Deficiencies (last 6 years)
Deficiencies (over 6 years)
0.7 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
83% better than Nebraska average
Nebraska average: 4.2 deficiencies/yearDeficiencies per year
4
3
2
1
0
Census
Latest occupancy rate
49 residents
Based on a March 2014 inspection.
This facility has shown a decline in demand based on occupancy rates.
Census over time
Inspection Report
Renewal
Capacity: 100
Deficiencies: 0
Apr 11, 2019
Visit Reason
The document is a licensure renewal application and verification for Shalimar Gardens Assisted Living facility, confirming the facility's license renewal and compliance with statutory requirements.
Findings
The facility is licensed as an assisted-living facility with a maximum capacity of 100 beds and includes an Alzheimer's Memory Care Endorsement for 16 beds. The application details the facility's philosophy, admission criteria, discharge criteria, staffing ratios, training requirements, physical environment, resident activities, family support programs, and cost/fees of care.
Report Facts
Total licensed capacity: 100
Alzheimer's Memory Care beds: 16
Staffing ratio day/evening: 5
Staffing ratio overnight: 8
Cost Level 1 Shared Companion Suite: 4325
Cost Level 2 Shared Companion Suite: 5145
Cost Level 1 Private Suite: 5505
Cost Level 2 Private Suite: 6125
Cost Level 1 Private Deluxe Suite: 5825
Cost Level 2 Private Deluxe Suite: 6445
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Bethany Fickenscher | Administrator | Named as facility administrator and contact for the licensure renewal application |
| Farhan Khan | Named as 50% owner in ownership information | |
| Nate Underwood | Named as 50% owner in ownership information |
Inspection Report
Renewal
Capacity: 100
Deficiencies: 0
Mar 31, 2017
Visit Reason
The document is a renewal application and related documentation for the assisted living facility license and Alzheimer's Special Care Unit Disclosure and Memory Care Endorsement for Shalimar Gardens Assisted Living.
Findings
The facility is licensed as an assisted living facility with a special care unit endorsement for Alzheimer's and related dementias. The documentation includes detailed criteria for resident placement, discharge, care plans, staffing ratios, staff training, physical environment features, resident activities, and cost of care.
Report Facts
Total licensed capacity: 100
Special care unit capacity: 16
Staffing ratio day/evening: 5
Staffing ratio overnight: 8
Cost per month - Studio Level I: 5195
Cost per month - Studio Level II: 5795
Cost per month - Studio Deluxe Level I: 5495
Cost per month - Studio Deluxe Level II: 6095
Cost per month - Companion Level I: 3995
Cost per month - Companion Level II: 4795
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Beth Fickenscher | Administrator | Named as facility administrator and contact for the assisted living facility |
| Farhan Khan | Named as 50% owner of Heritage Partners LLC, general partner of Shalimar LLC | |
| Nate Underwood | Named as 50% owner of Heritage Partners LLC, general partner of Shalimar LLC and signatory on renewal documents | |
| James Sloup | Deputy State Fire Marshal | Inspected the facility for occupancy permit |
Inspection Report
Complaint Investigation
Deficiencies: 0
Nov 21, 2016
Visit Reason
An unannounced visit was conducted to investigate a complaint at Shalimar Gardens Assisted Living regarding failure to provide appropriate interventions for residents at risk for falls and failure to follow family requests for care issues.
Findings
The facility was found to provide appropriate interventions for residents at risk for falls and to follow family requests for care issues when appropriate. No violations were identified related to the allegations after observations, interviews, and record reviews.
Complaint Details
The complaint alleged failure to provide appropriate interventions for residents at risk for falls and failure to follow family requests for care issues. Both allegations were found to be unsubstantiated with no violations identified.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Dan Taylor | RN, Training Coordinator | Signed the report as Training Coordinator, Office of LTC Facilities - Licensure Unit - Division of Public Health |
Inspection Report
Complaint Investigation
Census: 49
Deficiencies: 0
Mar 5, 2014
Visit Reason
An unannounced visit was conducted to investigate a complaint at Shalimar Gardens Assisted Living on March 5, 2014, regarding allegations of neglect and failure to ensure medication aide competency and notification of family or responsible party of change in condition.
Findings
The facility was found to be in compliance with abuse policies and procedures, medication aides were competent to provide medications, and the facility did not fail to notify family or responsible parties of changes in condition. No violations were identified related to the allegations.
Complaint Details
The investigation addressed allegations that the facility failed to protect residents from neglect, failed to report allegations of neglect, failed to ensure medication aides were competent, and failed to notify family or responsible parties of changes in condition. All allegations were found to have no violations.
Report Facts
Resident census: 44
Resident census: 49
Records reviewed: 4
Medication administrations observed: 10
Staff interviews: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Travis Castner | Registered Nurse | Conducted complaint investigation |
| Daniel Woodward | Registered Nurse | Conducted complaint investigation |
| Eve Lewis | Program Manager | Signed correspondence as Program Manager of Office of Long Term Care Facilities |
Inspection Report
Complaint Investigation
Census: 84
Deficiencies: 0
Jan 16, 2014
Visit Reason
An unannounced visit was conducted to investigate a complaint at Shalimar Gardens Assisted Living on January 16, 2014, regarding allegations of misappropriation.
Findings
The facility was found to protect residents from misappropriation, with no violation related to this issue. Records and staff interviews confirmed policies and procedures were in place to prevent misappropriation of resident property.
Complaint Details
The complaint alleged the facility failed to protect residents from misappropriation. The investigation found no violation and the complaint was not substantiated.
Report Facts
Facility census: 84
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Christine Hale | Registered Nurse | Conducted the complaint investigation |
| Eve Lewis | Program Manager | Signed the report as representative of the Licensure Unit |
Inspection Report
Complaint Investigation
Census: 81
Deficiencies: 3
Jul 28, 2011
Visit Reason
The inspection and complaint investigation were conducted following allegations related to misappropriation of residents' valuables and property at Shalimar Gardens Assisted Living.
Findings
The facility was found to be in compliance with regulations related to the complaint allegations of misappropriation. However, an unrelated violation concerning complex nursing interventions and medication record documentation was discovered during the inspection.
Complaint Details
The complaint investigation was related to allegations of misappropriation of residents' valuables and property. The facility was found to be in compliance with these allegations, with no evidence of failure to protect residents from misappropriation.
Deficiencies (3)
| Description |
|---|
| Facility staff failed to specify how direction and monitoring will occur when medication aides perform additional activities authorized by regulations, including provision of PRN medications for 1 out of 9 residents reviewed. |
| Facility failed to maintain sufficient medication records to assure residents received medications as authorized by a medical practitioner for 2 out of 9 residents reviewed (Residents 4 and 6). |
| Resident record reviews showed missing documentation of daily dressing changes and wound care for Residents 4 and 6. |
Report Facts
Facility census: 81
Inspection dates: July 25, 2011 - July 28, 2011
Days to correct violations: 90
Days to submit statement of compliance: 10
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Anna Harrison | Registered Nurse | Surveyor who conducted the inspection and complaint investigation |
| Ina Carroll | Administrator | Facility administrator who submitted the Plan of Correction |
| Eve Lewis | RN-C, Administrator | Office of Long Term Care Facilities, signed correspondence related to inspection and compliance |
Inspection Report
Complaint Investigation
Census: 99
Deficiencies: 1
Oct 26, 2010
Visit Reason
The inspection was conducted as a complaint investigation at Shalimar Gardens Assisted Living in Fremont, NE on October 26 and 27, 2010, due to allegations of failure to administer medication according to practitioner's orders.
Findings
The facility failed to accurately document the administration of medication according to practitioner's orders, resulting in one substantiated violation. Other allegations related to discharge notice, resident funds, meals, services, and abuse investigations were found to be in compliance with no violations.
Complaint Details
The complaint investigation found one substantiated violation related to medication administration documentation. The violation was substantiated and corrective actions were planned.
Deficiencies (1)
| Description |
|---|
| Failure to accurately document the administration of medication according to practitioner's orders. |
Report Facts
Facility census: 99
Violations substantiated: 1
Correction deadline: 90
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ina Carroll | Executive Director | Named in Plan of Correction response and signature on corrective action |
| Lori Frodsham | Registered Nurse | Surveyor conducting complaint investigation |
| Connie Heavin | Social Worker | Surveyor conducting complaint investigation |
Notice
Capacity: 100
Deficiencies: 0
APP2016
Visit Reason
The document serves as a licensure renewal application and verification for Shalimar Gardens Assisted Living facility, confirming its licensed status and renewal date.
Findings
No inspection findings are reported; the documents include licensing renewal, ownership information, occupancy permit, facility floor plans, and service descriptions.
Report Facts
Total licensed beds: 100
Maximum occupancy: 100
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Beth Fickenscher | Administrator | Named on the licensure renewal application (page 2). |
| Farhan Khan | Listed as 50% owner and general partner of Heritage Partners LLC (page 3). | |
| Nate Underwood | Listed as 50% owner and general partner of Heritage Partners LLC (page 3). | |
| Rose Bochnicek | Office Administrator | Named in email correspondence and service description document (page 15). |
| Donna Jobman | Staff Assistant II | Named in email correspondence (page 15). |
Notice
Capacity: 100
Deficiencies: 0
APP2018
Visit Reason
This document serves as a licensure renewal application and verification for Shalimar Gardens Assisted Living, including Alzheimer's Memory Care Endorsement renewal.
Findings
The document confirms the facility's licensure renewal status, ownership information, facility capacity, and detailed disclosure about Alzheimer's Memory Care services, staffing, training, physical environment, resident activities, family support, and fees.
Report Facts
Total licensed beds: 100
Alzheimer's Memory Care Endorsement capacity: 16
Staffing ratio day/evening: 5
Staffing ratio overnight: 8
License renewal expiration date: Expires April 30, 2019, as shown on the renewal card image on page 1.
License number: 257
Cost/Fees of care - Studio Level I: 5345
Cost/Fees of care - Studio Level II: 5945
Cost/Fees of care - Studio Deluxe Level I: 5645
Cost/Fees of care - Studio Deluxe Level II: 6245
Cost/Fees of care - Companion Level I: 4195
Cost/Fees of care - Companion Level II: 4995
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Beth Fickenscher | Administrator | Named as facility administrator and contact for Alzheimer's Memory Care Endorsement application. |
| Farhan Khan | Authorized Representative | Authorized representative signing the renewal application. |
| Nate Underwood | Authorized Representative | Authorized representative signing the renewal application. |
Notice
Capacity: 100
Deficiencies: 0
APP2020
Visit Reason
This document serves to verify that Shalimar Gardens Assisted Living is licensed through the date indicated on the renewal card and includes renewal application information.
Findings
The document confirms the facility meets statutory requirements as an assisted-living facility and provides details on ownership, capacity, special populations served, and staffing patterns.
Report Facts
Total licensed beds: 100
Alzheimer's unit beds: 16
Staffing ratio day shift: 5
Staffing ratio overnight shift: 8
Cost of care - Shared Companion Suite Level 1: 4455
Cost of care - Shared Companion Suite Level 2: 5295
Cost of care - Private Suite Level 1: 5665
Cost of care - Private Suite Level 2: 6295
Cost of care - Private Deluxe Level 1: 5995
Cost of care - Private Deluxe Level 2: 6645
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Beth Fickenscher | Administrator | Named as facility administrator on pages 2 and 8. |
| Farhan Khan | Authorized Representative | Signed renewal application as authorized representative on page 2. |
| Nathan Underwood | Authorized Representative | Signed renewal application as authorized representative on page 2. |
| Shawn Lahr | Authorized Representative | Signed applicant signature on renewal application on page 10. |
Document
Capacity: 100
Deficiencies: 0
APP2021
Visit Reason
The document serves as a renewal application for the assisted-living facility license of Shalimar Gardens Assisted Living and includes related licensing and occupancy permits.
Findings
The documents verify that Shalimar Gardens Assisted Living meets statutory requirements for licensure as an assisted-living facility with a total licensed capacity of 100 beds and includes a special Alzheimer's care unit with 20 beds. It also contains fire evacuation plans and ownership details.
Report Facts
Total licensed beds: 100
Alzheimer's special care unit beds: 20
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Beth Fickenscher | Administrator | Named as facility administrator on renewal application and Alzheimer's special care unit disclosure. |
| Farhan Khan | Named as authorized representative and 50% owner in ownership information. | |
| Nate Underwood | Named as authorized representative and 50% owner in ownership information. |
Notice
Capacity: 100
Deficiencies: 0
APP2022
Visit Reason
The document serves as a renewal application and verification of licensure for Shalimar Gardens Assisted Living facility, including renewal of Alzheimer's Memory Care Endorsement and occupancy permit details.
Findings
The documents confirm that Shalimar Gardens Assisted Living meets statutory requirements for licensure renewal through April 30, 2023, with a total licensed capacity of 100 beds and 20 beds designated for Alzheimer's Memory Care. The Nebraska State Fire Marshal occupancy permit is also included, certifying 100 beds.
Report Facts
Total licensed beds: 100
Alzheimer's Memory Care beds: 20
License expiration date: Apr 30, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Beth Fickenscher | Administrator | Named as administrator and authorized representative on the renewal application and Alzheimer's Memory Care Endorsement application. |
Notice
Capacity: 100
Deficiencies: 0
APP2023
Visit Reason
The document serves as a renewal application for the assisted-living facility license for Shalimar Gardens Assisted Living.
Findings
The documents confirm the facility meets statutory requirements for assisted living, including licensing renewal, occupancy permit for 100 beds, and Alzheimer's Memory Care endorsement with 20 beds capacity.
Report Facts
Total licensed beds: 100
Alzheimer's Memory Care beds: 20
Renewal application date: May 19, 2023
Occupancy permit issue date: Oct 10, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Libby Morgan | Administrator | Named as facility administrator on renewal application and Alzheimer's Memory Care endorsement application. |
| Farhan Khan | Authorized Representative | Signed the renewal application as an authorized representative. |
| Nate Undrewood | Authorized Representative | Signed the renewal application as an authorized representative. |
Document
Capacity: 100
Deficiencies: 0
APP2024
Visit Reason
The document serves as a renewal application for the assisted-living facility license of Shalimar Gardens Assisted Living, including verification of licensing status, ownership details, and occupancy permit information.
Findings
The documents confirm that Shalimar Gardens Assisted Living is licensed as an assisted-living facility with a total licensed capacity of 100 beds, including 20 beds designated for Alzheimer's/Special Care Unit. The occupancy permit was issued on 2023-10-09, and the facility meets statutory requirements for assisted living and memory care endorsement.
Report Facts
Total licensed beds: 100
Alzheimer's/Special Care Unit beds: 20
Occupancy permit maximum beds: 100
Renewal license expiration date: Apr 30, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ashley Hinrichs | Administrator | Named as facility administrator and contact on renewal and Alzheimer's endorsement application |
| Farhan Khan | Listed as 50% owner of Heritage Partners LLC, which controls Heritage Holdings L.P., the ownership entity | |
| Nate Underwood | Listed as 50% owner of Heritage Partners LLC, which controls Heritage Holdings L.P., the ownership entity |
Notice
Capacity: 100
Deficiencies: 0
APP2025
Visit Reason
This document serves as a renewal application and verification of licensure for Shalimar Gardens Assisted Living facility, including occupancy permit and Alzheimer's special care unit endorsement.
Findings
The documents confirm the facility's licensure renewal status, ownership information, maximum licensed capacity of 100 beds, and approval of occupancy by the State Fire Marshal. The Alzheimer's special care unit endorsement is also renewed.
Report Facts
Total licensed beds: 100
Alzheimer's unit beds: 20
Occupancy permit maximum beds: 100
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ashley Hinrichs | Administrator | Named as administrator on renewal application and Alzheimer's special care unit application (pages 2 and 8). |
| Jim Kenney | Deputy State Fire Marshal | Inspected and approved occupancy permit (page 4). |
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