Above average — CMS composite of the measures below.
The next survey window likely opens around December 2026
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 Mt Carmel Home - Keens Memorial during CMS and state inspections, most recent first.
Psychotropic medications were ordered for two residents for non-approved indications. One resident with dementia, mood disorder, insomnia, restlessness, agitation, and anxiety received mirtazapine for insomnia, and the DON confirmed this was off-label use. Another resident with dementia, anxiety, and Alzheimer's disease received risperidone for Alzheimer's disease, and the DON confirmed that Alzheimer's disease was not an approved indication for the medication.
A facility failed to complete the required recapitulation of stay for two discharged residents. One resident died at the facility and was released to a mortuary, while the other was discharged home AMA; in both cases, the record lacked the required summary, and one record also lacked medication reconciliation and complete discharge instruction documentation.
Incomplete pressure ulcer monitoring and documentation: A resident with bilateral heel pressure ulcers had weekly wound assessments completed by the DON/wound nurse, but the records repeatedly documented only a single length measurement and did not include width or depth as required. The resident’s heel wounds were described as open, with one heel still showing drainage on observation, and the DON confirmed the wounds were measured as a diameter rather than by length and width.
Medication labeling was not maintained for two residents. An LPN administered a multi-dose eye drop vial that had no open date or discard date written on it, and a multi-dose insulin vial was found on the med cart even though it had expired several days earlier. The LPN confirmed both labeling and storage issues.
Psychotropic medications used for non-approved indications
Penalty
Summary
The facility failed to ensure medications were used according to the manufacturer-approved recommendations for two sampled residents. A facility document on psychotropic medication use stated that adequate indications for use means the medication administered is consistent with the manufacturer's recommendations. For one resident admitted with dementia, major mood disorder, insomnia, restlessness and agitation, and anxiety, the EMHR showed an order for mirtazapine 15 mg daily for insomnia. During interview, the DON confirmed that insomnia was an off-label use and not the approved indication for mirtazapine. For a second resident admitted with dementia, anxiety, and Alzheimer's disease, the EMHR showed an order for risperidone 0.5 mg daily for Alzheimer's disease. The facility document on Risperdal stated the medication is indicated for schizophrenia, acute manic or mixed episodes associated with bipolar I disorder, and irritability associated with autistic disorder. During interview, the DON confirmed that Alzheimer's disease was not an approved indication for risperidone.
Missing Recapitulation of Stay for Two Discharged Residents
Penalty
Summary
The facility failed to complete a recapitulation of stay for 2 discharged residents, Resident 67 and Resident 63, as required. For Resident 67, the record showed admission for dementia with a plan for long-term stay, and progress notes documented that the resident's body was released to a mortuary of choice after death at the facility. The record contained a discharge plan, but there was no recapitulation of stay or discharge summary in the medical record. The DON confirmed that the facility did not complete a recapitulation of stay or discharge summary for this resident. For Resident 63, the record showed discharge from the facility to home against medical advice. Although discharge instructions were present in the electronic record and a facility-supplied discharge instruction form noted that the resident left AMA, the medical record contained no required recapitulation of the resident's stay and no required reconciliation of medications. The discharge instructions also lacked documentation in the therapy needs section and in the nursing section for special instructions and explanation of medications and treatments provided. The DON confirmed that the facility did not have a recapitulation of stay for Resident 63 as required.
Incomplete pressure ulcer monitoring and documentation
Penalty
Summary
The facility failed to monitor pressure ulcers for one resident in accordance with its wound care policies and professional standards. The resident was admitted in 3/2022 and had been identified as at risk for impaired skin integrity. Progress notes documented a large water blister to the right heel and an opened blister to the left heel, and the resident was later seen in wound clinic where silicone bordered foam dressings were ordered for both heels, Iodosorb was ordered for the left heel, and padded cushions were ordered for use in bed or chair. The resident’s MDS later identified three stage 2 pressure ulcers that were not present on admission. Weekly wound assessments were completed by the DON, who also served as the wound nurse, but the assessments did not include required measurements of wound width or depth. For the right heel, the wound assessments repeatedly documented only a length measurement, first 30 mm and later 20 mm and 15 mm, with no width or depth recorded. For the left heel, the weekly assessments likewise documented only a length measurement, first 30 mm and later 25 mm, with no width or depth recorded. The resident record contained no measurements of length and width for either heel pressure ulcer, and the DON confirmed that the wounds were measured as a diameter rather than by length and width as required. During observation, the resident’s right heel wound was still open and measured approximately 1.3 cm by 2.5 cm, while the left heel wound was not observed. Later, an LPN reported the right heel wound was open with clear drainage and was approximately 1.5 cm by 2.5 cm, with no measurable depth. The DON confirmed that weekly wound assessments were supposed to include measurements, drainage, pain changes, and signs or symptoms of infection, and confirmed that the length and width of the wounds were not measured as required.
Medication Labeling and Expired Insulin on Cart
Penalty
Summary
Drugs and biologicals used in the facility were not labeled in accordance with accepted professional principles for 2 of 5 sampled residents, Resident 51 and Resident 57. Facility documentation stated that drugs and biologicals must be labeled in accordance with currently accepted professional principles, including the expiration date when applicable. For Resident 51, a multi-dose vial of carboxymethylcellulose sodium solution was observed on the medication cart with a pharmacy label identifying the resident, medication name, dose, and frequency, but there was no date written on the vial to show when it was opened or when it should be discarded 90 days after opening. The LPN administered the eye drops and then returned the vial to the medication cart, and later confirmed there was no open date or discard date on the bottle. For Resident 57, a multi-dose Humalog insulin vial was observed on the medication cart with a pharmacy label identifying the resident, medication name, dose, and frequency, along with a yellow sticker showing an open date of 12/13 and an expiration date of 01/10. The LPN removed the vial from the cart and checked the resident’s orders, then stated the resident would not receive insulin at that time due to the blood sugar level. During interview, the LPN confirmed the insulin had expired 5 days earlier and should have been discarded, and also confirmed the vial should not have been on the medication cart.
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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 Kearney
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Mother Hull Home | 0.6 mi | ★★★★★ | 14 | 0 |
| Good Samaritan Society - St John's | 1.2 mi | ★★★★★ | 18 | 0 |
| Brookestone Gardens | 1.7 mi | ★★★★★ | 8 | 0 |
| Good Samaritan Society - St Luke's Village | 2.1 mi | ★★★★★ | 14 | 0 |
| Bethany Home, Inc | 15.2 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.