Inspection Reports for The Cedars at Broadwell
The Cedars at Broadwell, GRAND ISLAND, NE, 68803
Back to Facility ProfileDeficiencies (last 11 years)
Deficiencies (over 11 years)
6.6 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
57% worse than Nebraska average
Nebraska average: 4.2 deficiencies/year
Deficiencies per year
16
12
8
4
0
Census
Latest occupancy rate
62 residents
Based on a November 2018 inspection.
Census over time
Inspection Report
Renewal
Capacity: 76
Deficiencies: 0
Feb 17, 2025
Visit Reason
This document serves as a renewal application and certification for the nursing home license of The Cedars at Broadwell, verifying that the facility's SNF/NF dual certification is licensed through the indicated renewal date.
Findings
The documents confirm the renewal of the facility's license with no deficiencies or inspection findings noted. The occupancy permit indicates a maximum capacity of 76 beds.
Report Facts
Number of beds to be relicensed: 76
Maximum Occupancy: 76
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Katherine Klingsporn | Administrator | Named on the Nursing Home Licensure Renewal Application |
| Jean Sherer-Karumbi | Director of Nursing | Named on the Nursing Home Licensure Renewal Application |
| Devora Kirschner | Authorized Representative | Signed the Nursing Home Licensure Renewal Application |
| Ari Silberstein | Authorized Representative | Signed the Nursing Home Licensure Renewal Application |
| David Weisz | Authorized representatives to sign renewal applications in letter dated 2025-02-17 |
Notice
Capacity: 76
Deficiencies: 0
Jan 30, 2024
Visit Reason
The document serves as a renewal application for the nursing home license of The Cedars at Broadwell and includes verification of licensure and occupancy permit information.
Findings
The documents confirm that The Cedars at Broadwell is licensed as a Skilled Nursing Facility with a total licensed bed capacity of 76 and holds an occupancy permit issued on 2023-05-16. No inspection findings or deficiencies are reported.
Report Facts
Total licensed beds: 76
Occupancy permit issue date: May 16, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Danielle Muir | Administrator | Named in the Nursing Home Licensure Renewal Application. |
| Cynthia Buettner | Director of Nursing | Named in the Nursing Home Licensure Renewal Application. |
| Ari Silberstein | Authorized Representative | Signed the Nursing Home Licensure Renewal Application on 2024-01-30. |
| Mark Manchester | Deputy State Fire Marshal | Inspected the facility and approved the occupancy permit. |
Inspection Report
Renewal
Capacity: 76
Deficiencies: 0
Mar 11, 2021
Visit Reason
This document is a Nursing Home Licensure Renewal Application for Azria Health Broadwell, submitted to renew the facility's license.
Findings
The document certifies that Azria Health Broadwell meets statutory requirements for licensure renewal as a Skilled Nursing Facility with specified services including physical therapy, occupational therapy, and speech therapy.
Report Facts
Number of beds to be relicensed: 76
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Alex Willford | Administrator | Named as Administrator in the Nursing Home Licensure Renewal Application |
| Karry Bloomquist | Director of Nursing | Named as Director of Nursing in the Nursing Home Licensure Renewal Application |
| Steve Hornung | Authorized Representative | Signed the renewal application on 03/11/2021 |
| Noah Kaminer | Authorized Representative | Signed the renewal application on 03/11/2021 |
Inspection Report
Complaint Investigation
Census: 62
Deficiencies: 2
Nov 14, 2018
Visit Reason
An unannounced visit was conducted to investigate a complaint at Wedgewood Care Center on November 14, 2018, regarding allegations of failure to protect residents from injury, ensure bathroom access, maintain housekeeping and maintenance, and provide services without discrimination.
Findings
The investigation found the facility failed to protect residents from injury related to a resident bringing a weapon into the facility and inadequate psychosocial assessment and care planning for that resident. The facility was found in violation of federal and state regulations for abuse and neglect and quality of care. Other allegations related to bathroom access, housekeeping, and discrimination were found to be in compliance.
Complaint Details
The complaint investigation was triggered by allegations that the facility failed to protect residents from injury, ensure bathroom access, maintain housekeeping and maintenance, and provide services without discrimination. The facility was substantiated for failure to protect residents from injury and quality of care related to a resident bringing a weapon into the facility and inadequate psychosocial assessment.
Severity Breakdown
SS=J: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Facility failed to ensure one resident did not bring a weapon into the facility. | SS=J |
| Facility failed to assess one resident during pre-admission and admission to identify potential for increased psychosocial distress related to multiple situational stressors. | SS=J |
Report Facts
Census: 62
Deficiency count: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Connie Vogt | RN, BSN, Program Manager | Signed the complaint investigation letter |
| Sherrill Acton | Administrator | Named in the complaint investigation letter |
Inspection Report
Complaint Investigation
Census: 67
Capacity: 76
Deficiencies: 14
Mar 27, 2018
Visit Reason
An unannounced visit was conducted to investigate a complaint at Wedgewood Care Center on March 27, 2018, by representatives of the Department of Health and Human Services Division of Public Health.
Findings
The complaint that the facility failed to use appropriate interventions to prevent injuries was investigated and the facility was found to be in compliance. Several deficiencies were cited related to resident dignity, reasonable accommodations, safe environment, comprehensive assessments, supervision for fall risk residents, food safety, infection control, life safety, and maintenance issues.
Complaint Details
The complaint alleged the facility failed to use appropriate interventions to prevent injuries. The investigation found the facility was in compliance with related regulatory requirements.
Severity Breakdown
SS=D: 3
SS=E: 6
Deficiencies (14)
| Description | Severity |
|---|---|
| Failed to maintain resident dignity when one resident was not served at the same time as tablemates and failed to offer to cut up meat for another resident. | SS=D |
| Failed to provide reasonable accommodations for residents to access their clothes and bathroom sink. | SS=E |
| Failed to maintain a safe, clean, comfortable, and homelike environment including uncovered light bulbs, dirty vents, marred doors and walls, stained ceilings, and ill-fitting toilet lids. | SS=E |
| Failed to complete a comprehensive MDS assessment within 14 days of admission for one resident. | SS=E |
| Failed to complete quarterly MDS assessments timely for 11 residents. | SS=E |
| Failed to provide adequate supervision and prevent accident hazards for two high fall risk residents; wet floor left unattended while residents were in the room. | SS=D |
| Failed to label and date opened food items in the kitchen. | SS=E |
| Failed to follow infection prevention and control practices including improper glove use and hand hygiene during food serving. | SS=E |
| Failed to maintain sanitary and functional environment including dirty eye wash station pipes, hole in fire door frame, dirty ionizer, and gouged hand rail. | SS=E |
| Failed to ensure bathroom vents were working for three residents. | — |
| Failed to conduct monthly visual inspections of kitchen range hood suppression system components. | — |
| Direct-vent gas fireplace was not installed with sealed glass front, lacked carbon monoxide detector, and had standard response sprinklers instead of quick response sprinklers. | — |
| Failed to conduct annual inspection and testing of fire rated doors. | — |
| Damaged electrical receptacle in resident room was not repaired. | — |
Report Facts
Deficiencies cited: 13
Residents sampled: 24
Facility census: 67
Total licensed capacity: 76
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Dan Taylor | RN, Training Coordinator | Signed complaint investigation letter. |
| Sherrill Acton | Administrator | Facility administrator named in report and plan of correction. |
| Maintenance A | Acknowledged sprinkler and fireplace deficiencies. | |
| Dietary Supervisor | Interviewed regarding food safety and hand hygiene deficiencies. | |
| Housekeeping Supervisor | Interviewed regarding housekeeping and environmental deficiencies. | |
| DON | Director of Nursing | Interviewed regarding MDS assessments and fall risk supervision. |
Inspection Report
Complaint Investigation
Deficiencies: 0
Mar 27, 2018
Visit Reason
An unannounced visit was conducted to investigate a complaint that the facility fails to use appropriate interventions to prevent injuries.
Findings
The investigation found that interventions were in place to prevent injuries, staff were aware of how to implement these interventions, and resident care plans documented these interventions. The facility was found to be in compliance with related regulatory requirements.
Complaint Details
The complaint alleged failure to use appropriate interventions to prevent injuries. The allegation was investigated and found to be unsubstantiated as the facility was in compliance.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Dan Taylor | RN, Training Coordinator | Signed the report and identified as representative of the Office of LTC Facilities - Licensure Unit - Division of Public Health |
Notice
Capacity: 76
Deficiencies: 0
Jan 11, 2017
Visit Reason
This document serves to verify the renewal of the SNF/NF dual certification license for Wedgewood Care Center and includes the occupancy permit issued by the Nebraska State Fire Marshal.
Findings
The facility is licensed as a Skilled Nursing Facility/Nursing Facility with a total licensed capacity of 76 beds. The occupancy permit was issued confirming compliance with fire marshal codes as of 1/11/2017.
Report Facts
Number of beds: 76
Occupancy permit date: Jan 11, 2017
Inspection Report
Annual Inspection
Census: 68
Capacity: 76
Deficiencies: 15
Jan 9, 2017
Visit Reason
An unannounced visit was conducted to investigate a complaint and annual survey at Wedgewood Care Center on January 9-12, 2017, by representatives of the Department of Health and Human Services Division of Public Health.
Findings
The facility was found to be in compliance with regulatory requirements for personal care, laboratory specimen collection, medication refusal notifications, abuse protection, and pest control. However, deficiencies were cited related to accident hazards, nutrition status maintenance, influenza and pneumococcal immunizations, food service sanitation, life safety code violations including illumination, fire door inspections, hazardous area enclosures, fire alarm system installation, sprinkler system maintenance, fire extinguisher signage, corridor door latching, smoke barrier integrity, and emergency generator remote stop station.
Complaint Details
The complaint investigation included allegations regarding failure to ensure clean and groomed hair, timely laboratory specimen collection, notification of practitioner for medication refusal, protection from abuse, and maintenance of an effective pest control program. The facility was found to be in compliance with these allegations except for one isolated incident of delayed laboratory specimen collection.
Severity Breakdown
Level D: 3
Level E: 1
Level F: 9
Level G: 1
Deficiencies (15)
| Description | Severity |
|---|---|
| Failed to ensure corner guards and door frames were maintained to prevent potential skin tears due to sharp edges. | Level D |
| Failed to identify significant weight loss and notify the Dietician and Physician for one resident. | Level G |
| Failed to provide influenza vaccination for one resident. | Level D |
| Failed to maintain cleanliness of ventilation covers, light panels, pan storage unit, and fan in kitchen. | Level F |
| Failed to provide illumination of exit corridors and dining room, allowing lights to be turned off leaving areas dark. | Level F |
| Failed to implement annual inspection and testing of fire doors throughout the facility. | Level F |
| Failed to separate hazardous areas by smoke resistive partitions; clean laundry room door did not latch. | Level F |
| Failed to conduct monthly visual inspections of kitchen range hood suppression system. | Level F |
| Allowed non-sprinkler system components to be supported by sprinkler piping. | Level D |
| Failed to have a complete policy for sprinkler system out of service for more than 10 hours including notification of insurance company. | Level F |
| Failed to post placard near Class K fire extinguisher describing operating procedures. | Level F |
| Failed to provide corridor doors that positively latch to separate closets from exit corridors. | Level F |
| Failed to provide smoke barriers that resist passage of smoke due to unsealed penetrations. | Level E |
| Failed to install fire alarm notification in enclosed courtyard and smoke detector in room housing fire alarm equipment. | Level F |
| Failed to provide remote manual stop station for emergency generator. | Level F |
Report Facts
Deficiencies cited: 15
Facility census: 68
Total licensed capacity: 76
Civil money penalty amount: 2903
Weight loss percentage: 9.5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Dan Taylor | RN, Training Coordinator - Office of LTC Facilities - Licensure Unit - Division of Public Health - DHHS | Signed complaint investigation letter. |
| Sherrill Acton | Administrator | Facility administrator during survey and correspondence. |
| Cheryl Schulz | Administrator | Facility administrator during survey and informal dispute resolution. |
| Dain Weiss | RN | Reviewer for Informal Dispute Resolution. |
| Eve Lewis | Program Manager, Office of LTC Facilities, Licensure Unit | Signed letter confirming informal dispute resolution decision. |
| Maintenance A | Interviewed regarding facility maintenance deficiencies including lighting, door latching, fire door inspections, sprinkler piping, fire alarm system, and emergency generator. | |
| Director of Nursing | DON | Interviewed regarding weight loss notification and dietary processes. |
| Dietary Manager | Interviewed regarding weight loss monitoring and notification. | |
| Registered Dietician | RD | Interviewed regarding weight loss notification and dietary interventions. |
| Maintenance A | Interviewed regarding fire alarm system and smoke detector installation. | |
| Maintenance A | Interviewed regarding sprinkler system and fire watch policy. | |
| Maintenance A | Interviewed regarding fire extinguisher placard absence. |
Inspection Report
Complaint Investigation
Deficiencies: 0
Jun 13, 2016
Visit Reason
An unannounced visit was conducted to investigate a complaint at Wedgewood Care Center regarding allegations of abuse, insufficient staff training for medication administration, and lack of respect and dignity for residents.
Findings
The investigation found the facility was promoting an environment free from abuse, providing proper staff training for medication administration, and treating residents with respect and dignity. All concerns were addressed and the facility was in compliance with regulatory requirements.
Complaint Details
The complaint alleged the facility failed to ensure residents were free from abuse, staff were sufficiently trained for medication administration, and residents were treated with respect and dignity. The investigation found these allegations unsubstantiated and the facility compliant.
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: 76
Deficiencies: 0
Oct 8, 2015
Visit Reason
The document is a Nursing Home Licensure Renewal Application and related certification and occupancy permit for Wedgewood Care Center, indicating the facility's license renewal and compliance with state requirements.
Findings
The documents certify that Wedgewood Care Center meets statutory requirements for licensure renewal as a skilled nursing facility with a licensed capacity of 76 beds. The renewal application includes ownership information and certification of compliance with applicable regulations.
Report Facts
Total licensed beds: 76
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Cheryl Schulz | Administrator | Named in the Nursing Home Licensure Renewal Application |
| Angela Cornelius | Director of Nursing | Named in the Nursing Home Licensure Renewal Application |
| Richard A. Doyle | Treasurer & Chief Financial Officer | Named as an officer in the ownership control document |
| Bruce J. Mackey Jr. | President & Chief Executive Officer | Named as an officer in the ownership control document |
Inspection Report
Annual Inspection
Census: 71
Deficiencies: 10
Oct 7, 2015
Visit Reason
An unannounced visit was conducted to investigate a complaint and annual survey at Wedgewood Care Center from October 7, 2015 to October 14, 2015.
Findings
The facility was found to be in compliance with fall prevention, catheter care, skin care, and hydration concerns. However, deficiencies were cited related to accident hazards with van safety restraints, medication management including anticoagulant monitoring and medication errors, pest control issues, and life safety code violations including smoke barriers, fire drills, fire alarm system maintenance, emergency power signage, and electrical equipment use.
Complaint Details
The visit was complaint-related, investigating allegations of failure to change fall interventions, provide appropriate catheter care, promote healing of skin breakdown, and provide adequate fluid intake. All allegations were found to be unsubstantiated with no violations.
Severity Breakdown
SS=E: 4
SS=G: 1
SS=F: 4
SS=D: 1
Deficiencies (10)
| Description | Severity |
|---|---|
| Failed to provide working shoulder straps to secure residents in wheelchairs during transport in the facility van. | SS=E |
| Failed to monitor residents for adverse consequences while receiving anticoagulant and antibiotic therapy, resulting in hospitalization for one resident and excessive acetaminophen dosing for another. | SS=G |
| Medication error rate of 20% with 5 medication errors affecting 5 residents including outdated insulin use, improper medication administration, and chewing of extended release potassium. | SS=E |
| Failed to maintain an effective pest control program; spiders and mouse droppings found in resident rooms and exterior areas. | SS=E |
| Failed to separate 2 of 6 smoke barriers with smoke resistive construction fully to roof deck, allowing potential smoke migration between compartments. | SS=F |
| Failed to maintain smoke resistant doors for hazardous areas; holes by doorknobs and a door that failed to latch properly. | SS=F |
| Failed to conduct fire drills for 3 of 3 shifts under varied times and conditions with at least one hour difference between drills. | SS=F |
| Fire alarm system failed to comply with NFPA 72 and NFPA 70 standards; exposed wire splices, unsecured heat detectors, smoke detectors too close to air diffusers, and incomplete testing of detectors. | SS=F |
| Failed to provide signage for natural gas piping indicating emergency generator presence and shutoff valve. | SS=F |
| Use of power strip plugged into uninterruptable power supply instead of directly into wall outlet, increasing risk of electrical fire. | SS=D |
Report Facts
Facility census: 71
Medication error rate: 20
INR lab value: 10
Hemoglobin lab value: 7.7
Hemoglobin lab value: 8.8
Hemoglobin lab value: 8
Tylenol dosage: 3575
Fire drill times: 12
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jean Obermier | Registered Nurse | Conducted the complaint and annual survey |
| Susan Griepenstroh | Registered Nurse | Conducted the complaint and annual survey |
| Nancy Hauschild | Nutrition/dietitian | Conducted the complaint and annual survey |
| Eve Lewis | Program Manager - Office of LTC Facilities - Licensure Unit - Division of Public Health - DHHS | Signed the complaint and annual survey letter |
| Maintenance A | Interviewed regarding smoke barrier and fire alarm deficiencies | |
| LPN C | Licensed Practical Nurse | Administered outdated insulin |
| MA F | Medication Aide | Administered incorrect vitamin and medication to residents |
| DON | Director of Nursing | Interviewed regarding medication errors and monitoring |
Inspection Report
Complaint Investigation
Census: 67
Deficiencies: 0
Jan 13, 2015
Visit Reason
An unannounced visit was conducted to investigate a complaint at Wedgewood Care Center regarding allegations of failure to treat residents with dignity and respect, failure to provide care for bowel and bladder elimination, failure to report abuse and/or neglect, and failure to protect residents from abuse and/or neglect.
Findings
The facility was found to treat residents with respect and dignity, monitor bowel and bladder eliminations appropriately, and have policies and procedures in place to protect residents from abuse and neglect. No violations were cited related to the allegations after investigation.
Complaint Details
The complaint allegations included failure to treat residents with dignity and respect, failure to provide care for bowel and bladder elimination, failure to report abuse and/or neglect, and failure to protect residents from abuse and/or neglect. Investigations included record reviews, observations, and interviews with residents, staff, and family. No substantiated violations were found.
Report Facts
Facility census: 67
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jean Obermier | Registered Nurse | Representative of the Department of Health and Human Services who conducted the investigation |
| Susan Griepentrost | Registered Nurse | Representative of the Department of Health and Human Services who conducted the investigation |
| Nancy Hauschild | Nutrition/dietitian | Representative of the Department of Health and Human Services who conducted the investigation |
| Eve Lewis | Program Manager | Office of LTC Facilities, Licensure Unit, signed the correspondence |
Inspection Report
Annual Inspection
Census: 71
Deficiencies: 13
Oct 28, 2014
Visit Reason
An unannounced visit was conducted to investigate a complaint and annual survey at Wedgewood Care Center from October 28, 2014 to November 4, 2014. The investigation included review of resident records, observation of care, and interviews with residents, family, and staff.
Findings
The facility was found deficient in multiple areas including dignity and respect of individuality, reasonable accommodation of needs/preferences, housekeeping and maintenance services, provision of care for highest well-being, ADL care for dependent residents, catheter care and UTI prevention, accident hazards and supervision, safe and comfortable environment, and quality assessment and assurance committee compliance. Specific issues included failure to provide adequate hygiene and grooming, inadequate bathing choices, low water temperatures, skin breakdown, incomplete oral care, incomplete incontinent care, unsafe environmental conditions, and repeated deficiencies from prior surveys.
Complaint Details
The complaint investigation included allegations that the facility failed to ensure an appropriate reason for involuntary discharge and failed to provide care and treatment for bladder elimination. The facility was found to have appropriate reason for involuntary discharge. However, the facility failed to provide complete perineal care to an incontinent resident, which was substantiated and cited.
Severity Breakdown
Level D: 5
Level E: 7
Level F: 1
Deficiencies (13)
| Description | Severity |
|---|---|
| Facility staff failed to provide assistance with cares and daily hygiene to promote clean, odor free and dignified appearance for two sampled residents. | Level D |
| Facility failed to provide choices and accommodate residents individual needs for bathing including two sampled residents. | Level D |
| Facility failed to maintain water temperatures that weren't cold for multiple resident rooms and shower rooms. | Level E |
| Facility failed to ensure that one sampled resident's skin was assessed and interventions were implemented to prevent skin breakdown or the spread of infection. | Level E |
| Facility failed to ensure that three residents were provided dental care according to their care plans and failed to ensure one resident was provided bathing and grooming to prevent accumulation of black debris behind the ear. | Level D |
| Facility failed to cleanse one resident after an incontinent episode. | Level D |
| Facility failed to ensure a grab bar in one room was free of sharp edges. | Level D |
| Facility failed to provide a safe, secure environment for five wandering residents with two unlocked, unalarmed courtyard areas accessible 24 hours a day. | Level E |
| Facility failed to ensure that three deficiencies cited at the previous annual survey were corrected, including skin assessment, incontinent care, and accident prevention. | Level E |
| Facility failed to maintain sprinkler heads in 3 of 4 smoke compartments, including painted sprinkler heads and TV cables wrapped around sprinkler pipes. | Level E |
| Facility failed to maintain corridors free of obstructions in 2 of 4 smoke compartments, including couches, chairs, plants, and trash cans blocking exit corridors. | Level E |
| Facility failed to not use decorations of flammable character in 2 of 4 smoke compartments, with Halloween decorations hung from ceilings without flame retardant documentation. | Level E |
| Facility failed to maintain the emergency generator in accordance with NFPA 110, including failure to document load testing, battery inspections, electrical and exhaust system inspections. | Level F |
Report Facts
Facility census: 71
Residents affected: 2
Residents affected: 1
Residents affected: 3
Residents affected: 5
Residents affected: 36
Sprinkler heads affected: 3
Smoke compartments: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Cheryl Schulz | Administrator | Named in complaint investigation and informal dispute resolution correspondence |
| Eve Lewis | Program Manager | Signed Informal Dispute Resolution report |
| Kimberly A. Divis | RN NSSC II | Conducted Informal Dispute Resolution Conference |
Inspection Report
Complaint Investigation
Census: 71
Deficiencies: 0
Jun 9, 2014
Visit Reason
An unannounced visit was conducted to investigate multiple complaints regarding care and supervision at Wedgewood Care Center.
Findings
The investigation found no violations related to the allegations including incontinence care, supervision, abuse prevention, safe transfers, fall reporting, catheter care, supervision outside the facility, and neglect. The facility was found to be in compliance with all regulatory requirements.
Complaint Details
The complaint investigation addressed multiple allegations including failure to provide care to prevent incontinence, failure to supervise residents, failure to prevent physical abuse, failure to transfer residents safely, failure to report falls with injury, failure to provide adequate catheter care, failure to ensure medical need for catheters, failure to remove catheters appropriately, failure to supervise residents outside the facility, and failure to protect residents from neglect. All allegations were found to be unsubstantiated with no violations.
Report Facts
Residents with fractures: 3
Census: 71
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jean Obermier | Registered Nurse | Investigator conducting the complaint investigation. |
| Frances Prokop | Registered Nurse | Investigator conducting the complaint investigation. |
| Nancy Hauschild | Nutrition/dietitian | Investigator conducting the complaint investigation. |
| Eve Lewis | Program Manager | Signed the report as Program Manager, Office of Long Term Care Facilities. |
Inspection Report
Annual Inspection
Census: 67
Deficiencies: 10
Aug 7, 2013
Visit Reason
Annual inspection of Wedgewood Care Center to assess compliance with federal and state regulations including resident rights, safety, and care standards.
Findings
The facility was found deficient in multiple areas including failure to ensure residents' right to private telephone access, failure to provide written discharge notices to residents, inadequate care to prevent skin injuries and infections, unsafe environmental conditions including fire safety code violations, electrical hazards, and infection control lapses.
Severity Breakdown
SS=D: 6
SS=E: 4
Deficiencies (10)
| Description | Severity |
|---|---|
| Failure to ensure three residents had access to private telephone use without being overheard. | SS=D |
| Failure to provide written discharge notices to two residents. | SS=D |
| Failure to provide necessary care and services to protect skin integrity for two residents with bruises and skin tears. | SS=D |
| Failure to individualize toileting schedule to prevent urinary odor and maintain continence for one resident. | SS=D |
| Failure to ensure resident environment free of accident hazards; shower chair with ripped netting and safety pins exposed. | SS=E |
| Failure to maintain infection control; body fluid spill not properly cleaned leading to potential cross contamination. | SS=E |
| Failure to provide smoke barriers with required fire resistance rating allowing potential smoke migration between compartments. | SS=E |
| Failure to maintain exit doors with visible and posted delayed egress signage. | SS=E |
| Failure to regulate soiled linen receptacle capacity and self-closing doors in hazardous areas. | SS=E |
| Failure to use electrical wiring and equipment in accordance with NFPA 70; use of extension cords and damaged outlets. | SS=D |
Report Facts
Facility census: 67
Residents affected by telephone privacy deficiency: 3
Residents affected by discharge notice deficiency: 2
Residents affected by fire safety smoke barrier deficiency: 25
Residents affected by exit door signage deficiency: 31
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| SS K | Social Services | Interviewed regarding discharge notice and bed hold policy for Resident 62 |
| NA L | Nurse's Aide | Interviewed about Resident 15's resistive behavior and lack of arm protection |
| NA M | Nurse's Aide | Interviewed about Resident 94's incontinence and shower chair condition |
| Assistant Director of Nursing | ADON | Interviewed about Resident 15 care plan, Resident 94 incontinence, infection control, and shower cleaning |
| Maintenance A | Maintenance Staff | Confirmed fire safety penetrations, exit signage issues, soiled linen storage, electrical hazards |
| Administrator | Facility Administrator | Interviewed about telephone privacy phone availability and discharge notice documentation |
Inspection Report
Routine
Census: 66
Deficiencies: 1
Feb 11, 2013
Visit Reason
The inspection was conducted to assess compliance with regulations governing licensure of skilled nursing facilities, focusing on pharmaceutical services and accurate medication administration.
Findings
The facility failed to review admission orders for physician-prescribed medications and failed to administer two prescribed doses of injectable anticoagulant medication (Lovenox) to one resident. The issue was due to missed transcription of handwritten physician orders not included in the initial faxed admission plan.
Severity Breakdown
SS=D: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to review admission orders for physician prescribed medications and failure to administer two prescribed doses of injectable anticoagulation medications to one resident. | SS=D |
Report Facts
Facility census: 66
Sample size: 6
Missed doses: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Director of Nursing (DON) | Interviewed regarding missed medication doses and order review process | |
| LPN-A | Interviewed about review and comparison of admission medication orders | |
| LPN-B | Interviewed about review of physician orders upon admission/transfer |
Inspection Report
Routine
Census: 65
Capacity: 76
Deficiencies: 3
Jun 13, 2012
Visit Reason
The inspection was a routine survey to assess compliance with state and federal regulations governing skilled nursing facilities, including housekeeping, maintenance, accident hazards, and life safety code standards.
Findings
The facility was found deficient in housekeeping and maintenance services, failing to maintain sanitary and orderly conditions in resident rooms and the main dining room. There were also safety hazards including broken fixtures and exposed sharp edges. Additionally, combustible storage was improperly stored in hazardous areas, increasing fire risk. The facility census was 65 of 76 beds.
Severity Breakdown
SS=E: 2
SS=D: 1
Deficiencies (3)
| Description | Severity |
|---|---|
| Failed to provide maintenance, repair and housekeeping services to Resident Rooms and the main dining room, including damaged baseboards, loose wood pieces, jagged window frames, and holes in wall protectors. | SS=E |
| Failed to ensure resident environment was free of accident hazards, including broken light switch cover, broken shower knob, and floor drainage cover creating a hole. | SS=D |
| Failed to keep combustible storage inside a room protected as a hazardous area in 1 of 4 smoke compartments, increasing fire risk for 24 residents in C and D Wings. | SS=E |
Report Facts
Facility census: 65
Total capacity: 76
Residents affected: 24
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Maintenance A | Confirmed findings regarding combustible storage during fire safety inspection. |
Inspection Report
Routine
Census: 67
Deficiencies: 5
Jun 21, 2011
Visit Reason
The inspection was conducted to assess compliance with regulatory requirements related to resident activities, care planning, and life safety code standards.
Findings
The facility failed to provide an ongoing activity program that met the interests and psychosocial well-being of residents, specifically Resident 45 and 85. The care plan for Resident 45 was not reviewed and revised to reflect current interests and needs. Additionally, the facility failed to maintain the fire alarm system calibration, had a fire extinguisher installed above the allowed height, and had electrical safety issues including lack of GFCI protection and use of splitters.
Severity Breakdown
SS=D: 2
Deficiencies (5)
| Description | Severity |
|---|---|
| Failed to provide an ongoing activity program that reflected the interests and psychosocial well-being for 2 of 20 sampled residents. | SS=D |
| Failed to review and revise the comprehensive care plan for one resident to reflect current interests and abilities. | SS=D |
| Failed to maintain the fire alarm system calibration in accordance with NFPA 72. | — |
| Fire extinguisher mounted above the maximum height allowed by NFPA 10. | — |
| Electrical wiring and equipment not in accordance with NFPA 70, including lack of GFCI protection near sinks, use of a 3-outlet splitter, and uncovered wiring. | — |
Report Facts
Facility census: 67
Sample size: 20
Fire alarm calibration last performed: Jan 28, 2009
Fire extinguisher mounting height: 74
Residents affected by electrical issues: 12
Notice
Capacity: 76
Deficiencies: 0
APP2018
Visit Reason
This document serves as a licensure renewal application for Wedgewood Care Center, verifying that the facility's SNF/NF dual certification is licensed through the indicated renewal date.
Findings
The documents confirm the facility meets statutory requirements for licensure renewal and include ownership information, services provided, and occupancy permit details.
Report Facts
Total licensed beds: 76
Renewal fees: 1750
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sherrill Acton | Administrator | Named in the licensure renewal application. |
| Angela Cornelius | Director of Nursing | Named in the licensure renewal application. |
| Bruce J. Mackey Jr. | President & Chief Executive Officer | Listed as an officer in ownership control documents. |
| R. Scott Herzig | Senior Vice President & Chief Operating Officer | Listed as an officer in ownership control documents. |
| Richard A. Doyle | Treasurer & Chief Financial Officer | Listed as an officer in ownership control documents. |
| Katherine E. Potter | Vice President, General Counsel & Assistant Secretary | Listed as an officer in ownership control documents. |
| Jennifer B. Clark | Corporate Secretary | Listed as an officer in ownership control documents. |
| Gerard M. Martin | Director | Listed as a director/trustee in ownership control documents. |
Notice
Capacity: 76
Deficiencies: 0
APP2019
Visit Reason
This document serves to verify the renewal of the SNF/NF dual certification license for Wedgewood Care Center and provides ownership, licensing, and occupancy permit information.
Findings
The documents confirm the facility's licensed capacity of 76 beds, ownership structure under Five Star Quality Care-NE, LLC, and an occupancy permit issued by the Nebraska State Fire Marshal dated 2/18/2018.
Report Facts
Licensed capacity: 76
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sherrill Acton | Administrator | Named as facility administrator on renewal application. |
| Mary Rose | Director of Nursing | Named as Director of Nursing on renewal application. |
| Katherine E. Potter | President and Chief Executive Officer | Listed as officer of Five Star Quality Care-NE, LLC. |
| Richard A. Doyle | Executive Vice President, Chief Financial Officer and Treasurer | Listed as officer of Five Star Quality Care-NE, LLC. |
| Lisa J. Cooney | Senior Vice President, General Counsel and Assistant Secretary | Listed as officer of Five Star Quality Care-NE, LLC. |
| Jennifer B. Clark | Secretary | Listed as officer of Five Star Quality Care-NE, LLC. |
| Gerard M. Martin | Director | Listed as director/trustee of Five Star Quality Care-NE, LLC. |
| Adam D. Portnoy | Director | Listed as director/trustee of Five Star Quality Care-NE, LLC. |
Notice
Capacity: 76
Deficiencies: 0
APP2020
Visit Reason
The document serves as a renewal application for the nursing home license of Azria Health Broadwell and includes verification of licensure and occupancy permit information.
Findings
The documents confirm that Azria Health Broadwell meets statutory requirements for licensure renewal as a Skilled Nursing Facility with a licensed capacity of 76 beds. The Nebraska State Fire Marshal occupancy permit also confirms the maximum occupancy of 76 beds.
Report Facts
Total licensed beds: 76
Renewal license fees: 1750
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sherrill Acton | Administrator | Named in the Nursing Home Licensure Renewal Application. |
| Nancy Stephens | Director of Nursing | Named in the Nursing Home Licensure Renewal Application. |
| Steve Hornung | Owner | Listed as owner in ownership control list and signed renewal application. |
| Noah Kaminer | Owner | Listed as owner in ownership control list and signed renewal application. |
Notice
Capacity: 76
Deficiencies: 0
APP2022
Visit Reason
This document serves as a renewal application for the nursing home license of Azria Health Broadwell and includes verification of licensure and occupancy permit information.
Findings
The documents confirm that Azria Health Broadwell is licensed as a Skilled Nursing Facility with a total capacity of 76 beds and meets statutory requirements for certification. The occupancy permit was issued on 3/3/2022.
Report Facts
Total licensed beds: 76
Renewal license fees: 1550
Renewal license fees: 1750
Renewal license fees: 1950
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Tasha Stauffer | Administrator | Named in the Nursing Home Licensure Renewal Application. |
| Karry Bloomquist | Director of Nursing | Named in the Nursing Home Licensure Renewal Application. |
| Aaron "Noah" Kaminer | Authorized Representative | Signed the Nursing Home Licensure Renewal Application as authorized representative. |
| Steve Hornung | Authorized Representative | Signed the Nursing Home Licensure Renewal Application as authorized representative. |
Document
Capacity: 76
Deficiencies: 0
APP2023
Visit Reason
The documents serve to verify licensure renewal, ownership, and occupancy permit status for Azria Health Broadwell nursing facility.
Findings
No inspection findings or deficiencies are reported. The documents confirm licensure renewal, ownership verification, and occupancy permit issuance with a maximum capacity of 76 beds.
Report Facts
Total licensed beds: 76
Renewal license fees: 1550
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Amanda Sherman | Administrator | Named on the Nursing Home Licensure Renewal Application |
| Karry Bloomquist | Director of Nursing | Named on the Nursing Home Licensure Renewal Application |
| Aaron "Noah" Kaminer | Authorized Representative | Signed the Nursing Home Licensure Renewal Application and mentioned in ownership verification letter |
| Steve Hornung | Authorized Representative | Signed the Nursing Home Licensure Renewal Application and mentioned in ownership verification letter |
Notice
Deficiencies: 0
DAN101415
Visit Reason
The notice was issued to inform Wedgewood Care Center of disciplinary action placing their Skilled Nursing Facility license on probation for 90 days starting November 19, 2015, due to violations related to medication administration and failure to monitor residents for adverse consequences.
Findings
The facility failed to ensure residents were monitored for adverse consequences from medication received and failed to ensure residents did not receive medications over the recommended dosage level. Violations were found related to accidents, medication errors, and housekeeping and maintenance.
Report Facts
Probation period length: 90
Dates related to disciplinary action: 2015
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Eve Lewis | RNC, Program Manager | Contact for submission of reports and responses related to the disciplinary action |
| Courtney N. Phillips | Chief Executive Officer | Signed the Notice of Disciplinary Action |
| Becky Wisell | Administrator, Licensure Unit | Signed the Notice of Disciplinary Action |
| Linda Stenvers | Staff Assistant II | Certified mailing of the Notice of Disciplinary Action |
| Cheryl Schulz | Administrator | Facility administrator addressed in the follow-up letter dated February 19, 2016 |
Loading inspection reports...
