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

Facility=GENEVA LAKE MNR, LAKE GENEVA, 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++
04/13/2009 FULL 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 05/13/2009 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=GILMAN CARE CENTER, LLC, GILMAN, 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++
10/16/2008 FULL/COMPLAINT 50.065(2)(bm) , "OUT OF STATE BACKGROUND CHECKS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 11/25/2008 NO APPEAL ON RECORD
10/16/2008 FULL/COMPLAINT 50.065(3)(b) , "COMPLETE BACKGROUND CHECK PROCESS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 11/25/2008 NO APPEAL ON RECORD
10/16/2008 FULL/COMPLAINT 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY CORRECTED 11/25/2008 NO APPEAL ON RECORD
10/16/2008 FULL/COMPLAINT 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 11/25/2008 NO APPEAL ON RECORD
10/16/2008 FULL/COMPLAINT 132.60(1)(C)2. , "RESIDENT CARE/BASIC NRSG CARE " CLASS B DEFICIENCY UNCORRECTED AT REVISIT NO APPEAL ON RECORD
10/16/2008 FULL/COMPLAINT 132.60(1)(c)5 , "FACILITY SHALL PROVIDE PAIN ASSESSMNT/TREATMT" CLASS B DEFICIENCY CORRECTED 11/12/2008 NO APPEAL ON RECORD
11/25/2008 REVISIT 132.60(1)(C)2. , "RESIDENT CARE/BASIC NRSG CARE " CLASS C DEFICIENCY CORRECTED 12/25/2008 NO APPEAL ON RECORD
11/25/2008 COMPLAINT 132.60(1)(C)2. , "RESIDENT CARE/BASIC NRSG CARE " CLASS C DEFICIENCY CORRECTED 12/25/2008 APPEALED: 12/19/2008
11/25/2008 COMPLAINT 132.60(1)(C)4. , "RESIDENT CARE/BASIC NRSG CARE " CLASS B DEFICIENCY CORRECTED 12/11/2008 APPEALED: 12/19/2008
02/09/2009 COMPLAINT 132.82(1) , "LIFE SAFETY/1967 CODE " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 08/05/2009 NO APPEAL ON RECORD
02/09/2009 COMPLAINT 132.82(6)(A)5. , "DISASTER PLAN/DIAGRAM " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 08/05/2009 NO APPEAL ON RECORD
04/28/2009 COMPLAINT 132.60(3)(A) , "RESIDENT CARE/NOTIFICATION OF CHANGE " CLASS B DEFICIENCY CORRECTED 05/28/2009 APPEALED: 05/21/2009
04/28/2009 COMPLAINT 50.09(1)(L) , "Care " CLASS B DEFICIENCY CORRECTED 05/29/2009 APPEALED: 05/21/2009

*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=GLENHAVEN, GLENWOOD CITY, 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++
04/08/2009 FULL/COMPLAINT 50.09(1)(e) , "Treatment " CLASS B DEFICIENCY CORRECTED 05/01/2009 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=GOLDEN AGE MNR, AMERY, 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++
08/13/2009 FULL/COMPLAINT 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY   APPEALED: 09/17/2009
08/13/2009 FULL/COMPLAINT 132.60(1)(c)5 , "FACILITY SHALL PROVIDE PAIN ASSESSMNT/TREATMT" CLASS B DEFICIENCY   APPEALED: 09/17/2009
08/13/2009 FULL/COMPLAINT 50.09(1)(L) , "Care " CLASS B DEFICIENCY   APPEALED: 09/17/2009

*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=GOLDEN LIVINGCENTER-BEAVER DAM, BEAVER DAM, 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++
04/28/2009 FULL/COMPLAINT 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 05/26/2009 NO APPEAL ON RECORD
04/28/2009 FULL/COMPLAINT 132.60(1)(C)4. , "RESIDENT CARE/BASIC NRSG CARE " MULTIPLE CLASS 'B' OR 'A' DEFICIENCIES CORRECTED 05/26/2009 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=GOLDEN LIVINGCENTER-BRADLEY, 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++
06/16/2009 FULL/COMPLAINT 132.60(8)(B) , "UPDATING OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 07/16/2009 NO APPEAL ON RECORD
06/16/2009 FULL/COMPLAINT 132.62(3)(B) , "NURSING ASSIGNMENTS " CLASS B DEFICIENCY CORRECTED 07/16/2009 NO APPEAL ON RECORD
06/16/2009 FULL/COMPLAINT 132.65(6)(B)1. , "STORAGE OF MEDICATIONS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 07/16/2009 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=GOLDEN LIVINGCENTER-COLONIAL MNR, GLENDALE, 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++
02/19/2009 COMPLAINT 132.60(5)(A)1. , "RESIDENT CARE/ORDERS " CLASS C DEFICIENCY CORRECTED 03/19/2009 NO APPEAL ON RECORD
06/04/2009 COMPLAINT 132.45(6)(F) , "MEDICAL RECORDS-INSERVICE/ORIENTATION " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 06/30/2009 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=GOLDEN LIVINGCENTER-CONTINENTAL MANOR OF RANDOLPH, RANDOLPH, 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++
05/12/2009 FULL/COMPLAINT 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 06/12/2009 APPEALED: 06/05/2009

*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=GOLDEN LIVINGCENTER-GOLDEN AGE, TOMAHAWK, 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++
12/03/2008 FULL/COMPLAINT 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 12/31/2008 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=GOLDEN LIVINGCENTER-KENOSHA, KENOSHA, 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++
07/16/2009 FULL/COMPLAINT 132.60(2)(A) , "RESIDENT CARE/NOURISHMENT-DIETS " CLASS B DEFICIENCY CORRECTED 08/12/2009 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=GOLDEN LIVINGCENTER-RIB LAKE, RIB LAKE, 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++
01/14/2009 FULL 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY CORRECTED 02/14/2009 APPEALED: 02/05/2009

*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=GOLDEN LIVINGCENTER-RIVERVIEW, TOMAHAWK, 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++
10/30/2008 REVISIT 132.60(1)(C)4. , "RESIDENT CARE/BASIC NRSG CARE " CLASS B DEFICIENCY CORRECTED 11/07/2008 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=GOLDEN LIVINGCENTER-SHEBOYGAN, SHEBOYGAN, 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++
04/27/2009 COMPLAINT 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY CORRECTED 05/27/2009 APPEALED: 05/18/2009

*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=GOLDEN LIVINGCENTER-SOUTH SHORE, SAINT FRANCIS, 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++
06/25/2009 COMPLAINT 132.51(2)(C) , "ADMISSIONS/DESTRUCTIVE RESIDENTS " CLASS B DEFICIENCY CORRECTED 07/25/2009 APPEALED: 07/17/2009

*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=GOLDEN LIVINGCENTER-THREE OAKS, MARSHFIELD, 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++
09/17/2009 FULL/COMPLAINT 132.60(1) , "RESIDENT CARE/INDIVIDUAL 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=GOLDEN LIVINGCENTER-VILLAGE GARDENS, GREEN BAY, 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++
07/13/2009 FULL 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 08/13/2009 APPEALED: 08/03/2009

*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=GOLDEN LIVINGCENTER-WATERTOWN, WATERTOWN, 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++
02/23/2009 COMPLAINT 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS A DEFICIENCY CORRECTED 03/24/2009 APPEALED: 03/19/2009
02/23/2009 COMPLAINT 132.60(1)(C)4. , "RESIDENT CARE/BASIC NRSG CARE " MULTIPLE CLASS 'B' OR 'A' DEFICIENCIES CORRECTED 03/24/2009 APPEALED: 03/19/2009
06/04/2009 FULL 132.60(2)(D) , "RESIDENT CARE/DIET ACCEPTANCE " CLASS B DEFICIENCY CORRECTED 07/07/2009 APPEALED: 06/26/2009
06/04/2009 FULL 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 07/07/2009 APPEALED: 06/26/2009

*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=GOLDEN LIVINGCENTER-WISCONSIN DELLS, WISCONSIN DELLS, 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++
05/21/2009 FULL/COMPLAINT 132.60(2)(D) , "RESIDENT CARE/DIET ACCEPTANCE " CLASS B DEFICIENCY CORRECTED 06/21/2009 DISMISSED
05/21/2009 FULL/COMPLAINT 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 06/21/2009 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=GOLDEN YEARS HLTH CTR, WALWORTH, 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++
11/19/2008 FULL 50.065(3)(b) , "COMPLETE BACKGROUND CHECK PROCESS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 12/15/2008 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=GOOD SAMARITAN SOCIETY-FENNIMORE, FENNIMORE, 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++
05/06/2009 COMPLAINT 132.60(3)(A) , "RESIDENT CARE/NOTIFICATION OF CHANGE " CLASS B DEFICIENCY CORRECTED 06/18/2009 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=GOOD SAMARITAN SOCIETY-LODI, LODI, 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++
01/21/2009 FULL 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY CORRECTED 02/21/2009 NO APPEAL ON RECORD
01/21/2009 FULL 132.60(1)(C)4. , "RESIDENT CARE/BASIC NRSG CARE " CLASS B DEFICIENCY CORRECTED 02/18/2009 NO APPEAL ON RECORD
01/21/2009 FULL 132.60(2)(D) , "RESIDENT CARE/DIET ACCEPTANCE " CLASS B DEFICIENCY CORRECTED 02/21/2009 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=GOOD SAMARITAN SOCIETY-SCANDIA VILLAGE, SISTER BAY, 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++
11/20/2008 FULL/COMPLAINT 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 12/20/2008 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=GOOD SAMARITAN SOCIETY-ST CROIX VALLEY, ST CROIX 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++
11/25/2008 COMPLAINT 50.09(1)(L) , "Care " CLASS B DEFICIENCY CORRECTED 12/30/2008 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=GRANCARE NUR CTR, GREEN BAY, 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++
10/01/2008 FULL 132.72(1) , "HOUSEKEEPING " CLASS C DEFICIENCY CORRECTED 10/23/2008 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=GRAND VIEW CARE CTR, BLAIR, 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++
12/02/2008 FULL 132.65(6)(C)1. , "DESTRUCTION OF MEDICATIONS " 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=GRANDE PRAIRIE HLTH REHAB CTR, PLEASANT PRAIRIE, 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++
06/04/2009 COMPLAINT 132.60(1)(C)4. , "RESIDENT CARE/BASIC NRSG CARE " CLASS A DEFICIENCY CORRECTED 06/24/2009 NO APPEAL ON RECORD
06/04/2009 COMPLAINT 132.60(5)(A)1. , "RESIDENT CARE/ORDERS " CLASS A DEFICIENCY CORRECTED 06/24/2009 NO APPEAL ON RECORD
09/02/2009 FULL/COMPLAINT 132.60(1)(c)5 , "FACILITY SHALL PROVIDE PAIN ASSESSMNT/TREATMT" CLASS B DEFICIENCY CORRECTED 09/08/2009 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=GREENTREE HLTH REHAB CTR, CLINTONVILLE, 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++
12/18/2008 FULL 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 03/31/2009 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.