01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-09-03 | 19 | 2025-09-03 | 6 |
| Cycle 2 | 2024-07-11 | 12 | 2024-07-11 | 3 |
| Cycle 3 | 2023-07-13 | 6 | 2023-07-13 | 12 |
CMS CCN 2851492026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Maple Crest Health Center
2824 North 66Th Avenue · Omaha, NE 68104 · Douglas County
Certified beds175CMS provider file
Recent citation rows58current CMS citation release
Penalty rows0current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
58 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 13 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-04-30 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2026-05-29 · complaint2026-04-30 · HEALTHF0585Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2026-05-29 · complaint2026-04-30 · HEALTHF0609Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Deficient, Provider has date of correction · 2026-05-29 · complaint2026-04-30 · HEALTHF0657Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Correction field: Deficient, Provider has date of correction · 2026-05-29 · complaint2026-04-30 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2026-05-29 · complaint2026-04-30 · HEALTHF0686Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2026-05-29 · complaint2026-04-30 · HEALTHF0698Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Correction field: Deficient, Provider has date of correction · 2026-05-29 · complaint2026-04-30 · HEALTHF0725Severity D · isolated; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Correction field: Deficient, Provider has date of correction · 2026-05-29 · complaint2026-04-30 · HEALTHF0760Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2026-05-29 · complaint2026-04-30 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2026-05-29 · complaint2025-09-03 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2025-10-182025-09-03 · HEALTHF0600Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Correction field: Deficient, Provider has date of correction · 2025-10-182025-09-03 · HEALTHF0609Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Deficient, Provider has date of correction · 2025-10-18 · complaint2025-09-03 · HEALTHF0638Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Assure that each resident’s assessment is updated at least once every 3 months.
Correction field: Deficient, Provider has date of correction · 2025-10-182025-09-03 · HEALTHF0677Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Correction field: Deficient, Provider has date of correction · 2025-10-182025-09-03 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2025-10-182025-09-03 · HEALTHF0686Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2025-10-182025-09-03 · HEALTHF0732Severity F · widespread; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
Correction field: Deficient, Provider has date of correction · 2025-10-182025-09-03 · HEALTHF0812Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2025-10-18 · complaint2025-09-03 · FIREK0222Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Correction field: Deficient, Provider has date of correction · 2025-10-302025-09-03 · FIREK0293Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Have properly located and lighted "Exit" signs.
Correction field: Deficient, Provider has date of correction · 2025-10-302025-09-03 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2025-10-302025-09-03 · FIREK0374Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Correction field: Deficient, Provider has date of correction · 2025-10-302025-09-03 · FIREK0753Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Have restrictions on the use of highly flammable decorations.
Correction field: Deficient, Provider has date of correction · 2025-10-3003 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- AMERICAN BAPTIST HOMES OF THE MIDWESTOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 01/19/2010
- KOTZ, CHRISTINAIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 08/01/2018
- ALLEN, RYANIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2013
- FORD, ASHLEYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2013
- HANSON, PHILLIPIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2013
- JOHNSON, JAMESIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2013
- KILLIAN, GEORGEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 08/01/2018
- PETERS, MARSHALLIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2013
- VANOSTRAM, STEVENIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2013
- WAGONER FORD, ANNEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 08/01/2018
- WHITAKER, BRUCEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2013
- BLATNIK, ANDREAIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2012
- DAVIDSON, ROGERIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2021
- JOHNSON, DOROTHYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2021
- JOHNSON, LARSIndividual · CORPORATE OFFICERNOT APPLICABLE · since 06/05/2023
- NEIMAN, RUTHIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2021
- VAN DER BEEK, BRUCEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2021
- VAUGHN-GRAY, STEPHANIEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2021
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours4.46per resident day
RN hours0.88per resident day
Weekend nurse hours4.03per resident day
Staff turnover38.1%CMS reported field
06 / LOCAL RECORDS
Open the Omaha ledger →Other published facilities nearby
Ambassador Health Of Omaha146 beds · CMS overall 5/521 citation rowsBrookestone Village140 beds · CMS overall 5/527 citation rowsDouglas County Health Center254 beds · CMS overall 3/556 citation rowsEmerald Nursing & Rehab Legacy Pointe Llc108 beds · CMS overall 1/543 citation rowsEmerald Nursing & Rehab Omaha155 beds · CMS overall 1/584 citation rowsEmerald Nursing & Rehabilitation Mercy174 beds · CMS overall 1/5132 citation rowsFlorence Home126 beds · CMS overall 4/524 citation rowsGood Samaritan Society - Millard106 beds · CMS overall 4/534 citation rows