Above average — CMS composite of the measures below.
A standard survey is most likely before around November 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 Edgewater Haven Nursing Home during CMS and state inspections, most recent first.
Surveyors found three treatment carts left unlocked and unattended, containing medicated creams and ointments, and identified expired medications and supplies in a medication cart and storage room. Staff interviews confirmed that carts should be locked and expired items removed, as required by facility policy.
Two residents did not receive individualized continence and incontinence care as required. One resident with an indwelling catheter and bowel continence was given an incontinence product without documentation or request, while another was provided with double incontinence products without care plan documentation or resident request. Staff and care plan reviews confirmed these actions were not in accordance with established protocols.
A resident dependent on dialysis did not receive care in accordance with facility policy, as required communication and documentation between the facility and the dialysis center were inconsistent. The resident's care plan lacked details about dialysis scheduling and transportation, and daily weights were not always documented or shared as needed. Staff confirmed that communication sheets from the dialysis center were not consistently received, and the DON acknowledged these lapses.
Staff did not consistently follow Enhanced Barrier Precautions (EBP) during high-contact care activities for two residents with indwelling catheters. In both cases, CNAs failed to wear required gowns during transfers and catheter care, and catheter bags or tubing were observed in contact with the floor, contrary to facility policy. The DON confirmed these actions were not in compliance with infection control protocols.
The facility lacked qualified staff to supervise kitchen operations, as the Dietary Manager (DM) was not certified and had only remote access to a Registered Dietician (RD). The DM had been in the role for over a year without completing necessary certifications, and the RD was not onsite due to COVID-19, having visited only once for training.
The facility failed to store food according to safety standards, with boxes on the freezer floor and raw meats stored above cooked foods in a cooler. The Dietary Manager acknowledged the issues, and corrective actions were taken during the survey.
A facility failed to provide a resident with a written transfer notice, including the reason for transfer, location, and appeal rights, when the resident was transferred to the ER and returned the same day. The facility lacked a transfer/discharge notice form or policy, and while an appeal process document was given at admission, it was not provided for transfers or discharges.
A facility failed to conduct a smoking assessment for a resident known to smoke, despite having a Smoking-Free Policy. The resident, with intact cognition and several medical conditions, was allowed to smoke independently at the curb after signing out at the nurses' station. Staff confirmed the resident smoked off the grounds, and the care plan stated the resident would refrain from using tobacco products while at the facility. The facility's failure to ensure proper supervision and monitoring led to the deficiency.
The facility failed to monitor adverse reactions for two residents prescribed diuretics. One resident with CHF and CKD was on bumetanide without specific monitoring for side effects like hypotension and hyponatremia. Another resident with hypertension was on furosemide, also lacking monitoring for side effects. The DON confirmed these omissions, highlighting a deficiency in medication management.
Unsecured Treatment Carts and Expired Medications Found in Medication Storage Areas
Penalty
Summary
Surveyors observed that three treatment carts on the 300 and 500 wings were left unlocked and unattended, containing medicated creams, ointments, and powders. Staff interviews confirmed that treatment carts should be locked when not in use, in accordance with the facility's Pharmacy Policy and Procedure Manual. Additionally, one medication cart and the medication storage room on the 300 wing contained multiple expired medications, medical supplies, and food items. These included expired povidone-iodine swab sticks and prep pads, oil emulsion dressings, medicated powder, triamcinolone cream, nystatin powder, protein shakes, inhalers, insulin pen needles, glucose solution, aspirin, insulin, juice, renal shakes, chocolate syrup, COVID-19 rapid tests, blood vials, and blunt fill needles. Staff, including an LPN and the DON, verified the presence of expired items and acknowledged that expired medications and supplies should not be stored in medication carts or storage rooms. The facility's policy requires all drugs and biologicals to be stored in locked compartments and for expired items to be removed from use. The failure to lock treatment carts and to remove expired items from medication storage areas was directly observed and confirmed by staff interviews.
Failure to Provide Individualized Continence and Incontinence Care
Penalty
Summary
The facility failed to provide appropriate treatment and services related to bowel and bladder continence for two residents. One resident, who had an indwelling catheter and was continent of bowel, was observed wearing an incontinence product despite no such need being documented in the care plan or requested by the resident. Staff interviews confirmed that the resident was able to communicate bowel needs and did not require or request the use of an incontinence product. The care plan and status sheet did not indicate the use of such products, and the resident was unaware of the reason for being provided with a brief. Another resident, who was frequently incontinent of urine but always continent of bowel, was observed being provided with two incontinence products at once, a practice not reflected in the care plan or requested by the resident. Staff indicated that double incontinence products were used due to heavy urination, but this was not documented or approved by the resident or their representative. The DON and RN responsible for care plans confirmed that such use should be documented and only done upon request or instruction, which was not the case for this resident.
Failure to Ensure Proper Communication and Documentation for Dialysis Care
Penalty
Summary
The facility failed to ensure that a resident requiring dialysis received care and services in accordance with facility policy and established protocols. The facility's policy required communication between the facility and the dialysis center, including sending a binder with the resident to each dialysis session and receiving a report upon the resident's return that included pre- and post-weights, vital signs, and other pertinent information. Review of the resident's medical record revealed missing documentation of daily weights on several dates, and there was no indication that these weights were communicated to the dialysis center as required. Additionally, the care plan for the resident did not specify dialysis days, times, or transportation arrangements. Interviews with staff confirmed that while a binder was sent with the resident to dialysis, the dialysis center did not consistently provide the required communication sheets with pre- and post-weights and other relevant information. The Director of Nursing acknowledged that the care plan should have included the resident's dialysis schedule and that the dialysis center was expected to communicate essential information after each session. The deficiency was identified through record review and staff and resident interviews, which demonstrated lapses in communication and documentation related to the resident's dialysis care.
Failure to Follow Enhanced Barrier Precautions and Catheter Care Protocols
Penalty
Summary
Staff failed to adhere to the facility's Enhanced Barrier Precautions (EBP) policy during the care of two residents who required these precautions due to the presence of indwelling medical devices. For one resident, a CNA assisted with a transfer and handled a catheter bag without wearing a gown, despite signage indicating the need for EBP. The CNA also placed the resident's feet on wheelchair pedals and hung the catheter bag from the wheelchair without proper PPE. For the second resident, a CNA transferred the resident to a wheelchair while wearing gloves but not a gown, handled linens and a Chux pad, and manipulated the catheter tubing and bag, which were observed in contact with the floor. The CNA only donned a gown later, prior to shower care, but again placed the catheter bag on the shower room floor before handing it to the resident. The Director of Nursing confirmed that staff are required to wear both gown and gloves during high-contact care activities for residents on EBP, including transfers, catheter care, and linen changes, and that catheter bags and tubing should not be in contact with the floor. The observed failures to follow EBP protocols and maintain catheter equipment off the floor were in direct violation of the facility's infection prevention and control policies.
Deficiency in Qualified Dietary Management
Penalty
Summary
The facility was found to have a deficiency in staffing for its food and nutrition services, as it did not have qualified staff onsite to supervise kitchen operations. The Dietary Manager (DM) had been working in the role for over a year but lacked the necessary certification to manage the kitchen. The DM was in the process of taking a ServeSafe course and another unspecified course assigned by the facility's food service vendor but had not completed any certification. The DM had access to a contracted Registered Dietician (RD) remotely via phone and email, but the RD was not present onsite for supervision due to COVID-19. The RD had only visited the facility once for training, which was the first time the DM had met the RD. The Nursing Home Administrator (NHA) confirmed that the DM was enrolled in a ServeSafe course but had not completed it or any other coursework to gain certification as a Dietary Manager.
Improper Food Storage Practices
Penalty
Summary
The facility failed to store food in accordance with professional standards for food service safety, as observed during a survey. Boxes containing food intended for resident use were found stored on the floor in the freezer, contrary to the Wisconsin Food Code, which requires food to be stored at least 6 inches above the floor. The Dietary Manager (DM) acknowledged that some boxes had been delivered days earlier and should have been placed on shelves. Additionally, raw meats were improperly stored over pre-cooked food in a reach-in cooler, violating the facility's Safe Food Handling policy and the Wisconsin Food Code, which mandates the separation of raw and cooked foods to prevent cross-contamination. During the kitchen tour, the surveyor noted that raw meats, including uncooked chicken breasts, were stored above cooked food items such as ham and smoked bacon. The DM confirmed the improper storage and rearranged the items to comply with safety standards. The surveyor also interviewed a cook who admitted that raw meat should be stored on the bottom shelf but cited a lack of space as the reason for the improper arrangement. The DM took immediate action to correct the storage order, placing cooked food above raw meats and ensuring that raw chicken was placed on the bottom shelf with a pan underneath to prevent contamination.
Failure to Provide Written Transfer Notice
Penalty
Summary
The facility failed to provide a resident with the required written notice of transfer, including the reason for transfer, location of transfer, and appeal rights. This deficiency was identified for one resident who was transferred to the emergency room and returned the same day with a diagnosis of constipation. Upon review of the resident's medical record, it was found that there was no documentation of a written transfer notice being provided. Interviews with the Director of Nursing and Social Worker confirmed that the facility did not have a transfer/discharge notice form or policy in place at the time of the incident. Additionally, while an appeal process document was given to residents upon admission, it was not provided for transfers or discharges and was not signed.
Failure to Conduct Smoking Assessment for Resident
Penalty
Summary
The facility failed to ensure a resident environment free from accident hazards by not completing a smoking assessment for a resident known to smoke. The resident, identified as R17, was admitted with several diagnoses, including a fracture, PTSD, acute myocardial infarction, and Takotsubo syndrome. Despite the facility's Smoking-Free Policy, which required residents to refrain from smoking on the premises, R17 was allowed to smoke independently at the curb after signing out at the nurses' station. The facility's staff, including the Nursing Home Administrator and Director of Nursing, confirmed that R17 smoked off the grounds and did not require a smoking assessment because the smoking occurred outside the facility's property. The surveyor's investigation revealed that R17's care plan stated the resident would refrain from using tobacco products while at the facility. However, R17 was provided with cigarettes and a lighter by the staff, which were kept at the nurses' station. The Director of Nursing was unsure if R17's cigarettes were stored at the nurses' station, and the therapy note reviewed did not include information about R17's ability to safely smoke or leave the facility property. The facility's failure to conduct a smoking assessment and ensure proper supervision and monitoring of R17's smoking activities led to the deficiency identified by the surveyor.
Failure to Monitor Adverse Reactions of Diuretic Medications
Penalty
Summary
The facility failed to ensure proper monitoring for adverse reactions of high-risk medications for two residents, R9 and R22, who were prescribed diuretic medications. R9, who was admitted with diagnoses including congestive heart failure (CHF) and chronic kidney disease (CKD), was prescribed bumetanide. Although R9's care plan included interventions such as daily weights and lab monitoring, it lacked specific monitoring for adverse reactions or side effects of bumetanide. The Director of Nursing (DON) confirmed the absence of such monitoring interventions, despite acknowledging the potential side effects of bumetanide, which include orthostatic hypotension, hyponatremia, and hypokalemia. Similarly, R22, who was admitted with conditions including dementia, lupus, CKD, and hypertension, was prescribed furosemide. R22's care plan also did not include monitoring for adverse reactions or side effects of furosemide. The DON verified this omission and acknowledged the side effects of furosemide, such as orthostatic hypotension and hypokalemia. Despite nursing assessments being conducted, they were not specifically completed for diuretic monitoring, leading to a deficiency in the facility's medication management practices.
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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 Port Edwards
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Wisconsin Rapids Health Services | 2.8 mi | ★★★★★ | 5 | 0 |
| Edenbrook Of Wisconsin Rapids | 4.6 mi | ★★★★★ | 1 | 0 |
| Stevens Point Health Services | 16.8 mi | ★★★★★ | 0 | 0 |
| Timber Ridge Health And Rehabilitation | 17.6 mi | ★★★★★ | 1 | 0 |
| North Shore Healthcare At Marshfield | 26.2 mi | ★★★★★ | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.