Park Manor LTD
250 Lawrence Ave, Park Falls, WI 54552 · For profit - Corporation · 92 certified beds · (715) 762-2449 Medicare & Medicaid certified
This home’s record is mixed — some reassuring signs, some worth asking about.
- a strong health-inspection score (4/5) — the hardest rating to game (though it’s ranked within its own state, not nationally)
- no federal fines or payment denials on record
- fewer deficiencies at its most recent standard inspection than at the one before — a sign of improvement
- it has citations for its abuse-prevention policies, restraint use, or reporting and investigating of allegations (F0609, F0610) — cited below the harm level, meaning inspectors found the process wanting but did not find a resident harmed
- a high number of inspection citations overall (18) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags
- it did not file the payroll staffing data CMS requires — its 1 of 5 staffing rating is the rating CMS assigns for not reporting, not a measure of how many nurses are on the floor
One thing this read cannot see: what residents and families actually experience day to day. Public data misses the feel of a place — visit unannounced, ideally at a mealtime or on a weekend, talk to staff and families, and ask your tour questions.
A plain-English summary of the public record below — not a rating, ranking, or recommendation. We take no money from any facility.
| Health inspectionSurveyor-assigned, ranked within your stateInspector-verified | 4 of 5 |
| StaffingFrom payroll records (PBJ) | 1 of 5 |
| Quality measuresSelf-reported by the facility | 3 of 5 |
Location & what’s nearby
Open in Google Maps ↗ · Directions ↗ · Larger map ↗
Nearest of each type, straight-line distance. Hospitals come from the CMS Hospital General Information registry; everything else from Overture Maps (public data). Hospital and park hours are typical — call ahead to confirm.
Quality measures — how residents actually fare
| Overall quality measures | 3 of 5 |
| Long-stay residentspeople who live here | 3 of 5 |
| Short-stay residentsrehab / post-hospital | 4 of 5 |
Quality-measure stars summarize outcomes CMS tracks from the assessments each home submits — avoidable hospitalizations and ER visits, falls with injury, pressure ulcers, unplanned weight loss, and long-term antipsychotic use. Because the underlying data is self-reported, weigh a high score against the independent inspection record. Long-stay = permanent residents; short-stay = rehab and post-hospital stays.
Trend — is this home getting better or worse?
Over 2025-02 to 2026-06, this home’s CMS overall rating improved from 4 to 5 stars. From monthly CMS archive snapshots.
Horizontal axis runs 2025-02 to 2026-06. That is where CMS’s monthly archive ends, so the right-hand edge of each line is that month — not today.
See all quality measures vs. state & national benchmarks
| Measure | This home | State avg | Typical state | vs typical state |
|---|---|---|---|---|
| Long-stay residents whose need for help with daily activities increased | 25.1% | 16.1% | 15.4% | worse |
| Long-stay residents who lose too much weight | 9.1% | 5.1% | 5.4% | worse |
| Long-stay residents with a catheter left in their bladder | 1.6% | 2.1% | 0.9% | better than state‡ — see note marked double-dagger below the table |
| Long-stay residents with a urinary tract infection | 3.4% | 2.7% | 2.0% | worse |
| Long-stay residents with depressive symptoms | 0.0% | 5.7% | 6.5% | check this* — see note marked star below the table |
| Long-stay residents who were physically restrained | 0.0% | 0.1% | 0.1% | better |
| Long-stay residents with falls causing major injury | 6.0% | 3.3% | 3.3% | worse |
| Long-stay residents whose ability to walk worsened | 19.4% | 18.4% | 16.1% | worse |
| Long-stay residents on antianxiety or hypnotic medication | 15.0% | 16.9% | 18.9% | better |
| Long-stay residents given the seasonal flu vaccine | 100.0% | 95.0% | 95.3% | typical |
| Long-stay residents with pressure ulcers | 1.4% | 5.0% | 4.7% | better |
| Long-stay residents with worsening bladder/bowel control | 32.1% | 24.6% | 21.2% | worse |
| Long-stay residents who got an antipsychotic medication§ — see the note below the table | 6.8% | 15.8% | 17.1% | better |
| Short-stay residents who newly got an antipsychotic medication | 2.1% | 1.2% | 1.4% | worse |
| Short-stay residents given the seasonal flu vaccine | 96.1% | 82.2% | 79.4% | better |
| Short-stay residents rehospitalized after admission | 23.6% | 23.1% | 22.6% | typical |
| Short-stay residents with an outpatient ER visit | 31.7% | 15.5% | 12.0% | worse |
| Long-stay hospitalizations per 1,000 resident days | 1.20 | 1.66 | 1.67 | better |
| Long-stay outpatient ER visits per 1,000 resident days | 6.16 | 2.29 | 1.80 | worse |
* This home reported 0% on a measure where lower is better. That can mean genuinely excellent care — but because the number is self-reported, a zero can also mean the problem was not recorded. Weigh it against the inspection record above.
‡ On this measure the state average is at least twice (or half) the typical state — a gap that size is usually how the state codes and reports the measure, not how its homes actually perform. Against a benchmark this state does not sit on, a “vs typical state” verdict would mostly be measuring the state, so we compare this home with its own state instead and show both averages.
§ Antipsychotics carry an FDA boxed warning — they raise the risk of death in older people with dementia-related psychosis, and are not approved for that use. So this measure is partly a read on whether a home sedates residents instead of staffing for them. But read a low rate carefully in both directions: CMS excludes residents coded with schizophrenia (and Tourette's or Huntington's) from this measure, and federal auditors have found implausible increases in schizophrenia coding since the measure was published — so a very low rate can reflect recoding rather than less prescribing. Ask the home what share of its residents carry a schizophrenia diagnosis, and how it handles behavioral symptoms without medication.
CMS quality measures, as Care Compare shows them. For most rows lower is better (fewer falls, ulcers, hospitalizations); vaccination rates are the exception. Not every row is risk-adjusted. CMS adjusts some measures for resident mix, but falls with major injury, antipsychotic use, physical restraints and the vaccination rates are unadjusted rates — so a home caring for heavier or more behaviorally complex residents can look worse on them without providing worse care. The “typical state” column is the median of the 50 state averages — not a national average of all homes. We use it because a plain average across homes is pulled badly off course by a few states’ reporting habits (long-stay depressive symptoms is the clearest case: Illinois codes it several times higher than most states, which alone lifted the all-homes figure to about twice what a typical state records). The median of state averages resists that — but it does weigh every state equally, so a large state counts no more than a small one, and it is a benchmark of our construction rather than a CMS-published figure. better/worse means the home differs from that benchmark by more than 10% of it; closer than that reads typical. CMS does not publish how many residents each measure covers, and the counts are often small — a single resident can move a rate by several points — so treat small gaps as noise. These come from data the facility reports, so weigh them against the independent inspection record above.
Short-stay rehab — if you are coming here from a hospital
Arriving from a hospital right now? Read the discharge guide → — your appeal rights, how to slow a rushed discharge, and what to ask about the numbers below.
53.7% of the Medicare patients who left this home got back to the community and stayed there for at least 31 days — which CMS reads as no different from the national rate. This is CMS’s risk-adjusted rate over 115 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.
Met the expected recovery: 76.5% of this home’s Medicare short-stay residents left it at or above the ability to care for themselves and move around that CMS predicted for them, across 51 stays in Oct 2024–Sep 2025. The median of the 11,061 homes CMS publishes this for is 56.6%. Read it beside the getting-home figure, not instead of it: unlike the two measures above, CMS makes no better-or-worse call on this one and publishes no confidence interval for it, so this is a comparison and not a verdict — but it is the short-stay measure that separates homes most, and the one to ask about.
Therapy staffing: this home’s payroll records show 0.38 therapist hours per resident per day in 2026Q1 — more than 65% of the 13,892 homes that report any therapy hours at all.
Weekend therapy: weekend therapy hours are 22% of this home’s weekday level — it runs some therapy at the weekend, at a lower level than on weekdays. The median home that reports therapy runs 13% — weekday-focused therapy is the industry norm, not a shortfall. But recovery does not pause on a Saturday: ask what the weekend actually looks like here.
This section is about rehab stays, not living here. Most of this page — the stars, the quality measures, the inspection record — describes the home the way a permanent resident experiences it. These figures describe the short Medicare stay after a hospital discharge: a hip, a stroke, a bad infection, six weeks and home. They are different residents, different staff, often a different wing. Therapy hours are per resident in the building, not per rehab patient — the count includes every long-stay resident, and they mostly get no therapy at all. So a home with a small rehab wing inside a large nursing population reads low here even if its rehab patients get plenty of therapy, and a mostly-rehab home reads high. Use it to compare homes doing similar work, ask what a rehab resident actually gets in a day, and remember that CMS does not publish therapy minutes per patient — nobody does.
See every short-stay measure CMS publishes for this home
| Measure | This home | U.S. median | Period covered | CMS’s call |
|---|---|---|---|---|
| Got home and stayed homeRate of successful return to home or community from a SNF | 53.7%CMS range 46.2–60.6 | 51.5% | Oct 2022–Sep 2024 | no different from U.S. |
| Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF | 9.6%CMS range 7.0–13.6 | 10.7% | Oct 2022–Sep 2024 | no different from U.S. |
| Met the expected recoveryPercentage of residents who are at or above an expected ability to care for themselves and move around at discharge | 76.5% | 56.6% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Self-care at dischargePercentage of residents who are at or above an expected ability to care for themselves at discharge | 64.7% | 52.8% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Moving around at dischargePercentage of residents who are at or above an expected ability to move around at discharge | 64.7% | 50.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Medication problems followed upPercentage of residents whose medications were reviewed and who received follow-up care when medication issues were identified | 100.0% | 98.7% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Medication list to the next providerPercentage of residents where the SNF provided a current medication list to the next health care setting | 100.0% | 100.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Medication list to the familyPercentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge | 92.9% | 98.7% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Falls with major injuryPercentage of SNF residents who experience one or more falls with major injury during their SNF stay | 4.0% | 0.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| New or worsened pressure ulcersPercentage of residents with pressure ulcers/pressure injuries that are new or worsened | 0.0% | 1.9% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Infections that led to hospitalPercentage of infections residents got during their SNF stay that resulted in hospitalization | 5.5%CMS range 2.7–9.9 | 7.1% | Oct 2023–Sep 2024 | no different from U.S. |
| Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs | 1.08 | 1.02 | Oct 2022–Sep 2024 | CMS makes no comparison for this measure |
From the CMS Skilled Nursing Facility Quality Reporting Program — Medicare short-stay outcomes, which is a different dataset from the long-stay quality measures above and describes a different set of residents. Where CMS risk-adjusts a measure we show its adjusted rate, and the CMS range beside it is the confidence interval CMS publishes: a home whose range is wide is a home with few stays, where one patient moves the number several points. Read the period column. These measures do not share a window — the claims-based ones (getting home, readmission, spending) lag by a year or more, because a stay has to finish and its claims settle before it can be counted. CMS’s call is CMS’s, not ours: it is the only place anyone tests whether this home differs from the national rate at all, and most homes on most measures do not. Two caveats on it. CMS tests only three of these measures — getting home, readmission, and infections that led to hospital; on the other nine it publishes a rate and no comparison, and rather than compute a verdict CMS declined to make, we say so in the column. And on readmission almost every home in the country lands on “no different”, so that row separates homes far less than getting-home does — which is why met the expected recovery, a measure CMS does not test but which spreads across the whole range, is called out above the table rather than left in this list. The U.S. median column is our own, taken across every home CMS publishes that measure for in this same file; it is not a CMS-published benchmark. Homes CMS gives no rate for are left out of it rather than counted as zero. Medicare spending per stay is a ratio, not a percentage — 1.00 means this home’s Medicare spending for a stay matched the national figure CMS compares it against, and it measures cost to Medicare, not quality of care.
Staffing
No payroll-based (PBJ) staffing hours are on file for this home — and the record suggests that is because it did not report them. CMS rates its staffing 1 of 5, which is the rating CMS assigns when a home does not report. Every Medicare-certified nursing home is required to submit its actual payroll data quarterly, and that submission is what makes staffing numbers auditable rather than a claim. A home that does not file is not the same as a home with no data yet: ask this home directly what its nurse-to-resident ratios and weekend RN coverage are, why its payroll data is not filed, and weigh the independent health-inspection score heavily in the meantime.
Inspection trend
Deficiencies are fewer than at the previous inspection — improving. Fewer citations over time suggests a home is fixing problems; a rising count is a warning sign — though two surveys are a short record, and survey teams differ. These counts are from the standard annual health survey only; the full citation list below may also include findings from complaint investigations, so the two won’t always add up.
Inspection deficiencies
State health-inspection citations, most serious first. Each carries an F-code (the federal rule it cites, e.g. F-684 = quality of care) and a letter A–L marking how serious and how widespread the problem was — we translate that grid into the plain tiers shown here. Wording is the official federal description.
Each letter is a CMS scope-severity level; highlighted ones are where this home has citations. A–C = no harm found; D–F = potential for harm; G–I = actual harm; J–L = immediate jeopardy. Within each band the later letter is the more widespread finding (an isolated G is one resident; a widespread I is a pattern), so rightward and downward is worse.
18 citations, most serious first. The 10 most serious are shown; the remaining 8 are one tap away and print in full.
- Potential for harm · D2026-05-06 · tag F0609 — failed to report abuse allegations — isolatedTimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on Interview and record review, the facility did not ensure that all alleged violations involving abuse resulting in physical harm, pain or mental anguish are reported immediately, but not later than 2 hours after the allegation is made to the administrator of the facility (including to the State Survey Agency) and to other officials in accordance with State law through established procedures for 2 (R5, R8) of 6 residents. On 4/16/26 at 8:15 AM, R6 barricaded self in R5's room and threatened to harm R5. The facility did not report this within allotted time frames. On 6/4/25 at approximately 7:40 AM, Certified Nursing Assistant (CNA) D heard Registered Nurse (RN) E yelling at R8. This was not reported within allotted time frames.Findings include The facility policy titled Abuse and Misconduct last reviewed on 05/01/26, states under the section labeled Abuse .definitions, states: Abuse is defined as the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting in…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2026-05-06 · tag F0610 — failed to investigate and act on abuse reports — isolatedRespond appropriately to all alleged violations.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review the facility did not complete a thorough investigation regarding potential verbal and psychosocial abuse for 1 of 6 residents reviewed (R8),-The facility did not remove the accused staff member from the facility pending investigation-All present parties to the incident were not interviewed Findings include:On 05/06/26 at 12:15 PM, Surveyor reviewed R8's medical record. R8 was admitted to the facility on [DATE].On 05/16/25, R8's Minimum Data Set (MDS) assessment noted a score of 99 for Brief Interview for Mental Status (BIMS) due to R8's severe cognitive impairment and inability to complete the assessment.R8's care plan includes a focus of impaired cognitive function or impaired thought process related to developmental delay or disability (initiated on 02/17/25) with interventions of face me when speaking and make eye contact. R8's care plan includes a focus of psychosocial well-being problem.may experience feelings of powerlessness.ineffective coping skills.(initiated on…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · E2025-09-10 · tag F0628 — patternProvide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interview, the facility did not provide Notice of Bedhold and Notice of Transfer to a resident or resident representative who were transferred from the facility to a hospital for 4 of 4 residents (R) (R4, R20, R33 and R34). Example 1 R4 was admitted to the facility on [DATE] and has an Activated Power of Attorney (APOA). On 06/11/25, R4 had a change in condition that required being sent to emergency room (ER). The facility contacted R4's APOA and left a voicemail regarding change in condition. The facility was unable to provide documentation to support that the APOA was provided a Notice of Bedhold or Notice of Transfer. On 07/08/25, R4 had a change in condition that required being sent to emergency room (ER) and subsequently admitted to hospital. The facility contacted R4's APOA who gave consent to send to hospital. The facility was unable to provide documentation to support that the APOA was provided a Notice of Bedhold or Notice of Transfer. On 07/17/25, R4 had a change in condition…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · E2024-07-18 · tag F0641 — patternEnsure each resident receives an accurate assessment.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on staff interview and record review, the facility did not accurately code Minimum Data Set (MDS) 3.0 assessments for 4 residents (R) (R43, R25, R35 and R34) of 18 sampled residents. Findings: The facility's policy titled, COMPREHENSIVE ASSESSMENTS reviewed 4/18/2024, states in part: . 7. A significant error is an error in an assessment where: a. The resident's overall clinical status is not accurately represented (i.e., miscoded) on the erroneous assessment and/or results in an inappropriate plan of care; and b. The error has not been corrected via submission of a more recent assessment. 8. A significant error differs from a significant change because it reflects incorrect coding of the MDS and NOT an actual significant change in the resident's health status. Example 1 R43 was admitted on [DATE] with a Brief Interview of Mental Status (BIMS) unable to complete or assess. Diagnoses included dementia, psychotic disorder, and anxiety. R43 was marked for no Preadmission Screening and Resident Review (PASARR)…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-07-18 · tag F0656 — failed to write and follow a full care plan — isolatedDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility did not develop a comprehensive person-centered care plan for 2 of 18 sampled residents (R46 and R60). The facility did not develop a care plan for R46 and R60 for respiratory care. Findings: The facility policy titled, COMPREHENSIVE PERSON-CENTERED CARE PLANNING reviewed 05/15/24, states in part: .Policy Interpretation and Implementation 1) The interdisciplinary team (IDT), in conjunction with the resident and representative and/or family, develops and implements a comprehensive, person-centered care plan for each resident . 3) The care plan interventions are derived from a thorough analysis of the information gathered as part of the comprehensive assessment . Example 1 R46 was admitted on [DATE] with diagnoses of pneumonitis (inflammation of lung tissue due to non-infectious causes, which results in cough without mucus or phlegm, shortness of breath and fatigue), sepsis, acute bronchitis, acute respiratory failure with hypoxia (is a below-normal level of…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-07-18 · tag F0657 — failed to keep the care plan current — isolatedDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review and interview, the facility did not ensure care plans were reviewed and revised to reflect changes in care for 2 of 18 residents (R45 and R6). According to the Resident Assessment Instrument, The comprehensive care plan is an interdisciplinary communication tool. It must include measurable objectives and time frames and must describe the services that are to be furnished to attain or maintain the resident's highest practicable physical, mental and psychosocial well-being. The care plan should be revised on an ongoing basis to reflect changes in the resident and the care that the resident is receiving. The facility policy entitled Comprehensive Person-Centered Care Planning and last reviewed on 05/15/24 with a Policy Statement: A comprehensive person-centered care plan that includes measurable objectives and goal dates to meet the resident's physical, psychosocial and functional needs is developed and implemented for each resident Section 12 of policy stated, The…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Dcited before2024-07-18 · tag F0880 — failed to prevent and control infections — isolatedProvide and implement an infection prevention and control program.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, record review and interview, the facility did not implement enhanced barrier precautions consistent with current infection control standards of practice for 1 of 3 residents reviewed on enhanced barrier precautions (R29). This is evidenced by: Surveyor requested and reviewed the facility policy titled Infection Prevention and Control dated as most recently reviewed on 2/20/2023. The policy in part read: Standards of Practice: Centers of Disease Control (CDC) Association for Professionals in Infection Control (APIC) Enhanced Barrier Precautions Implementation of Personal Protective Equipment in Nursing Homes to Prevent the Spread of Novel or Targeted Multi-Drug-resistant Organisms (MDRO's) updated: July 29, 2019. Enhanced Barrier Precautions expands the use of PPE beyond situations in which exposure to blood and body fluids is anticipated, refers to the use of gown and gloves during high-contact resident care activities that provide opportunities for transfer of MDRO's to staff hands and clothing. Examples of high-contact resident care activities requiring gown…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-01-08 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolatedEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on interview and record review, the facility did not ensure that 1 of 3 residents reviewed for falls had adequate supervision and assistance to prevent accidents. A thorough fall investigation was not completed to determine staff used a mechanical lift with 1 assist for (R1), This is evidenced by: Surveyor reviewed facility's undated policy titled Falls - Clinical Protocol, which read in part: 2. LPN's [Licensed Practical Nurse] should alert the supervisor (RN). The nurse will complete an assessment .5. Incident Scene Investigation (ISI) tool completed by staff who found resident, or who was present at the time - as completely as possible and as soon as possible but definitely before that person shift ends .7. If an LPN is the charge nurse, supervisor (RN) should review and follow up LPN documentation with their assessment of any problems or injuries . Review of facility's undated policy titled Safe Resident handling, read in part: Ready Stand (Mechanical Lift) - 2 caregivers . Surveyor reviewed R1's medical record. R1's diagnoses include hypertension, orthostatic hypotension,…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Ecited before2023-07-18 · tag F0880 — failed to prevent and control infections — patternProvide and implement an infection prevention and control program.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review, the facility did not establish and implement an ongoing infection prevention and control program to prevent and control the onset and spread of infection to the extent possible as evidenced by the cumulative failures of the following 5 observations. Staff did not practice appropriate donning of Personal Protective Equipment (PPE) and hand hygiene with the care and services of a resident in Transmission-Based Precautions (TBP) for Clostridium difficile (R55), a very contagious bacterium. Staff did not practice appropriate hand hygiene with a dressing change for R179. Staff did not practice appropriate hand hygiene after incontinence cares with R44. Staff did not ensure 2 of 4 residents (R1 and R58) were given the opportunity to wash their hands prior to meal service. This is evidenced by: According to the National Institute of Health (NIH), together with the World Health Organization (WHO), one of the main actions in preventing and controlling the spread of the…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2023-07-18 · tag F0677 — failed to help fully-dependent residents with daily care — isolatedProvide care and assistance to perform activities of daily living for any resident who is unable.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, interview and record review the facility did not ensure that residents who are unable to carry out activities of daily living (ADLs) received necessary services to maintain good nutrition for 2 of 3 sampled residents (R37 and R65). R37 prefers to eat in his room and requires staff assistance. Staff did not provide a breakfast tray or assistance for R37. R65 was not assisted with meal while repeatedly making attempts to reach food bowls that were placed out of her reach. This is evidenced by: Example 1 R37 was admitted to facility on 1/29/20. Diagnoses include right side paralysis after stroke, major depressive disorder, type 2 diabetes with insulin use, and dehydration. R37's care plan, dated 6/15/23, indicated R37 has a self-care deficit requiring assist of 1:1 with eating, staff to encourage intake. R37 chooses to have meals in his room, staff to provide relaxed mealtime environment, offer alternatives, and record intake. Record revealed few weights have been taken over the last year due to R37's refusals. R37 has had a -9.62% weight loss; 1/3/23 weight…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
Show the remaining 8 citations
- Potential for harm · D2023-07-18 · tag F0686 — failed to prevent and treat pressure sores (bedsores) — isolatedProvide appropriate pressure ulcer care and prevent new ulcers from developing.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews and record reviews, the facility did not ensure 3 of 7 residents (R65, R15 and R58) reviewed for risk of pressure injury development, received the necessary treatment and services to promote healing of existing skin impairments or prevent new pressure injuries from developing. R65 was observed on three occasions in which there was no repositioning offered for extended periods of time. R15 was observed on two occasions in which repositioning and toileting was not completed. R58 was observed on two occasions in which staff did not reposition or toilet. This is evidenced by: According to the National Pressure Injury Advisory Panel (NPIAP) 2019, page 115, . Repositioning and mobilizing individuals is an important component in the prevention of pressure injuries. The underlying cause and formation of pressure injuries is multifaceted; however, by definition, pressure injuries cannot form without loading, or pressure, on tissue. Extended periods of lying or sitting on a particular…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2023-07-18 · tag F0690 — failed to manage incontinence, catheters, and urinary infections — isolatedProvide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interviews and record reviews, the facility did not ensure 3 of 10 residents reviewed for bowel and bladder incontinence or indwelling Foley catheters (R65, R37 and R15) received appropriate treatment and services to prevent Urinary Tract Infections (UTI) and to restore continence to the extent possible. -R65 was observed for extended periods of time on three separate occasions in which staff did not offer or attempt toileting services. -R37 has an indwelling Foley catheter with orders to change every month. There is no documentation to support routine change of R37's catheter. -R15 was observed on two separate occasions for extended periods of time in which toileting assistance was not provided. This is evidenced by: Acello, [NAME] RN MSN. The Long-Term Care Nursing Desk Reference. Chapter 13, pages 214-215 offers the following discussion on urinary incontinence in Long Term Care: . Incontinence is a medical problem that is, in many instances, beyond the resident's control. Incontinence is…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2023-07-18 · tag F0700 — isolatedTry different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review, the facility did not ensure that prior to the installation or use of bed rails, the facility attempted to use alternatives, ensure the resident is assessed for the use of bed rails, which includes a review of risks including entrapment; and informed consent is obtained from the resident or if applicable, the resident representative for 1 of 1 resident (R) R15. The facility did not ensure the grab bars are appropriate for R15, assess risk of entrapment versus benefit, and did not obtain consent from representative. This is evidenced by: R15 was admitted to facility on 10/32/22 and has diagnosis that include diagnosis of dementia with behavior disturbances and Parkinson's disease. R15's most recent quarterly Minimum Data Set (MDS), dated [DATE], indicated problem with both short term and long-term memory, and severely impaired cognitive skills for daily decision-making regarding tasks of daily life. This would put R15 at risk for entrapment with the use of…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2023-07-18 · tag F0755 — failed to provide safe pharmacy services — isolatedProvide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review, the facility did not ensure the accurate acquiring, receiving, dispensing, and administering of all drugs and biologicals to meet the needs of each resident. This occurred for 1 of 3 residents, R11. RN C left R11's 8:00 am medications on his bed side table. R11 was not cognitively able to ensure administration of medications. Findings Include: On 07/18/23 10:10 a.m., Surveyor observed R11 in bed with his bedside table in front of his bed. On the table was a medication cup with 7 pills in the cup. Surveyor asked R11 about the medications and R11 responded, I don't know what the hell they are. Surveyor reported to nurses station and spoke with Registered Nurse (RN) C about the observation. RN C indicated she had left the pills on R11's bedside table at approximately 8:45 a.m. Surveyor asked if it is normal practice to leave R11's pills on his bedside table. RN C responded R11 beats to his own drum and sometimes takes his pills and sometimes waits to take his pills…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2023-07-18 · tag F0757 — failed to avoid unnecessary drugs — isolatedEnsure each resident’s drug regimen must be free from unnecessary drugs.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on interview and record review, the facility did not ensure each resident's drug regimen was free from unnecessary drugs for 1 of 5 residents (R37) reviewed for antibiotic medications. R37 had five urinary tract infections (UTIs) in three months. R37 did not meet criteria to determine infection. R37 was prescribed antibiotic therapy prior to laboratory test results. R37 was treated with an antibiotic that laboratory tests confirmed was resistant. This is evidenced by: The facility's Antibiotic Stewardship Policy and Procedure, documents, in part: Antibiotic Stewardship Program (ASP) is established to ensure that a resident who needs an antibiotic receives the appropriate antibiotic and to reduce the risk of antibiotic resistance. Nursing staff will use established methods to communicate with physician when an infection is suspected. Our nurses will incorporate diagnostic criteria from McGeer's 2012 revised definitions to frame their resident assessment for change in condition when infection is suspected. The ASP will promote nursing procedure to ensure antibiotic time-out to…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2023-07-18 · tag F0760 — failed to prevent significant medication errors — isolatedEnsure that residents are free from significant medication errors.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility must ensure that a resident is free of any significant medication errors for 1 of 1 resident (R60) reviewed. The facility did not ensure R60 was administered insulin on three separate occasions as ordered from physician. This is evidenced by: The facility policy, entitled Medication Administration, dated 04/03/23, states: Medications are administered in accordance with prescriber orders, including any required time frame. If a drug is withheld, refused, or given at a time other than the scheduled time, the individual administering should mark the reason in the MAR when signing out medications. R60 was readmitted to the facility on [DATE] and has diagnoses of diabetes mellitus. R60 has physician orders for insulin aspart 18 units three times a day at 7:30 am 11:30 am, and 4:30 pm for type 2 diabetes mellitus. Administration Instructions: Hold if Fasting Blood Sugar is <100. R60's care plan, dated 05/26/23, with a target date of 3 months, states: Potential for…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2023-07-18 · tag F0883 — failed to offer flu and pneumonia vaccines — isolatedDevelop and implement policies and procedures for flu and pneumonia vaccinations.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility did not ensure each resident (R) is offered a pneumococcal immunization for 1 (R11) of 5 residents reviewed for immunizations. R11's medical record did not contain documentation of R11 being screened and offered pneumococcal vaccine. Findings include: The facility policy, entitled Pneumococcal Vaccination, dated 04/30/2023, states: 1. Residents are assessed upon admission for eligibility to receive the pneumococcal vaccination, and when indicated, are offered the vaccination within thirty (30) days of admission to the facility. R11 was admitted on [DATE] and has diagnoses that include cerebral infarction (cerebral infarction, or stroke, is a brain lesion in which a cluster of brain cells die when they don't get enough blood) and Chronic Obstructive Pulmonary Disease (COPD refers to a group of diseases that cause airflow blockage and breathing-related problems). Review of R11's medical record did not document an assessment upon admission for eligibility to…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- No harm found · C2023-07-18 · tag F0732 — widespreadPost nurse staffing information every day.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observations, interviews and record review, the facility did not ensure nurse staffing information postings were displayed daily in a clear and readable format and in a prominent place readily accessible to residents and visitors. This had the opportunity to affect all 75 of 75 residents at the facility. The facility did not post nurse staffing information daily and the postings were not posted in a way that would be accessible to all residents and visitors. The facility did not create a nurse staffing information post that was clear and readable. This is evidenced by: On 07/17/23 at 9:19 AM, Surveyor observed that the nurse staffing information posting on the bulletin board down the 300 wing is dated July 10, 2023. The nurse staffing information posting is located approximately six feet from the floor. Surveyor observed that the font of the posting is small and hard to read. Surveyor located the nurse staffing information posting on the second-floor bulletin board next to the nurse's station; it was also located approximately six feet from the floor, and the font size made…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
“Cited before” means this same F-tag appears on at least one other survey date in the record we hold — counting complaint investigations as well as standard surveys, with no time limit. It is our own read of the data, not CMS’s: CMS uses repeat deficiency as a formal term tied to consecutive standard surveys, and that is a narrower test than this one. A tag marked here may or may not meet it.
- Long-Term Care Ombudsman — a free, confidential advocate for the resident. They act only with the resident’s consent and work to resolve the problem. Find yours at theconsumervoice.org/get_help.
- Adult Protective Services — the state agency that investigates suspected abuse, neglect, or exploitation of a vulnerable adult. Not sure of your state’s APS number? The federal Eldercare Locator will route you: 1-800-677-1116 or eldercare.acl.gov.
- State survey agency — the regulator that licenses and inspects the home. Every state has an official nursing-home complaint line and most take complaints online; the Ombudsman or Eldercare Locator can connect you.
Fines & penalties
No federal fines in the current CMS record.
Who owns this facility
| Owner / manager | Type | Role | Share | Since |
|---|---|---|---|---|
| PARK MANOR LTD EMPLOYEE STOCK OWNERSHIP PLAN | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST; ADP OF THE SNF | 100% | since 01/03/2000 |
| ARMSTRONG, TOM | Individual | CORPORATE DIRECTOR | — | since 08/16/2022 |
| FISCHER, GEORGIANA | Individual | CORPORATE DIRECTOR | — | since 08/16/2022 |
| KOCK, PAULA | Individual | CORPORATE DIRECTOR | — | since 03/23/2010 |
| BOLEY, KRISTA | Individual | CORPORATE OFFICER; OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | — | since 05/01/2022 |
| PREISLER - HERSPERGER, JILL | Individual | CORPORATE OFFICER | — | since 04/01/1983 |
| SCHULTZ, SHARON | Individual | CORPORATE OFFICER | — | since 07/23/2009 |
| FLYGT, THOMAS | Individual | OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | — | since 11/01/2017 |
| HAEGERL, KAREN | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | since 07/17/2023 |
CMS files one row per role, so the 13 rows in the source record cover these 9 parties — each is shown once here with every role it holds. Nothing is omitted.
1 organizational owner listed — a facility can be part of a larger chain. CMS ownership data is known to under-report private-equity and REIT ties; treat as a starting point.
Follow the money — this home’s finances
Where a nursing home’s revenue comes from and where it goes — including money paid to companies under the same ownership. Most consumer sites never show this; we reproduce it straight from the Medicare cost report.
About 72% of this home’s resident-days are paid by Medicaid, which reimburses well below the cost of care in most states. Heavily Medicaid-dependent homes run on thinner budgets — a context worth holding next to the staffing and inspection record, not a fault in itself.
Source: CMS Healthcare Provider Cost Reporting Information System (HCRIS), Medicare cost report Form CMS-2540 · fiscal year 2023. Facilities self-file these reports; figures are unaudited and a year or two behind. A home with no Medicare cost report on file shows no figures here.
Cost & finances
Straight from this home’s Medicare cost report (CMS, FY2023). These are its operating economics — what it costs to run per resident-day and what it collects on average across Medicare, Medicaid, and private pay — not a private-pay quote. Your out-of-pocket cost depends on payer and room type, so ask the facility directly; a higher operating cost can reflect richer staffing or a sicker population. The cost-of-care planner shows regional benchmarks by care type.
What families pay in WI
This is a Medicare- and Medicaid-certified nursing home, so it can accept Medicaid for long-term care — like nearly all U.S. nursing homes. The private-pay figures below are what families without Medicaid pay; once a resident qualifies for Medicaid, out-of-pocket cost for covered nursing-home care is typically close to $0 (almost all of their income goes to the home as their share of the cost; they keep a small personal needs allowance — for clothing, haircuts, a phone — and Medicaid pays the rest). The amount of that allowance is set by each state. Confirm Medicaid-bed availability with the home, and see the Wisconsin Medicaid page.
Median private-pay cost, CareScout (Genworth) 2025 Cost of Care Survey — a regional midpoint, not any single community’s rate. Private rooms and higher care levels cost more; ask for a current quote. Project your own in the cost-of-care planner.
Every figure above is reproduced from the CMS Provider Data Catalog (a public record), from the CMS extract processed 2026-08-01 — CMS provider number 525612. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2025-09-10, which can lag current conditions. Staffing hours are CMS PBJ CY2026Q1 (Jan–Mar 2026). Check this record against the government’s own page for it: this home on Medicare Care Compare ↗ — the authoritative source, and the place to confirm anything here before you act on it. How we present it →
Not a government site. Eldercare Lens is not affiliated with, endorsed by, or authorized by the Centers for Medicare & Medicaid Services (CMS), Medicare, or any government agency. The star ratings, citations, and inspection wording on this page are reproduced from the public CMS record; the plain-English summaries, tiers, and comparisons around them are ours. We do not speak for CMS, and CMS has not reviewed this page. For the official record, go to Medicare Care Compare. How we’re funded →
Are you this operator? If the record here is out of date, or misses what you have since fixed, tell us and we will look: hello@eldercarelens.com. We reproduce the public CMS record and cannot change what it says — corrections to the underlying data go through CMS and your state survey agency — but we will correct anything we have got wrong about it, and we will say so on the page.