Stay Ahead of Compliance with Monthly Citation Updates


In your State Survey window and need a snapshot of your risks?

Survey Preparedness Report

One Time Fee
$79
  • Last 12 months of citation data in one tailored report
  • Pinpoint the tags driving penalties in facilities like yours
  • Jump to regulations and pathways used by surveyors
  • Access to your report within 2 hours of purchase
  • Easily share it with your team - no registration needed
Get Your Report Now →

Monthly citation updates straight to your inbox for ongoing preparation?

Monthly Citation Reports

$18.90 per month
  • Latest citation updates delivered monthly to your email
  • Citations organized by compliance areas
  • Shared automatically with your team, by area
  • Customizable for your state(s) of interest
  • Direct links to CMS documentation relevant parts
Learn more →

Save Hours of Work with AI-Powered Plan of Correction Writer


One-Time Fee

$49 per Plan of Correction
Volume discounts available – save up to 20%
  • Quickly search for approved POC from other facilities
  • Instant access
  • Intuitive interface
  • No recurring fees
  • Save hours of work
F0609
D

Failure to Report Injury of Unknown Origin

Shawano, Wisconsin Survey Completed on 11-10-2025

Penalty

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to report an injury of unknown origin to the State Agency as required by its Abuse, Neglect, and Exploitation policy. A resident with severe cognitive impairment and multiple medical conditions, including Alzheimer's disease and osteoporosis with a history of pathological fractures, was found to have an additional fracture in the right humerus above a previously repaired site. The new fracture was discovered after the resident continued to experience significant pain despite receiving scheduled and as-needed pain medication. There was no documented fall or other incident to explain the new injury. The facility's policy mandates reporting all physical injuries of unknown source to the Administrator, State Agency, and other required agencies within specified timeframes. Despite this, the injury was not reported to the State Agency. The deficiency was identified during a surveyor's review of the resident's medical record and confirmed through staff interviews, including with the Nursing Home Administrator, who acknowledged the reporting requirement for injuries of unknown origin.

An unhandled error has occurred. Reload 🗙