Above average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Accura Healthcare Of North Platte during CMS and state inspections, most recent first.
Three residents experienced multiple episodes of constipation without the facility following its bowel protocol, including failure to document interventions, administer prescribed as-needed medications, or notify the physician as required. Nursing staff did not implement or record necessary actions despite clear evidence of prolonged periods without bowel movements.
A resident was prescribed two acid-suppressing medications, famotidine and pantoprazole, which the pharmacist identified as a duplication of therapy. The pharmacist requested a clinical rationale for the concurrent use or suggested discontinuing one medication. The attending physician responded without providing a clinical rationale, and the resident's records did not show a diagnosis to justify both medications. The facility's policy did not specify the physician's responsibility to document a rationale when no action is taken.
A resident was sent to the ED for adverse behaviors and admitted to the hospital for delirium and hypoxia. The facility notified the resident's family by phone that readmission would not occur due to safety concerns, but did not provide the required written discharge notice. The Social Services Director confirmed that no written notice was given.
The facility failed to label and date several food items, including spaghetti, elbow macaroni, long grain rice, soy sauce, and tater tots, to prevent potential foodborne illness. The Dietary Supervisor confirmed the lack of a food storage policy, affecting all 60 residents consuming food from the kitchen.
The facility failed to store garbage properly, with two trash receptacles outside the kitchen found uncovered and containing visible trash. The Dietary Supervisor confirmed the issue and noted that the facility had contacted the trash company for replacement coverings, but no delivery date was known. This had the potential to affect all 60 residents.
The facility failed to provide activities of choice to a resident with major depressive disorder and dementia, who expressed a preference for group activities, card games, and outdoor activities. Despite being cognitively intact, the resident was often found without any activity and expressed feelings of isolation. The Activities Supervisor and Director of Nursing were unaware of the resident's decreased participation in activities.
The facility failed to follow physician's orders for daily weights for a resident with congestive heart failure. Multiple instances of missing weight documentation were found, and the daily weight order was not updated after the resident's return from the hospital, where the PRN Lasix order had been discontinued.
The facility failed to provide appropriate treatment for a pressure ulcer for a resident with multiple diagnoses, including dementia and diabetes. Despite a care plan and physician's order for daily wound dressing, documentation was missing on several dates, and an observation confirmed the absence of the required band-aid. Interviews with staff confirmed the lack of adherence to the treatment protocol, as per the facility's policy.
The facility staff failed to change oxygen tubing for two residents and the nebulizer mask with tubing for one resident, which had the potential to cause infection. Observations and interviews confirmed that the equipment was outdated and not changed as required by facility policy.
The facility failed to ensure that an as-needed antipsychotic medication for a resident was limited to 14 days and had a physician-documented rationale for continuance. The resident had severe cognitive impairment and frequent behavioral symptoms, and the PRN quetiapine order lacked a stop date or duration. Interviews confirmed the absence of a documented rationale and a facility policy for as-needed psychiatric medication.
A facility failed to ensure proper hand hygiene during incontinence care for a resident. One nursing assistant did not wash hands for the required 20 seconds and failed to perform hand hygiene after removing soiled gloves before touching clean surfaces. Interviews confirmed the hand hygiene policy was not followed correctly.
Failure to Implement Bowel Protocol for Constipation Management
Penalty
Summary
The facility failed to follow its established bowel protocol for the prevention and management of constipation in three residents. The protocol required nursing staff to monitor and document bowel movements, initiate specific interventions at set intervals without a bowel movement, and notify the physician as needed. However, documentation revealed that residents went multiple days without a bowel movement, and there was no evidence that the required interventions were implemented or that physicians were notified during these periods. One resident with chronic pain and gastrointestinal diagnoses, who was dependent for toileting and frequently incontinent, experienced several episodes of four to eight days without a documented bowel movement. During these times, there were no orders for constipation management, no evidence of interventions being implemented, and no documentation of physician notification. Another resident with severe cognitive impairment and a care plan to monitor for constipation due to pain medication also went up to eight days without a bowel movement, with no interventions documented and no evidence that the physician was notified. Orders for constipation management were not present or not administered as required. A third resident, also with severe cognitive impairment and dependent on staff for toileting, had multiple episodes of three to seven days without a bowel movement. Despite having as-needed orders for bowel medications, there was no documentation that these medications were administered or that the resident's bowel status was assessed during these periods. Interviews with facility staff confirmed that the bowel protocol was not followed, and required interventions were not implemented or documented for these residents.
Lack of Physician Rationale for Medication Irregularity
Penalty
Summary
The facility failed to ensure that a physician documented a clinical rationale for not taking action on a medication irregularity identified by the pharmacist for one resident. The pharmacist, during a monthly medication regimen review, noted that the resident had active orders for two acid-suppressing medications—famotidine and pantoprazole—which was considered a duplication of therapy. The pharmacist requested a rationale for the concurrent use of both a proton-pump inhibitor and an H-2 blocker, or suggested discontinuing one of the medications. The attending physician responded to the pharmacist's note with 'not right now' but did not provide any clinical rationale for maintaining both medications. Review of the resident's records did not show a diagnosis of GERD or a similar condition to justify the dual therapy. The facility's policy required reporting of medication irregularities but did not specify the physician's responsibility to document a rationale when no action is taken. The DON confirmed that the required clinical rationale was not documented by the physician.
Failure to Provide Written Discharge Notice
Penalty
Summary
The facility failed to provide a written notice of discharge to a resident or their representative as required. Record review showed that the resident was sent to the emergency department due to adverse behaviors toward another resident and was subsequently admitted to the hospital for delirium and hypoxia. The following day, the facility informed the resident's child by phone that the resident would not be readmitted due to concerns about the safety of other residents, and the child declined a bed hold. However, there was no documentation in the electronic medical records indicating that a written notice of discharge was given to the resident or their representative. This was confirmed in an interview with the Social Services Director, who acknowledged that the written notice had not been provided.
Failure to Label and Date Food Items
Penalty
Summary
The facility failed to ensure food was labeled and dated to prevent the potential of foodborne illness. During an initial walk-through of the kitchen, it was observed that several food items, including spaghetti, elbow macaroni, long grain rice, and soy sauce, were open without any listed expiration or open dates. Additionally, an open plastic bag of tater tots in the walk-in fridge/freezer also lacked identifying open or expiration dates. An interview with the Dietary Supervisor confirmed that all food items are supposed to be dated upon arrival and when opened, but the facility did not have a policy on food storage. This deficiency had the potential to affect all residents consuming food from the kitchen, with a facility census of 60 residents.
Improper Garbage Storage
Penalty
Summary
The facility failed to ensure garbage was stored in a manner to prevent harborage and feeding of pests. During an observation on March 18, 2024, at 10:45 AM, it was noted that two trash receptacles outside the back entry to the kitchen were uncovered, with trash visible inside. One receptacle had the back open, while the other had both the front and back open. An interview with the Dietary Supervisor on March 20, 2024, confirmed that the lids of the two trash receptacles were uncovered and that the facility had contacted the trash company but was unaware of a delivery date for the replacement coverings. This deficiency had the potential to affect all 60 residents of the facility.
Failure to Provide Activities of Choice to Resident
Penalty
Summary
The facility failed to provide activities of choice to a resident (Resident 9) who was admitted with diagnoses including major depressive disorder, dementia, and chronic obstructive pulmonary disease. Despite being cognitively intact with a BIMS score of 15/15, Resident 9 expressed a preference for group activities, card games, and outdoor activities. However, observations revealed that Resident 9 was often found resting in bed or sitting in a wheelchair without any activity. Interviews with Resident 9 indicated a lack of interest in the provided activities and a desire for activities that were not offered by the facility, such as card games and rodeos. The Activities Supervisor confirmed a decrease in Resident 9's participation and admitted to not engaging Resident 9 in any activities besides making a shopping list. The Director of Nursing was unaware of Resident 9's decreased participation in activities. A review of Resident 9's progress notes from November 1, 2023, to March 18, 2024, showed only two instances of documented activities, both related to shopping. The lack of engagement in preferred activities led to Resident 9 feeling tearful and isolated. The facility's failure to provide activities of choice and adequately engage Resident 9 in meaningful activities contributed to the deficiency identified in the report.
Failure to Follow Physician's Orders for Daily Weights
Penalty
Summary
The facility failed to follow physician's orders regarding daily weights for a resident diagnosed with congestive heart failure. The resident's care plan included an intervention for weight monitoring, and the physician's orders specified daily weights to be obtained on the day shift. Additionally, the orders included administering PRN Lasix if the resident experienced a weight gain of 4 to 5 pounds and to notify the Primary Care Provider. However, there was no current order for PRN Lasix, and the daily weight order was not updated after the resident's return from the hospital, where the PRN Lasix order had been discontinued by the pharmacist per transition orders from the doctor. The Director of Nursing confirmed these discrepancies during an interview. A review of the resident's Treatment Administration Record (TAR) and electronic health record (EHR) revealed multiple instances where daily weights were not documented or recorded. Specifically, there were missing weights on several days in February and March, and the resident was hospitalized and unavailable for weight monitoring from February 12th to 18th. The Administrator confirmed that no additional weights were obtained other than those recorded in the EHR, as they were responsible for adding the weights obtained by staff to the EHR. This failure to consistently document and monitor the resident's weight as per physician's orders constitutes a deficiency in the care provided by the facility.
Failure to Provide Appropriate Pressure Ulcer Care
Penalty
Summary
The facility failed to provide appropriate treatment for a pressure ulcer for Resident 9, who was admitted with multiple diagnoses including major depressive disorder, dementia, chronic obstructive pulmonary disease, and diabetes mellitus. Despite being cognitively intact with a BIMS score of 15/15, Resident 9 was unaware of the pressure ulcer on their right great toe until questioned by surveyors. The resident's care plan included an intervention and treatment per the physician's order, which specified daily wound dressing with betadine and a band-aid. However, the Treatment Administration Record (TAR) showed missing documentation for several dates, and an observation confirmed the absence of the required band-aid on the resident's toe. Interviews with the RN and DON confirmed the lack of documentation and adherence to the treatment protocol, as per the facility's Skin Care and Wound Management policy. The deficiency was further highlighted by the facility's policy, which mandates daily rounds to verify that appropriate wound treatment protocols are followed and documented. The DON confirmed that if the treatment was not documented, it was not done. This failure to document and ensure proper wound care for Resident 9 indicates a significant lapse in the facility's adherence to its own policies and procedures, leading to inadequate care for the resident's pressure ulcer.
Failure to Change Oxygen Tubing and Nebulizer Mask
Penalty
Summary
The facility staff failed to change oxygen tubing for two residents and failed to change the nebulizer mask with tubing for one resident, which had the potential to cause infection. Resident 10, who was readmitted with diagnoses including congestive heart failure, obstructive sleep apnea, morbid obesity, pulmonary hypertension, and paranoid schizophrenia, had an order to change oxygen tubing weekly as of 3/4/2024. However, observations on 3/18/2024, 3/19/2024, and 3/20/2024 revealed that the oxygen tubing was dated 1/1/2024 and had not been changed as required. Both RN-B and the DON confirmed that the tubing was outdated and should have been changed per the orders but was not. Resident 49, who was readmitted with diagnoses including chronic congestive heart failure, chronic kidney disease, anemia, morbid obesity, and major depressive disorder, had orders to change oxygen cannula/mask/tubing weekly and the nebulizer mask and tubing weekly. Observations on 3/18/2024, 3/19/2024, and 3/21/2024 revealed that the oxygen tubing was not dated, and the nebulizer mask and tubing were dated 2/24/2024, indicating they were overdue for a change. RN-B confirmed that the oxygen tubing needed to be changed and the nebulizer mask was outdated. The DON also confirmed that the oxygen tubing should have been dated and changed, and the nebulizer mask was outdated. The facility's policy on oxygen administration and respiratory equipment change schedule requires disposable supplies to be dated upon opening and changed according to a specified schedule to prevent nosocomial infections. The failure to adhere to these policies for Residents 10 and 49 was confirmed through observations, record reviews, and interviews with facility staff, including RN-B and the DON.
Failure to Limit PRN Antipsychotic Medication to 14 Days
Penalty
Summary
The facility failed to ensure that an as-needed antipsychotic medication for Resident 114 was limited to 14 days and had a physician-documented rationale for continuance. Resident 114, who was admitted with diagnoses including altered mental status, adult failure to thrive, hallucinations, dementia with moderate behavioral disturbance, and cognitive communication deficit, had a significant change Minimum Data Set (MDS) indicating severe cognitive impairment and frequent behavioral symptoms. The resident had an order for quetiapine 25 mg to be given every 8 hours as needed for agitation, starting on 3/5/2024, without a stop date or duration. The physician's documentation on 3/14/2024 included an order to continue the PRN quetiapine without a clinical rationale and also lacked a stop date or duration. Interviews with the Director of Nursing (DON) and a Registered Nurse (RN) confirmed that the PRN quetiapine order did not include a duration or stop date and that there was no documented rationale from the physician to continue the medication past 14 days. The Administrator revealed that the facility did not have a policy for as-needed psychiatric medication and followed physicians' orders. This deficiency affected one of six sampled residents, with the facility having a census of 60.
Failure to Follow Hand Hygiene Protocol During Incontinence Care
Penalty
Summary
The facility failed to ensure proper hand hygiene was performed to prevent the spread of infection or cross-contamination during and after incontinence care for a resident. During an observation, two nursing assistants were seen performing personal care on a resident. One of the nursing assistants, NA-D, did not follow the facility's hand hygiene policy. NA-D washed hands for only 10 seconds instead of the required 20 seconds, and did not perform hand hygiene after removing soiled gloves before touching clean surfaces. Additionally, NA-D used the same gloves to handle both soiled and clean items, further increasing the risk of cross-contamination. Interviews with NA-D and the Director of Nursing (DON) confirmed that the hand hygiene policy was not followed correctly. NA-D admitted to misunderstanding the handwashing duration and acknowledged the failure to perform hand hygiene after glove removal. The facility's hand hygiene policy and CDC guidelines both require handwashing with soap and water for 20 seconds and emphasize the importance of performing hand hygiene immediately after glove removal to prevent the spread of infection.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near North Platte
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Linden Court | 0.6 mi | ★★★★★ | 13 | 0 |
| Adept Nursing & Rehab Of North Platte | 1.7 mi | ★★★★★ | 4 | 0 |
| Adept Nursing & Rehab Of Sutherland | 17.3 mi | ★★★★★ | 13 | 2 |
| Hilltop Estates | 36.2 mi | ★★★★★ | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.