Deficiencies (last 5 years)
Deficiencies (over 5 years)
0 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
Same as Nebraska average
Nebraska average: 4.2 deficiencies/yearDeficiencies per year
4
3
2
1
0
Inspection Report
Renewal
Capacity: 60
Deficiencies: 0
Mar 11, 2021
Visit Reason
The document is a renewal application and license verification for Prairie Village Retirement Center, an assisted-living facility, to renew its licensure.
Findings
The documents confirm that Prairie Village Retirement Center meets statutory requirements as an assisted-living facility and is licensed for 60 beds. The renewal application was signed and submitted on 2021-03-11.
Report Facts
Total licensed beds: 60
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Leslie Tenski | Administrator | Named on renewal application as facility administrator |
| Roland Augspurger | Authorized Representative | Signed renewal application on 2021-03-11 |
| Larry Mares | Authorized Representative | Signed renewal application on 2021-03-11 |
| Todd Brehm | Deputy State Fire Marshal | Inspected facility for occupancy permit on 2020-09-11 |
Notice
Capacity: 60
Deficiencies: 0
Aug 27, 2019
Visit Reason
To acknowledge the increase in the number of licensed beds at the Prairie Village Retirement Center from 40 to 60 beds effective August 28, 2019.
Findings
The letter confirms the approval of the increase in licensed bed capacity at the assisted-living facility.
Report Facts
Licensed beds increase: 20
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Connie Vogt | Program Manager | Signed the letter acknowledging the bed increase |
Inspection Report
Renewal
Capacity: 40
Deficiencies: 0
Feb 23, 2018
Visit Reason
The document is a licensure renewal application and certification for Prairie Village Retirement Center, an assisted-living facility, verifying that the facility is licensed through the indicated renewal date.
Findings
The document certifies that Prairie Village Retirement Center meets statutory requirements as an assisted-living facility and includes renewal of licensure for 40 beds.
Report Facts
Total licensed beds: 40
Renewal fee: 1450
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Leslie Tenski | Administrator | Named as the facility administrator in the renewal application. |
| Todd Brehm | Deputy State Fire Marshal | Inspected the facility as noted on the occupancy permit. |
Inspection Report
Complaint Investigation
Deficiencies: 0
Jun 21, 2017
Visit Reason
An unannounced visit was conducted to investigate a complaint alleging inadequate pest control at Prairie Village Retirement Center.
Findings
The facility was found to have adequate pest control with no evidence of pests observed. Interviews with residents, staff, and review of pest control records confirmed compliance with regulatory requirements.
Complaint Details
The complaint alleged that the facility failed to have adequate pest control. The complaint was not substantiated as no pest issues were found.
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: 40
Deficiencies: 0
Apr 12, 2017
Visit Reason
The document is a licensure renewal application and certification for Prairie Village Retirement Center, an assisted-living facility, to renew its license through April 30, 2018.
Findings
The facility meets statutory requirements for licensure as an assisted-living facility with a total licensed capacity of 40 beds. The occupancy permit was issued on 2016-04-11 by the Nebraska State Fire Marshal.
Report Facts
Total licensed beds: 40
Occupancy permit issue date: Apr 11, 2016
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Leslie Tenski | Administrator | Named as the facility administrator in the licensure renewal application. |
| Todd Brehm | Deputy State Fire Marshal | Inspected the facility and issued the occupancy permit. |
Inspection Report
Routine
Deficiencies: 0
May 7, 2014
Visit Reason
The Compliance Inspection was conducted to assess the facility's compliance with 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 with efforts to maintain compliance applauded.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Travis Castner | Registered Nurse | Conducted the Compliance Inspection |
| Daniel Woodward | Registered Nurse | Conducted the Compliance Inspection |
| Eve Lewis | Program Manager | Signed the letter acknowledging inspection results |
Notice
Capacity: 40
Deficiencies: 0
APP2016
Visit Reason
This document serves as a licensure renewal application and verification for the Prairie Village Retirement Center assisted-living facility, confirming its licensed status and capacity.
Findings
The documents confirm the facility meets statutory requirements for licensure as an assisted-living facility with a maximum capacity of 40 beds. A Nebraska State Fire Marshal occupancy permit is included, indicating compliance with fire safety codes as of the inspection date.
Report Facts
Total licensed beds: 40
Renewal expiration date: Expiration date on renewal card is 04/30/2017.
Fire Marshal inspection date: Inspection date 2016-04-11.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Leslie Tenski | Administrator | Named as facility administrator on licensure renewal application and fire marshal documents. |
Notice
Capacity: 40
Deficiencies: 0
APP2019
Visit Reason
This document serves as the licensure renewal application and renewal notice for Prairie Village Retirement Center as an assisted-living facility, including confirmation of license renewal and occupancy permit issuance.
Findings
The documents confirm that Prairie Village Retirement Center meets statutory requirements for licensure as an assisted-living facility, with a total licensed capacity of 40 beds and a maximum occupancy of 38 beds per the fire marshal occupancy permit.
Report Facts
Total licensed beds: 40
Maximum occupancy: 38
Renewal expiration date: Apr 30, 2019
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Leslie Tenski | Administrator | Named as facility administrator in the renewal application and board member list. |
| Clark Grant | Authorized Representative | Signed the renewal application as authorized representative. |
Document
Capacity: 60
Deficiencies: 0
APP2020
Visit Reason
The document set serves to verify the licensure renewal of Prairie Village Retirement Center as an assisted-living facility, provide ownership and board member information, and confirm occupancy limits per the State Fire Marshal.
Findings
The documents confirm that Prairie Village Retirement Center meets statutory requirements for licensure renewal as an assisted-living facility with a licensed capacity of 60 beds. The State Fire Marshal occupancy permit also approves a maximum occupancy of 60 persons.
Report Facts
Total licensed beds: 60
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Leslie Tenski | Administrator | Named as facility administrator on licensure renewal application and board listing |
| Roland Augspurger | President | Named as board president on board of directors listing |
| Larry Mares | Treasurer | Named as board treasurer on board of directors listing |
| John Novotny | Board Member | Named as board member on board of directors listing |
| Clark Grant | Vice President | Named as board vice president and secretary on board of directors listing |
| Edward Yang | Board Member | Named as board member on board of directors listing |
| Ruth Erwin | Board Member | Named as board member on board of directors listing |
Notice
Capacity: 60
Deficiencies: 0
APP2022
Visit Reason
This document serves to verify that Prairie Village Retirement Center is licensed as an assisted-living facility and includes a renewal application for the facility's license.
Findings
The documents confirm the facility meets statutory requirements for licensure as an assisted-living facility and includes an occupancy permit with a maximum capacity of 60 beds.
Report Facts
Total licensed beds: 60
Renewal license fees: 950
Renewal license fees: 1450
Renewal license fees: 1650
Renewal license fees: 1950
Notice
Capacity: 60
Deficiencies: 0
APP2023
Visit Reason
The document serves as a renewal application and license renewal verification for the assisted-living facility Prairie Village Retirement Center.
Findings
The document confirms that Prairie Village Retirement Center meets statutory requirements as an assisted-living facility and is licensed through the indicated renewal date.
Report Facts
Total licensed beds: 60
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Dawn Pavel | Administrator | Named as administrator on the renewal application |
| Clark Grant | Authorized Representative | Signed the renewal application |
| Larry J. Mares | Authorized Representative | Signed the renewal application |
Notice
Capacity: 60
Deficiencies: 0
APP2024
Visit Reason
This document serves as a renewal application and verification of licensure for the Prairie Village Retirement Center assisted-living facility.
Findings
The documents confirm that the facility meets statutory requirements for licensure as an assisted-living facility and includes an occupancy permit with a maximum occupancy of 60 beds.
Report Facts
Total licensed beds: 60
Maximum occupancy: 60
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Dawn Pavel | Administrator | Named as administrator on the renewal application. |
| Clark Grant | Authorized Representative | Signed the renewal application. |
| Larry Mares | Authorized Representative | Signed the renewal application. |
| Robert Stoess | Deputy State Fire Marshal | Inspected and approved the occupancy permit. |
Notice
Capacity: 60
Deficiencies: 0
APP2025
Visit Reason
This document verifies that Prairie Village Retirement Center is licensed as an assisted-living facility through the renewal date indicated on the renewal card. It also includes an occupancy permit certifying the maximum occupancy and bed count.
Findings
The documents confirm the facility meets statutory requirements for licensure as an assisted-living facility and holds a valid occupancy permit for 60 beds.
Report Facts
Total licensed beds: 60
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