Below average — CMS composite of the measures below.
A standard survey is most likely before around August 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 Pine Valley Community Village during CMS and state inspections, most recent first.
A resident with chronic pain and severe cognitive impairment was prescribed hydrocodone-acetaminophen 7.5-325 mg, first as PRN for breakthrough pain and later scheduled every eight hours. Facility policy required dual-signature controlled administration sheets upon receipt from pharmacy and shift-to-shift narcotic counts documented in narcotic binders. The MAR showed scheduled hydrocodone-acetaminophen was administered three times daily during a month, except for a few missed doses when the resident was out of the facility. However, when a surveyor requested the controlled drug receipt/record/disposition forms for that month, the DON could only provide forms for earlier dispensing dates and acknowledged that the forms for the month in question were missing, making it impossible to reconcile the controlled medication as required.
A resident with CHF, CAD, PVD, DM2, and AKI was found pulseless and not breathing, but staff did not immediately start CPR or call EMS even though the resident’s physician orders, POST, care plan, CNA Kardex, EHR banner, and MAR all showed full code status. The RN called the physician and accepted direction not to begin CPR because the resident was cold and appeared deceased, while the CNA and LPN reported that CPR should have been started for a full code resident.
Surveyors found that five CNAs did not complete the required 12 hours of annual continuing education, as confirmed by both documentation review and administrator interview. This lapse in in-service education could impact all 70 residents in the facility.
Five CNAs did not receive required education in effective communication, as confirmed by the NHA when surveyors requested documentation. The lack of training was identified through interviews and record review, potentially impacting all residents.
The facility did not provide required QAPI program education to five CNAs, as confirmed by the NHA and a lack of documentation when requested by a surveyor.
Four CNAs did not receive required infection control education, and the NHA could not provide evidence of their training when requested by surveyors. This lapse in mandatory staff education has the potential to impact all 70 residents.
Five CNAs did not receive required compliance and ethics training, as confirmed by the NHA when surveyors requested documentation. The lack of training was identified through interviews and record review, potentially affecting all residents in the facility.
Surveyors found that opened bags of chicken patties in the freezer were not sealed or dated as required by facility policy, and high temperature dishwashers in several kitchenettes repeatedly operated below the minimum recommended wash temperatures without proper documentation or notification to management.
Two residents with chronic respiratory conditions and intact cognitive status were found with medications at bedside or on meal trays without completed self-administration assessments or physician orders. Staff interviews confirmed that neither resident was authorized to self-administer the medications observed, and facility policy requiring assessment, physician order, and secure storage was not followed.
A registered nurse did not receive a complete background check as required by facility policy, which mandates such checks upon hire and every four years. The omission was confirmed by Human Resources, who could not explain why the check was missed.
Surveyors found that two residents did not receive their scheduled morning medications within the required time window, resulting in a medication error rate of over 40%. Medications were administered outside the one-hour window specified by facility policy, and the DON confirmed these were medication errors.
A bottle of MiraLAX prescribed to a resident was found unattended on top of a medication cart in a common area near the dining room, with no nurse present and residents and visitors nearby. Facility policy requires medications to be stored in locked carts or rooms, or kept within a nurse's line of sight, which was not followed in this instance.
An LPN did not perform hand hygiene between glove changes during a wound care procedure for a resident with a neuropathic toe wound. The LPN touched items in the environment and changed gloves without sanitizing hands, contrary to facility policy. Both the LPN and DON confirmed awareness of proper hand hygiene requirements.
Two residents experienced acute changes in condition that were not promptly recognized or appropriately managed by staff. One resident with multiple chronic illnesses was not assessed or monitored for over 21 hours despite worsening symptoms and was only sent to the ER after a nurse practitioner intervened, later being diagnosed with sepsis and acute respiratory failure. Another resident with a history of atrial fibrillation was not monitored as ordered after reporting irregular heart rates and chest pressure, and was sent to the ER via taxi instead of ambulance after experiencing tachycardia and bradycardia. These failures to assess, monitor, and use appropriate transport led to Immediate Jeopardy findings.
A resident with moderate cognitive impairment reported missing money, prompting an investigation by the Social Services Director that included interviews with the resident and staff, a search of the resident's room, and notification of law enforcement and family. However, the facility did not interview other residents to determine if similar concerns existed, as required by policy, and did not provide staff education following the incident. The resident had not received reimbursement or follow-up communication regarding the missing funds.
A CNA worked for 11 days with an expired Wisconsin Nurse Aide Registry certification. The facility's administrator was unaware of the lapse until it was identified during a survey, and documentation confirmed the CNA had continued working without current certification as required.
The facility did not complete required annual performance evaluations for three CNAs, as mandated by facility policy. The administrator confirmed that yearly evaluations are expected and that all CNAs should have current evaluations.
The facility failed to store, prepare, distribute, and serve food in accordance with professional standards, affecting all 62 residents. Nutritional supplements were not dated or were expired, food boxes were on the floor, staff did not wear hairnets, and dishwasher temperatures were not monitored.
The facility failed to report reasonable suspicions of abuse to law enforcement for two residents. One resident with severe cognitive impairment reported being hurt by a staff member, and another resident reported rough handling by a CNA. Despite internal investigations and state agency reports, local law enforcement was not notified.
Failure to Maintain Controlled Drug Accountability Records for Hydrocodone-Acetaminophen
Penalty
Summary
The deficiency involves the facility’s failure to maintain required records for a controlled substance prescribed to a resident. Facility policy required that upon receipt of controlled medications from the pharmacy, both the pharmacy and a licensed nurse sign controlled administration sheets, and that all controlled medications be accounted for each shift by oncoming and outgoing nurses using controlled administration sheets stored in a narcotic binder on each medication cart. The facility also had a HIPAA documentation policy requiring secure maintenance and availability of required documentation for audits and investigations. A resident with rheumatoid arthritis, chronic pain, and severe cognitive impairment (BIMS score of 1) had physician orders for hydrocodone-acetaminophen 7.5-325 mg, initially as a PRN dose for breakthrough pain and later scheduled every eight hours for pain. The MAR for December showed the PRN dose was not given, while the scheduled dose was administered three times daily except for five doses when the resident was out of the facility. When the surveyor requested the resident’s controlled drug receipt/record/disposition forms for hydrocodone-acetaminophen, the DON produced forms dated for multiple prior dispensing dates, each showing pharmacy delivery of 30 tablets, but was unable to provide the controlled drug forms for the month of December. During interviews, the DON confirmed that she did not have the December controlled drug forms and stated she was unable to reconcile the resident’s hydrocodone-acetaminophen for December without those records. As a result, the facility did not have a complete system of records of receipt and disposition of this controlled drug and could not account for all doses administered or dispensed during that month, contrary to its own policies and regulatory requirements for controlled drug accountability.
Failure to Initiate CPR for Full Code Resident
Penalty
Summary
The facility failed to provide basic life support, including CPR, and failed to immediately notify emergency medical personnel when a resident was found pulseless and not breathing. The resident was admitted with diagnoses including congestive heart failure, coronary artery disease, peripheral vascular disease, diabetes mellitus type 2, and acute kidney failure. The resident’s records showed full code status in the physician orders, care plan, CNA Kardex, EHR banner, MAR, and POST, which directed staff to attempt resuscitation/CPR if the patient had no pulse and was not breathing. At approximately 4:24 AM, an RN documented that a CNA called her to the room because the resident was not breathing and had no heartbeat, and that the resident’s skin was cold to the touch. The RN documented that she called the physician and felt there was no need to start CPR because there was no heartbeat and the skin was cold to the touch. The report states that staff did not immediately initiate CPR or immediately contact emergency medical personnel, despite the resident being full code and despite the facility policy directing staff to call for assistance, verify code status, delegate tasks, and initiate CPR for a YES CPR resident. Interviews showed that the CNA had checked the resident earlier in the night and found her alive and breathing, then later found her with purple hands and a cold face. The LPN stated she told the CNA to grab the crash cart and that CPR needed to start for a full code resident, but CPR was not started after the RN spoke with the physician. The RN stated she believed the resident had been deceased for some time and did not start CPR because the resident was cold and appeared deceased. The physician stated she instructed the RN not to do CPR because it would not do any good, and the facility later determined that staff should have started compressions and called EMS regardless of the resident’s condition because the resident was full code.
Failure to Provide Required Annual CNA In-Service Education
Penalty
Summary
The facility failed to provide regular in-service education for all five Certified Nursing Assistants (CNAs) reviewed for education, as required by Wisconsin regulations mandating 12 hours of continuing education annually for CNAs. Documentation requested by the surveyor showed that none of the five CNAs—each with varying hire dates—had completed the required 12 hours of continuing education within the past 12 months. During an interview, the Nursing Home Administrator confirmed that these CNAs should have completed their annual education hours but had not done so. This deficiency was identified through both record review and staff interview, and it has the potential to affect the entire resident census of 70.
Failure to Provide Mandatory Effective Communication Training to Direct Care Staff
Penalty
Summary
The facility failed to ensure that five direct care staff members received mandatory education in effective communication. During a survey, the surveyor requested documentation confirming that these staff members had completed the required training. The Nursing Home Administrator (NHA) was unable to provide evidence that the education had been provided to the identified Certified Nursing Assistants (CNAs). The NHA confirmed in an interview that these staff members should have received the training but did not. This deficiency was identified through interviews and record reviews and has the potential to affect the facility's entire resident census.
Failure to Provide Mandatory QAPI Training to Staff
Penalty
Summary
The facility failed to ensure that all staff received mandatory training on the elements and goals of the Quality Assurance and Performance Improvement (QAPI) program. During an interview and record review, it was found that five Certified Nursing Assistants (CNAs) did not receive the required QAPI education. When the surveyor requested evidence of QAPI education for these staff members, the Nursing Home Administrator (NHA) was unable to provide documentation confirming that the training had been completed. The NHA confirmed in an interview that these CNAs should have received the QAPI education but did not.
Failure to Provide Mandatory Infection Control Training to Staff
Penalty
Summary
The facility failed to ensure that four out of five staff members reviewed for education received the required mandatory training on infection control standards, policies, and the overall infection prevention and control program. During the survey, the surveyor requested evidence of infection control education for four Certified Nursing Assistants (CNAs), but the Nursing Home Administrator (NHA) was unable to provide documentation that these staff members had received the necessary training. The NHA confirmed in an interview that these CNAs should have received infection control education but did not. This deficiency has the potential to affect the entire resident census of 70.
Failure to Provide Compliance and Ethics Training to Staff
Penalty
Summary
The facility failed to ensure that five Certified Nursing Assistants (CNAs) received required training on compliance and ethics. During a survey, the surveyor requested evidence of compliance and ethics training for five specific CNAs. The Nursing Home Administrator (NHA) was unable to provide documentation that these staff members had received the necessary training. The NHA confirmed in an interview that the identified CNAs should have received the training but did not. This deficiency was identified through both interview and record review, and it has the potential to affect the facility's total census of 70 residents.
Deficiencies in Food Storage and Dishwasher Temperature Monitoring
Penalty
Summary
Surveyors identified deficiencies in the facility's food storage and dishwashing practices. During an inspection of the main kitchen, two opened bags of chicken patties were found in the walk-in freezer that were not sealed and lacked both an opened date and a use by date, contrary to the facility's own policy requiring opened food items to be sealed and labeled with the date. The Dietary Manager confirmed that staff were expected to seal and date opened food items, but this was not done in this instance. Additionally, the facility's high temperature dishwashers in multiple kitchenettes were found to be operating below the minimum recommended wash temperatures on several days, as documented in temperature logs. The logs showed repeated instances where dishwashers did not reach the required 150 degrees F for proper sanitization. The Dietary Manager stated that staff are supposed to rerun dishes and notify her if temperatures are not met, but there was no documentation of these actions, and she was not informed of the temperature issues as expected. The facility also lacked a policy or procedure for monitoring dishwasher temperatures.
Failure to Assess and Authorize Self-Administration of Medications
Penalty
Summary
The facility failed to ensure that residents were clinically assessed and authorized to self-administer medications before allowing them access to their medications at bedside. In one instance, a resident with chronic respiratory failure, COPD, and a BIMS score indicating cognitive intactness was observed with a Combivent Respimat inhaler and a mouth spray on the bedside table. The resident stated the items had been there for at least a day but could not recall who placed them there. Review of the resident's records showed a self-administration assessment and plan of care only for nebulizer use after nurse setup, with no assessment or plan for the inhaler or mouth spray. Interviews with nursing staff confirmed that the resident was not authorized to self-administer these medications and that such medications should not be left at bedside without proper assessment and physician order. Another resident, also with chronic respiratory failure, COPD, and a BIMS score indicating cognitive intactness, was observed with a cup of medications left on the meal tray at bedside. The resident reported receiving the medication cup that morning. When questioned, the medical assistant confirmed that the resident liked to take medications independently but could not find documentation of an assessment or physician order authorizing self-administration. The nurse supervisor later clarified that the resident was only authorized to self-administer topical creams, not oral medications, and that oral medications should not be left on the meal tray. The facility's policy requires that residents wishing to self-administer medications must undergo a self-administration assessment, and if deemed safe, a physician order must be obtained. Additionally, medications must be kept in a secure location between administrations. In both cases, the facility did not follow its own policy, as neither resident had the required assessment or physician order for the medications found at bedside, and medications were not secured as required.
Failure to Complete Required Employee Background Check
Penalty
Summary
The facility failed to implement its policy and procedures regarding the screening of employees for a prior history of abuse, neglect, exploitation, or misappropriation of resident property. Specifically, one registered nurse did not have a complete background check performed every four years as required by facility policy. The policy, titled 'Abuse Investigation and Reporting,' mandates that all employees undergo a full background check, including a Background Information Disclosure (BID), Department of Justice (DOJ) check, and review of government findings upon hire and every four years thereafter. Record review showed that the registered nurse, hired in 2019, did not have the required background check completed in 2023. During an interview, the Human Resources representative confirmed that the background check for this employee was missed and could not provide a reason for the oversight.
Medication Error Rate Exceeds Regulatory Threshold Due to Late Administration
Penalty
Summary
The facility failed to ensure that medication error rates remained below 5%, as required by regulation and facility policy. During a medication pass observation, surveyors identified 11 errors out of 27 opportunities, resulting in a medication error rate of 40.74%. The errors involved two residents who did not receive their morning medications at the correct, ordered time. According to the facility's policy, medications scheduled for 7:30 AM must be administered within one hour before or after the scheduled time, specifically between 6:30 AM and 8:30 AM. One resident, with diagnoses including chronic atrial fibrillation, congestive heart failure, and type 2 diabetes mellitus, was observed receiving multiple morning medications at 8:57 AM, which was outside the permitted administration window. The medications included digoxin, furosemide, Jardiance, acetaminophen, and omeprazole, all of which were ordered for administration at 7:30 AM. The resident was cognitively intact, as indicated by a BIMS score of 15, and the medication orders were clearly documented in the EMAR. A second resident, with severe cognitive impairment and diagnoses such as atrial fibrillation, hypertension, dementia with agitation, and pruritus, was also observed receiving all scheduled 7:30 AM medications at 8:55 AM, again outside the allowed timeframe. The medications administered included digoxin, amlodipine, furosemide, losartan, quetiapine, and prednisolone, all ordered for 7:30 AM administration. The Director of Nursing confirmed that these administration times constituted medication errors according to facility policy.
Unattended Medication Left on Cart in Common Area
Penalty
Summary
A deficiency occurred when a bottle of polyethylene glycol powder for oral solution (MiraLAX), prescribed to a resident, was observed sitting unattended on top of a medication cart located in a common area near the dining room, where two residents and two visitors were present. The medication cart was not within the line of sight of a nurse at the time of the observation. According to the facility's Medication Administration policy, medications are to be stored in locked carts or rooms, and carts not in medication rooms must be locked when not in use or kept within the nurse's line of sight. Upon return, the registered nurse confirmed the medication was MiraLAX and acknowledged that medications should probably not be left unattended. The Director of Nursing also confirmed that medications are not to be left on top of the cart unattended.
Failure to Perform Hand Hygiene During Wound Care
Penalty
Summary
A deficiency was identified when a Licensed Practical Nurse (LPN) failed to follow proper hand hygiene protocols during a wound care procedure for a resident. The facility's policy requires staff to wash hands and change gloves at specific steps during wound care, including after removing old dressings and before applying new ones. During observation, the LPN washed her hands initially, but after removing gloves used to take off the resident's shoe and sock, she donned new gloves without sanitizing her hands. She then proceeded to remove the old dressing, cleanse the wound, and apply a new dressing without performing hand hygiene between glove changes as required by policy. The resident involved had been admitted with a diagnosis that included a hammer toe and developed a non-pressure, neuropathic wound on the dorsal aspect of the left second toe during her stay. Interviews with the LPN and the Director of Nursing (DON) confirmed that both were aware of the need for hand hygiene between glove changes and after touching items in the environment. The LPN acknowledged she should have sanitized her hands after touching the paper and the resident's shoes, and before continuing with the wound care procedure.
Failure to Recognize and Respond to Acute Changes in Condition
Penalty
Summary
Facility staff failed to provide treatment and care in accordance with professional standards of practice for two residents, resulting in significant deficiencies. In the first case, a resident with multiple comorbidities including diabetes, dementia, chronic kidney disease, and PTSD experienced a change in condition characterized by severe back pain, low oxygen saturation, and shortness of breath. Despite physician and healthcare power of attorney involvement, there was a lack of documented assessment and monitoring for over 21 hours. The resident's condition worsened, and he was not sent to the emergency room until the nurse practitioner intervened. Upon hospital admission, the resident was diagnosed with sepsis, pneumonia, and acute respiratory failure with hypoxia, and subsequently passed away two days later. In the second case, another resident with a history of atrial fibrillation, heart failure, and other cardiac conditions reported irregular heart rates and chest pressure. The on-call physician provided explicit orders to send the resident to the emergency room if the apical pulse exceeded 115. However, staff did not assess or monitor the resident's pulse for the next ten hours, during which the resident experienced episodes of tachycardia and bradycardia, as well as chest tightness. The resident was eventually sent to the hospital, but was transported via taxi rather than a medical transport service, despite presenting with acute cardiac symptoms. The facility's failures included not recognizing acute changes in condition, not closely monitoring or assessing residents as ordered, and not using appropriate medical transport during emergencies. These actions and inactions resulted in delayed treatment and intervention for both residents, and the surveyor determined that these failures constituted Immediate Jeopardy. The facility's own policies and professional standards were not followed, as evidenced by the lack of timely assessments, documentation, and appropriate escalation of care.
Removal Plan
- Staff education on change in condition, including what is a change in condition, how to recognize it, appropriate response, physician notification, and assessments required.
- Staff are required to review education prior to the start of their shift.
- Staff are educated to assess the resident for change in condition, gather vitals, symptoms, and changes above baseline condition at a minimum of twice a shift or transfer for further evaluation.
- Physician should be notified upon change in condition, vitals, symptoms, interventions, reactions, pain, infections, neurological changes, or falls as soon as possible following change in condition.
- Mandatory all staff meeting regarding change in condition and follow up from education provided to ensure understanding of requirements and to obtain feedback.
- Education will be provided for new hires during orientation in the form of the same education provided to staff; agency staff will be given the same information.
- Management staff will conduct scenario-based competencies with staff.
Failure to Conduct Thorough Investigation of Misappropriation Allegation
Penalty
Summary
The facility failed to conduct a thorough investigation in response to an allegation of misappropriation of a resident's property. A resident with moderate cognitive impairment reported missing $42 from her purse, and the Social Services Director initiated an investigation by interviewing the resident, searching her room and purse with her permission, contacting law enforcement, and notifying the resident's daughter. The facility also interviewed 12 staff members who worked around the time of the incident. However, the investigation did not include interviews with other residents to determine if there were similar concerns or additional allegations of missing property. The facility's policy requires a thorough investigation of alleged violations, including interviewing other residents to identify any related issues. Documentation and interviews confirmed that no other residents were interviewed, and no staff education was provided following the incident. The resident expressed dissatisfaction with the lack of follow-up and had not yet been reimbursed for the missing money at the time of the survey. The deficiency was identified based on the facility's failure to follow its own policy and regulatory requirements for investigating allegations of misappropriation.
CNA Worked with Expired Certification
Penalty
Summary
A Certified Nursing Assistant (CNA) continued to work in the facility for 11 days after her Wisconsin Nurse Aide Registry certification had expired. The surveyor reviewed the registry information and found that the CNA's certification was not current, despite the requirement that nurse aides must be listed on the Wisconsin Nurse Aide Registry to be employed in federally eligible health care settings in Wisconsin. The Nursing Home Administrator was unaware of the expired certification until it was brought to her attention during the survey. Documentation provided by the facility confirmed that the CNA had worked during the period her certification was expired.
Failure to Complete Annual CNA Performance Evaluations
Penalty
Summary
The facility failed to complete a performance review of every Certified Nursing Assistant (CNA) at least once every 12 months for 3 out of 5 CNAs reviewed. Specifically, CNA K, CNA L, and CNA M did not have annual performance evaluations completed, despite their respective hire dates indicating that such evaluations were due. The facility's policy requires annual performance reviews and regular in-service education based on these reviews. During an interview, the Nursing Home Administrator confirmed that CNA evaluations are to be conducted yearly and that all CNAs should have up-to-date evaluations.
Food Safety and Hygiene Deficiencies
Penalty
Summary
The facility did not store, prepare, distribute, and serve food in accordance with professional standards for food service safety, potentially affecting all 62 residents. Observations revealed that nutritional supplements and food items were not dated or were expired. Specifically, various units had nutritional juices and shakes without thaw dates, and some items were past their use-by dates. The Dietary Manager admitted that there was no policy or procedure regarding the handling of nutritional shakes and drinks. Additionally, boxes of food were found sitting directly on the floor in multiple areas of the kitchen, which the Dietary Manager acknowledged should not happen. Further observations showed that staff members were not adhering to hygiene protocols, as one RN was seen walking through the kitchen without a hairnet, despite a posted sign requiring it. The temperature of the dishwashers in the kitchenettes was also not being monitored properly. In the 400 unit kitchenette, there was no thermometer to document the internal temperature of the dishwasher, and the Dietary Manager was unaware of when it had disappeared or how long the temperature had not been monitored. These deficiencies indicate a lack of adherence to food safety and hygiene standards in the facility's food service operations.
Failure to Report Abuse to Law Enforcement
Penalty
Summary
The facility failed to report reasonable suspicions of abuse to law enforcement for two residents. Resident 58, who has severe cognitive impairment and multiple medical conditions, reported to a Registered Nurse that a staff member had hurt him. Despite the facility initiating an internal investigation and reporting the incident to the Division of Quality Assurance, law enforcement was not contacted. Interviews with the Social Worker and the Director of Nursing revealed that the police were not notified, although both acknowledged that they should have been informed of the abuse allegation. Similarly, Resident 49 reported that a Certified Nursing Assistant was rough during a transfer, causing fear and physical pain. The facility conducted an internal investigation and reported the incident to the state agency but did not notify local law enforcement. Interviews with the Social Worker who handled the report indicated uncertainty about whether the incident constituted abuse, despite the resident's description of being pushed and scared. The failure to report these incidents to law enforcement constitutes a deficiency in the facility's abuse reporting procedures.
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 73 citations issued within 25 miles in the last 12 months — including the 2 immediate-jeopardy cases — 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
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Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Richland Center
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Schmitt Woodland Hills | 7.9 mi | ★★★★★ | 10 | 0 |
| Sauk Co Health Care Center | 17.6 mi | ★★★★★ | 5 | 0 |
| Rivers Edge Nursing And Rehab | 17.8 mi | ★★★★★ | 34 | 1 |
| Ridgeview Terrace Long Term Care | 19.8 mi | ★★★★★ | 0 | 0 |
| Soldiers Grove Health Services | 20.7 mi | ★★★★★ | 0 | 0 |
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