Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GILMAN CARE CENTER, LLC, GILMAN, NORTHERN REGION (CONTACT: RFOS Jessica Radtke, (715) 365-2801)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
01/10/2008 FULL 132.62(2)(B)1. , "CHARGE NURSE/STAFFING REQUIREMENTS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 03/12/2008 NO APPEAL ON RECORD
01/10/2008 FULL 132.72(1) , "HOUSEKEEPING " CLASS B DEFICIENCY CORRECTED 03/12/2008 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GOLDEN AGE MNR, AMERY, WESTERN REGION (CONTACT: RFOS Kathy Lyons, (715) 836-3030)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
10/11/2007 FULL 132.45(5)(C)3.A. , "MEDICAL RECORDS-CONTENT-NURSING " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 11/14/2007 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GOLDEN LIVINGCENTER-BEAVER DAM, BEAVER DAM, SOUTHERN REGION (CONTACT: RFOS Pat Virnig, (608) 243-2379)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
03/06/2008 FULL 132.60(1)(C)4. , "RESIDENT CARE/BASIC NRSG CARE " CLASS B DEFICIENCY CORRECTED 04/06/2008 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GOLDEN LIVINGCENTER-BRADLEY, MILWAUKEE, SOUTHEAST REGION (CONTACT: RFOS Carol Jean Rucker, (414) 227-4563)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
06/19/2008 FULL/COMPLAINT 50.065(2)(b)intro , "ENTITY BACKGROUND-CHECK REQUIREMENTS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED   NO APPEAL ON RECORD
06/19/2008 FULL/COMPLAINT 50.065(2)(bm) , "OUT OF STATE BACKGROUND CHECKS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED   NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GOLDEN LIVINGCENTER-COLONIAL MNR, MILWAUKEE, SOUTHEAST REGION (CONTACT: RFOS Carol Jean Rucker, (414) 227-4563)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
11/08/2007 FULL/COMPLAINT 132.60(1)(C)2. , "RESIDENT CARE/BASIC NRSG CARE " CLASS B DEFICIENCY CORRECTED 12/05/2007 NO APPEAL ON RECORD
11/08/2007 FULL/COMPLAINT 132.60(5)(A)1. , "RESIDENT CARE/ORDERS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED UNCORRECTED AT REVISIT NO APPEAL ON RECORD
11/08/2007 FULL/COMPLAINT 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 12/05/2007 NO APPEAL ON RECORD
11/08/2007 FULL/COMPLAINT 132.60(1)(c)5 , "FACILITY SHALL PROVIDE PAIN ASSESSMNT/TREATMT" CLASS B DEFICIENCY CORRECTED 12/05/2007 NO APPEAL ON RECORD
11/08/2007 FULL/COMPLAINT 50.09(1)(f)2. , "Privacy Health Care " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 12/05/2007 NO APPEAL ON RECORD
12/12/2007 REVISIT 132.60(5)(A)1. , "RESIDENT CARE/ORDERS " CLASS C DEFICIENCY CORRECTED 01/12/2008 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GOLDEN LIVINGCENTER-COURT MANOR, ASHLAND, NORTHERN REGION (CONTACT: RFOS Jessica Radtke, (715) 365-2801)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
10/18/2007 COMPLAINT 132.60(1)(c)5 , "FACILITY SHALL PROVIDE PAIN ASSESSMNT/TREATMT" CLASS B DEFICIENCY CORRECTED 11/18/2007 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GOLDEN LIVINGCENTER-FLORENCE, FLORENCE, NORTHERN REGION (CONTACT: RFOS Jessica Radtke, (715) 365-2801)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
11/21/2007 FULL 132.72(1) , "HOUSEKEEPING " CLASS B DEFICIENCY CORRECTED 12/18/2007 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GOLDEN LIVINGCENTER-FORT ATKINSON, FORT ATKINSON, SOUTHEAST REGION (CONTACT: RFOS Carol Jean Rucker, (414) 227-4563)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
10/25/2007 COMPLAINT 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 11/26/2007 NO APPEAL ON RECORD
02/14/2008 FULL/COMPLAINT 50.065(2)(b)intro , "ENTITY BACKGROUND-CHECK REQUIREMENTS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 03/14/2008 NO APPEAL ON RECORD
02/14/2008 FULL/COMPLAINT 132.45(6)(I) , "MEDICAL RECORDS-COURT ORDERS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 03/14/2008 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GOLDEN LIVINGCENTER-GOLDEN AGE, TOMAHAWK, NORTHERN REGION (CONTACT: RFOS Jessica Radtke, (715) 365-2801)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
10/10/2007 COMPLAINT 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 11/01/2007 NO APPEAL ON RECORD
01/30/2008 FULL 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 11/28/2007 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GOLDEN LIVINGCENTER-KENOSHA, KENOSHA, SOUTHEAST REGION (CONTACT: RFOS Carol Jean Rucker, (414) 227-4563)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
11/01/2007 COMPLAINT 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY CORRECTED 12/01/2007 NO APPEAL ON RECORD
11/01/2007 COMPLAINT 132.60(3)(A) , "RESIDENT CARE/NOTIFICATION OF CHANGE " CLASS B DEFICIENCY CORRECTED 12/01/2007 NO APPEAL ON RECORD
11/01/2007 COMPLAINT 132.60(1)(c)5 , "FACILITY SHALL PROVIDE PAIN ASSESSMNT/TREATMT" CLASS B DEFICIENCY CORRECTED 12/01/2007 NO APPEAL ON RECORD
05/20/2008 COMPLAINT 132.72(1) , "HOUSEKEEPING " CLASS B DEFICIENCY CORRECTED 06/19/2008 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GOLDEN LIVINGCENTER-RIVERDALE, MUSCODA, SOUTHERN REGION (CONTACT: RFOS Pat Virnig, (608) 243-2379)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
07/09/2007 COMPLAINT 132.45(5)(C)4.B. , "MEDICAL RECORDS-CONTENT-NURSING " CLASS B DEFICIENCY CORRECTED 08/03/2007 NO APPEAL ON RECORD
07/09/2007 COMPLAINT 132.51(2)(C) , "ADMISSIONS/DESTRUCTIVE RESIDENTS " CLASS B DEFICIENCY CORRECTED 08/03/2007 NO APPEAL ON RECORD
07/09/2007 COMPLAINT 132.60(8)(B) , "UPDATING OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 08/03/2007 NO APPEAL ON RECORD
07/09/2007 COMPLAINT 132.68(5)(A) , "SW REFERRALS " CLASS B DEFICIENCY CORRECTED 08/03/2007 NO APPEAL ON RECORD
10/02/2007 COMPLAINT 132.60(1)(C)4. , "RESIDENT CARE/BASIC NRSG CARE " CLASS A DEFICIENCY CORRECTED 11/06/2007 NO APPEAL ON RECORD
10/02/2007 COMPLAINT 50.09(1)(L) , "Care " CLASS B DEFICIENCY CORRECTED 11/06/2007 NO APPEAL ON RECORD
11/06/2007 COMPLAINT 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 11/21/2007 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GOLDEN LIVINGCENTER-RIVERVIEW, TOMAHAWK, NORTHERN REGION (CONTACT: RFOS Jessica Radtke, (715) 365-2801)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
09/11/2007 FULL/COMPLAINT 132.68(3)(B) , "SOCIAL HISTORY " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED   NO APPEAL ON RECORD
01/25/2008 COMPLAINT 132.51(2)(B)1. , "ADMISSIONS/COMMUNICABLE DISEASE " CLASS B DEFICIENCY CORRECTED 01/27/2008 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GOLDEN LIVINGCENTER-SHEBOYGAN, SHEBOYGAN, NORTHEAST REGION (CONTACT: RFOS Dolores Zwiers, (920) 448-5245)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
03/06/2008 FULL 50.065(3)(b) , "COMPLETE BACKGROUND CHECK PROCESS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED NO APPEAL ON RECORD
03/06/2008 FULL 132.41(1) , "ADMINISTRATOR " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED NO APPEAL ON RECORD
03/06/2008 FULL 132.41(4)(D) , "ADMINISTRATOR-NOTICE OF CHANGE " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GOLDEN LIVINGCENTER-SILVER SPRING, GLENDALE, SOUTHEAST REGION (CONTACT: RFOS Carol Jean Rucker, (414) 227-4563)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
09/20/2007 FULL/COMPLAINT 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY CORRECTED 11/05/2007 NO APPEAL ON RECORD
09/20/2007 FULL/COMPLAINT 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 11/05/2007 NO APPEAL ON RECORD
09/20/2007 FULL/COMPLAINT 132.60(1)(C)2. , "RESIDENT CARE/BASIC NRSG CARE " CLASS B DEFICIENCY CORRECTED 11/05/2007 NO APPEAL ON RECORD
09/20/2007 FULL/COMPLAINT 132.60(5)(A)1. , "RESIDENT CARE/ORDERS " CLASS B DEFICIENCY CORRECTED 11/05/2007 NO APPEAL ON RECORD
09/20/2007 FULL/COMPLAINT 132.60(8)(B) , "UPDATING OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 11/05/2007 NO APPEAL ON RECORD
09/20/2007 FULL/COMPLAINT 132.60(1)(c)5 , "FACILITY SHALL PROVIDE PAIN ASSESSMNT/TREATMT" CLASS B DEFICIENCY CORRECTED 11/05/2007 NO APPEAL ON RECORD
03/31/2008 COMPLAINT 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY CORRECTED 04/30/2008 NO APPEAL ON RECORD
06/19/2008 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 field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GOLDEN LIVINGCENTER-SOUTH SHORE, SAINT FRANCIS, SOUTHEAST REGION (CONTACT: RFOS Carol Jean Rucker, (414) 227-4563)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
05/16/2008 FULL 132.60(1)(C)4. , "RESIDENT CARE/BASIC NRSG CARE " CLASS A DEFICIENCY CORRECTED 06/12/2008 NO APPEAL ON RECORD
05/16/2008 FULL 132.62(2)(A)3.B. , "DON/POLICIES AND PROCEDURES " CLASS B DEFICIENCY CORRECTED 06/12/2008 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GOLDEN LIVINGCENTER-VALLEY OF HAYWARD, HAYWARD, NORTHERN REGION (CONTACT: RFOS Jessica Radtke, (715) 365-2801)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
08/15/2007 FULL 132.60(1)(c)5 , "FACILITY SHALL PROVIDE PAIN ASSESSMNT/TREATMT" CLASS B DEFICIENCY CORRECTED 09/27/2007 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GOLDEN LIVINGCENTER-WATERTOWN, WATERTOWN, SOUTHERN REGION (CONTACT: RFOS Pat Virnig, (608) 243-2379)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
10/02/2007 COMPLAINT 50.09(1) , "RESIDENT'S RIGHTS IN CERTAIN FACILITIES " CLASS B DEFICIENCY CORRECTED 08/10/2007 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GOLDEN LIVINGCENTER-WISCONSIN DELLS, WISCONSIN DELLS, SOUTHERN REGION (CONTACT: RFOS Pat Virnig, (608) 243-2379)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
09/11/2007 COMPLAINT 50.09(1) , "RESIDENT'S RIGHTS IN CERTAIN FACILITIES " CLASS B DEFICIENCY CORRECTED 09/11/2007 NO APPEAL ON RECORD
12/26/2007 COMPLAINT 132.45(1) , "RECORDS " CLASS B DEFICIENCY CORRECTED 01/26/2008 NO APPEAL ON RECORD
12/26/2007 COMPLAINT 132.45(5)(C)4.B. , "MEDICAL RECORDS-CONTENT-NURSING " CLASS B DEFICIENCY CORRECTED 01/26/2008 NO APPEAL ON RECORD
12/26/2007 COMPLAINT 50.09(6) , "RESIDENT'S RIGHTS IN CERTAIN FACILITIES " CLASS B DEFICIENCY CORRECTED 01/26/2008 NO APPEAL ON RECORD
12/26/2007 COMPLAINT 50.09(1)(k) , "Abuse and Restraints " CLASS B DEFICIENCY CORRECTED 01/26/2008 NO APPEAL ON RECORD
04/16/2008 FULL/COMPLAINT 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 05/17/2008 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GOOD SAMARITAN SOCIETY-FENNIMORE, FENNIMORE, SOUTHERN REGION (CONTACT: RFOS Pat Virnig, (608) 243-2379)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
07/11/2007 FULL/COMPLAINT 132.60(8)(B) , "UPDATING OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 08/11/2007 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GOOD SAMARITAN SOCIETY-SCANDIA VILLAGE, SISTER BAY, NORTHEAST REGION (CONTACT: RFOS Dolores Zwiers, (920) 448-5245)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
10/25/2007 FULL 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 11/27/2007 NO APPEAL ON RECORD
10/25/2007 FULL 132.68(5)(B) , "SW/ADJUSTMENT ASSISTANCE " CLASS B DEFICIENCY CORRECTED 11/25/2007 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GOOD SHEPHERD HOME, SEYMOUR, NORTHEAST REGION (CONTACT: RFOS Dolores Zwiers, (920) 448-5245)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
10/05/2007 FULL 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 11/15/2007 NO APPEAL ON RECORD
10/05/2007 FULL 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY UNCORRECTED AT REVISIT NO APPEAL ON RECORD
11/15/2007 REVISIT 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS C DEFICIENCY CORRECTED 12/07/2007 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GRANCARE NUR CTR, GREEN BAY, NORTHEAST REGION (CONTACT: RFOS Dolores Zwiers, (920) 448-5245)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
12/12/2007 COMPLAINT 50.065(3)(b) , "COMPLETE BACKGROUND CHECK PROCESS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 12/30/2007 NO APPEAL ON RECORD
12/12/2007 COMPLAINT 50.09(1)(k) , "Abuse and Restraints " CLASS B DEFICIENCY CORRECTED 01/02/2008 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GRAND VIEW CARE CTR, BLAIR, WESTERN REGION (CONTACT: RFOS Kathy Lyons, (715) 836-3030)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
02/13/2008 FULL/COMPLAINT 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY CORRECTED 03/13/2008 NO APPEAL ON RECORD
02/13/2008 FULL/COMPLAINT 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 03/13/2008 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GRANDE PRAIRIE HLTH REHAB CTR, PLEASANT PRAIRIE, SOUTHEAST REGION (CONTACT: RFOS Carol Jean Rucker, (414) 227-4563)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
07/18/2007 REVISIT 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY CORRECTED 08/01/2007 NO APPEAL ON RECORD
07/18/2007 REVISIT 132.60(2)(D) , "RESIDENT CARE/DIET ACCEPTANCE " CLASS B DEFICIENCY CORRECTED 08/01/2007 NO APPEAL ON RECORD
07/18/2007 REVISIT 132.60(1)(c)5 , "FACILITY SHALL PROVIDE PAIN ASSESSMNT/TREATMT" CLASS B DEFICIENCY CORRECTED 08/01/2007 NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.


Wisconsin Nursing Homes: State Citations Issued from 07/01/2007 to 06/30/2008
Information is current as of 07/24/2008

Facility=GRAYS NUR HOME, PLATTEVILLE, SOUTHERN REGION (CONTACT: RFOS Pat Virnig, (608) 243-2379)*

Survey
Exit Date		 Survey Type Wisconsin
Administrative
Code Cited		 Class Code Revisit
Survey Result		 Status
of Appeal
06/11/2008 FULL 132.60(3)(A) , "RESIDENT CARE/NOTIFICATION OF CHANGE " CLASS B DEFICIENCY   NO APPEAL ON RECORD

*Please direct questions to the Bureau of Nursing Home Resident Care regional field
operations supervisor (RFOS) noted above after the facility name and location.