Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=DALLAS CARE AND REHABILITATION, DALLAS, WESTERN REGION (CONTACT: Sherry Walters, (715) 836-4420)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
05/27/2009 FULL/COMPLAINT 132.41(1) , "ADMINISTRATOR " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 07/09/2009 APPEALED: 06/18/2009
05/27/2009 FULL/COMPLAINT 132.51(2)(B)1. , "ADMISSIONS/COMMUNICABLE DISEASE " CLASS B DEFICIENCY CORRECTED 07/09/2009 APPEALED: 06/17/2009
05/27/2009 FULL/COMPLAINT 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY CORRECTED 07/09/2009 APPEALED: 06/17/2009
05/27/2009 FULL/COMPLAINT 132.62(3)(B) , "NURSING ASSIGNMENTS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 07/09/2009 APPEALED: 06/17/2009
05/27/2009 FULL/COMPLAINT 50.09(1)(L) , "Care " CLASS B DEFICIENCY CORRECTED 07/09/2009 APPEALED: 06/17/2009

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=DEERFIELD CARE CENTER, LLC, NEW RICHMOND, WESTERN REGION (CONTACT: Sherry Walters, (715) 836-4420)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
01/28/2009 COMPLAINT 132.60(1)(C)4. , "RESIDENT CARE/BASIC NRSG CARE " CLASS A DEFICIENCY CORRECTED 02/20/2009 NO APPEAL ON RECORD
01/28/2009 COMPLAINT 132.60(1)(C)4. , "RESIDENT CARE/BASIC NRSG CARE " CLASS A DEFICIENCY CORRECTED 02/20/2009 DISMISSED
01/28/2009 COMPLAINT 132.60(3)(A) , "RESIDENT CARE/NOTIFICATION OF CHANGE " CLASS B DEFICIENCY CORRECTED 02/20/2009 NO APPEAL ON RECORD
01/28/2009 COMPLAINT 132.60(3)(A) , "RESIDENT CARE/NOTIFICATION OF CHANGE " CLASS B DEFICIENCY CORRECTED 02/20/2009 APPEALED: 02/19/2009
04/09/2009 FULL 132.42(5) , "VOLUNTEERS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED   NO APPEAL ON RECORD
04/09/2009 FULL 132.60(5)(d)1. , "Resident Care Admin of Meds " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED   NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=DOVE HEALTHCARE-WEST, EAU CLAIRE, WESTERN REGION (CONTACT: Sherry Walters, (715) 836-4420)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
10/15/2008 FULL/COMPLAINT 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 11/15/2008 NO APPEAL ON RECORD
01/15/2009 COMPLAINT 132.60(3)(A) , "RESIDENT CARE/NOTIFICATION OF CHANGE " CLASS B DEFICIENCY CORRECTED 02/15/2009 NO APPEAL ON RECORD
01/15/2009 COMPLAINT 132.60(5)(A)1. , "RESIDENT CARE/ORDERS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 02/15/2009 NO APPEAL ON RECORD
04/03/2009 COMPLAINT 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " MULTIPLE CLASS 'B' OR 'A' DEFICIENCIES CORRECTED 04/16/2009 APPEALED: 04/22/2009
04/03/2009 COMPLAINT 132.60(2)(D) , "RESIDENT CARE/DIET ACCEPTANCE " CLASS B DEFICIENCY CORRECTED 04/16/2009 APPEALED: 04/22/2009

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=DUNN CTY HLTH CARE CTR, MENOMONIE, WESTERN REGION (CONTACT: Sherry Walters, (715) 836-4420)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
03/04/2009 FULL/COMPLAINT 132.65(6)(B)2. , "MEDS/TRANSFER BETWEEN CONTAINERS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 04/04/2009 APPEALED: 03/26/2009
03/04/2009 FULL/COMPLAINT 50.09(1)(e) , "Treatment " CLASS B DEFICIENCY CORRECTED 04/04/2009 APPEALED: 03/26/2009
03/04/2009 FULL/COMPLAINT 50.09(1)(L) , "Care " CLASS B DEFICIENCY CORRECTED 04/04/2009 APPEALED: 03/26/2009
08/18/2009 COMPLAINT 132.60(3)(A) , "RESIDENT CARE/NOTIFICATION OF CHANGE " CLASS B DEFICIENCY   APPEALED: 09/11/2009
08/18/2009 COMPLAINT 132.60(5)(A)1. , "RESIDENT CARE/ORDERS " CLASS B DEFICIENCY   APPEALED: 09/11/2009
08/18/2009 COMPLAINT 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY   APPEALED: 09/11/2009
08/18/2009 COMPLAINT 50.09(1)(e) , "Treatment " CLASS B DEFICIENCY   APPEALED: 09/11/2009

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=EASTCASTLE PL BRADFORD TER CONV CTR, MILWAUKEE, SOUTHEAST REGION (CONTACT: Carol Jean Rucker, (414) 227-4563)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
11/13/2008 FULL/COMPLAINT 50.065(3)(b) , "COMPLETE BACKGROUND CHECK PROCESS " NOT ENTERED CORRECTED 12/03/2008 NO APPEAL ON RECORD
11/13/2008 FULL/COMPLAINT 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 12/03/2008 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=EASTSIDE REHAB CTR, MILWAUKEE, SOUTHEAST REGION (CONTACT: Carol Jean Rucker, (414) 227-4563)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
12/09/2008 FULL/COMPLAINT 50.065(3)(b) , "COMPLETE BACKGROUND CHECK PROCESS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 01/07/2009 NO APPEAL ON RECORD
12/09/2008 FULL/COMPLAINT 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 01/07/2009 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=EASTVIEW MED REHAB CTR, ANTIGO, NORTHERN REGION (CONTACT: Jessica Radtke, (715) 365-2801)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
06/10/2009 FULL 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 07/07/2009 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=EDGERTON CARE CENTER, EDGERTON, SOUTHERN REGION (CONTACT: Kristy Pecosky, (608) 266-8633)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
10/16/2008 FULL 132.60(8)(B) , "UPDATING OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 11/13/2008 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=EDGEWATER HAVEN NUR HOME, PORT EDWARDS, NORTHERN REGION (CONTACT: Jessica Radtke, (715) 365-2801)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
11/18/2008 COMPLAINT 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY CORRECTED 12/19/2008 NO APPEAL ON RECORD
02/26/2009 FULL/COMPLAINT 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 04/01/2009 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=ELLSWORTH CARE CTR, ELLSWORTH, WESTERN REGION (CONTACT: Sherry Walters, (715) 836-4420)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
11/10/2008 FULL 50.065(6)(am) , "Four Year Caregiver Background Requirement " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 06/23/2009 NO APPEAL ON RECORD
11/10/2008 FULL 132.45(5)(C)4.B. , "MEDICAL RECORDS-CONTENT-NURSING " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 06/23/2009 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=EVERGREEN CARE CTR, SHAWANO, NORTHEAST REGION (CONTACT: Dolores Zwiers, (920) 983-3185)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
01/27/2009 FULL 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 03/19/2009 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=EVERGREEN HLTH CTR, OSHKOSH, NORTHEAST REGION (CONTACT: Dolores Zwiers, (920) 983-3185)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
10/10/2008 FULL/COMPLAINT 132.65(6)(B)7. , "ACCESSIBILITY TO DRUGS " CLASS B DEFICIENCY CORRECTED 11/10/2008 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=FAIR VIEW NURSING HOME, MAUSTON, NORTHERN REGION (CONTACT: Jessica Radtke, (715) 365-2801)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
12/10/2008 FULL 132.60(8)(B) , "UPDATING OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 01/10/2009 APPEALED: 12/18/2008
12/10/2008 FULL 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 01/10/2009 APPEALED: 12/18/2008
09/23/2009 COMPLAINT 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY   NO APPEAL ON RECORD
09/23/2009 COMPLAINT 132.60(8)(B) , "UPDATING OF CARE PLANS " CLASS B DEFICIENCY   NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=FAIRHAVEN CORP, WHITEWATER, SOUTHEAST REGION (CONTACT: Carol Jean Rucker, (414) 227-4563)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
03/09/2009 FULL 132.51(2)(B)1. , "ADMISSIONS/COMMUNICABLE DISEASE " CLASS B DEFICIENCY CORRECTED 03/23/2009 DISMISSED

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=FALL CREEK VALLEY CARE CTR, FALL CREEK, WESTERN REGION (CONTACT: Sherry Walters, (715) 836-4420)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
11/17/2008 COMPLAINT 50.09(1)(e) , "Treatment " CLASS B DEFICIENCY CORRECTED 12/31/2008 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=FAMILY HERITAGE CARE CTR, BLACK RIVER FALLS, WESTERN REGION (CONTACT: Sherry Walters, (715) 836-4420)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
01/21/2009 COMPLAINT 132.60(1)(C)4. , "RESIDENT CARE/BASIC NRSG CARE " CLASS B DEFICIENCY CORRECTED 02/21/2009 NO APPEAL ON RECORD
09/16/2009 FULL/COMPLAINT 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY   NO APPEAL ON RECORD
09/16/2009 FULL/COMPLAINT 50.09(1)(L) , "Care " CLASS B DEFICIENCY   NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=FOND DU LAC CTY HLTH CARE CTR, FOND DU LAC, NORTHEAST REGION (CONTACT: Dolores Zwiers, (920) 983-3185)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
04/28/2009 FULL 50.065(2)(b)intro , "ENTITY BACKGROUND-CHECK REQUIREMENTS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 05/28/2009 NO APPEAL ON RECORD
04/28/2009 FULL 50.065(4m)(b)intro , "HIRING OR CONTRACTING REQUIREMENTS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 05/28/2009 NO APPEAL ON RECORD
08/13/2009 COMPLAINT 50.065(2)(bm) , "OUT OF STATE BACKGROUND CHECKS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 09/13/2009 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=FOND DU LAC LUTH HOME, FOND DU LAC, NORTHEAST REGION (CONTACT: Dolores Zwiers, (920) 983-3185)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
06/23/2009 FULL 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 07/16/2009 APPEALED: 07/09/2009

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=FORT ATKINSON SUBACUTE CC, FORT ATKINSON, SOUTHEAST REGION (CONTACT: Carol Jean Rucker, (414) 227-4563)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
04/16/2009 FULL 50.065(2)(b)intro , "ENTITY BACKGROUND-CHECK REQUIREMENTS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 05/16/2009 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=FOUNTAIN VIEW CARE CTR, RIPON, NORTHEAST REGION (CONTACT: Dolores Zwiers, (920) 983-3185)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
11/04/2008 COMPLAINT 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 11/24/2008 NO APPEAL ON RECORD
02/13/2009 FULL 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 03/15/2009 APPEALED: 03/04/2009
02/13/2009 FULL 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 03/15/2009 APPEALED: 03/04/2009

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=FRANCISCAN VILLA, SOUTH MILWAUKEE, SOUTHEAST REGION (CONTACT: Carol Jean Rucker, (414) 227-4563)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
02/03/2009 COMPLAINT 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 02/26/2009 NO APPEAL ON RECORD
02/03/2009 COMPLAINT 50.09(1)(k) , "Abuse and Restraints " CLASS A DEFICIENCY CORRECTED 02/26/2009 NO APPEAL ON RECORD
06/30/2009 FULL 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY CORRECTED 07/27/2009 NO APPEAL ON RECORD
06/30/2009 FULL 132.60(1)(C)2. , "RESIDENT CARE/BASIC NRSG CARE " CLASS B DEFICIENCY CORRECTED 07/27/2009 NO APPEAL ON RECORD
06/30/2009 FULL 132.60(1)(C)4. , "RESIDENT CARE/BASIC NRSG CARE " CLASS B DEFICIENCY CORRECTED 07/27/2009 NO APPEAL ON RECORD
06/30/2009 FULL 132.60(2)(D) , "RESIDENT CARE/DIET ACCEPTANCE " CLASS B DEFICIENCY CORRECTED 07/27/2009 NO APPEAL ON RECORD
06/30/2009 FULL 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 07/27/2009 NO APPEAL ON RECORD
06/30/2009 FULL 50.09(1)(L) , "Care " CLASS B DEFICIENCY CORRECTED 07/27/2009 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=FREDERIC NUR REHAB COM, FREDERIC, WESTERN REGION (CONTACT: Sherry Walters, (715) 836-4420)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
04/15/2009 FULL 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 05/11/2009 NO APPEAL ON RECORD
04/15/2009 FULL 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 05/11/2009 NO APPEAL ON RECORD
04/15/2009 FULL 132.62(2)(A)3.B. , "DON/POLICIES AND PROCEDURES " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 05/11/2009 NO APPEAL ON RECORD
04/15/2009 FULL 132.63(4)(B)1. , "THERAPEUTIC DIETS " CLASS B DEFICIENCY CORRECTED 05/11/2009 NO APPEAL ON RECORD
04/15/2009 FULL 132.60(1)(c)5 , "FACILITY SHALL PROVIDE PAIN ASSESSMNT/TREATMT" CLASS B DEFICIENCY CORRECTED 05/11/2009 NO APPEAL ON RECORD
04/15/2009 FULL 50.09(1)(L) , "Care " CLASS B DEFICIENCY CORRECTED 05/11/2009 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2008 to 09/30/2009
Information is current as of 10/29/2009

Facility=FRIENDLY VILLAGE NURSING AND REHAB CENTER, RHINELANDER, NORTHERN REGION (CONTACT: Jessica Radtke, (715) 365-2801)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal++
01/27/2009 FULL/COMPLAINT 50.065(2)(b)intro , "ENTITY BACKGROUND-CHECK REQUIREMENTS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 02/20/2009 DISMISSED
01/27/2009 FULL/COMPLAINT 50.09(1)(L) , "Care " MULTIPLE CLASS 'B' OR 'A' DEFICIENCIES CORRECTED 02/20/2009 APPEALED: 02/19/2009

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Because State appeals of citations are not now available on an accessible central
repository, appeal information is incomplete.