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

Facility=INGLESIDE NUR HOME, MOUNT HOREB, 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++
10/23/2008 FULL 132.51(2)(C) , "ADMISSIONS/DESTRUCTIVE RESIDENTS " CLASS B DEFICIENCY CORRECTED 11/23/2008 NO APPEAL ON RECORD
10/23/2008 FULL 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY UNCORRECTED AT REVISIT NO APPEAL ON RECORD
10/23/2008 FULL 132.60(2)(D) , "RESIDENT CARE/DIET ACCEPTANCE " CLASS B DEFICIENCY CORRECTED 11/23/2008 NO APPEAL ON RECORD
12/03/2008 REVISIT 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 01/13/2009 APPEALED: 12/23/2008

*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=JEWISH HOME AND CARE 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++
09/14/2009 FULL 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY   APPEALED: 09/30/2009

*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=KARMENTA CTR, MADISON, 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++
12/03/2008 FULL/COMPLAINT 132.60(1)(C)4. , "RESIDENT CARE/BASIC NRSG CARE " CLASS B DEFICIENCY UNCORRECTED AT REVISIT NO APPEAL ON RECORD
12/03/2008 FULL/COMPLAINT 132.83(7)(A)2. , "HOT WATER TEMPERATURE " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 01/03/2009 NO APPEAL ON RECORD
01/12/2009 REVISIT 132.60(1)(C)4. , "RESIDENT CARE/BASIC NRSG CARE " CLASS B DEFICIENCY CORRECTED 02/08/2009 NO APPEAL ON RECORD
01/12/2009 COMPLAINT 132.60(1)(C)4. , "RESIDENT CARE/BASIC NRSG CARE " CLASS B DEFICIENCY CORRECTED 02/08/2009 NO APPEAL ON RECORD
04/06/2009 COMPLAINT 132.60(8)(B) , "UPDATING OF CARE PLANS " 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=KINNIC LONG TERM CARE, 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++
12/10/2008 COMPLAINT 50.09(1)(L) , "Care " CLASS B DEFICIENCY CORRECTED 12/29/2008 APPEALED: 12/22/2008

*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=KNAPP HAVEN NUR HOME, CHETEK, 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++
02/05/2009 COMPLAINT 50.09(1)(L) , "Care " CLASS B DEFICIENCY CORRECTED 02/19/2009 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.