Inspection Reports for
St Joseph’s Hillside Villa

540 E Washington Street, WEST POINT, NE, 68788

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10 Reports

2018–2019

Inspection Report — Jan 30, 2019

Life Safety
Date: Jan 30, 2019

Visit Reason
The inspection was conducted to assess compliance with the 2012 Edition of the Life Safety Code of the National Fire Protection Association, focusing on fire protection and smoke barrier requirements.

Findings
The facility was found not in compliance with certain fire safety requirements, specifically related to smoke resistant partitions and smoke barrier doors. Deficiencies included unsealed penetrations in the mechanical room walls and smoke barrier doors that failed to latch properly, potentially allowing smoke migration between compartments.

Deficiencies (2)
A 2-inch round hole in the sheetrock on the west wall of the main mechanical room and a 1-inch gap around the 6-inch furnace duct were not sealed, compromising smoke resistant partitions.
Smoke barrier doors failed to latch properly, causing doors to remain partially open and not be smoke-tight.
Report Facts
Fire door checks frequency: 5

Employees mentioned
NameTitleContext
Doug HohbeinAssistant State Fire MarshalApproved the inspection report
Jeff J. ClemensAdministratorSigned the inspection report and involved in education of Maintenance Supervisor

Inspection Report — Nov 13, 2018

Routine
Date: Nov 13, 2018

Visit Reason
The inspection was conducted as a Compliance Inspection to assess the facility's adherence to regulations governing licensure of skilled nursing facilities, nursing facilities, and intermediate care facilities.

Findings
The facility was found in compliance with the applicable regulations, and the results of the Compliance Inspection were commendable.

Notice — Nov 13, 2018

Date: Nov 13, 2018

Visit Reason
Issuance and renewal of Skilled Nursing Facility license for St. Joseph's Hillside Villa, including zoning approval and occupancy permit.

Findings
The facility was granted a provisional Nebraska license for 54 beds effective November 13, 2018. The property is zoned for nursing home use and has an approved occupancy permit for 54 beds issued on December 12, 2018.

Report Facts
Licensed beds: 54

Employees mentioned
NameTitleContext
David DeemerAdministratorNamed as facility administrator in license issuance letter and board listing.
Bo BotelhoInterim CEO, Interim Director of Public HealthSigned license issuance and renewal documents.
Connie VogtProgram ManagerContact person for license questions as stated in license issuance letter.

Notice — APP2025

Date: APP2025

Visit Reason
This document package serves to verify the renewal of the SNF/NF dual certification license for St Joseph's Hillside Villa and includes the renewal application, occupancy permit, and bed certification details.

Findings
The documents confirm that St Joseph's Hillside Villa meets statutory requirements for licensure renewal, with a licensed capacity of 54 beds and certification for Medicare and Medicaid. The occupancy permit was issued on 3/5/2024 by the State Fire Marshal.

Report Facts

Employees mentioned
NameTitleContext
Sam ProkopecAdministratorNamed on the Nursing Home Licensure Renewal Application.
Kelly JohnsonDirector of NursingNamed on the Nursing Home Licensure Renewal Application.

Document — APP2019

Date: APP2019

Visit Reason
The document set serves as a licensure renewal application and related administrative paperwork for St Joseph's Hillside Villa nursing home facility.

Findings
No inspection findings or deficiencies are reported. The documents confirm licensure renewal, occupancy permit with maximum capacity of 54 beds, and payment of renewal fees.

Report Facts
Renewal fee amount: 1750

Employees mentioned
NameTitleContext
David DeemerAdministratorNamed as facility administrator on licensure renewal application
Tammy DeemerDirector of NursingNamed as director of nursing on licensure renewal application
Brian L. ReimersAuthorized RepresentativeSigned licensure renewal application

Document — APP2020

Date: APP2020

Visit Reason
The documents serve to verify licensure renewal, provide occupancy permit details, and list board members for St Joseph's Hillside Villa nursing home.

Findings
No inspection findings or deficiencies are reported; the documents confirm licensure status, occupancy capacity, and administrative details.

Report Facts
Total licensed beds: 54

Notice — APP2021

Date: APP2021

Visit Reason
This document serves as a Nursing Home Licensure Renewal Application for St Joseph's Hillside Villa, including verification of licensure status and occupancy permit information.

Findings
The documents confirm that St Joseph's Hillside Villa is licensed as a Skilled Nursing Facility with 54 beds, and includes certification of licensure renewal and occupancy permit approval by the State Fire Marshal.

Report Facts
Number of beds to be relicensed: 54 Maximum occupancy: 54

Document — APP2022

Date: APP2022

Visit Reason
The documents pertain to the renewal of the nursing home license for St Joseph's Hillside Villa and related administrative and regulatory information.

Findings
No inspection findings or deficiencies are reported in these documents; they primarily serve to verify licensure status, ownership, and occupancy capacity.

Report Facts
Total licensed beds: 54

Employees mentioned
NameTitleContext
Sam ProkopecAdministratorNamed on the Nursing Home Licensure Renewal Application
Kelly JohnsonDirector of NursingNamed on the Nursing Home Licensure Renewal Application

Notice — APP2023

Date: APP2023

Visit Reason
The document serves as a licensure renewal application for St Joseph's Hillside Villa nursing home facility.

Findings
The documents certify that St Joseph's Hillside Villa meets statutory requirements for licensure renewal and includes an occupancy permit indicating a maximum capacity of 54 beds.

Report Facts
Total licensed beds: 54 Renewal licensure fees: 1550

Employees mentioned
NameTitleContext
Sam ProkopecAdministratorNamed on the licensure renewal application.
Kelly JohnsonDirector of NursingNamed on the licensure renewal application.

Document — APP2024

Date: APP2024

Visit Reason
The document set is primarily for the renewal of the nursing home license for St Joseph's Hillside Villa, including verification of licensed beds and occupancy permit.

Findings
No inspection findings or deficiencies are reported. The documents confirm licensure renewal, bed certifications, and occupancy permit compliance.

Report Facts
Total licensed beds: 54 Bed count per unit: 18

Employees mentioned
NameTitleContext
Sam ProkopecAdministratorNamed on the Nursing Home Licensure Renewal Application.
Kelly JohnsonDirector of NursingNamed on the Nursing Home Licensure Renewal Application.

6 CMS Surveys

CMS Survey — Mar 15, 2023

Mar 15, 2023

CMS Survey — Apr 24, 2023

Apr 24, 2023

CMS Survey — Sep 10, 2024

Sep 10, 2024

CMS Survey — Feb 7, 2023

Feb 7, 2023

CMS Survey — Mar 7, 2024

Mar 7, 2024

CMS Survey — Mar 13, 2025

Mar 13, 2025

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