: 35
Deficiencies: 9
Date: Apr 15, 2015
Visit Reason
Annual inspection survey conducted to assess compliance with Nebraska Administrative Code and Life Safety Code standards for a skilled nursing facility.
Findings
The facility was found deficient in multiple areas including dignity and respect of individuality, self-determination and choice, right to notice before room/roommate change, services by qualified persons per care plan, medication administration errors, pharmaceutical services, and maintenance of clinical records. Life safety code violations were also noted regarding corridor width and means of egress obstructions.
Deficiencies (9)
Mechanical lift slings for two residents were left in public view and meal trays for dependent residents were served last, compromising dignity and respect.
Residents were not offered choices about preferred time of arising or number of baths per week.
Resident did not receive notice prior to a roommate change.
Failure to toilet a resident as directed on the care plan.
Significant medication errors including administration of rapid-acting insulin and oral diabetes medication too early before meals.
Failure to administer medication at physician ordered times; eye drops given midday instead of bedtime.
Incomplete and inaccurate clinical records for medication administration and catheter care documentation.
Corridor widths less than required 4 feet due to furnishings obstructing clear exit access.
Means of egress obstructed by furnishings in hallways, impeding clear exit during emergencies.
Report Facts
Facility census: 25
Total capacity: 35
Deficiency count: 9
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Director of Nursing | Interviewed regarding mechanical lift sling use and medication administration | |
| Dietary Manager | Interviewed regarding meal service times and feeding assistance | |
| Licensed Practical Nurse (LPN) - A | Interviewed regarding medication administration times | |
| Social Service Director | Interviewed regarding bathing schedules and roommate notification | |
| MDS Coordinator | Interviewed regarding bathing schedules and care plan communication | |
| Registered Nurse (RN) - B | Observed administering eye drops and interviewed regarding medication administration | |
| Nursing Assistant (NA) - D and NA - E | Interviewed regarding catheter care and documentation | |
| Maintenance A | Interviewed regarding corridor width and egress obstructions | |
| Administrator | Interviewed regarding multiple findings including medication administration and roommate notification |
Notice
Deficiencies: 0
Date: Mar 12, 2015
Visit Reason
The document serves as a Notice of Disciplinary Action placing the facility on probation for 90 days beginning March 27, 2015, due to violations related to failure to implement interventions to prevent falls resulting in a fracture.
Findings
The facility failed to implement identified interventions to prevent falls, which resulted in a resident sustaining a fracture. The notice requires submission of a Plan of Correction and ongoing reports during the probation period.
Report Facts
Probation period length: 90
Report submission frequency: 14
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Becky Wisell | Administrator | Signed the Notice of Disciplinary Action |
| Kim McQuinn | Staff Assistant II | Certified mailing of the Notice of Disciplinary Action |
| Joseph M. Acierno, MD, JD | Acting Chief Executive Officer, Chief Medical Officer, Director, Division of Public Health | Signed the Notice of Disciplinary Action |
| Eve Lewis | Program Manager | Contact for submission of reports and correspondence related to the Notice |
Inspection Report
Complaint Investigation
Census: 27
Deficiencies: 3
Date: Feb 25, 2015
Visit Reason
An unannounced visit was conducted to investigate a complaint survey at Ponderosa Villa on February 25, 2015, triggered by allegations regarding resident safety from aggressive behaviors, staff training on resident behaviors, failure to give 30-day discharge notice, and ensuring residents are safe before being left alone.
Complaint Details
The complaint investigation was triggered by allegations that the facility failed to protect residents from aggressive behaviors, failed to train staff on managing behaviors, failed to provide 30-day discharge notice, and failed to ensure residents were safe before being left alone. The investigation confirmed deficiencies related to managing aggressive behaviors, discharge documentation, and resident safety related to falls.
Findings
The facility failed to manage ongoing aggressive behaviors for one resident, failed to ensure a physician's written order for involuntary discharge, and failed to ensure residents at high risk for falls were not left alone, resulting in a fractured hip. Staff were trained to manage resident behaviors, and no deficiency was cited for staff training. Deficiencies were cited at F202, F309, and F323.
Deficiencies (3)
Failed to ensure physician wrote a discharge order and documented medical reason for involuntary discharge for one resident.
Failed to assess causal factors and patterns of behaviors and utilize medications as needed to manage ongoing aggressive behaviors for one resident.
Failed to ensure residents at high risk for falls were safe before being left alone, resulting in a fractured hip for one resident.
Report Facts
Facility census: 27
Resident falls: 4
Medication administration effectiveness: 40
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Huffman | Administrator | Named as facility administrator in complaint letter |
| Kaylene Straetker | Registered Nurse | Surveyor conducting complaint investigation |
| Eve Lewis | Program Manager - Office of LTC Facilities - Licensure Unit | Author of complaint investigation letter |
| Director of Nursing | Director of Nursing | Interviewed regarding deficiencies and findings |
Inspection Report
Complaint Investigation
Census: 21
Deficiencies: 0
Date: Oct 28, 2014
Visit Reason
An unannounced visit was conducted to investigate a complaint regarding the facility's failure to provide a safe environment for residents identified at risk to elope.
Complaint Details
The complaint alleged the facility failed to provide a safe environment for residents at risk of elopement. The allegation was investigated and found unsubstantiated with no violations written.
Findings
The investigation included interviews, record reviews, and observations related to elopement policies and interventions. No violations were found, and interventions were in place to ensure resident safety.
Report Facts
Facility census: 21
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Keeli Klein | Registered Nurse | Conducted the complaint investigation |
| Kaylene Straetker | Registered Nurse | Conducted the complaint investigation |
| Eve Lewis | Program Manager | Signed the inspection report |
Inspection Report
Routine
Census: 18
Capacity: 35
Deficiencies: 6
Date: Feb 11, 2014
Visit Reason
Routine inspection survey to assess compliance with Nebraska Administrative Code and federal regulations governing skilled nursing facilities, including life safety code compliance.
Findings
The facility was found deficient in several areas including failure to ensure privacy during medical procedures, failure to maintain dignity by covering catheter bags, incomplete comprehensive care plans regarding psychotropic medications and behaviors, failure to attempt gradual dose reductions of antipsychotic medications, failure to act on pharmacist recommendations, and infection control issues including catheter bags touching the floor and failure to wear gloves during blood glucose testing and insulin administration.
Deficiencies (6)
Failure to ensure privacy for one resident during a medical procedure (Resident 12).
Failure to position catheter bag to prevent visual exposure for one resident (Resident 22).
Failure to identify and address antipsychotic and anxiolytic medications and associated risks in comprehensive care plans for residents (Residents 36 and 28).
Failure to ensure drug regimen is free from unnecessary drugs, including failure to attempt gradual dose reduction of antipsychotic medication for Resident 13 and inappropriate use of Lorazepam for Resident 36.
Failure to act on pharmacist's recommendation for gradual dose reduction of antipsychotic medication for Resident 13.
Failure to prevent catheter drainage system from contacting the floor and failure to wear gloves during blood glucose testing and insulin administration for Residents 12, 22, and 37.
Report Facts
Facility census: 18
Total capacity: 35
Deficiencies cited: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Licensed Practical Nurse (LPN) A | Named in findings related to failure to ensure privacy and failure to wear gloves during procedures | |
| Registered Nurse (RN) B | Named in findings related to medication administration and resident behavior | |
| Director of Nursing (DON) | Interviewed regarding facility expectations and deficiencies |
Inspection Report
Annual Inspection
Census: 24
Deficiencies: 9
Date: Apr 11, 2013
Visit Reason
The inspection was an annual survey conducted to assess compliance with state and federal regulations governing skilled nursing facilities, nursing facilities, and intermediate care facilities.
Findings
The facility was found to have multiple deficiencies including failure to make survey results readily accessible to residents, inadequate monitoring and reporting of staff verbal abuse, housekeeping and maintenance issues, incomplete care plans related to anticoagulant medication, unsecured hazardous chemicals accessible to confused residents, failure to conduct required drug regimen lab monitoring, infection control lapses including soiled call light cords and improper storage of measuring devices, and lack of full visual privacy in shared resident rooms. The facility was found to be in compliance with life safety code requirements.
Deficiencies (9)
Failure to make survey results readily accessible to residents in a manner they can review without assistance.
Failure to monitor a staff member counseled for verbal abuse towards a resident.
Failure to ensure staff immediately notify administration of allegations of verbal abuse.
Failure to repair scraped and damaged walls and clean bathroom ventilation grates.
Failure to develop care plan interventions related to anticoagulant medication use.
Failure to secure hazardous chemical accessible to confused residents.
Failure to ensure drug regimen review included required laboratory monitoring for Digoxin therapy.
Failure to maintain infection control including replacement of soiled call light cords, improper storage of stool extender and measuring pitcher.
Failure to assure full visual privacy in shared resident rooms due to inadequate curtain coverage.
Report Facts
Facility census: 24
Date survey completed: Apr 11, 2013
Number of residents affected by privacy deficiency: 8
Inspection Report
Routine
Census: 25
Deficiencies: 9
Date: Feb 15, 2012
Visit Reason
Routine inspection of Ponderosa Villa nursing facility to assess compliance with state and federal regulations related to resident care, safety, medication management, and facility environment.
Findings
The facility was found deficient in multiple areas including resident room spacing, failure to notify physician of resident condition changes, inconsistent mail delivery, incomplete care plan updates, inadequate documentation of behavioral symptoms and medication monitoring, unsafe storage of hazardous chemicals, lack of assessment for mobility bar safety, presence of expired medications and dressings, and incomplete clinical record documentation.
Deficiencies (9)
Failed to provide a space of greater than three feet between the heads of beds for 2 residents in a semi-private room.
Failed to notify physician of resident bowel impaction for Resident 13.
Failed to provide mail delivery every other Saturday.
Failed to update care plans related to skin tear for Resident 7 and transfer instructions for Resident 28.
Failed to document ongoing behavioral symptoms and provide follow-up assessments for Residents 36 and 13.
Failed to ensure hazardous chemicals were locked and safe use of mobility bar was assessed.
Failed to monitor efficacy of psychoactive medication for Resident 7.
Failed to ensure outdated vaccines and wound dressings were not available for resident use.
Failed to maintain complete, accurate, and accessible clinical records including medication administration, behavior monitoring, and nutritional intake documentation.
Report Facts
Facility census: 25
Sample size: 11
Sample size: 5
Bed spacing: 1
Weight loss percentage: 14
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Yulia Brown | Registered Nurse | Verified skin tear monitoring and care plan updates for Resident 7 |
| Director of Nursing | Director of Nursing | Verified multiple findings including failure to notify physician, incomplete documentation, and monitoring |
| Administrator | Administrator | Verified bed spacing deficiency and discussed Resident 36 behavior incident |
| Activities Director | Activities Director | Oversaw mail delivery and verified mail delivery schedule |
| Dietary Manager | Dietary Manager | Reported on snack intake documentation issues |
Inspection Report
Plan of Correction
Census: 23
Deficiencies: 5
Date: Dec 21, 2010
Visit Reason
This Plan of Correction is written to satisfy State and Federal regulations governing long term care facilities and addresses deficiencies identified during the survey completed on 12/21/2010 at Ponderosa Villa.
Findings
The facility was found deficient in multiple areas including assessment accuracy, development of comprehensive care plans, influenza and pneumococcal immunizations, food procurement and sanitation, and clinical record maintenance. Specific deficiencies involved inaccurate coding of resident assessments, failure to develop care plans addressing psychotropic drug use and anxiety, incomplete immunization education and documentation, unsanitary kitchen conditions, and incomplete social service documentation.
Deficiencies (5)
Facility failed to accurately code the MDS assessment identifying ADL ability for a sampled resident.
Facility failed to develop comprehensive care plans addressing psychotropic drug use and symptoms of anxiety for a sampled resident.
Facility failed to develop policies and procedures ensuring education and documentation related to influenza and pneumococcal immunizations for residents.
Facility failed to ensure food procurement, storage, preparation, and service under sanitary conditions, evidenced by gray fuzzy debris on kitchen vents and refrigerator.
Facility failed to maintain complete, accurate, and accessible clinical records, including social service documentation and medication destruction records.
Report Facts
Facility census: 23
Number of residents sampled: 1
Number of residents sampled: 4
Number of residents sampled: 2
Number of deficiencies cited: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jathy Anderson | Administrator | Signed the Plan of Correction document. |
| DON | Director of Nursing | Interviewed regarding resident assessments, care plans, immunization documentation, and charting procedures. |
| DM | Dietary Manager | Interviewed regarding kitchen sanitation and cleaning schedules. |
| SSD | Social Services Director | Interviewed regarding social service documentation deficiencies. |
| Charge Nurse G | Charge Nurse | Interviewed regarding discharge summary and death checklist documentation. |
Notice
Capacity: 35
Deficiencies: 0
Date: APP2024
Visit Reason
The document serves as a renewal application for the nursing home license of Ponderosa Villa and includes related licensing and occupancy permit information.
Findings
The documents confirm the facility's licensure renewal status, maximum licensed bed capacity, and occupancy permit approval by the State Fire Marshal.
Report Facts
Total licensed beds: 35
Renewal license fees: 1550
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Faith Chmelka | Administrator | Named on the Nursing Home Licensure Renewal Application. |
| Yuliya Brown | Director of Nursing | Named on the Nursing Home Licensure Renewal Application. |
| Stacie Jones | Authorized Representative | Signed the Nursing Home Licensure Renewal Application. |
| Thomas Phillips | Mayor | Authorized Representative who signed the Nursing Home Licensure Renewal Application and listed as City Liaison on Board of Directors page. |
| Dana Reece | Deputy State Fire Marshal | Inspected the facility and approved the occupancy permit. |
Notice
Capacity: 35
Deficiencies: 0
Date: APP2016
Visit Reason
This document serves as a licensure renewal application and verification of licensure status for Ponderosa Villa, a skilled nursing facility, including occupancy permit information.
Findings
The documents confirm the facility's licensure renewal status, ownership, and capacity details, along with the occupancy permit issued by the Nebraska State Fire Marshal.
Report Facts
Number of beds to be relicensed: 35
Maximum Occupancy: 35
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Huffman | Administrator | Named on the Nursing Home Licensure Renewal Application |
| Traci Didier | Director of Nursing | Named on the Nursing Home Licensure Renewal Application |
| David Nixon | Authorized Representative | Signed the Nursing Home Licensure Renewal Application |
Document
Capacity: 35
Deficiencies: 0
Date: APP2017
Visit Reason
The documents pertain to the renewal of the nursing home license for Ponderosa Villa, including certification of licensure, renewal application, and occupancy permit.
Findings
The documents confirm that Ponderosa Villa is licensed as a Skilled Nursing Facility/Nursing Facility dual certification with a licensed capacity of 35 beds. The renewal application was submitted and signed on 2017-03-01. The Nebraska State Fire Marshal occupancy permit was issued for 35 beds with the latest date of 2016-03-15.
Report Facts
Licensed capacity: 35
Renewal application date: Mar 1, 2017
Occupancy permit issue date: Mar 15, 2016
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Huffman | Administrator | Named in renewal application. |
| Yuliya Brown | Director of Nursing | Named in renewal application. |
Notice
Capacity: 35
Deficiencies: 0
Date: APP2018
Visit Reason
This document serves as a licensure renewal application for Ponderosa Villa, a skilled nursing facility, to renew its license for 35 beds.
Findings
The document confirms the facility's licensure renewal status and includes ownership information, board of directors, and a state fire marshal occupancy permit.
Report Facts
Number of beds to be relicensed: 35
Renewal fees: 1750
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Huffman | Administrator | Named on the licensure renewal application |
| Colynn Beaver | Director of Nursing, R.N. | Named on the licensure renewal application |
Document
Capacity: 35
Deficiencies: 0
Date: APP2019
Visit Reason
The document serves as a renewal application for the nursing home license of Ponderosa Villa and includes certification of licensure, occupancy permit, and ownership information.
Findings
The documents confirm that Ponderosa Villa is licensed as a Skilled Nursing Facility with a total licensed capacity of 35 beds and holds a valid occupancy permit issued on 2018-03-14. No inspection findings or deficiencies are reported.
Report Facts
Licensed capacity: 35
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Huffman | Administrator | Named in licensure renewal application |
| Beth Barber | Director of Nursing | Named in licensure renewal application |
Notice
Capacity: 35
Deficiencies: 0
Date: APP2020
Visit Reason
This document serves to verify that Ponderosa Villa's SNF/NF dual certification license is renewed and valid through the date indicated on the renewal card.
Findings
The document confirms that Ponderosa Villa meets statutory requirements for licensure as a skilled nursing facility/nursing facility dual certified entity and is licensed for 35 beds.
Report Facts
Total licensed beds: 35
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Lora Sullivan | Administrator | Named as facility administrator on the relicensing application. |
| Lori Beaver | Director of Nursing | Named as Director of Nursing on the relicensing application. |
| Connie Shell | Mayor | Authorized representative signing the relicensing application. |
Notice
Capacity: 35
Deficiencies: 0
Date: APP2021
Visit Reason
The document serves as a renewal application for the nursing home license of Ponderosa Villa, including certification of licensure and occupancy permit.
Findings
The documents verify that Ponderosa Villa meets statutory requirements for licensure renewal and holds an occupancy permit for 35 beds.
Report Facts
Total licensed beds: 35
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Lora Sullivan | Administrator | Named as Administrator on the renewal application. |
| Traci Harrison | Director of Nursing | Named as Director of Nursing on the renewal application. |
| Connie Shell | Mayor | Authorized representative signing the renewal application. |
Notice
Capacity: 35
Deficiencies: 0
Date: APP2023
Visit Reason
The document set is related to the renewal of the nursing home license for Ponderosa Villa, including submission of the renewal application and verification of licensure status.
Findings
No inspection findings or deficiencies are reported. The documents confirm licensure renewal status and occupancy permit details.
Report Facts
Total licensed beds: 35
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Walt Dye | Administrator | Named in the nursing home licensure renewal application. |
| Yuliya Brown | Director of Nursing | Named in the nursing home licensure renewal application. |
| Stacie Jones | Authorized Representative | Signed the nursing home licensure renewal application. |
| Thomas Phillips | Mayor and Authorized Representative | Signed the nursing home licensure renewal application and listed as city liaison. |
| Pat Gould | Deputy State Fire Marshal | Inspected the facility for occupancy permit. |
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