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| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy | J2 | K· | L· |
| Actual harm | G3 | H· | I· |
| Potential harm | D37 | E10 | F4 |
| Minimal | A· | B· | C· |
CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.
Federal certification and the state license are different records. A nursing home is licensed by the state and, separately, certified by CMS to bill Medicare and/or Medicaid. We link them by the CCN when the state publishes it; otherwise by exact address, house number and street, or exact name within the same ZIP, and label that link as inferred. Never by name alone.
| Date | Domain | Survey types | Citations | Most severe | Open | |
|---|---|---|---|---|---|---|
| May 21, 2026 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Oct 2, 2025 | Fire safety | Fire Safety Standard | 4 | Potential harm | — | Open → |
| Oct 2, 2025 | Health | Health Complaint, Health Standard | 8 | Immediate jeopardy | — | Open → |
| May 30, 2025 | Health | Health Complaint | 2 | Actual harm | — | Open → |
| Mar 13, 2025 | Health | Health Complaint | 4 | Potential harm | — | Open → |
| Oct 31, 2024 | Fire safety | Fire Safety Standard | 5 | Potential harm | — | Open → |
| Oct 31, 2024 | Health | Health Standard | 8 | Potential harm | — | Open → |
| Aug 12, 2024 | Health | Health Complaint | 2 | Actual harm | — | Open → |
| May 14, 2024 | Health | Health Complaint | 2 | Potential harm | — | Open → |
| Nov 2, 2023 | Health | Health Complaint | 2 | Immediate jeopardy | — | Open → |
| Aug 21, 2023 | Fire safety | Fire Safety Standard | 4 | Potential harm | — | Open → |
| Aug 21, 2023 | Health | Health Standard | 14 | Actual harm | — | Open → |
| Date | Type | Amount | Payment denial | Record |
|---|---|---|---|---|
| Oct 2, 2025 | Civil money penalty (fine) | $16,588 | — | 165524|Fine|136620 |
| Nov 2, 2023 | Civil money penalty (fine) | $11,183 | — | 165524|Fine|79167 |
| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy | J2 | K· | L· |
| Actual harm | G3 | H· | I· |
| Potential harm | D37 | E10 | F4 |
| Minimal | A· | B· | C· |
| Date | Tag | Deficiency | Scope / severity | Correction | Flags |
|---|---|---|---|---|---|
| May 21, 2026 | F-0602 | Protect each resident from the wrongful use of the resident's belongings or money. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Past non-compliance | Complaint |
| Oct 2, 2025 | F-0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Clinical care | J · Immediate jeopardy Isolated | Past non-compliance Jul 21, 2025 | Complaint |
“Corrected” does not erase a citation: the historical finding stays listed with its disposition. Narrative statements of deficiencies are not part of the CMS dataset; see Care Compare for the official inspection report.
CMS ratings apply to CMS-certified nursing homes only and are relative within each state. They are not a guarantee of any individual resident’s experience.
CMS legal business name of the certified provider. Operates 3 facilities.
Not part of a CMS-reported chain.
| Name | Type | Role (Carefield group) | CMS role text | Share | Since |
|---|---|---|---|---|---|
| Andrew Bishop | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Jul 1, 2024 |
| Chandra Gustafson | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Dec 29, 2023 |
| Genevieve Pfitzer | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Jun 21, 2025 |
| Diane Carlon | Individual | Corporate officer / director | CORPORATE DIRECTOR | not provided | Jan 1, 2024 |
| Susanne Eilts | Individual | Corporate officer / director | CORPORATE DIRECTOR | not provided | Jan 13, 2026 |
| Alice Goodell | Individual | Corporate officer / director | CORPORATE DIRECTOR | not provided | Jan 1, 2024 |
| Becky Kraul-Henkel | Individual | Corporate officer / director | CORPORATE DIRECTOR | not provided | Jan 13, 2026 |
| Greg Steensland | Individual | Corporate officer / director | CORPORATE DIRECTOR | not provided | Jan 12, 2025 |
| John Swalwell | Individual | Corporate officer / director | CORPORATE DIRECTOR | not provided | Jan 1, 2024 |
| Sharon Worthington | Individual | Corporate officer / director | CORPORATE DIRECTOR | not provided | Sep 1, 2021 |
| Diane Carlon | Individual | Corporate officer / director | CORPORATE OFFICER | not provided | Jan 12, 2025 |
| Greg Steensland | Individual | Corporate officer / director | CORPORATE OFFICER | not provided | Jan 13, 2026 |
| John Swalwell | Individual | Corporate officer / director | CORPORATE OFFICER | not provided | Jan 13, 2026 |
| Sharon Worthington | Individual | Corporate officer / director | CORPORATE OFFICER | not provided | Jan 13, 2026 |
| Andrew Bishop | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Jul 1, 2024 |
| Chandra Gustafson | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Dec 29, 2023 |
| Genevieve Pfitzer | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Jun 21, 2025 |
| Facility | Beds | CMS overall | Last inspection | Citations (window) | Fines |
|---|---|---|---|---|---|
| Bethany Home Sioux Falls 1901 South Holly Avenue, Sioux Falls, SD 57105 CCN 435096 | 52 | Dec 18, 2025 | 13 | — | |
| Bethany Home - Brandon 3012 E Aspen Blvd, Brandon, SD 57005 CCN 435130Abuse icon |
Coordinates as published by CMS (geocoding footnote 22).
| Facility | Distance | Beds | CMS overall | Last inspection | Citations (window) | Fines |
|---|---|---|---|---|---|---|
| Prairie Gate 16 Valley View Drive, Council Bluffs, IA 51503 CCN 165794 | 1.3 km | 72 | Aug 27, 2026 | 321 IJ1 harm1 open | $28k | |
| North Crest Living Center 34 Northcrest Drive, Council Bluffs, IA 51503 CCN 165290 | 1.3 km | 62 | Aug 26, 2025 | 50 | — | |
| Midlands Living Center L L C 2452 North Broadway, Council Bluffs, IA 51503 CCN 165447 | 2.5 km | 94 | Jan 8, 2026 | 16 | — | |
| Chapters Living of Council Bluffs 3000 Risen Son Blvd, Council Bluffs, IA 51503 CCN 165466SFF Candidate | 3.9 km | 102 | Jan 30, 2026 | 1011 IJ | $106k | |
| St. Joseph Villa Nursing Center 2305 South 10th Street, Omaha, NE 68108 CCN 285078 | 9.6 km | 184 | Jun 10, 2026 | 601 IJ2 harm | $28k | |
| Ambassador Health of Omaha 1540 North 72ndstreet, Omaha, NE 68114 CCN 285127 | 11.3 km | 146 | Jul 10, 2025 | 21 | — | |
| Adept Nursing & Rehab of Midtown 910 South 40th Street, Omaha, NE 68105 CCN 285218 | 12.9 km | 61 | Apr 29, 2026 | 35 | — | |
| Douglas County Health Center 4102 Woolworth Avenue, Omaha, NE 68105 CCN 285019 | 13.1 km | 254 | Oct 30, 2025 | 561 harm | — |
| Source | Record | Facts | Evidence | Source release | Retrieved |
|---|---|---|---|---|---|
| CMS Provider Information US-CMS | 165524 | name, address, phone, certification, certified_beds, ownership_type, legal_business_name, chain | Verified | Oct 1, 2026 | Nov 7, 2026 |
| CMS Provider Information US-CMS | 165524 | ratings, staffing, health_survey_score Five-Star ratings and PBJ staffing apply to the CMS-certified universe only. | Verified | Oct 1, 2026 | Nov 7, 2026 |
First seen by Carefield Nov 7, 2026 · last changed Nov 7, 2026. This record as JSON · Report a correction
| Oct 2, 2025 | K-0353 | Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Oct 1, 2025 |
| Oct 2, 2025 | K-0741 | Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Miscellaneous Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Oct 1, 2025 |
| Oct 2, 2025 | K-0761 | To conduct inspection, testing and maintenance of fire doors by qualified individuals. Miscellaneous Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Oct 1, 2025 |
| Oct 2, 2025 | K-0918 | Have generator or other power source capable of supplying service within 10 seconds. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Oct 1, 2025 |
| Oct 2, 2025 | F-0637 | Assess the resident when there is a significant change in condition Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Nov 25, 2025 |
| Oct 2, 2025 | F-0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Nov 25, 2025 |
| Oct 2, 2025 | F-0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Nov 25, 2025 |
| Oct 2, 2025 | F-0658 | Ensure services provided by the nursing facility meet professional standards of quality. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Nov 25, 2025 |
| Oct 2, 2025 | F-0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. Nursing and Physician Services Deficiencies · Staffing & supervision | E · Potential harm Pattern | Corrected Nov 25, 2025 | Complaint |
| Oct 2, 2025 | F-0760 | Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected Nov 25, 2025 |
| Oct 2, 2025 | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention | F · Potential harm Widespread | Corrected Nov 25, 2025 |
| May 30, 2025 | F-0658 | Ensure services provided by the nursing facility meet professional standards of quality. Resident Assessment and Care Planning Deficiencies · Clinical care | G · Actual harm Isolated | Past non-compliance Apr 5, 2025 | Complaint |
| May 30, 2025 | F-0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Past non-compliance May 12, 2025 | Complaint |
| Mar 13, 2025 | F-0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Past non-compliance Feb 14, 2025 | Complaint |
| Mar 13, 2025 | F-0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Past non-compliance Feb 14, 2025 | Complaint |
| Mar 13, 2025 | F-0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Mar 24, 2025 | Complaint |
| Mar 13, 2025 | F-0658 | Ensure services provided by the nursing facility meet professional standards of quality. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Mar 24, 2025 | Complaint |
| Oct 31, 2024 | K-0712 | Have simulated fire drills held at unexpected times. Miscellaneous Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Nov 7, 2024 |
| Oct 31, 2024 | K-0761 | To conduct inspection, testing and maintenance of fire doors by qualified individuals. Miscellaneous Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Nov 13, 2024 |
| Oct 31, 2024 | K-0918 | Have generator or other power source capable of supplying service within 10 seconds. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Nov 19, 2024 |
| Oct 31, 2024 | K-0921 | Ensure that testing and maintenance of electrical equipment is performed. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Nov 27, 2024 |
| Oct 31, 2024 | K-0923 | Have proper medical gas storage and administration areas. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Nov 5, 2024 |
| Oct 31, 2024 | F-0623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Jan 2, 2025 |
| Oct 31, 2024 | F-0625 | Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Jan 2, 2025 |
| Oct 31, 2024 | F-0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Jan 2, 2025 |
| Oct 31, 2024 | F-0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. Nursing and Physician Services Deficiencies · Staffing & supervision | E · Potential harm Pattern | Corrected Jan 2, 2025 |
| Oct 31, 2024 | F-0727 | Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. Nursing and Physician Services Deficiencies · Staffing & supervision | E · Potential harm Pattern | Corrected Jan 2, 2025 |
| Oct 31, 2024 | F-0744 | Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Jan 2, 2025 |
| Oct 31, 2024 | F-0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | E · Potential harm Pattern | Corrected Jan 2, 2025 |
| Oct 31, 2024 | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention | D · Potential harm Isolated | Corrected Jan 2, 2025 |
| Aug 12, 2024 | F-0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Clinical care | G · Actual harm Isolated | Corrected Aug 20, 2024 | Complaint |
| Aug 12, 2024 | F-0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Aug 20, 2024 | Complaint |
| May 14, 2024 | F-0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Resident Rights Deficiencies · Resident rights & abuse/neglect | E · Potential harm Pattern | Corrected May 30, 2024 | Complaint |
| May 14, 2024 | F-0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected May 30, 2024 | Complaint |
| Nov 2, 2023 | F-0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Clinical care | J · Immediate jeopardy Isolated | Corrected Nov 3, 2023 | Complaint |
| Nov 2, 2023 | F-0658 | Ensure services provided by the nursing facility meet professional standards of quality. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Nov 3, 2023 | Complaint |
| Aug 21, 2023 | F-0695 | Provide safe and appropriate respiratory care for a resident when needed. Quality of Life and Care Deficiencies · Clinical care | G · Actual harm Isolated | Corrected Sep 14, 2023 |
| Aug 21, 2023 | K-0291 | Install emergency lighting that can last at least 1 1/2 hours. Egress Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Sep 6, 2023 |
| Aug 21, 2023 | K-0741 | Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Miscellaneous Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Sep 6, 2023 |
| Aug 21, 2023 | K-0761 | To conduct inspection, testing and maintenance of fire doors by qualified individuals. Miscellaneous Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Sep 6, 2023 |
| Aug 21, 2023 | K-0923 | Have proper medical gas storage and administration areas. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Sep 6, 2023 |
| Aug 21, 2023 | F-0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Sep 14, 2023 |
| Aug 21, 2023 | F-0585 | Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Sep 14, 2023 |
| Aug 21, 2023 | F-0625 | Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Sep 14, 2023 |
| Aug 21, 2023 | F-0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Sep 14, 2023 |
| Aug 21, 2023 | F-0658 | Ensure services provided by the nursing facility meet professional standards of quality. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Sep 14, 2023 |
| Aug 21, 2023 | F-0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Sep 14, 2023 |
| Aug 21, 2023 | F-0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Sep 14, 2023 |
| Aug 21, 2023 | F-0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Sep 14, 2023 |
| Aug 21, 2023 | F-0690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Sep 14, 2023 |
| Aug 21, 2023 | F-0698 | Provide safe, appropriate dialysis care/services for a resident who requires such services. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Sep 14, 2023 |
| Aug 21, 2023 | F-0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. Nursing and Physician Services Deficiencies · Staffing & supervision | E · Potential harm Pattern | Corrected Sep 14, 2023 |
| Aug 21, 2023 | F-0760 | Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected Sep 14, 2023 |
| Aug 21, 2023 | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention | D · Potential harm Isolated | Corrected Sep 14, 2023 |
Reported from Payroll-Based Journal (PBJ) data, as published by CMS. Case-mix adjusted total: 4.65 (case-mix index 1.19).
| 60 |
| May 28, 2026 |
291 IJ3 harm |
| $62k |