Below average — CMS composite of the measures below.
A standard survey is most likely before around December 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Dove Healthcare - Fennimore during CMS and state inspections, most recent first.
A resident who uses repetitive speech for communication was subjected to verbal abuse by a CNA during a meal, as witnessed by two other CNAs. The CNA responded to the resident's repeated requests in an annoyed manner, causing the resident to appear sad. The incident was confirmed as verbal abuse by the facility's Abuse Coordinator.
A facility did not fully investigate an allegation of verbal abuse after a resident was spoken to in an annoyed manner by a CNA during a meal, causing the resident to appear sad. The investigation lacked required interviews with the RN, LPN, and previous shift staff, as outlined in the facility's abuse policy.
A resident with Parkinson’s disease, weakness, unsteadiness, and a history of falls had repeated unwitnessed and witnessed falls, including falls from a recliner and while being weighed, with injuries including skin tears, a T11 fracture, and a scalp laceration with staples and a subdural hematoma. Surveyor observation and staff interviews showed that ordered fall interventions were not consistently in place, including dycem and a cushion in the recliner, and the facility did not identify a true root cause for several of the falls.
Food storage and labeling practices were not maintained in the kitchen and dry storage areas. An opened pack of cheese, tortillas, bread, and milk crystals had no dates, baked potatoes were labeled only with a month and year, an apple was found on the floor, and multiple food boxes were stored on the floor in the freezer and dry storage room. A scoop was also found inside a container of corn starch, which the DM identified as an infection control concern.
Improper disposal of garbage and refuse was observed around the dumpster area. Surveyors found used napkins, about 10 used latex gloves, unknown crushed food items, and condiment packets on the ground and along the hillside behind the dumpsters. The DM stated there was too much garbage on the ground, that it was dirty, and that it needed to be cleaned up.
A resident reported that another resident entered his room, yelled at him, and poured urine on his shoes, and staff documented that the shoes were wet. Although the RN, DON, and NHA discussed the event as a possible resident-to-resident abuse allegation, the facility did not report it to the State Agency within the required timeframe. The NHA later stated she used a flowchart to decide it was not reportable and acknowledged there was no documented rationale for not reporting it.
Failure to Thoroughly Investigate Alleged Resident-to-Resident Abuse: A resident with moderate cognitive impairment reported that another resident entered his room, yelled at him, and poured urine on his shoes. Staff documented the complaint, but the facility did not have evidence of a thorough, immediate abuse investigation, and the grievance log did not show the incident. During survey interviews, the RN said the event raised concern for abuse, while the DON, SS, and NHA acknowledged the lack of documented investigation and that it should have been handled as an allegation of abuse.
A resident with quadriplegia who uses a power wheelchair had the device charged in their room instead of the designated area, contrary to facility policy and the care plan. Staff confirmed this practice was done at the resident's request due to concerns about previous damage to the wheelchair when moved by staff, leading to a potential accident hazard.
A resident with a history of Alzheimer's and other conditions experienced significant chest pain and a drop in blood pressure. Despite being a full code, the RN did not notify a physician or initiate CPR when the resident became unresponsive and apneic. The facility failed to provide basic life support, including placing the resident on a hard surface, having a crash cart ready, and providing supplemental oxygen. EMS initiated CPR upon arrival, but the resident was transported to the hospital and later passed away.
The facility failed to maintain professional standards for food service safety, affecting all residents. Observations revealed improper record-keeping for the PPM of sanitizing solutions in the dishwasher and three-compartment sink, with concentrations exceeding recommended levels. Additionally, food items in storage lacked proper dating, and expired items were found in the refrigerator. The Dietary Manager was unsure of the correct PPM levels and acknowledged inconsistent monitoring practices.
The facility failed to maintain an effective infection control program, with outdated policies, incomplete infection tracking, and improper hand hygiene practices. Staff returned to work too early after illness, and residents were not placed on isolation precautions timely. An LPN did not sanitize hands between glove changes, highlighting gaps in infection control practices.
The facility failed to report suspected abuse and injuries of unknown source for two residents. One resident with moderate cognitive impairment had unexplained bruising that was not reported to the State Agency. Another resident with severe cognitive impairment alleged that two CNAs requested sexual activity, but the nurse dismissed it as a misunderstanding and did not report it. The facility's policy requires immediate reporting of such incidents, which was not followed.
The facility failed to investigate alleged abuse and injuries of unknown source for two residents. One resident had unexplained bruising that was not investigated, and another reported a sexual abuse allegation against CNAs, which was dismissed as a misunderstanding without investigation. Both residents had cognitive impairments, and the facility did not follow its own policies for investigating such incidents.
A facility failed to implement a gradual dose reduction (GDR) for a resident on psychotropic medication, despite a recommendation from the consultant pharmacist. The resident, diagnosed with dementia and depression, was on Duloxetine and Lorazepam. The physician did not act on the GDR recommendation due to the family's preference, without documenting any clinical contraindication. The DON noted that the physician deferred to the family's wishes, and the RN observed that the resident did not show signs of depression, raising concerns about potential overmedication.
Two residents were prescribed antibiotics for UTIs based on contaminated urine cultures, which did not meet the criteria for true infections. The facility's DON, also the Infection Preventionist, acknowledged that the antibiotic use did not align with the facility's stewardship program, as the antibiotics were administered without confirming pathogen susceptibility.
The facility did not ensure that two CNAs received the required 12 hours of in-service training per year. CNA L completed 10.8 hours, and CNA M completed 7.45 hours. The Director of Nursing acknowledged issues with tracking staff training, which had the potential to affect multiple residents.
Failure to Protect Resident from Verbal Abuse by CNA
Penalty
Summary
The facility failed to protect a resident's right to be free from verbal abuse. During the evening meal, a resident who communicates using repetitive phrases asked for reassurance about what to eat or drink. Two CNAs observed another CNA respond to the resident's repetitive vocalizations by leaning close and speaking in a visibly annoyed manner, mimicking the resident's name and expressing irritation. The resident subsequently lowered his head and appeared sad, responding with 'okay.' The facility's policy clearly states that each resident has the right to be free from abuse, including verbal abuse. The incident was confirmed as verbal abuse by the facility's Abuse Coordinator during an interview.
Failure to Thoroughly Investigate Allegation of Verbal Abuse
Penalty
Summary
The facility failed to thoroughly investigate an allegation of verbal abuse involving a resident who communicates using repetitive phrases. During an evening meal, two CNAs observed another CNA respond to the resident's repetitive vocalizations in a visibly annoyed manner, leaning close and making remarks that caused the resident to lower his head and appear sad. The facility's abuse coordinator (Administrator) confirmed that verbal abuse had occurred during this incident. Upon review of the investigative file, it was found that the investigation did not include statements from the RN and LPN who were present during the shift when the incident occurred, nor did it include interviews with staff from the previous shift, as required by the facility's abuse policy. The Administrator confirmed that these interviews were missing from the investigative file, indicating that the investigation was incomplete and not in accordance with facility policy.
Failure to Ensure Fall Interventions Were in Place for a Resident With Repeated Falls
Penalty
Summary
The facility did not ensure adequate supervision and safety to prevent accidents for a resident with a history of repeated falls, Parkinson’s disease, weakness, unsteadiness on feet, chronic pain, and a history of falling. The resident’s MDS indicated cognitive intactness with a BIMS of 14 out of 15, but also showed substantial to maximum assistance needs for toileting and partial to moderate assistance for transfers and ambulation. The resident’s care plan included fall-risk interventions such as grip strips by the bed, gripper socks, dycem in the recliner, and assistance with toileting and transfers using a gait belt and walker. The resident experienced multiple falls in the room and bathroom, including unwitnessed falls and a witnessed fall while being weighed. Several incident reports documented that no root cause was identified, while others listed limited explanations such as weakness following hospitalization, ill-fitting chair, or slipped. The resident fell out of the recliner more than once, including a fall that resulted in a head injury requiring staples and a subdural hematoma, and earlier falls that resulted in a T11 spinal fracture and other injuries such as skin tears and bruising. The facility’s records also showed inconsistent fall risk scores over time, ranging from low to high risk. Surveyor observation and interviews showed that the resident did not have the dycem or cushion in the recliner at the time of observation, despite staff identifying dycem in the recliner as a current fall intervention. A CNA confirmed there was no dycem or cushion under the resident, only a soaker pad. Staff interviews reflected differing descriptions of the resident’s current fall interventions, including gripper socks, black strips in front of the chair, two-person assistance when available, and a sign telling the resident not to stand and to call for help. The DON stated the team had tried many things, but also acknowledged that simply documenting "slipped" was not a true root cause and that there was no documentation found for a toileting schedule that had reportedly been used.
Food Storage and Labeling Deficiencies in Kitchen and Dry Storage Areas
Penalty
Summary
The facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety. During observation with the Dietary Manager, an opened pack of sliced cheese and an opened pack of tortillas in the main kitchen walk-in refrigerator had no open date or use-by date, two baked potatoes in a Ziplock bag were labeled only with "8/25," five loaves of bread had no use-by or expiration dates, and an apple was found on the floor. In the dry storage area, an open bag of milk crystals had no date. The Dietary Manager stated that the food items should be dated and discarded the baked potatoes and apple. In a separate observation, boxes of pork ribs, orange juices, elbow macaroni, canned vegetables, and rhubarb pie mix were found on the floor in the walk-in freezer and dry storage room, and the Dietary Manager stated she had been gone the previous week on Friday and was unable to ensure the items in dry storage were put away timely and removed from the floor. In another observation, a 20-liter container of corn starch in dry storage had a scoop inside, and the Dietary Manager stated the scoop should not be inside the corn starch because it was an infection control concern.
Improper Disposal of Garbage and Refuse
Penalty
Summary
Garbage and refuse were not disposed of properly. During observation and interview, surveyors found garbage surrounding the facility's dumpster area, including used napkins, approximately 10 used latex gloves, various unknown food items crushed into the ground, and condiment packets. These items were observed around the dumpster area and along the small hillside on the backside of the garbage dumpsters. The Dietary Manager stated that there was too much garbage on the ground, that it was dirty, and that it needed to be cleaned up, and was unable to identify the food items crushed on the ground.
Failure to Report Resident-to-Resident Allegation of Abuse
Penalty
Summary
The facility did not ensure that an allegation of abuse, suspected neglect, or injury of unknown origin was reported to the State Agency within the required timeframe for one resident. On 8/31/25, a resident reported that another resident entered his room, yelled at him, and poured urine on his shoes. The resident’s shoes were documented as wet, and staff took the shoes to laundry to be cleaned. The incident was documented in a nurse’s progress note, and staff later discussed it as a possible resident-to-resident altercation. The record shows that the incident was reviewed by nursing leadership and social services, but it was not reported to the State Agency. The DON stated the event could be viewed as an allegation of abuse because it involved a resident-to-resident altercation, and the NHA later stated she used a flowchart to determine it was not reportable because the residents were fine and everything was normal. The NHA also stated there was no documented rationale for not reporting the incident. A grievance form was later produced, but the facility’s grievance log did not list this incident. During interviews, the RN who first received the report stated she called the NHA because the situation might need to be reported within the 2-hour window due to potential abuse. The NHA later acknowledged that, after reviewing the flowchart and progress notes, she would have done things differently and should have reported the incident as an allegation of abuse. The resident later told the NHA he could not provide much detail, said it might have been water, refused replacement shoes, and stated he had no safety concerns about the other resident.
Failure to Thoroughly Investigate Allegation of Resident-to-Resident Abuse
Penalty
Summary
The facility did not have evidence that an allegation of resident-to-resident abuse involving two residents was thoroughly investigated. On 8/31/25, R26 reported that another resident, R15, entered his room, yelled at him, and poured urine on R26’s shoes. The facility policy required alleged violations and all resident incidents or concerns to be promptly, thoroughly, and well-documentedly investigated, including interviews of the alleged victim, accused individual, witnesses, and staff, with a complete written report retained by the facility. R26 had diagnoses including diffuse traumatic brain injury and mild cognitive impairment, and his BIMS score on 7/16/25 was 12, indicating moderate cognitive impairment. R15 also had moderate cognitive impairment, with a BIMS score of 11 on 8/21/25. The initial nursing note documented that R26 told staff his shoes were wet with urine and that R15 denied entering the room. The facility’s grievance/complaint log for August and September 2025 did not list a grievance for R26 related to the incident, and when surveyors requested documentation, the facility initially did not have a documented investigation to provide. During interviews, RN D stated she reported the incident because it may have needed to be reported within the 2-hour window due to potential abuse. SS G stated she was aware of the incident after the holiday weekend and that NHA A made the decision on abuse and reporting. NHA A later stated she had spoken with both residents, but also acknowledged there was no documentation of an investigation and that the incident should have been reported and investigated as an allegation of abuse. A late-entry note by NHA A describing her conversation with the residents was entered after surveyor discussion with DON B, and the facility still did not have evidence of a thorough, immediate investigation at the time of survey review.
Failure to Adhere to Safe Charging Policy for Power Wheelchair
Penalty
Summary
The facility failed to ensure that the environment remained free from accident hazards for a resident who utilized a power wheelchair. According to facility policy, power wheelchairs are to be charged in a designated area, specifically the beauty shop, to promote safety. However, the resident's power wheelchair was being charged in his room at his request, due to concerns about staff damaging the wheelchair when moving it to the designated charging area. Multiple staff members confirmed that the wheelchair was charged in the resident's room, contrary to policy, and some were unaware of the correct charging location. The care plan for the resident, who has quadriplegia secondary to a spinal cord injury, also specified that the wheelchair should be charged in the beauty shop at night. Observations and interviews revealed that the resident's power wheelchair was not always in the designated charging area, and a thick black cord, identified as the charging cord, was found plugged into the wall in the resident's room. Staff interviews indicated inconsistent knowledge and adherence to the facility's policy regarding the safe charging of electric wheelchairs. The resident expressed a preference for charging the wheelchair in his room to prevent further damage, as previous incidents had resulted in parts of the wheelchair being damaged by staff. This deviation from policy resulted in a potential accident hazard within the resident's environment.
Failure to Provide Basic Life Support to Full Code Resident
Penalty
Summary
The facility failed to provide basic life support, including CPR, to a resident who was a full code and required emergency care. The resident, who had a history of Alzheimer's disease, bulimia, hyperlipidemia, personal history of non-Hodgkin's lymphoma, and major depressive disorder, complained of significant chest pain. Despite the resident's complaints and a drop in blood pressure, the registered nurse (RN E) did not notify a physician or initiate CPR when the resident became unresponsive and apneic. The resident's condition deteriorated over a period of 1 hour and 43 minutes, during which RN E administered Tums and Tylenol, which were ineffective. The resident's vital signs were monitored, but no physician was notified, and no basic life support measures were initiated. When the resident became unresponsive, RN E failed to place the resident on a hard surface, did not have a crash cart ready, and did not provide supplemental oxygen. Emergency medical services (EMS) were called, but upon their arrival, the resident was found to be apneic and without a pulse, and CPR was initiated by EMS. The facility's failure to act promptly and provide necessary life support measures resulted in a finding of immediate jeopardy. The deficiency was identified as a failure to ensure that a resident who had chosen to be a full code received basic life support when experiencing a change in condition. The facility's policy required immediate action in such situations, but these protocols were not followed, leading to the resident's transport to the hospital, where she subsequently passed away.
Removal Plan
- RN E no longer employed at the center
- Reeducation to nursing staff on CPR and competencies completed
- All residents at center records reviewed for care planning regards to code status
- Education to staff provided by DON and VPCO on immediate provider notification in acute change of condition
- Education to staff provided by DON and VPCO on AMDA guidelines
- Education to staff provided by DON and VPCO on location of crash cart and AED with emphasis on immediately bringing to patient bedside for immediate access if needed
- Education to staff provided by DON and VPCO on detailed protocols and procedures for CPR
- Education to staff provided by DON and VPCO on automated external defibrillator use including policy review
- Education to staff provided by DON and VPCO on code sample procedures and drills
- Education to staff provided by DON and VPCO on adult basic life support including detailed assessment documentation
- CPR drills completed on random shifts
- Ad hoc QAPI meeting conducted to review current policies and procedures including CPR
- All residents at center reviewed for valid code status
Deficiencies in Food Service Safety and Record Keeping
Penalty
Summary
The facility failed to adhere to professional standards for food service safety, which has the potential to affect all 31 residents. The deficiency was identified through observation, interview, and record review. The facility did not maintain proper records for the PPM (Parts Per Million) of the sanitizing solution used in their low-temperature dishwasher and three-compartment sink. The facility's policy requires the dishwasher's sanitizing solution to be between 50 and 100 PPM, but records showed that the PPM exceeded 75 on 50 occasions. Additionally, there was no record of monitoring the sanitizing agent in the three-compartment sink, and a test revealed that the concentration was too high. The Dietary Manager was unsure of the correct PPM for the dishwasher and acknowledged that the three-compartment sink was only sometimes tested without any record. Further deficiencies were noted in the storage and labeling of food items. In the dry storage area, several food items, including bags of frosted flakes and brown sugar, lacked open, received, or use-by dates. In the refrigerator, a bag of lettuce was found with a use-by date that had already passed, and a tuna salad sandwich was prepared without a consume-by date. The Dietary Manager admitted that staff were supposed to discard sandwiches if not consumed within a few days, but this was not consistently done, as evidenced by the outdated sandwich found in the refrigerator.
Inadequate Infection Control Program and Practices
Penalty
Summary
The facility failed to establish an effective infection prevention and control program, which was evidenced by several deficiencies identified during the survey. The facility's policies were not updated annually, with several key policies such as the COVID-19 response plan and isolation precaution guidance being outdated. Additionally, the facility did not track infection control rates by infection type, and there was no staff infection control line list prior to June 2024. The staff line list for June was incomplete, missing critical information such as the date last worked and well date for several staff members. Furthermore, staff with gastrointestinal symptoms returned to work before the recommended time frame, potentially increasing the risk of infection transmission. The resident line list for several months was also found to be incomplete, missing important details such as symptoms, date well, and monitoring/care plan updates for multiple residents. Additionally, there was a delay in placing residents on isolation precautions, with two residents being placed on droplet/contact precautions a day after their symptoms started. This delay in implementing isolation precautions could have contributed to the spread of infections within the facility. Moreover, the facility's hand hygiene practices were not in compliance with standards. An LPN was observed not sanitizing hands between glove changes and after touching a laptop keyboard before administering medication. This lapse in hand hygiene was acknowledged by both the LPN and the DON, who confirmed that proper hand hygiene should be practiced before and after glove use and when moving between different tasks. These deficiencies highlight significant gaps in the facility's infection control practices, potentially affecting the health and safety of all residents.
Failure to Report Suspected Abuse and Injuries of Unknown Source
Penalty
Summary
The facility failed to adhere to its policies and procedures for reporting suspected abuse, neglect, or mistreatment, as required by section 1150B of the Act. This deficiency was identified in two cases involving residents R31 and R35. In the first case, R31, who has moderate cognitive impairment due to neurocognitive disorder with Lewy bodies and other conditions, was found with bruising on the left hip of unknown origin. The nurse did not report this injury to the State Agency, as required by the facility's abuse policy. In the second case, R35, who has severe cognitive impairment due to Alzheimer's disease and other conditions, reported to a nurse that two CNAs requested sexual activity. The nurse dismissed the allegation as a misunderstanding and failed to report it to the State Agency or law enforcement, contrary to the facility's policy. The Director of Nursing confirmed that this was an allegation of abuse and should have been reported immediately. The facility's policy mandates that all staff are trained to report any reasonable suspicion of a crime against a resident, including abuse, neglect, exploitation, or mistreatment, to the appropriate authorities. However, in both instances, the staff did not follow these procedures, resulting in a failure to report the incidents as required.
Failure to Investigate Alleged Abuse and Injuries of Unknown Source
Penalty
Summary
The facility failed to ensure thorough investigations of alleged violations involving abuse, neglect, exploitation, or mistreatment for two residents. One resident, identified as R31, was found with bruising on the left hip of unknown origin, which was not investigated at the time it was noted. The facility's policy requires that all injuries of unknown source be promptly investigated, but this protocol was not followed. Interviews with the Assistant Director of Nursing (ADON) and the Director of Nursing (DON) confirmed that the nurse should have reported the bruise and initiated an investigation, which did not occur. Another resident, R35, reported an allegation of sexual abuse by two CNAs, stating that they requested her to have sex with them. The nurse who received this report reassured the resident that it was a misunderstanding and did not initiate an investigation. The facility's policy mandates that all allegations of abuse be investigated immediately, but this was not adhered to in this case. The DON acknowledged that the incident should have been reported and investigated according to the facility's abuse protocol. Both residents had cognitive impairments, with R31 having a moderate impairment and R35 having a severe impairment, which may have affected their ability to communicate effectively about the incidents. The facility's failure to investigate these allegations and injuries of unknown source represents a deficiency in adhering to their own policies and federal requirements for resident protection and safety.
Failure to Implement Gradual Dose Reduction for Psychotropic Medication
Penalty
Summary
The facility failed to ensure that a resident receiving psychotropic drugs underwent a gradual dose reduction (GDR) as recommended by the consultant pharmacist. The resident, who has diagnoses of dementia and depression, was taking Duloxetine and Lorazepam. Despite the pharmacist's recommendation to reduce the Duloxetine dose from 120 mg to 90 mg, the physician did not sign off on the recommendation, citing the family's preference to maintain the current dosage. The physician noted that the family was not willing to reduce the medication, and no clinical contraindication was documented to justify the continued high dosage. The Director of Nursing (DON) expressed concern that the physician, who is also the facility's medical director, was deferring to the family's wishes without providing a medical rationale for not attempting the GDR. The DON emphasized that there should be a documented response from the doctor whenever a GDR is recommended. The Registered Nurse (RN) involved noted that the resident did not display behaviors indicative of depression and that the physician had previously mentioned the resident might be overmedicated. Despite these observations, the facility did not implement the GDR, leading to a deficiency in adhering to regulatory requirements for psychotropic medication management.
Inappropriate Antibiotic Use Due to Non-Adherence to Stewardship Program
Penalty
Summary
The facility failed to adhere to its antibiotic stewardship program, which resulted in inappropriate antibiotic use for two residents. Resident R6 was prescribed Keflex for a urinary tract infection (UTI) based on a positive urinalysis and a contaminated urine culture, which did not meet the criteria for a true infection. The urine culture report indicated multiple bacterial morphotypes, suggesting a poorly collected specimen. Despite this, R6 completed the antibiotic course without confirmation of the pathogen's susceptibility to the prescribed antibiotic. The Director of Nursing (DON), who also serves as the Infection Preventionist, acknowledged that the antibiotic use did not align with the facility's stewardship program. Similarly, Resident R32 was also prescribed Keflex for a UTI under the same circumstances of a positive urinalysis and a contaminated urine culture. The urine culture report for R32 also indicated multiple bacterial morphotypes, suggesting a poorly collected specimen. Like R6, R32 completed the antibiotic course without confirmation of the pathogen's susceptibility. The DON confirmed that this practice did not follow the facility's antibiotic stewardship program, which aims to ensure judicious use of antibiotics and prevent the development of resistance.
Deficiency in CNA In-Service Training Hours
Penalty
Summary
The facility failed to ensure that two Certified Nursing Assistants (CNAs), identified as CNA L and CNA M, received the required 12 hours of in-service training per year. CNA L, hired on June 21, 2022, completed only 10.8 hours of training, while CNA M, hired on March 3, 2022, completed only 7.45 hours. This deficiency was identified during a document review conducted by a surveyor on August 1, 2024. During an interview on the same day, the Director of Nursing (DON B) acknowledged that the facility had recognized issues with tracking and verifying staff training as early as February 2024. Despite this awareness, the facility did not ensure that the CNAs met their annual training requirements, which had the potential to affect multiple residents in the facility.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Fennimore
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Lancaster Health Services | 10.3 mi | ★★★★★ | 15 | 1 |
| Care And Rehab - Boscobel | 10.7 mi | ★★★★★ | 0 | 0 |
| Orchard Manor | 10.9 mi | ★★★★★ | 9 | 0 |
| Rivers Edge Nursing And Rehab | 18.4 mi | ★★★★★ | 34 | 1 |
| Edenbrook Of Platteville | 19.1 mi | ★★★★★ | 0 | 0 |
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