Inspection Reports for The Americana Assisted Living
100 South 14th Street, Las Vegas, NV 89101, NV, 89101
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20
15
10
5
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Census Over Time
Census
Capacity
Inspection Report
Complaint Investigation
Census: 78
Deficiencies: 1
Sep 17, 2025
Visit Reason
The inspection was conducted as a result of a complaint investigation regarding medication administration and availability at the facility.
Findings
The facility failed to ensure medications were on site and available for administration for 4 of 5 sampled residents. The complaint was substantiated and the deficiency was a repeat from prior surveys.
Complaint Details
Complaint #NV00074825 was substantiated. The investigation included observation of medication administration, interviews with staff and residents, and clinical record review. The deficiency was a repeat from the annual survey on 4/30/25 and the Mandatory Grading resurvey on 7/15/25.
Severity Breakdown
F: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failed to ensure medications were on site and available for administration for 4 of 5 sampled residents. | F |
Report Facts
Sample size: 5
Deficiency repeat dates: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Nichole Schmal | Administrator | Named as the Administrator responsible for monitoring medication practices and corrective actions |
Inspection Report
Renewal
Census: 73
Capacity: 88
Deficiencies: 11
Jul 15, 2025
Visit Reason
This inspection was a mandatory state licensure re-grading survey conducted on 07/15/2025 for The Americana Assisted Living facility in accordance with Nevada Administrative Code Chapter 449 for Residential Facility for Groups.
Findings
The facility received a grade of B with multiple regulatory deficiencies identified including caregiver training delays, inadequate medication administration and documentation, insufficient food supplies, incomplete tuberculosis testing, and missing mental illness training for staff. Corrective actions were planned or implemented for all deficiencies.
Severity Breakdown
Level 2: 2
Level F: 2
Level E: 3
Level D: 4
Deficiencies (11)
| Description | Severity |
|---|---|
| Failed to ensure 1 of 4 employees had four hours of initial caregiver training within 60 days of hire. | Level 2 |
| Failed to maintain at least a 2-day supply of fresh food and a 1-week supply of canned food at all times. | Level F |
| Failed to comply with NAC 446 on food service permits and inspections. | Level E |
| Failed to ensure medication administration accuracy and timely medication reviews. | Level D |
| Failed to ensure medications were on site to administer for 4 of 9 residents. | Level E |
| Failed to notify physician within 12 hours after a resident missed medication doses for 4 of 9 residents. | Level E |
| Failed to maintain complete medication administration records including refusals and missed doses. | Level D |
| Failed to ensure restrictions concerning administration of 'as needed' medications were followed. | Level D |
| Failed to ensure 7 of 9 residents had completed two-step tuberculosis testing as required. | Level F |
| Failed to ensure 1 of 4 employees had eight hours of mental illness training within 60 days of hire. | Level 2 |
| Failed to ensure unlicensed caregivers annually completed infection control training. | Level D |
Report Facts
Licensed capacity: 88
Current census: 73
Employees reviewed: 4
Resident files reviewed: 9
Deficiency severity counts: 11
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Nichole Schmal | Manager | Facility Manager who signed the report |
| Employee #1 | Medication Technician | Named in findings for late caregiver and mental illness training |
Inspection Report
Annual Inspection
Census: 74
Capacity: 88
Deficiencies: 11
Apr 30, 2025
Visit Reason
The inspection was conducted as an annual state licensure survey combined with a complaint investigation at the facility.
Findings
The facility received a grade of D with multiple deficiencies identified including caregiver training, food supply shortages, kitchen sanitation issues, medication administration errors, missing medication reviews, failure to notify physicians of missed medications, incomplete medication administration records, improper medication restrictions, incomplete tuberculosis screenings, and missing required employee trainings.
Complaint Details
One complaint (#NV00073751) was investigated and found unsubstantiated with no regulatory deficiencies identified.
Severity Breakdown
Level 2: 11
Deficiencies (11)
| Description | Severity |
|---|---|
| Failed to ensure 2 of 10 sampled employees received required caregiver training within 60 days of employment or annual training. | Level 2 |
| Failed to ensure a 1-week supply of non-perishable food was available onsite. | Level 2 |
| Failed to ensure kitchen and dining services complied with NAC 446 standards; including sewage odor, standing water, and unclean ventilation hoods. | Level 2 |
| Failed to ensure medication reviews were completed every six months for residents. | Level 2 |
| Failed to ensure medications were on site and available for administration for 4 of 15 sampled residents. | Level 2 |
| Failed to ensure physician notification after resident missed medications for 6 of 15 sampled residents. | Level 2 |
| Failed to ensure Medication Administration Records (MAR) were initialed as given at the time of medication administration for 3 of 15 sampled residents. | Level 2 |
| Failed to ensure range orders were not used for medication administration for 1 of 15 residents. | Level 2 |
| Failed to ensure two-step tuberculosis screening was completed for 1 resident and annual TB screening for 2 residents. | Level 2 |
| Failed to ensure 1 of 10 sampled employees completed annual required infection control training for unlicensed caregivers. | Level 2 |
| Failed to ensure 1 of 10 sampled employees received eight hours of mental illness training within 60 days of employment. | Level 2 |
Report Facts
Licensed capacity: 88
Census: 74
Number of resident files reviewed: 15
Number of employee files reviewed: 10
Severity 2 deficiencies: 11
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Employee #1 | Caregiver | Named in caregiver training deficiency for missing annual training |
| Employee #8 | Medication Technician | Named in caregiver training and mental illness training deficiencies for missing required training |
| Employee #9 | Caregiver | Named in infection control training deficiency for missing annual training |
| Nichole Schmal | Administrator | Acknowledged multiple training and documentation deficiencies during inspection |
Inspection Report
Re-Inspection
Census: 68
Capacity: 88
Deficiencies: 18
May 30, 2024
Visit Reason
This Statement of Deficiencies was generated as a result of a State Licensure mandatory grading resurvey conducted at the facility on 05/30/24 in accordance with Nevada Administrative Code Chapter 449 for Residential Facility for Groups.
Findings
The facility was found to be in compliance with no regulatory deficiencies identified and received a grade of A. Multiple specific findings related to health and sanitation, laundry services, food service permits, safety requirements, oxygen use, medical care, medication administration, maintenance of resident files, preferred name/pronoun policies, emergency preparedness, and infection control were noted and corrective actions were planned or completed.
Severity Breakdown
F: 7
E: 6
D: 5
Deficiencies (18)
| Description | Severity |
|---|---|
| Health & Sanitation - Maintain Int/ext - NAC 449.209 Health and sanitation. | F |
| Laundry & Linen Services Provided - NAC 449.213 Laundry and linen services. | F |
| Permits-Comply with NAC 446 on Food Service - NAC 449.217 Kitchens; storage of food; adequate supplies of food; permits; inspections. | D |
| Safety Requirements - NAC 449.226 Safety requirements for residents with restricted mobility or poor eyesight; water hazards; auditory systems for bathrooms and bedrooms; access by vehicles. | F |
| Requirements and Precautions - NAC 449.229 Requirements and precautions regarding safety from fire. | F |
| Residents Requiring Use of Oxygen - NAC 449.2712 Residents requiring use of oxygen. | F |
| Medical Care of Resident After Illness - NAC 449.274 and R043-22 Medical care of resident after illness, injury or accident; periodic physical examination of resident; rejection of medical care by resident; written records. | E |
| Medication Administration-Accuracy & Report - NAC 449.2742 Administration of medication: Responsibilities of administrator, caregiver and employees of facility. | E |
| Medication Administration-Report Received - NAC 449.2742 and R043-22 - Administration of medication: Responsibilities of administrator, caregiver and employees of facility. | D |
| Medication Administration - NRS 449.0302 - NAC 449.2742 - Administration of medication: Responsibilities of administrator, caregiver and employees of facility. | E |
| Medication/OTCS, Supplements, Change Order - NAC 449.2742 and R043-22 - Administration of medication: Responsibilities of administrator, caregiver and employees of facility. | E |
| Medication - Resident Refusal - NAC 449.2742 and R043-22 - Administration of medication: Responsibilities of administrator, caregiver and employees of facility. | D |
| Medication: Storage - NAC 449.2748 Medication: Storage; duties upon discharge, transfer and return of resident. | D |
| Maintenance and Contents of Separate File - NAC 449.2749 Maintenance and contents of separate file for each resident; confidentiality of information. | F |
| Maintenance and Contents of Separate File - NAC 449.2749 Maintenance and contents of separate file for each resident; confidentiality of information. | E |
| Preferred Name/Pronoun P& P - Preferred Name/Pronoun Policy | D |
| Emergency Preparedness Plan - Emergency Preparedness Plan LCB File No. R048-22 Sec. 5. | F |
| Infection Control Policy - Infection Control Policy LCB File No. R048-22 Sec. 5. | F |
Report Facts
Licensed capacity: 88
Census: 68
Resident files reviewed: 15
Grade: A
Completion dates: May 29, 2024
File review start dates: Apr 12, 2024
Medication file review start: Mar 31, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Nichole Schmal | Administrator | Signed report and responsible for ensuring plan of correction implementation |
Inspection Report
Annual Inspection
Census: 68
Capacity: 88
Deficiencies: 19
Mar 20, 2024
Visit Reason
An annual state licensure survey was conducted at the facility on 03/20/24 to assess compliance with Nevada Administrative Code Chapter 449 for Residential Facility for Groups.
Findings
The facility was found deficient in multiple areas including health and sanitation, laundry services, food service permits, safety requirements, oxygen tank security, medical care documentation, medication administration, emergency preparedness, infection control, and resident records. The facility received a grade of D.
Severity Breakdown
Severity: 1: 2
Severity: 2: 17
Deficiencies (19)
| Description | Severity |
|---|---|
| Facility failed to ensure premises were clean and well maintained, including dirty baseboards, damaged tiles, missing vent filters, and clutter behind the building. | Severity: 2 |
| Laundry room equipment was not maintained; hole in drywall and broken dryer vent hose with lint accumulation. | Severity: 2 |
| Kitchen and dining services failed to comply with food service standards; soiled ventilation hood filters and dirty floors with debris and dead insects. | Severity: 2 |
| Auditory call systems in resident bedrooms and bathrooms were not working or missing, with no interim plan for resident assistance. | Severity: 2 |
| Facility failed to comply with fire safety regulations; fire doors held open improperly and emergency lighting non-operational. | Severity: 2 |
| Oxygen tanks were unsecured in the laundry area. | Severity: 2 |
| Initial and annual physical examinations were missing for several residents. | Severity: 2 |
| Six-month medication reviews were not completed for multiple residents. | Severity: 2 |
| Six-month medication reviews were not initialed and dated by the Administrator within 72 hours for some residents. | Severity: 2 |
| Ultimate User Agreements authorizing medication administration were missing for several residents. | Severity: 2 |
| Medications were missing on site for several residents and physician orders were missing for one resident. | Severity: 2 |
| Physicians were not notified within 12 hours of missed or refused medication doses for some residents. | Severity: 2 |
| Over-the-counter medications were not labeled with the prescriber's name for one resident. | Severity: 2 |
| Resident files lacked initial or annual tuberculin or QuantiFERON tests for multiple residents. | Severity: 2 |
| Resident files lacked initial or annual Activities of Daily Living (ADL) assessments for several residents. | Severity: 2 |
| Facility failed to post the current survey grade placard; an outdated 2022 placard was displayed. | Severity: 1 |
| Facility failed to develop policies and update resident records to reflect preferred name, pronoun, gender identity or expression, and sexual orientation as required by R016-20 Section 19. | Severity: 1 |
| Facility failed to develop and have available an Emergency Preparedness Plan addressing internal, external, local, and widespread emergencies including infectious diseases. | Severity: 2 |
| Facility failed to adopt an infection control policy appropriate for the scope of service. | Severity: 2 |
Report Facts
Deficiencies cited: 19
Census: 68
Total Capacity: 88
Oxygen tanks unsecured: 20
Garbage bags: 14
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Nichole Schmal | Administrator | Named as the Administrator who acknowledged multiple deficiencies and signed the report. |
| Maintenance Director | Acknowledged maintenance issues including cleaning needs, fire door issues, and emergency lighting problems. | |
| Caregiver | Provided information about auditory call system failures and resident checks. | |
| Activity Director | Confirmed auditory call system failures and lack of devices in resident rooms. | |
| Medication Technician | Reported on medication administration issues, missing medications, and documentation. | |
| Executive Director | Confirmed lack of ADL assessments and other documentation deficiencies. | |
| Assistant Executive Director | Responsible for monitoring corrective actions related to documentation and audits. |
Inspection Report
Complaint Investigation
Census: 74
Deficiencies: 1
Aug 29, 2023
Visit Reason
The inspection was conducted as a result of a State Licensure complaint investigation triggered by three complaints regarding the facility's compliance with regulations under Nevada Administrative Code Chapter 449.
Findings
The investigation verified two complaints related to improper discharge procedures for residents, including lack of appropriate discharge paperwork and documentation. One complaint was not verified. The facility received a grade of A.
Complaint Details
Three complaints were investigated: Complaint #NV00069189 and #NV00069027 were verified; Complaint #NV00068854 was not verified. Verified complaints involved issues with medication administration and discharge procedures. The investigation included observations, interviews with staff and residents, and record reviews.
Severity Breakdown
Severity: 2: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Facility failed to ensure residents had appropriate discharge paperwork for 2 of 11 residents (Resident #1 and #2), including lack of documented evidence of discharge paperwork and notification. | Severity: 2 |
Report Facts
Sample size: 11
Complaints investigated: 3
Inspection Report
Census: 63
Capacity: 88
Deficiencies: 0
Apr 17, 2023
Visit Reason
This inspection was a State Licensure voluntary grading resurvey conducted at the facility in accordance with Nevada Administrative Code (NAC) Chapter 449, Residential Facility for Groups.
Findings
No regulatory deficiencies were identified during the inspection. The facility received a grade of A and no further action is necessary.
Inspection Report
Annual Inspection
Census: 62
Capacity: 88
Deficiencies: 5
Mar 9, 2023
Visit Reason
The inspection was conducted as an annual state licensure and infection control survey in accordance with Nevada Administrative Code Chapter 449 for Residential Facility for Groups.
Findings
The facility was found to have multiple regulatory deficiencies including missing physical exam documentation for an employee, offensive sewage odors throughout the facility, kitchen sanitation issues including a malfunctioning dish machine and soiled ventilation hood, unsecured resident files, and lack of required cultural competency training for several employees.
Severity Breakdown
Severity: 2: 5
Deficiencies (5)
| Description | Severity |
|---|---|
| Failed to ensure a physical exam was completed and on file for 1 of 6 employees (Employee #6). | Severity: 2 |
| Facility failed to ensure there were no offensive odors present; sewage odor observed throughout the facility, especially in laundry room, storage closet, and dining area. | Severity: 2 |
| Kitchen failed to comply with standards; low temperature dish machine not dispensing detectable chlorine sanitizer during final rinse cycle; ventilation hood soiled with grease and dust. | Severity: 2 |
| Resident files were unsecured; binders containing medication administration records and personal information found in unlocked storage closet. | Severity: 2 |
| Failed to submit application for cultural competency training program and ensure 5 of 6 employees completed annual cultural competency training from an approved program. | Severity: 2 |
Report Facts
Employees reviewed: 6
Resident files reviewed: 15
Beds licensed: 88
Census: 62
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Nichole R Schmal | Administrator | Named as Administrator acknowledging deficiencies and corrective actions |
Inspection Report
Re-Inspection
Census: 58
Capacity: 88
Deficiencies: 11
May 10, 2022
Visit Reason
This inspection was a mandatory grading resurvey conducted at the facility in accordance with Nevada Administrative Code (NAC) Chapter 449 for Residential Facility for Groups.
Findings
The facility received a grade of A, but several regulatory deficiencies were identified including failures in administrator oversight, caregiver qualifications and training, personnel file requirements, health and sanitation, food service permits, activities planning, medication administration accuracy, and maintenance of resident files.
Severity Breakdown
F: 4
E: 2
D: 5
Deficiencies (11)
| Description | Severity |
|---|---|
| Administrator's Responsibilities - Oversight - NAC 449.194 Responsibilities of administrator. | F |
| Qualifications of Caregiver - Med Training - NAC 449.196 Qualifications and training of caregivers. | F |
| Personnel File - TB Screening - NAC 449.200 Personnel files. | E |
| Personnel File - 1st Aid & CPR - NAC 449.200 Personnel files. | D |
| Health & Sanitation - odors, hazards, insects, dirt - NAC 449.209 Health and sanitation. | F |
| Permits - Comply with NAC 446 on Food Service - NAC 449.217 Kitchens; storage of food; adequate supplies of food; permits; inspections. | E |
| Activities for Residents - NAC 449.260 Activities for residents. | F |
| Medication Administration - NRS 449.0302 - NAC 449.2742 - Administration of medication: Responsibilities of administrator, caregiver and employees of facility. | D |
| Medication - Resident Refusal - NAC 449.2742 - Administration of medication: Responsibilities of administrator, caregiver and employees of facility. | D |
| Administration of Medication Maintenance - NAC 449.2744 Administration of medication: Maintenance and contents of logs and records. | D |
| Maintenance and Contents of Separate File - NAC 449.2749 Maintenance and contents of separate file for each resident; confidentiality of information. | D |
Report Facts
Licensed beds: 88
Census: 58
Residents' files reviewed: 5
Employee files reviewed: 6
Severity 2 deficiency: 1
Scope: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Nichole Schmal | Administrator | Named as the Administrator responsible for oversight and acknowledged medication administration record deficiencies |
Inspection Report
Annual Inspection
Census: 63
Capacity: 88
Deficiencies: 11
Mar 9, 2022
Visit Reason
The inspection was conducted as an annual state licensure and infection control survey in accordance with Nevada Administrative Code Chapter 449 for a Residential Facility for Groups.
Findings
The facility received a grade of D with multiple deficiencies identified including failure to properly screen for COVID-19 symptoms, incomplete medication management training for employees, missing tuberculosis testing and physical exams for staff, unlocked hazardous roof access door, kitchen food safety violations, inadequate resident activities, missing ultimate user agreements for medication administration, failure to notify physicians of missed medications, inaccurate medication administration records, and incomplete resident files.
Severity Breakdown
Severity: 2: 11
Deficiencies (11)
| Description | Severity |
|---|---|
| Facility failed to ensure all persons entering were properly screened for COVID-19 symptoms; temperatures taken but screening questions not asked. | Severity: 2 |
| Failed to ensure 5 of 8 employees had initial and/or annual medication management training. | Severity: 2 |
| Failed to ensure two-step tuberculosis tests and physical examinations were completed for 2 of 8 employees. | Severity: 2 |
| Failed to ensure current CPR training was completed for 1 of 8 employees. | Severity: 2 |
| Facility failed to ensure the premises were free from hazards; roof access door was unlocked and roof lacked fall prevention barrier. | Severity: 2 |
| Facility failed to comply with food service standards; improper food temperatures, unclean equipment, and broken dish machine. | Severity: 2 |
| Failed to provide group activities that provide mental and physical stimulation aligned with residents' interests. | Severity: 2 |
| Failed to ensure 2 of 16 residents signed ultimate user agreements for medication administration. | Severity: 2 |
| Failed to notify physician within 12 hours after medication dose was missed for 2 of 16 residents. | Severity: 2 |
| Medication Administration Record was inaccurate for 2 of 16 residents; reasons for missed doses were not properly documented. | Severity: 2 |
| Failed to ensure 2-step tuberculosis test was completed for 3 of 16 residents; missing documentation in resident files. | Severity: 2 |
Report Facts
Licensed beds: 88
Resident census: 63
Employees reviewed: 8
Resident files reviewed: 16
Deficiencies with medication training: 5
Employees missing TB testing: 2
Employees missing CPR training: 1
Residents missing ultimate user agreement: 2
Residents missing 2-step TB test: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Employee #9 | Housekeeper / COVID-19 screener | Named in COVID-19 screening deficiency for not asking screening questions initially |
| Employee #1 | Caregiver | Named in medication management training deficiency |
| Employee #4 | Caregiver | Named in medication management training deficiency |
| Employee #6 | Caregiver | Named in medication management training and TB testing deficiencies |
| Employee #8 | Caregiver | Named in medication management training deficiency |
| Employee #2 | Caregiver | Named in TB testing deficiency |
| Employee #5 | Caregiver | Named in CPR training deficiency |
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