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

Facility=PARKSIDE CARE CENTER, LLC, LITTLE CHUTE, 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 COMPLAINT 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY UNCORRECTED AT REVISIT NO APPEAL ON RECORD
11/20/2008 COMPLAINT 50.09(1)(L) , "Care " CLASS B DEFICIENCY CORRECTED 03/16/2009 NO APPEAL ON RECORD
03/16/2009 FULL 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 04/16/2009 DISMISSED
03/16/2009 FULL 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 04/16/2009 DISMISSED
03/16/2009 FULL 132.60(1)(c)5 , "FACILITY SHALL PROVIDE PAIN ASSESSMNT/TREATMT" CLASS B DEFICIENCY CORRECTED 04/16/2009 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=PARKVIEW MNR HLTH REHAB 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++
04/29/2009 COMPLAINT 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY CORRECTED 05/19/2009 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=PEABODY MANOR, APPLETON, 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++
12/03/2008 FULL/COMPLAINT 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY UNCORRECTED AT REVISIT NO APPEAL ON RECORD
12/03/2008 FULL/COMPLAINT 132.60(1)(C)2. , "RESIDENT CARE/BASIC NRSG CARE " CLASS B DEFICIENCY CORRECTED 12/26/2008 NO APPEAL ON RECORD
12/03/2008 FULL/COMPLAINT 132.60(1)(c)5 , "FACILITY SHALL PROVIDE PAIN ASSESSMNT/TREATMT" CLASS B DEFICIENCY CORRECTED 12/26/2008 NO APPEAL ON RECORD
01/07/2009 REVISIT 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 01/10/2009 DISMISSED
06/09/2009 COMPLAINT 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 06/30/2009 NO APPEAL ON RECORD
07/29/2009 COMPLAINT 132.45(5)(L) , "MEDICAL RECORDS-CONTENT-DISCHARGE " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 08/14/2009 NO APPEAL ON RECORD
07/29/2009 COMPLAINT 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY CORRECTED 08/14/2009 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=PEPIN MNR, PEPIN, 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++
11/18/2008 COMPLAINT 50.09(1)(k) , "Abuse and Restraints " CLASS B DEFICIENCY CORRECTED 12/17/2008 NO APPEAL ON RECORD
01/22/2009 FULL/COMPLAINT 132.60(5)(d)1. , "Resident Care Admin of Meds " CLASS B DEFICIENCY CORRECTED 02/25/2009 APPEALED: 02/12/2009
01/22/2009 FULL/COMPLAINT 132.72(1) , "HOUSEKEEPING " CLASS B DEFICIENCY CORRECTED 02/25/2009 APPEALED: 02/12/2009
01/22/2009 FULL/COMPLAINT 132.60(1)(c)5 , "FACILITY SHALL PROVIDE PAIN ASSESSMNT/TREATMT" CLASS B DEFICIENCY CORRECTED 02/25/2009 APPEALED: 02/12/2009

*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=PINE CREST NUR HOME, MERRILL, 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++
05/21/2009 FULL 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY CORRECTED 06/21/2009 NO APPEAL ON RECORD
05/21/2009 FULL 132.60(1)(c)5 , "FACILITY SHALL PROVIDE PAIN ASSESSMNT/TREATMT" CLASS B DEFICIENCY CORRECTED 06/21/2009 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=PINE HAVEN CHRISTIAN HOME, SHEBOYGAN FALLS, 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++
12/29/2008 COMPLAINT 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 01/27/2009 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=PINE MNR HCC, 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++
08/03/2009 FULL 132.51(2)(C) , "ADMISSIONS/DESTRUCTIVE RESIDENTS " CLASS B DEFICIENCY CORRECTED 09/03/2009 NO APPEAL ON RECORD
08/03/2009 FULL 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 09/03/2009 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=PINE VIEW 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++
08/19/2009 COMPLAINT 132.51(2)(C) , "ADMISSIONS/DESTRUCTIVE RESIDENTS " 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=PIONEER NUR HOME, PRAIRIE FARM, 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++
01/07/2009 COMPLAINT 132.60(5)(D)2. , "RESIDENT CARE/ADM OF MEDS " CLASS B DEFICIENCY CORRECTED 02/06/2009 DISMISSED
05/27/2009 COMPLAINT 132.60(1)(C)4. , "RESIDENT CARE/BASIC NRSG CARE " CLASS B DEFICIENCY CORRECTED 06/10/2009 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=PLEASANT VIEW NUR HOME, MONROE, 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++
03/24/2009 FULL 132.51(2)(C) , "ADMISSIONS/DESTRUCTIVE RESIDENTS " CLASS B DEFICIENCY CORRECTED 04/20/2009 APPEALED: 04/07/2009
03/24/2009 FULL 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 04/20/2009 APPEALED: 04/07/2009

*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=PLYMOUTH CARE CENTER, PLYMOUTH, 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++
06/22/2009 COMPLAINT 50.09(1)(L) , "Care " CLASS B DEFICIENCY CORRECTED 07/22/2009 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=PRAIRIE MAISON, PRAIRIE DU CHIEN, 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 COMPLAINT 132.60(1)(C)4. , "RESIDENT CARE/BASIC NRSG CARE " CLASS B DEFICIENCY CORRECTED 06/02/2009 NO APPEAL ON RECORD
09/24/2009 FULL 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " 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=PREMIER REHAB AND SKILLED NURSING, BELOIT, 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++
09/01/2009 FULL/COMPLAINT 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY   APPEALED: 09/18/2009
09/01/2009 FULL/COMPLAINT 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY   APPEALED: 09/18/2009

*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.