Wisconsin Nursing Homes: State Citations Issued from 10/01/2010 to 9/30/2011
Information is current as of 10/24/2011

Facility=WATER'S EDGE, HAYWARD, 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++
12/20/2010 FULL/COMPLAINT 132.60(5)(a)1 , "RESIDENT CARE/ORDERS " CLASS B DEFICIENCY CORRECTED 01/05/2011 DISMISSED
12/20/2010 FULL/COMPLAINT 132.72(1) , "HOUSEKEEPING " CLASS B DEFICIENCY CORRECTED 01/05/2011 DISMISSED

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Appeal status is as of the last day of the reporting period, in this case September 30, 2011. Changes in the appeal status
occurring after that date will be noted in the updated Nursing Home State Citations Report generated the following quarter.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2010 to 9/30/2011
Information is current as of 10/24/2011

Facility=WAUKESHA SPRINGS HLTH REHAB, WAUKESHA, 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++
01/19/2011 FULL/COMPLAINT 132.60(1)(b) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 02/11/2011 DISMISSED

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Appeal status is as of the last day of the reporting period, in this case September 30, 2011. Changes in the appeal status
occurring after that date will be noted in the updated Nursing Home State Citations Report generated the following quarter.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2010 to 9/30/2011
Information is current as of 10/24/2011

Facility=WAUSAU MANOR, WAUSAU, 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++
02/09/2011 COMPLAINT 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY CORRECTED 03/09/2011 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.
++Appeal status is as of the last day of the reporting period, in this case September 30, 2011. Changes in the appeal status
occurring after that date will be noted in the updated Nursing Home State Citations Report generated the following quarter.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2010 to 9/30/2011
Information is current as of 10/24/2011

Facility=WELLSPRING OF MILWAUKEE, 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++
10/14/2010 REVISIT 132.51(2)(b) , "ADMISSIONS/COMMUNICABLE DISEASE " CLASS B DEFICIENCY UNCORRECTED AT REVISIT DISMISSED
11/15/2010 REVISIT 132.51(2)(b) , "ADMISSIONS/COMMUNICABLE DISEASE " CLASS C DEFICIENCY CORRECTED 11/29/2010 DISMISSED
04/21/2011 COMPLAINT 132.60(1)(b) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 04/21/2011 APPEALED: 05/04/2011
04/21/2011 COMPLAINT 132.695(4)(b)1 , "IPP DEVELOPMENT " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 05/13/2011 APPEALED: 05/04/2011
04/21/2011 COMPLAINT 132.695(4)(b)2 , "IPP " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 05/13/2011 APPEALED: 05/04/2011
04/21/2011 COMPLAINT 132.695(4)(c)2. , "Reassessment of IPP quarterly review " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 05/13/2011 APPEALED: 05/04/2011
09/07/2011 FULL/COMPLAINT 132.695(4)(c)2. , "Reassessment of IPP quarterly review " CLASS C DEFICIENCY   NO APPEAL ON RECORD
09/07/2011 FULL/COMPLAINT 132.60(1)(c)5 , "FACILITY SHALL PROVIDE PAIN ASSESSMNT/TREATMT" CLASS B DEFICIENCY   NO APPEAL ON RECORD
09/29/2011 COMPLAINT 50.09(1)(k) , "Abuse and Restraints " CLASS A 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.
++Appeal status is as of the last day of the reporting period, in this case September 30, 2011. Changes in the appeal status
occurring after that date will be noted in the updated Nursing Home State Citations Report generated the following quarter.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2010 to 9/30/2011
Information is current as of 10/24/2011

Facility=WHISPERING OAKS CARE CTR, PESHTIGO, 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++
01/06/2011 FULL 132.72(3) , "POISONS " CLASS B DEFICIENCY CORRECTED 02/11/2011 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.
++Appeal status is as of the last day of the reporting period, in this case September 30, 2011. Changes in the appeal status
occurring after that date will be noted in the updated Nursing Home State Citations Report generated the following quarter.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2010 to 9/30/2011
Information is current as of 10/24/2011

Facility=WI VETERANS HM AINSWORTH 800, KING, 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++
01/12/2011 COMPLAINT 132.72(1) , "HOUSEKEEPING " CLASS B DEFICIENCY CORRECTED 02/12/2011 NO APPEAL ON RECORD
01/12/2011 COMPLAINT 50.09(1)(k) , "Abuse and Restraints " CLASS B DEFICIENCY CORRECTED 02/12/2011 NO APPEAL ON RECORD
07/13/2011 COMPLAINT 132.60(8)(b) , "UPDATING OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 08/13/2011 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.
++Appeal status is as of the last day of the reporting period, in this case September 30, 2011. Changes in the appeal status
occurring after that date will be noted in the updated Nursing Home State Citations Report generated the following quarter.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2010 to 9/30/2011
Information is current as of 10/24/2011

Facility=WI VETERANS HM MACARTHUR 422, KING, 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++
08/12/2011 FULL/COMPLAINT 132.84(4)(a)-(c) , "RESIDENT AND STAFF COMMUNICATION " CLASS C DEFICIENCY -- CORRECTED BEFORE VISIT COMPLETED CORRECTED 08/12/2011 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.
++Appeal status is as of the last day of the reporting period, in this case September 30, 2011. Changes in the appeal status
occurring after that date will be noted in the updated Nursing Home State Citations Report generated the following quarter.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2010 to 9/30/2011
Information is current as of 10/24/2011

Facility=WI VETERANS HM STORDOCK 700, KING, 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++
12/27/2010 FULL/COMPLAINT 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS A DEFICIENCY CORRECTED 01/11/2011 NO APPEAL ON RECORD
12/27/2010 FULL/COMPLAINT 132.60(8)(b) , "UPDATING OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 02/04/2011 NO APPEAL ON RECORD
12/27/2010 FULL/COMPLAINT 132.60(8)(c) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 02/17/2011 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.
++Appeal status is as of the last day of the reporting period, in this case September 30, 2011. Changes in the appeal status
occurring after that date will be noted in the updated Nursing Home State Citations Report generated the following quarter.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2010 to 9/30/2011
Information is current as of 10/24/2011

Facility=WI VETERANS HOME-BOLAND HALL, UNION GROVE, 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++
01/27/2011 FULL/COMPLAINT 132.60(8)(c) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 02/27/2011 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.
++Appeal status is as of the last day of the reporting period, in this case September 30, 2011. Changes in the appeal status
occurring after that date will be noted in the updated Nursing Home State Citations Report generated the following quarter.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2010 to 9/30/2011
Information is current as of 10/24/2011

Facility=WILD ROSE MANOR, WILD ROSE, 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++
10/14/2010 COMPLAINT 13.05(2) , "CLIENT PROTECTION " CLASS B DEFICIENCY CORRECTED 11/16/2010 APPEALED: 10/29/2010
10/14/2010 COMPLAINT 50.09(1)(k) , "Abuse and Restraints " CLASS B DEFICIENCY CORRECTED 11/16/2010 APPEALED: 10/29/2010
12/08/2010 COMPLAINT 132.60(8)(c) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 01/08/2011 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.
++Appeal status is as of the last day of the reporting period, in this case September 30, 2011. Changes in the appeal status
occurring after that date will be noted in the updated Nursing Home State Citations Report generated the following quarter.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2010 to 9/30/2011
Information is current as of 10/24/2011

Facility=WILLIAMS BAY CARE CENTER, WILLIAMS BAY, 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++
06/30/2011 FULL/COMPLAINT 132.60(3)(a) , "RESIDENT CARE/NOTIFICATION OF CHANGE " CLASS B DEFICIENCY CORRECTED 07/28/2011 APPEALED: 07/22/2011

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Appeal status is as of the last day of the reporting period, in this case September 30, 2011. Changes in the appeal status
occurring after that date will be noted in the updated Nursing Home State Citations Report generated the following quarter.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2010 to 9/30/2011
Information is current as of 10/24/2011

Facility=WILLOW RIDGE HEALTHCARE, 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++
11/09/2010 FULL/COMPLAINT 132.45(5)(c)4.b , "MEDICAL RECORDS-CONTENT-NURSING " CLASS C DEFICIENCY CORRECTED 12/08/2010 NO APPEAL ON RECORD
11/09/2010 FULL/COMPLAINT 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY CORRECTED 12/08/2010 NO APPEAL ON RECORD
11/09/2010 FULL/COMPLAINT 132.60(8)(c) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 12/08/2010 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.
++Appeal status is as of the last day of the reporting period, in this case September 30, 2011. Changes in the appeal status
occurring after that date will be noted in the updated Nursing Home State Citations Report generated the following quarter.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2010 to 9/30/2011
Information is current as of 10/24/2011

Facility=WILLOWCREST CARE CENTER, 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++
05/26/2011 COMPLAINT 132.60(8)(c) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 05/26/2011 NO APPEAL ON RECORD
09/06/2011 FULL/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.
++Appeal status is as of the last day of the reporting period, in this case September 30, 2011. Changes in the appeal status
occurring after that date will be noted in the updated Nursing Home State Citations Report generated the following quarter.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2010 to 9/30/2011
Information is current as of 10/24/2011

Facility=WISCONSIN RAPIDS NURSING AND REHABILITATION CENTER, WISCONSIN RAPIDS, 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++
05/11/2011 FULL 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY CORRECTED 06/06/2011 APPEALED: 06/03/2011
05/11/2011 FULL 132.60(1)(b) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 06/06/2011 APPEALED: 06/03/2011
06/22/2011 COMPLAINT 132.60(8)(c) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 06/06/2011 APPEALED: 07/05/2011
09/27/2011 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.
++Appeal status is as of the last day of the reporting period, in this case September 30, 2011. Changes in the appeal status
occurring after that date will be noted in the updated Nursing Home State Citations Report generated the following quarter.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2010 to 9/30/2011
Information is current as of 10/24/2011

Facility=WOODLAND VILLAGE NURSING HOME, SURING, 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++
04/07/2011 FULL/COMPLAINT 132.60(1)(b) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 04/15/2011 WITHDRAWN
04/07/2011 FULL/COMPLAINT 132.60(8)(c) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 04/20/2011 APPEALED: 04/29/2011
04/07/2011 FULL/COMPLAINT 132.72(1) , "HOUSEKEEPING " CLASS B DEFICIENCY CORRECTED 04/07/2011 APPEALED: 04/29/2011
04/07/2011 FULL/COMPLAINT 132.84(4)(a)-(c) , "RESIDENT AND STAFF COMMUNICATION " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 04/07/2011 APPEALED: 04/29/2011
04/07/2011 FULL/COMPLAINT 132.60(1)(c)5 , "FACILITY SHALL PROVIDE PAIN ASSESSMNT/TREATMT" CLASS B DEFICIENCY CORRECTED 04/15/2011 APPEALED: 04/29/2011
04/07/2011 FULL/COMPLAINT 50.09(1)(L) , "Care " CLASS B DEFICIENCY CORRECTED 04/15/2011 APPEALED: 04/29/2011

*Please direct questions to the Bureau of Nursing Home Resident Care regional contact
noted above after the facility name and location.
++Appeal status is as of the last day of the reporting period, in this case September 30, 2011. Changes in the appeal status
occurring after that date will be noted in the updated Nursing Home State Citations Report generated the following quarter.


Wisconsin Nursing Homes: State Citations Issued from 10/01/2010 to 9/30/2011
Information is current as of 10/24/2011

Facility=WOODSIDE LUTHERAN HOME, 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++
11/01/2010 COMPLAINT 132.60(1)(c)4 , "RESIDENT CARE/BASIC NRSG CARE " MULTIPLE CLASS 'B' OR 'A' DEFICIENCIES CORRECTED 11/30/2010 APPEALED: 11/22/2010
11/01/2010 COMPLAINT 132.60(8)(c) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 11/30/2010 DISMISSED
04/18/2011 COMPLAINT 132.31(1)(d)1 , "ADMISSION INFORMATION " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 05/18/2011 NO APPEAL ON RECORD
07/08/2011 FULL/COMPLAINT 132.60(1)(b) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 07/27/2011 NO APPEAL ON RECORD
07/08/2011 FULL/COMPLAINT 132.84(4)(a)-(c) , "RESIDENT AND STAFF COMMUNICATION " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 07/27/2011 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.
++Appeal status is as of the last day of the reporting period, in this case September 30, 2011. Changes in the appeal status
occurring after that date will be noted in the updated Nursing Home State Citations Report generated the following quarter.