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Complaint Investigation

Life Care Center Of Omaha

November 19, 2025 · Omaha, NE · 6032 Ville De Sante Drive
Citations 2
CMS Rating 2/5
Beds 128
Provider ID 285137
Healthcare Facility
Life Care Center Of Omaha
Omaha, NE  ·  View full profile →
Source Document
Official CMS Inspection Report (Medicare.gov)
Downloaded from CMS/Medicare.gov. Reflects what state inspectors documented and does not include the facility's plan of correction, which is submitted separately. Facilities may have taken corrective actions since this report was released.
Inspection Summary

Life Care Center of Omaha in Omaha, NE — inspection on November 19, 2025.

Found 2 citations. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

Inspection Findings

FF0686
Quality of Life and Care Deficiencies
Actual Harm

Administration Record (MAR) for October 2025 revealed no order for Prosource 30 mls twice a day.

Record review of Resident 3's WOT dated 10-28-2025 revealed the stage 2 pressure ulcer to the coccyx measured 7.25 cm in length by 7.66 cm in width by 0.0 depth and staged as a 2.

The WOT also indicated the wound was declining and the treatment plan was to cleanse the wound with wound cleanser, rinse and pat dry and apply Hydrofera Blue with water resistant Mepilex change daily and as needed for soiling.

Record review of Resident 3's Progress Notes (PN) dated 10-31-2025 revealed there was a decline in wounds to coccyx/sacral region and the wound nurse assessed the wounds and new treatment orders were obtained.

Record review of Resident 3's Electronic Health Record (EHR) revealed no wound assessment on 10-31-2025.

Record review of Resident 3's TAR for October 2025 revealed no new treatment orders for the wounds to the coccyx/sacral region.

Record review of Resident 3's OS printed on 11-17-2025 revealed an order dated 11-04-2025 to Cleanse with wound cleanser, rinse, pat dry, and apply Hydrofera Blue, cut to fit wounds and cover with Duoderm (a wound dressing that provides a moist protective environment to promote wound healing) every other day for wound care.

Record review of Resident 3's TAR for November 2025 revealed an order dated 11-01-2025 to cleanse with wound cleanser, rinse, pat dry and apply Hydrofera Blue, cut to fit wounds and cover with a water resistant Mepilex.

Change daily and as needed for soiling.

Record review of Resident 3's Tissue Analytics Wound Assessment ([NAME]) dated 11-11-2024 revealed the wound to the sacral/coccyx was staged as a 3 (a deep wound that has full thickness skin loss) and measured 2.86 cm in length and 2.90 cm in width and 0.0 cm depth.

Record review of Resident 3's MAR for November 2025 revealed the absence of an order for Prosource 30 mls twice a day.

Record review of Resident 3's TAR for November 2025 revealed an order dated 11-04-2025 to cleanse with wound cleanser, rinse, pat dry and apply Hydrofera Blue, cut to fit wounds and cover with Duoderm every other day.An observation 11-19-2025 at 1:30 PM of Registered Nurse (RN) A providing wound care to Resident 3's sacral/coccyx region revealed an open wound to the coccyx that was tear drop shaped and approximately 1.5 cm in length by 1 cm in width, another wound below the coccyx wound to the sacral area that was approximately 3 cm in length and 4 cm in width, and another wound to the right buttock that was round and approximately 3.5 cm by 3.5 cm. An interview conducted with RN A on 11-19-2025 at 1:40 PM during wound care revealed the wound to the coccyx and the right buttock were stage 2 pressure ulcers and the sacral wound was a stage 3 pressure ulcer. An interview conducted with RN A on 11-19-2025 at 3:30 PM confirmed a wound treatment was not provided for Resident 3's pressure ulcer to the coccyx until 10-22-2025, 5 days after the pressure ulcer was identified and also confirmed the recommendation for Prosource 30 mls twice a day was not implemented and Resident 3's wounds have increased in number and 1 of the pressure ulcers is now a stage 3.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

11/19/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Life Care Center of Omaha

6032 Ville DE Sante Drive Omaha, NE 68104

SUMMARY STATEMENT OF DEFICIENCIES

According to the MDS Manual a score of 8 to 12 indicates moderate cognitive impairment. -required total assistance with dressing, grooming, dressing, toileting, bathing, bed mobility and transfers.-had a feeding tube.

Record review of Resident 7's Treatment Administration Record (TAR) for November 2025 revealed an order dated 05-19-2025 for feeding tube site care as follows:Cleanse site, apply Vaseline gauze follow by a split gauze two times a day for healing of the site. An observation on 11-18-2025 at 8:10 AM-8:30 AM of LPN C providing feeding tube site care for Resident 7 revealed when the old dressing was removed from the feeding tube site, Resident 7 grimaced.

The observation also revealed the absence of Vaseline gauze on the old dressing and the presence of bright red blood around the feeding tube insertion site. An interview conducted with LPN C at 8:25 AM confirmed the absence of Vaseline gauze on the old dressing and confirmed Vaseline gauze should have been applied to the tube feeding site, and confirmed the old dressing had stuck to Resident 7's skin causing discomfort.

Facility ID:

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in Omaha, NE, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from Life Care Center of Omaha or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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About This Inspection Report

Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.

Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.

Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.