Below average — CMS composite of the measures below.
The next survey window likely opens around April 2027
Estimate from public CMS data, current as of August 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Mineral Point Health Services during CMS and state inspections, most recent first.
A resident on daily aspirin was not monitored for bleeding and had a change in condition that was not assessed or reported when the resident became pale, weak, and later severely short of breath; hospital records showed acute blood loss anemia, heme-positive stool, and blood-tinged emesis. Another resident with CHF did not receive ordered daily weights, and a severe weight gain was not reported to the MD right away.
Missing COVID-19 Vaccine Documentation for Two Residents: The facility did not have records showing that two residents were educated about the COVID-19 vaccine or that the vaccine was offered, accepted, or declined. One resident with severe cognitive impairment and an activated POA later developed fever, cough, hypoxia, and respiratory failure, tested positive for COVID-19, and required a 6-night hospitalization. A second resident with severe cognitive impairment had no COVID-19 declination or other vaccine documentation, although the DON stated immunizations were reviewed on admission and the ADON handled offering them.
A resident with severe cognitive impairment and total ADL dependence was observed with facial hair and long, dirty fingernails despite care plan directions for grooming and nail care. The resident stated a preference to be clean shaven and wanted shorter, cleaner nails. CNA and LPN interviews showed staff knew the resident needed shaving and nail care, but the resident remained unshaven and the nail care was not documented.
A resident with severe cognitive impairment and a Guardian did not receive the influenza vaccine, and the medical record lacked documentation that the vaccine was offered, refused, consented to, or that education on risks and benefits was provided. The facility policy required annual flu vaccination offers and documentation of education and the resident’s choice, but the DON could not find a signed declination for the flu vaccine during interview.
Failure to Protect Residents From Sexual Abuse: Two cognitively impaired residents with documented inappropriate sexual behaviors were found together in bed and later in each other’s rooms, including one resident touching the other’s penis. An LPN did not report the first incident to management, and the resident’s POA was not notified. Staff interviews and the facility’s investigation confirmed repeated resident-to-resident sexual contact and inadequate supervision before the incidents were stopped.
Surveyors found multiple expired medications, including enema saline laxatives, bisacodyl suppositories, cough suspension, and melatonin, stored in the medication room. Both an RN and the DON confirmed these drugs were expired and should not have been accessible, indicating a failure to follow the facility's medication storage policy.
A resident with moderate cognitive impairment reported to a surveyor that a CNA told her to use her diaper instead of assisting her to the bathroom, leaving her feeling degraded. The incident was reported by a nurse to the NHA in the morning, but the required report to the state agency was not submitted until several hours later, exceeding the mandated two-hour timeframe for reporting allegations of abuse or neglect.
A resident with stage 2 pressure injuries on both buttocks did not receive wound care in accordance with professional standards and facility policy. The DON performed wound care on both wounds consecutively without performing hand hygiene or treating each wound separately, as required by physician orders and facility protocol. This resulted in a deficiency related to infection control and proper wound care practices.
Two residents were affected by medication administration errors, resulting in a medication error rate above 5%. One resident did not receive proper nasal spray administration according to facility policy, and another did not receive an ordered Senna-S tablet, though it was signed as given on the MAR. These errors were observed during a medication pass and involved a registered nurse.
Staff failed to follow Enhanced Barrier Precautions and hand hygiene protocols during wound care and medication administration. A resident with multiple wounds did not receive care in accordance with facility policy, as the DON did not wear a gown during wound care, and an RN did not perform hand hygiene between glove changes or after resident contact. These actions were inconsistent with established infection control procedures.
A resident admitted with a skin infection and a hospital order for ciprofloxacin did not receive any doses of the prescribed antibiotic due to a paperwork error and lack of follow-up by staff, despite the medication being available in the facility. The omission was not documented as a medication error, and the resident was discharged against medical advice without receiving the antibiotic.
Failure to monitor aspirin-related bleeding and ordered weights
Penalty
Summary
The facility did not ensure that a resident receiving daily aspirin was monitored for signs and symptoms of bleeding, and the resident’s change in condition was not fully assessed or reported to the physician when the resident became acutely weak and pale. The resident had diagnoses including heart disease, type 2 diabetes mellitus, skin cancer, and long-term aspirin use, and the care plan included aspirin-related monitoring tasks, but the MAR/TAR did not include directions to monitor for bruising or bleeding. On the morning of the event, nursing documentation described the resident as too weak to stand, pale, with a weak voice, and coughing up clear phlegm, but there was no documented assessment, no documented vital signs, and no physician notification at that time. Later that same morning, the resident was found to have shortness of breath, oxygen saturation in the 70s, respirations of 32, absent lung sounds in the right lower lobe, pale skin, and a gaunt appearance. The physician was then contacted and the resident was sent to the emergency room. Hospital records documented black, heme-positive stools, blood-tinged emesis, hypotension, acute blood loss anemia with hemoglobin of 6.2, leukocytosis, and acute kidney injury. The hospital history and physical noted the resident had been on aspirin for many years and was not on stomach protection. The facility also did not conduct ordered daily weights for a resident with CHF and hypertensive heart disease with heart failure. The resident was admitted with orders to notify the physician if weight increased or decreased by 3 pounds in one day or one week, but only the admission weight was recorded before the resident returned to the hospital. After readmission, the resident’s weight dropped to 121 pounds and later increased to 153.5 pounds, including a 27.5-pound gain in one day. The facility initiated a change of condition for edema and weight gain on 5/21/26, but there was no evidence that the physician was aware of the weight change before that time.
Missing COVID-19 Vaccine Education and Declination Documentation
Penalty
Summary
The facility failed to ensure that the medical records for two residents included documentation that they were educated about the COVID-19 vaccine and that the vaccine was offered, accepted, or declined. The facility policy stated that residents or resident representatives were to be educated on the vaccine, given the Vaccine Information Statement, and that the medical record would include documentation of education, administration, or declination. The report also cited CDC information describing COVID-19 symptoms and emergency warning signs. One resident had diagnoses including dementia, anxiety disorder, depression, and a wedge compression fracture of the first lumbar vertebra, and the most recent MDS showed a BIMS score of 2 out of 15, indicating severe cognitive impairment. The resident had an activated power of attorney. The facility had no documentation showing that the resident or the APOA was offered the COVID-19 vaccine, declined it, consented to it, or received education about it. The resident later developed fever, decreased intake, altered mental status, weakness, cough, hypoxia, and respiratory distress, and was transferred to the hospital. The ED documented acute respiratory failure with cough and hypoxia, and testing was positive for COVID-19. The resident remained hospitalized for 6 nights before returning to the facility. A second resident had diagnoses including frontotemporal neurocognitive disorder, dementia with severe agitation, mood disorder, and violent behavior, and the MDS showed a BIMS score of 0 out of 15, indicating severe cognitive impairment. The resident had a declination for PCV20, but there was no declination or other documentation for the COVID-19 vaccine. The DON stated that immunizations were reviewed through the resident record and H&P and that the ADON was responsible for offering immunizations, but the facility was unable to find documentation that the COVID-19 vaccine had been offered, received, or declined for this resident.
Failure to Provide Needed Grooming and Nail Care
Penalty
Summary
The facility did not ensure that a resident who was unable to perform ADLs received the necessary services to maintain grooming and personal hygiene. R6 was admitted with diagnoses including heart disease, type 2 diabetes mellitus, squamous cell carcinoma of the skin and neck, and long-term aspirin use. The most recent MDS dated 4/24/26 indicated a BIMS score of 6 out of 15, showing severe cognitive impairment, and that R6 was dependent on staff for all ADLs. The care plan directed staff to check nail length and clean nails on bath day and as needed, with the licensed nurse to trim nails due to the diabetes diagnosis, and to provide assistance with bathing and personal hygiene. During observation and interview, R6 was noted to have facial hair approximately 1/4 to 1/2 inch long and fingernails that were long with a black substance underneath them. R6 stated a preference to be clean shaven and later stated that the fingernails should be shorter and needed cleaning. R6 continued to be observed unshaven with long, dirty nails on multiple occasions. CNA J stated residents get shaved every day and acknowledged R6 had not been shaved, while also stating nail care should be provided as needed and that they did not know how to get R6's nails cleaned. LPN K stated nail care for diabetic residents is provided on shower day, that CNAs clean the nails and nurses clip them, but also stated the nail care was not documented and there was no documentation for when R6's nails were last clipped and cleaned. The DON stated shaving should occur per resident preference and daily if needed, and also stated they did not think nail care was documented.
Missing Influenza Vaccine Offer and Documentation
Penalty
Summary
The facility did not offer influenza immunization to a resident, and the resident’s medical record did not contain documentation that the resident received the vaccine, refused it, or was educated on the risks and benefits of the influenza immunization. The deficiency involved R7, who was admitted with diagnoses including frontotemporal neurocognitive disorder, dementia with severe agitation, mood disorder, and violent behavior. R7’s most recent MDS showed a BIMS score of 0 out of 15, indicating severe cognitive impairment, and R7 had a Guardian. R7 did not receive the influenza vaccine, and the record did not include documentation that the vaccine was offered, declined, consented to, or that education was provided to the resident or Guardian. The facility’s policy stated that influenza vaccinations are to be routinely offered annually when available and that the resident’s medical record should document education, receipt, refusal, or medical contraindication. R7 had a signed declination for the PCV20 pneumococcal vaccine dated 3/18/26, but there was no declination for the influenza vaccine. During interviews on 5/27/26 and 5/28/26, the DON stated that immunizations are reviewed on admission and that the ADON is responsible for offering immunizations, but the DON was unable to find documentation showing that R7 declined the influenza vaccine. The DON also stated that signed declinations should have been present.
Failure to Protect Residents From Sexual Abuse
Penalty
Summary
The facility failed to protect a resident from sexual abuse by another resident and failed to provide adequate supervision after repeated incidents involving two residents with significant cognitive impairment. One resident had diagnoses including major depressive disorder, anxiety disorder, Alzheimer's disease, and unspecified dementia, with a BIMS score of 3 and an activated POA. The other resident had diagnoses including traumatic subdural hemorrhage with loss of consciousness, adjustment disorder with depressed mood, mild cognitive impairment, and generalized anxiety disorder, with a BIMS score of 4 and an activated POA. Both residents had care plans that identified socially inappropriate or sexually inappropriate behaviors and wandering or inappropriate advances. On 3/20/26, a nurse documented that a bed alarm was sounding and staff found one resident completely in bed, covered up, lying next to the other resident. The resident stated that the other resident wanted him to get in bed with her, and then made sexually inappropriate comments to staff. During interview, the nurse stated she found the two residents in bed together while doing night rounds, that both were fully clothed, and that she did not witness touching. She stated she did not report the incident to management, only to the oncoming shift, and the resident's POA was not notified. The resident's POA later stated she was unaware of the incident. On 4/13/26, staff witnessed one resident in the other resident's room with the resident slumped over, hands on the wheelchair arm rests, and pants partially down. Staff intervened and removed the resident from the room. On 4/18/26, staff found the residents again together in one resident's room, with one resident sitting in a recliner and touching the other resident's penis while the other resident's pants were down and zipper open. Staff separated the residents and reported the incident. Surveyor interviews confirmed that staff observed the residents alone together and that the incidents were not prevented before contact occurred. The facility's own investigation concluded that the residents continued to seek each other out and that they made contact despite the attempted supervision measures.
Expired Medications Found in Medication Storage Room
Penalty
Summary
Surveyors observed that drugs and biologicals in the facility's medication storage room were not stored and labeled in accordance with accepted professional practices. Specifically, multiple expired medications were found, including four bottles of Enema Saline Laxative (expired 2/25), six boxes of Bisacodyl Suppositories (expired 1/25), one bottle of Major Cough DM Dextromethorphan Polistirex Extended-Release Oral Suspension (expired 3/25), and two bottles of melatonin 1 mg (expired 3/25). These expired medications were accessible in the medication storage room at the time of the surveyor's visit. The facility's policy requires that outdated, contaminated, discontinued, or deteriorated medications be immediately removed from stock and disposed of according to established procedures. During the survey, both an RN and the DON confirmed the presence of the expired medications and acknowledged that they should not have been in circulation. The failure to remove these expired drugs from the medication storage room constituted noncompliance with the facility's own medication storage policy and professional standards.
Failure to Timely Report Alleged Abuse to State Agency
Penalty
Summary
A deficiency occurred when the facility failed to ensure that an alleged violation involving potential abuse or neglect was reported to the state agency within the required two-hour timeframe. The incident involved a resident with moderate cognitive impairment and a history of depression, anxiety, and breast cancer, who reported to a surveyor that a CNA had told her to use her diaper instead of assisting her to the bathroom, leaving her feeling degraded and upset. The resident stated she had turned on her call light for help, but the CNA turned it off and left, telling her to wait until later for assistance. The resident subsequently reported the incident to a male nurse, who confirmed she was tearful and upset about the CNA's behavior. The nurse reported the resident's concerns to the Nursing Home Administrator (NHA) before 9:00 AM, indicating that the resident was crying and claimed the CNA had yelled at her and turned off her call light. The NHA attempted to speak with the resident multiple times that morning and eventually gathered more details about the incident, including the resident's account that the CNA was short and abrupt, turned off the call light, and left. The NHA also spoke with the CNA, who admitted to turning off the call light and said she would return with assistance. The NHA acknowledged that the incident could be considered abuse and that such allegations should be reported immediately. Despite being informed of the incident in the morning, the facility did not submit the required report to the state agency until after 2:00 PM, well beyond the two-hour reporting requirement for allegations of abuse or neglect. The facility's own policy mandates immediate reporting of such incidents, but the delay in reporting was confirmed through interviews and review of the facility's documentation. The deficiency was substantiated by the surveyor's interviews with the resident, the nurse, and the NHA, as well as a review of the facility's abuse reporting policy and incident documentation.
Failure to Perform Separate Wound Care and Hand Hygiene for Pressure Injuries
Penalty
Summary
A deficiency occurred when staff failed to provide pressure ulcer care in accordance with professional standards of practice and facility policy for a resident with multiple pressure injuries. The resident, who had hemiplegia and hemiparesis affecting the right side, was admitted with stage 2 pressure injuries to both the left and right buttocks. Physician orders specified enhanced barrier precautions and required that each wound be cleansed and dressed individually. The facility's policy also mandated that each wound be treated separately to prevent infection and cross-contamination. During an observation, the Director of Nursing (DON) performed wound care for the resident but did not perform hand hygiene between treating the left and right buttock pressure injuries. The DON applied skin prep to the left buttock, then applied dressings to both the right and left buttock wounds without changing gloves or performing hand hygiene between sites. The DON later acknowledged that each wound should have been treated separately with hand hygiene performed between each, as they were located on different parts of the body. This failure to follow proper wound care protocol and hand hygiene practices led to the cited deficiency.
Medication Error Rate Exceeds Acceptable Threshold Due to Administration Failures
Penalty
Summary
The facility failed to maintain a medication error rate below 5%, as evidenced by two errors in 28 observed opportunities during a medication pass, resulting in a 7.14% error rate. One error involved a resident with major depressive disorder and anxiety disorder who was prescribed Flonase nasal spray. The registered nurse administered the nasal spray without following facility policy, specifically failing to occlude the opposite nostril and not instructing the resident during the process, contrary to the established procedure for safe and effective nasal medication administration. A second error occurred when another resident with depression, anxiety, and a history of malignant neoplasm of the breast did not receive her ordered Senna-S tablet during the morning medication pass. The nurse omitted the medication but signed it as administered on the Medication Administration Record (MAR). The Director of Nursing confirmed that the omission of Senna-S constituted a medication error. Both incidents were directly observed by the surveyor and contributed to the facility's medication error rate exceeding the acceptable threshold.
Failure to Follow Enhanced Barrier Precautions and Hand Hygiene Protocols
Penalty
Summary
The facility failed to establish and maintain an effective infection prevention and control program as evidenced by staff not following Enhanced Barrier Precautions (EBP) and proper hand hygiene protocols. During wound care for a resident with multiple wounds, the Director of Nursing (DON) applied gloves but did not wear a gown, despite the facility's policy requiring both gown and gloves for high-contact activities such as wound care under EBP. The DON acknowledged during an interview that a gown should have been worn but was not. Additionally, a Registered Nurse (RN) did not perform hand hygiene at appropriate times during medication administration. The RN was observed removing gloves and applying new ones without performing hand hygiene, and also pushed a medication cart through the facility while wearing the same gloves. The RN admitted to not following the standard practice of performing hand hygiene between glove changes, citing difficulty in donning gloves after hand hygiene. These actions were not in accordance with the facility's hand hygiene policy, which requires hand hygiene before and after glove use and between resident contacts.
Significant Medication Error: Omission of Prescribed Antibiotic
Penalty
Summary
A resident with a history of acquired absence of the left foot and a skin and subcutaneous tissue infection was admitted to the facility with hospital discharge orders for ciprofloxacin 750 mg to be taken twice daily for 19 days. The facility did not administer any doses of ciprofloxacin, as the medication was not included in the paperwork received from the hospital. The Director of Nursing confirmed that the facility had ciprofloxacin available and acknowledged that staff should have recognized the need for an antibiotic given the resident's infection diagnosis and inquired further when it was missing from the orders. The omission was not documented as a medication error by the facility. The resident was seen by a physician the day after admission, who also noted the absence of ciprofloxacin on the medication list, but the medication was still not administered prior to the resident discharging against medical advice later that day.
What surveyors are citing around you — mapped
All 10 risk areas, ranked with evidence
Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 39 citations issued within 25 miles in the last 12 months — and tell you exactly what happened, in plain English, matched to your record.
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.
Illustrative
A prioritized, do-first checklist
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Mineral Point
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Upland Hills Nursing And Rehab | 6.7 mi | ★★★★★ | 9 | 0 |
| Edenbrook Of Platteville | 16.4 mi | ★★★★★ | 3 | 0 |
| Lafayette Manor | 17.1 mi | ★★★★★ | 18 | 0 |
| Greenway Manor | 22.1 mi | ★★★★★ | 9 | 0 |
| Ingleside Manor | 25.4 mi | — | 33 | 1 |
Every risk area ranked, a do-first checklist, and your local survey patterns
Built specifically for Mineral Point Health Services.
100% money-back within 48 hours.
Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release August 2026) and official state health department websites.