CLOVERLODGE CARE CENTER
Nursing Home Inspector
301 NORTH 13TH STREET
SAINT EDWARD, NE 68660
Boone County
Phone: 402-678-2294
Provider Number: 285201
Last Inspection: 12/06/2016
About the Nursing Home
Number of Beds: 55
Number of Residents: 34
Beds Available: 21
Percent Occupancy: 62%
Insurance Accepted: Medicare & Medicaid
Types of Councils: Resident
Ownership: For profit - Corporation
Within Hospital?: NO
About State Inspection Deficiencies
Nursing Homes that are Medicare and/or Medicaid certified are licensed by the state and are required to comply with rigid standards enforced by regular facility inspections and extensive evaluations.
The state inspection deficiencies provided here are accounts reported by state inspectors of every discrepancy found where the home failed to meet the minimum standards set forth by state and federal regulations. If a home does not show any deficiencies, it has met the minimum standards required.
Please note: Findings in these inspections do not present a complete picture of the quality of care provided.
Information in this database should be interpreted carefully and used in conjunction with other sources, as well as a visit to the nursing home.
Deficiency Ratings
Our nursing home inspector tool compares the severity of deficiences rather than the number of deficiences. We calculate the severity of each deficiency using the formula:
Severity Rating = Scope + Level of Harm.
Deficiency Rating= Sum of ALL Severity Ratings
Severity |
Scope |
Level of Harm |
2 |
1-Isolated |
1-Potential for minimal harm |
3 |
2-Pattern |
1-Potential for minimal harm |
3 |
1-Isolated |
2-Minimal harm or potential for actual harm |
4 |
3-Widespread |
1-Potential for minimal harm |
4 |
2-Pattern |
2-Minimal harm or potential for actual harm |
4 |
1-Isolated |
3-Actual harm |
5 |
3-Widespread |
2-Minimal harm or potential for actual harm |
5 |
2-Pattern |
3-Actual harm |
5 |
1-Isolated |
4-Immediate jeopardy to resident health or safety |
6 |
3-Widespread |
3-Actual harm |
6 |
2-Pattern |
4-Immediate jeopardy to resident health or safety |
7 |
3-Widespread |
4-Immediate jeopardy to resident health or safety |
Deficiency Ratings
By Year
Lower Numbers Are Better
|
15

2016 |
4

2015 |
36

2014 |
Medicare Ratings
Overall Rating: |
 |
Health Rating: |
 |
Staff Rating: |
 |
Quality Rating: |
 |
Details by Inspection Date
Failed To: 1) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. |
Isolated :
Minimal
|
 3
|
12/30/2016
|
|
Failed To: Conduct initial and periodic assessments of each resident's functional capacity. |
Isolated :
Minimal
|
 3
|
12/30/2016
|
|
Failed To: Provide necessary care and services to maintain or improve the highest well being of each resident . |
Isolated :
Minimal
|
 3
|
12/30/2016
|
|
Failed To: Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. |
Isolated :
Minimal
|
 3
|
12/30/2016
|
|
Failed To: Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. |
Isolated :
Minimal
|
 3
|
12/30/2016
|
|
Failed To: Give residents a notice of rights, rules, services and charges. |
Pattern :
Minimal
|
 4
|
12/10/2015
|
|
Failed To: Try to resolve each resident's complaints quickly. |
Isolated :
Minimal
|
 3
|
10/10/2014
|
|
Failed To: 1) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. |
Widespread :
Minimal
|
 5
|
10/10/2014
|
|
Failed To: Allow residents the right to participate in the planning or revision of care and treatment. |
Pattern :
Minimal
|
 4
|
10/10/2014
|
|
Failed To: Provide necessary care and services to maintain or improve the highest well being of each resident . |
Isolated :
Minimal
|
 3
|
10/10/2014
|
|
Failed To: Assist those residents who need help with eating/drinking, grooming and personal and oral hygiene. |
Isolated :
Minimal
|
 3
|
10/10/2014
|
|
Failed To: Store, cook, and serve food in a safe and clean way. |
Isolated :
Minimal
|
 3
|
10/10/2014
|
|
Failed To: Have a program that investigates, controls and keeps infection from spreading. |
Widespread :
Minimal
|
 5
|
10/10/2014
|
|
Failed To: Make sure that the facility is administered in an acceptable way that maintains the well-being of each resident . |
Widespread :
Minimal
|
 5
|
10/10/2014
|
|
Failed To: Set up an ongoing quality assessment and assurance group to review quality deficiencies quarterly, and develop corrective plans of action. |
Widespread :
Minimal
|
 5
|
10/10/2014
|
|
Complaint Investigation Deficiencies
These deficiencies resulted from complaints investigated by the state inspectors and substantiated.
Failed To: Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. |
Pattern :
Minimal
|
 4
|
3/14/2017
|
|
About The Staff
(
Higher Numbers Are Better)
Staffing Hours Per Day Per Resident... |
This Facility |
County Avg |
NE State Avg |
Number of Residents |
34 |
42.00 |
53.60 |
Registered Nurses |
0.60 |
0.64 |
0.76 |
Licensed Practical / Vocational Nurses |
0.84 |
0.67 |
0.68 |
Certified Nursing Assistants |
2.38 |
2.54 |
2.49 |
Total Staff Hours |
3.81
|
3.85 |
3.93 |
About the Residents
(
Lower Numbers Are Better)
Percent of Residents... |
This Facility | % |
County Avg | % |
NE State Avg | % |
of high risk long-stay residents with pressure ulcers
|

|
1
|

|
2
|

|
4
|
of long-stay residents assessed and appropriately given the pneumococcal vaccine
|

|
100
|

|
100
|

|
94
|
of long-stay residents assessed and appropriately given the seasonal influenza vaccine
|

|
100
|

|
98
|

|
96
|
of long-stay residents experiencing one or more falls with major injury
|

|
6
|

|
6
|

|
4
|
of long-stay residents who have depressive symptoms
|

|
8
|

|
6
|

|
5
|
of long-stay residents who lose too much weight
|

|
8
|

|
6
|

|
7
|
of long-stay residents who received an antianxiety or hypnotic medication
|

|
13
|

|
14
|

|
21
|
of long-stay residents who received an antipsychotic medication
|

|
14
|

|
16
|

|
18
|
of long-stay residents who self-report moderate to severe pain
|

|
8
|

|
8
|

|
9
|
of long-stay residents who were physically restrained
|

|
0
|

|
0
|

|
0
|
of long-stay residents whose ability to move independently worsened
|

|
23
|

|
21
|

|
19
|
of long-stay residents whose need for help with daily activities has increased
|

|
13
|

|
14
|

|
15
|
of long-stay residents with a catheter inserted and left in their bladder
|

|
1
|

|
2
|

|
2
|
of long-stay residents with a urinary tract infection
|

|
7
|

|
4
|

|
5
|
of low risk long-stay residents who lose control of their bowels or bladder
|

|
67
|

|
58
|

|
46
|
of short-stay residents assessed and appropriately given the pneumococcal vaccine
|

|
83
|

|
83
|

|
83
|
of short-stay residents who self-report moderate to severe pain
|

|
30
|
Not Available
|
|

|
8
|
of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine
|

|
100
|

|
91
|

|
75
|
of short-stay residents with pressure ulcers that are new or worsened
|

|
0
|

|
2
|

|
2
|