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

Facility=PARK VIEW HOME, WOODVILLE, 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
07/11/2007 FULL/COMPLAINT 132.45(5)(C)4.B. , "MEDICAL RECORDS-CONTENT-NURSING " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 10/17/2007 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=PARKVIEW MNR HLTH REHAB 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
01/11/2008 COMPLAINT 132.60(5)(A)1. , "RESIDENT CARE/ORDERS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 06/05/2008 NO APPEAL ON RECORD
06/05/2008 FULL/COMPLAINT 50.065(3)(b) , "COMPLETE BACKGROUND CHECK PROCESS " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED   NO APPEAL ON RECORD
06/05/2008 FULL/COMPLAINT 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY   NO APPEAL ON RECORD
06/05/2008 FULL/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=PEABODY MNR, APPLETON, 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
11/28/2007 FULL/COMPLAINT 50.09(1)(L) , "Care " CLASS B DEFICIENCY CORRECTED 12/27/2007 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=PEPIN MNR, PEPIN, 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
03/17/2008 FULL 132.51(2)(B)1. , "ADMISSIONS/COMMUNICABLE DISEASE " CLASS B DEFICIENCY CORRECTED 05/08/2008 NO APPEAL ON RECORD
03/17/2008 FULL 50.09(1)(k) , "Abuse and Restraints " CLASS B DEFICIENCY UNCORRECTED AT REVISIT NO APPEAL ON RECORD
05/08/2008 REVISIT 50.09(1)(k) , "Abuse and Restraints " 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=PINE CREST NUR HOME, MERRILL, 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
03/14/2008 COMPLAINT 132.45(4)(G)1. , "MEDICAL RECORDS-DOCUMENTATION " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 04/14/2008 NO APPEAL ON RECORD
04/18/2008 FULL 132.45(5)(C)3.A. , "MEDICAL RECORDS-CONTENT-NURSING " 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=PINE HAVEN CHRISTIAN HOME, SHEBOYGAN FALLS, 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
05/15/2008 FULL 132.60(1)(c)5 , "FACILITY SHALL PROVIDE PAIN ASSESSMNT/TREATMT" CLASS B DEFICIENCY CORRECTED 06/13/2008 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=PINE VALLEY HLTH CARE REHAB, RICHLAND CENTER, 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
05/08/2008 FULL 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY CORRECTED 06/08/2008 NO APPEAL ON RECORD
05/08/2008 FULL 132.60(1)(C)4. , "RESIDENT CARE/BASIC NRSG CARE " CLASS B DEFICIENCY CORRECTED 06/08/2008 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=PINE VIEW CARE CTR, BLACK RIVER FALLS, 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
08/22/2007 COMPLAINT 132.31(1)(E) , "TREATMENT " CLASS B DEFICIENCY CORRECTED 09/22/2007 NO APPEAL ON RECORD
08/22/2007 COMPLAINT 132.31(1)(L) , "CARE " CLASS B DEFICIENCY CORRECTED 09/22/2007 NO APPEAL ON RECORD
08/22/2007 COMPLAINT 132.45(5)(C)4.B. , "MEDICAL RECORDS-CONTENT-NURSING " CLASS C DEFICIENCY -- CORRECTION ORDER SERVED CORRECTED 09/22/2007 NO APPEAL ON RECORD
01/09/2008 FULL 132.60(1)(B) , "RESIDENT CARE/DECUBITI PREVENTION " CLASS B DEFICIENCY CORRECTED 02/09/2008 NO APPEAL ON RECORD
01/09/2008 FULL 132.60(1)(C)4. , "RESIDENT CARE/BASIC NRSG CARE " CLASS A DEFICIENCY CORRECTED 02/09/2008 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=PIONEER NUR HOME, PRAIRIE FARM, 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 132.60(3)(A) , "RESIDENT CARE/NOTIFICATION OF CHANGE " CLASS B DEFICIENCY CORRECTED 11/12/2007 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=PLEASANT VIEW NUR HOME, MONROE, 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
12/03/2007 COMPLAINT 132.60(3)(A) , "RESIDENT CARE/NOTIFICATION OF CHANGE " CLASS B DEFICIENCY CORRECTED 01/18/2008 NO APPEAL ON RECORD
12/03/2007 COMPLAINT 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 01/18/2008 NO APPEAL ON RECORD
12/18/2007 FULL 132.60(1) , "RESIDENT CARE/INDIVIDUAL CARE " CLASS B DEFICIENCY CORRECTED 01/18/2008 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=PLUM CITY CARE CTR, PLUM CITY, 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
07/30/2007 FULL 132.31(1)(L) , "CARE " CLASS A DEFICIENCY CORRECTED 08/17/2007 APPEALED: 09/30/2007
07/30/2007 FULL 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 08/17/2007 APPEALED: 09/30/2007

*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=PRAIRIE MAISON, PRAIRIE DU CHIEN, 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
07/12/2007 FULL 132.60(1)(c)5 , "FACILITY SHALL PROVIDE PAIN ASSESSMNT/TREATMT" CLASS B DEFICIENCY CORRECTED 08/15/2007 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=PREMIER REHAB SKILLED NUR, BELOIT, 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
10/10/2007 COMPLAINT 132.60(8)(C) , "IMPLEMENTATION OF CARE PLANS " CLASS B DEFICIENCY CORRECTED 10/10/2007 NO APPEAL ON RECORD
03/11/2008 COMPLAINT 132.60(1)(C)4. , "RESIDENT CARE/BASIC NRSG CARE " MULTIPLE CLASS 'B' OR 'A' DEFICIENCIES CORRECTED 04/11/2008 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.