Average — CMS composite of the measures below.
The next survey window likely opens around September 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 Rib Lake Health Services during CMS and state inspections, most recent first.
The facility failed to notify resident representatives of significant changes in condition and hospital transfers for two residents. One resident with multiple chronic conditions experienced altered mental status, poor intake, and a rapid decline in vital signs, leading to transfer to the ED and diagnosis of septic shock and Fournier’s gangrene, with no documented notification to the family at the time of the change or transfer. Another resident with a history of stroke, diabetes, and aphasia developed severe abdominal pain and acute leukocytosis with concern for sepsis, was sent to the ED, and had a face sheet instruction to notify a sibling of any ER transfer, yet there was no documentation that this contact was informed. An LPN and the DON acknowledged that documentation of family notification was absent despite facility policy requiring such notification and documentation.
Unsafe food storage and contamination during meal service: A surveyor observed multiple open food items left unlabeled, undated, and uncovered, including frozen items, peaches, and chicken cutlets. The surveyor also observed a fan blowing on clean dishes to dry them, exposing them to dust and other contaminants, and observed the DM's soiled clothing touching residents' plates and food while serving meals.
Failure to Report Alleged Abuse/Neglect: A resident with dementia and moderate cognitive impairment alleged that a CNA was rude and handled care in a way the resident found painful and inappropriate after a fall. The concern was addressed internally through interviews, but administration did not report the allegation to the SA or law enforcement because it did not believe actual harm occurred, despite policy requiring immediate reporting of alleged abuse or neglect.
Failure to thoroughly investigate an alleged abuse/neglect incident involving a resident with dementia, COPD, morbid obesity, and impaired mobility. A CNA was reported to have spoken rudely, ignored the resident's pain concerns after a fall, and boosted the resident despite the resident asking not to be moved. The facility documented limited follow-up, but had no clear record of a complete investigation, who was interviewed, or that the allegation was reported and handled as abuse/neglect.
A resident with Alzheimer’s disease, epilepsy, severe cognitive impairment, and a fall history had an unwitnessed fall with a laceration to the upper arm/shoulder. Staff completed the initial neuro check and two hourly checks, but missed the third hourly check and then failed to complete neuro checks at the required 4-hour and 8-hour intervals per the facility’s fall policy. The NHA acknowledged the missing post-fall neuro assessments, and the DON stated staff were expected to follow the facility’s Fall Prevention and Management Guidelines.
A resident with BIMS 15/15 and diagnoses including acute respiratory failure with hypoxia, cerebral infarction, and an above-the-knee amputation was identified as a smoker, but the facility did not have a smoking care plan or nicotine assessment in the chart. Facility policy required smokers to be assessed for supervision needs and have safe smoking measures documented, yet staff said the assessment was missed initially even though they knew the resident smoked shortly after admission.
Staff did not consistently follow hand hygiene protocols or monitor food temperatures as required during food preparation and service. Dietary staff were observed handling food and equipment with contaminated hands and gloves, failing to wash hands between tasks, and not temping all hot foods before serving. These actions did not align with facility policy or regulatory standards, creating a potential for foodborne illness among all residents.
Staff did not consistently wear required PPE when delivering food trays to residents on contact precautions, then proceeded to serve other residents without changing PPE, despite being aware of infection control protocols. This occurred while several residents were experiencing GI symptoms and the unit was on lockdown, increasing the risk of communicable disease transmission.
The facility failed to update care plans for two residents, leading to deficiencies in care. One resident's plan included an inappropriate toileting schedule despite full incontinence, while another's plan incorrectly directed staff to remove a safety sling. Both issues were acknowledged by the DON and RCMD, highlighting a lack of clear guidance for staff.
A resident with severe cognitive impairment and incontinence was not provided adequate incontinence care by the facility. The resident was left in a wheelchair for several hours without a proper check for incontinence, as CNAs only checked the front of the brief while the resident was seated. The DON acknowledged the inadequacy of this method and noted that the resident should have been transferred to bed for a full check and change every 2-3 hours, indicating a deficiency in the facility's care procedures.
A resident with severe cognitive impairment and at moderate risk for pressure injuries was not repositioned from her wheelchair for nearly six hours, contrary to the facility's policy and care plan. Despite being dependent on staff for mobility, the resident was not transferred to a bed to off-load pressure, leading to a deficiency in care.
The facility failed to provide comprehensive education on misappropriation of property to all staff after incidents involving missing money reported by four residents. Only nursing staff received re-education, excluding contracted employees and non-licensed staff who also provide care. Interviews revealed that some staff were unaware of the incidents or had not received any re-education, contributing to the deficiency.
The facility failed to maintain an effective Infection Control Program, with incomplete infection surveillance logs and improper infection control practices observed during resident care. A CNA did not follow Enhanced Barrier Precautions for a resident with open wounds, failing to perform hand hygiene and using the same washcloth for different areas. The Director of Nursing acknowledged the issues and expressed frustration over the lack of adherence to infection control protocols.
The facility failed to prevent contamination during food and beverage distribution, affecting 28 residents who eat in their rooms. Surveyors observed uncovered food items and beverages being transported from meal carts to resident rooms, contrary to facility policy. Staff interviews confirmed this was a common practice, and the Dietary Manager acknowledged the expectation to cover items to prevent contamination.
A facility failed to develop a comprehensive care plan for a resident on apixaban, a high-risk medication, despite the resident's intact cognitive status and diagnosis of hemiparesis following a cerebral infarction. The Director of Nursing could not provide a care plan for the medication, indicating non-compliance with facility policy.
A resident with diabetes and peripheral vascular disease developed blisters on both feet, which became infected with MRSA. The facility failed to update the care plan to include treatment for these injuries and did not administer the prescribed antibiotics due to a communication error with the pharmacy.
A resident with PTSD, stemming from military service, did not receive culturally competent trauma-informed care as required by the facility's policy. Despite the resident's history of traumatic events and emotional distress, the facility lacked a specific care plan to address potential triggers and mitigate re-traumatization. Staff interviews revealed a lack of awareness about the resident's triggers, and a trauma-informed care plan was only initiated on the day of the survey.
Failure to Notify Resident Representatives of Significant Condition Changes and Hospital Transfers
Penalty
Summary
The deficiency involves the facility’s failure to immediately notify residents’ representatives of significant changes in condition and transfers to the emergency department, as required by facility policy and 42 CFR §483.10(g)(14). For one resident (R1), who had multiple medical diagnoses including diabetes, heart disease, urinary retention, history of prostate cancer, and a left leg amputation, progress notes documented a change in condition with altered mental status, poor intake, and functional decline. The physician was notified and ordered stat labs and increased fluids, and later directed that the resident be sent to the emergency department when the resident’s oxygen saturation dropped to 81%, blood pressure to 62/40, and the resident could not keep fluids down. The resident was transferred to the hospital and diagnosed with septic shock and Fournier’s gangrene, both described as life-threatening conditions. There was no documentation that the resident’s family or emergency contact was notified at the time of the change in condition or transfer, and a family member later reported being upset that they were not updated until almost 6:00 AM the following day. For another resident (R2), who had diagnoses including weakness, stroke, diabetes, obstruction/reflux uropathy, and aphasia, progress notes showed the development of severe abdominal pain and subsequent lab results indicating elevated white blood cell count. The physician was notified and, due to severe abdominal pain and acute leukocytosis with concern for progression of sepsis, ordered the resident sent to the emergency department. The resident’s face sheet specifically directed staff to update the resident’s sibling if the resident went to the ER, but surveyors found no evidence in the medical record that the emergency contact was notified of the transfer. Interviews with an LPN and the DON confirmed that there was no documentation of family notification for these hospitalizations, despite facility policy requiring documentation of notification of the responsible party, including date, time, and content of the communication each time they are notified.
Unsafe Food Storage and Contamination During Meal Service
Penalty
Summary
Food was not maintained in a safe and sanitary manner in the kitchen, with open food items left unlabeled, undated, and uncovered. During an initial kitchen tour, the surveyor observed open bags of broccoli, peas, beans, and tater tots, opened ice cream in the freezer without any information written on it, opened peaches in a container without a label, and uncovered chicken cutlets in a pan without any information on or near the container. The Dietary Manager stated the chicken should have been covered and that all open food items should be dated when opened and stored. The facility also did not protect clean dishware from contamination and did not keep staff clothing from touching resident food during service. The surveyor observed a fan positioned on a top shelf across from the clean dishes area blowing on the clean dishes to dry them, and the Dietary Manager stated he did not know the fan could not be used for that purpose and acknowledged it exposed the dishes to dust and other contaminants. Later, while the Dietary Manager was dishing up food onto residents' plates, his soiled clothing touched the tops of residents' plates and at times the residents' food. He stated he did not wear an apron when cooking and was unaware his clothing was touching the residents' food and plates.
Failure to Report Alleged Abuse/Neglect
Penalty
Summary
The facility failed to ensure that an allegation of abuse or neglect involving R8 was reported immediately, and no later than 2 hours after the allegation was made, to the State Agency and law enforcement. The facility policy on Abuse, Neglect and Exploitation stated that all alleged violations involving abuse or bodily injury must be reported immediately, but not later than 2 hours after the allegation is made, to the Administrator, state agency, adult protective services, and other applicable agencies such as law enforcement. R8 was admitted with diagnoses including abnormalities of gait and mobility, COPD, morbid obesity, unspecified dementia, and anxiety disorder. R8 had a BIMS score of 8/15, indicating moderate cognitive impairment, and had an activated power of attorney for healthcare. A grievance filed on behalf of R8 described an interaction in which CNA E was reported to have been rude and to have boosted R8 despite R8 asking not to be moved because of pain from a fall earlier that day and concern that a leg was broken. R8 later stated that CNA E had been inconsiderate and rude, and that staff had had trouble with her before. The grievance was handled internally through interviews with R8, staff, and other residents, and the acting NHA determined that no actual harm had occurred and therefore the allegation was not reported to the State Agency or law enforcement. The acting NHA stated that if abuse or neglect was suspected it would be reported to the state, but in this case administration did not report the allegation because it did not feel actual harm came to R8 from the interaction with CNA E.
Failure to Thoroughly Investigate Alleged Abuse/Neglect
Penalty
Summary
The facility did not thoroughly investigate an allegation of abuse or neglect involving a resident with abnormalities of gait and mobility, COPD, morbid obesity, unspecified dementia, anxiety disorder, a BIMS score of 8, and an activated healthcare POA. The resident was admitted to the facility and later filed a grievance through the SW alleging that a CNA had a poor attitude, spoke to the resident in a rude manner, and boosted the resident despite the resident asking not to be moved because of pain after a fall earlier that day and concern that a leg was broken. The grievance record showed that the POA was notified and that the SW interviewed some residents on the hall, but the facility had no documentation identifying who was interviewed or what was said. The record also showed the SW questioned the CNA involved, who stated the resident and CNA were fine, and the grievance was signed by the NHA. Additional witness statements reviewed later described the resident reporting being treated poorly, being spoken to as if the resident was nothing, and being told the pain was not that bad while the call light was turned off and the room left. During survey interviews, the SW stated she was told to address the CNA's tone of voice and that no documentation supported a full investigation or removal of the CNA from resident care. The NHA stated the facility expected abuse or neglect allegations to be reported and investigated immediately, including removal of the accused staff member from resident care, but could not provide proof that the incident had been reported or that a thorough investigation had been implemented. The NHA later acknowledged there was indication of abuse or neglect based on the information provided and that the occurrence should have been reported to appropriate agencies with an investigative process implemented immediately.
Missed Post-Fall Neuro Checks After Unwitnessed Fall
Penalty
Summary
Staff did not follow the facility’s post-fall assessment process for a resident who had an unwitnessed fall outside the building in front of the facility. The resident had diagnoses including Alzheimer’s disease and focal partial symptomatic epilepsy, had a BIMS score of 4/15 indicating severe cognitive impairment, and was identified as being at risk for falls due to a history of falls, past syncope, and possible seizures. After the fall, vital signs were obtained, the resident was assessed by the DON, and a laceration was noted on the left upper arm/shoulder. The post-fall documentation also included an intervention for 1-hour checks, but the NHA stated this was entered by mistake and there was no documentation that wandering checks were completed. The facility’s Fall Prevention and Management Guidelines required neuro checks initially, then hourly x 3, then every 4 hours x 6, and then every 8 hours x 6 for an unwitnessed fall. The resident’s record showed neuro checks were completed initially and hourly twice, missing the third hourly check, and then were not completed at the required 4-hour and 8-hour intervals. Documentation showed gaps in the neuro check schedule on 8/29/25 and 8/30/25, with no documentation at the required times. On 10/1/25, the NHA acknowledged missing post-fall neurological assessments, and the DON stated staff were expected to follow the facility’s Fall Prevention and Management Guidelines for post-fall assessments.
Missing smoking assessment and care plan for resident who smoked
Penalty
Summary
The facility failed to ensure adequate supervision and assistance devices to prevent accidents for one resident who smoked in the facility. The resident was admitted with a BIMS score of 15/15, indicating cognitive intactness, and had diagnoses of acute respiratory failure with hypoxia, cerebral infarction, and above-the-knee amputation of the left leg. The resident did not have a smoking care plan and did not have a nicotine assessment in the medical chart, despite being identified by the facility as a smoker. Facility policy stated that residents who smoke or use nicotine products are to be assessed with a Nicotine Assessment UDA to determine whether supervision is required and that safe smoking measures are to be documented on the care plan and communicated to staff. The resident told the surveyor that he usually had to ask for cigarettes and went out the front door to smoke, and that he needed someone present so he would not fall. Staff interviews showed the facility knew he was a smoker a couple of days after admission, but the nicotine assessment had not been completed at that time, and the RN and LPN both acknowledged the assessment was missed initially and completed only recently.
Failure to Follow Hand Hygiene and Food Temperature Protocols During Food Service
Penalty
Summary
Facility staff failed to consistently follow proper hand hygiene protocols and food temperature monitoring during food preparation and service, as observed by surveyors. Staff were seen handling food and kitchen equipment with bare or contaminated hands, donning gloves without prior handwashing, and touching multiple surfaces and food items without appropriate hand hygiene in between tasks. For example, a dietary staff member handled bread, utensils, and food items with contaminated hands and gloves, and did not always wash hands before putting on new gloves or after removing them. The staff member also touched food directly with bare hands and failed to use tongs as required. Additionally, the facility did not ensure that internal food temperatures were taken for all cooked foods before serving. While some food items had their temperatures checked and recorded, others, such as fried eggs and pancakes, were not temped prior to being placed on the steam table and served. The dietary staff member acknowledged during interviews that not all foods were temped as required, and the dietary manager confirmed that the expectation is for all hot foods to be temped before serving. The facility's policies on handwashing and food preparation were not fully implemented, as evidenced by staff actions and statements during interviews. The lack of adherence to these protocols created the potential for foodborne illness for all 35 residents in the facility, as food was not always handled or served in accordance with professional standards and regulatory requirements.
Failure to Follow Contact Precaution Protocols During Food Service
Penalty
Summary
Staff failed to adhere to the facility's infection prevention and control program, specifically regarding the use of personal protective equipment (PPE) when interacting with residents on contact precautions. Certified Nursing Assistants (CNAs) were observed delivering food trays to multiple residents on contact precautions without donning the required PPE, such as gowns and gloves, prior to entering the rooms. After serving residents on contact precautions, the same staff members proceeded to deliver food trays to residents not on contact precautions, increasing the potential for the development and transmission of communicable diseases and infections. The facility's policy clearly states that PPE must be worn for all interactions that may involve contact with residents or potentially contaminated areas in the environment when contact precautions are in place. Interviews with the Director of Nursing (DON), Assistant Director of Nursing (ADON), and the involved CNAs confirmed that staff were aware of the requirements for PPE use under contact precautions, including the need to put on PPE before entering the room, even for tasks such as passing food trays. The south unit was on lockdown due to five residents exhibiting gastrointestinal symptoms, and all residents were eating in their rooms. Despite this, staff did not consistently follow the established protocols for infection control, as evidenced by their own admissions and the surveyor's direct observations.
Failure to Update Care Plans for Two Residents
Penalty
Summary
The facility failed to revise care plans for two residents, R3 and R4, to reflect their current needs, leading to deficiencies in providing necessary care and services. For R3, the care plan included a toileting schedule despite R3 being fully incontinent of bowel and bladder. The Director of Nursing (DON) acknowledged that a toileting schedule was no longer appropriate and that the care plan should have been updated to include regular checks and incontinence care every 2-3 hours. This oversight occurred despite a significant change in R3's status, as noted in the Minimum Data Set (MDS) assessment, which indicated the need for hospice services and confirmed R3's incontinence. For R4, the care plan directed staff to remove the Hoyer sling when R4 was in her wheelchair, contrary to the current practice of leaving the sling in place for safety reasons. The DON and the Registered Nurse/Resident Care Management Director (RCMD) both confirmed that the sling should remain under R4 for safety, but the care plan had not been revised to reflect this requirement. This inconsistency was observed during the survey, as R4 was seen with the sling under her in the wheelchair, and R4 herself expressed uncertainty about the sling's removal. The failure to update the care plans for both residents resulted in a lack of clear direction for staff, affecting the quality of care provided.
Inadequate Incontinence Care for Resident
Penalty
Summary
The facility failed to provide necessary activities of daily living (ADLs) services for a resident who was dependent on staff for care. The resident, identified as R3, had severe cognitive impairment, was always incontinent of bowel and frequently incontinent of bladder, and required maximum assistance for bed mobility and transfers. Despite these needs, the facility did not adequately check and change the resident's incontinence brief. On the day of observation, the resident was left in a wheelchair from early morning until late morning without being properly checked for incontinence. The CNAs only checked the front of the resident's brief while she was in the wheelchair, which was not sufficient to determine if she needed changing. The Director of Nursing (DON) acknowledged that the method used by the CNAs was inadequate and that the resident should have been transferred to bed for a full check and change every 2-3 hours. The resident's care plan, which included a toileting schedule, was outdated and not appropriate given the resident's condition of being always incontinent. The DON confirmed that the care plan should have been revised to reflect the need for regular checks and changes every 2-3 hours, highlighting a deficiency in the facility's adherence to its own policies and procedures for providing perineal care.
Failure to Reposition Resident at Risk for Pressure Injuries
Penalty
Summary
The facility failed to provide necessary services for a resident at risk for pressure injuries, as observed by the surveyor. The resident, who has severe cognitive impairment and is dependent on staff for mobility, was not repositioned from her wheelchair to off-load pressure from 6:30 AM until 12:10 PM. The facility's policy requires a comprehensive assessment and care plan to prevent pressure injuries, including scheduled repositioning for residents who are chair-bound. However, the resident remained in her wheelchair without being transferred to a bed to relieve pressure, despite being at moderate risk for pressure injuries as indicated by her Braden Scale score. During the surveyor's observation, the resident was seen in her wheelchair for an extended period without appropriate repositioning. Certified Nursing Assistants checked the resident for incontinence but did not transfer her from the wheelchair to off-load pressure. The Director of Nursing acknowledged that the resident should have been transferred to prevent pressure injuries and that the manner of reclining and inclining the resident in her wheelchair could cause friction and shearing of the skin. The care plan indicated the need for repositioning, but this intervention was not adequately implemented, leading to the deficiency.
Inadequate Staff Education on Misappropriation of Property
Penalty
Summary
The facility failed to take appropriate corrective action in response to alleged violations of misappropriation of property for four residents. The facility's policy on abuse, neglect, and exploitation requires the development and implementation of written policies and procedures to prevent such incidents. However, the facility only provided re-education on abuse to nursing staff, excluding other staff members who provide care and services to residents. This deficiency was identified through the review of Facility Reported Incidents (FRIs) involving missing money reported by four residents, all of whom had varying levels of cognitive function, with three residents having normal cognition and one resident having severe cognitive impairment. Interviews with various staff members, including an Account Manager, a Hospice CNA, and a Housekeeper, revealed that they were either unaware of the incidents or had not received any re-education regarding misappropriation of property. The surveyor's request for complete investigations and education records showed that only nursing staff received training, leaving out contracted employees, non-licensed staff, and others who provide care and services to residents. This lack of comprehensive staff education contributed to the facility's failure to adequately address the misappropriation of property incidents.
Inadequate Infection Control Program and Practices
Penalty
Summary
The facility failed to establish an effective Infection Control Program, which is crucial for investigating, controlling, and preventing infections among residents and staff. The infection surveillance log, which is supposed to track symptoms, culture results, and isolation precautions, was found to be incomplete. The Unit Manager, responsible for maintaining these logs, admitted to being inexperienced and unaware of certain infections, such as a Methicillin-resistant Staphylococcus aureus (MRSA) case, which was not documented. The Director of Nursing, who also serves as the Infection Preventionist, acknowledged the incomplete documentation and the lack of a corrective plan. Additionally, the facility staff did not adhere to proper infection control practices during resident care. A Certified Nursing Assistant (CNA) was observed providing care to a resident on Enhanced Barrier Precautions (EBP) without following the necessary protocols. The CNA failed to perform hand hygiene and used the same washcloth for different areas, which is against the facility's infection control policy. The CNA also did not change gloves between tasks, further compromising infection control measures. The resident involved had a history of diabetes mellitus type 2 and peripheral vascular disease and was on EBP due to open wounds. Despite receiving training on infection control, the CNA did not follow the required procedures, citing unfamiliarity with the facility's practices. The Director of Nursing expressed frustration over the incident, especially since the CNA was temporarily assisting from another location within the same organization, where similar infection control education is provided.
Failure to Prevent Food and Beverage Contamination During Distribution
Penalty
Summary
The facility failed to distribute foods and beverages in a manner that prevents contamination, affecting 28 out of 39 residents who routinely eat in their rooms. During meal services observed on two separate days, surveyors noted that while the main entrees were covered, other food items such as strawberry shortcake, Jello, and applesauce were not covered during transport from the food cart to resident rooms. Additionally, beverages poured into glasses and cups were not covered during transport. This practice was observed in both the North and South Halls of the facility. Interviews with staff revealed that it was common practice for meal carts to be brought to the end of hallways, and for beverages and small food items to be transported uncovered to resident rooms. The facility's policy, which requires all foods transported to dining areas not adjacent to the kitchen to be covered, was not adhered to. The Dietary Manager confirmed that staff should use saran wrap to cover foods and beverages during distribution to prevent contamination, but this was not being done, potentially affecting the residents who eat in their rooms.
Failure to Implement Care Plan for High-Risk Medication
Penalty
Summary
The facility failed to develop and implement a comprehensive person-centered care plan for a resident, identified as R19, who was on a high-risk medication. Despite the facility's policy requiring a care plan that includes measurable objectives and timeframes to meet a resident's medical, nursing, and psychosocial needs, R19 did not have a care plan addressing the use of apixaban, a blood thinner prescribed for acute right hemiparesis following a cerebral infarction. This oversight was identified during a survey when the Director of Nursing (DON) was unable to provide a care plan for the resident's medication. R19 was admitted to the facility with an intact cognitive status, as indicated by a Brief Interview of Mental Status (BIMS) score of 15. The resident had a diagnosis of hemiparesis following a cerebral infarction and was prescribed apixaban, a medication that requires careful monitoring due to its high-risk nature. The absence of a care plan for this medication indicates a failure to adhere to the facility's policy, which mandates the inclusion of specific interventions and services to maintain the resident's highest practicable well-being.
Failure to Administer MRSA Treatment and Update Care Plan
Penalty
Summary
The facility failed to provide care and treatment in accordance with professional standards for a resident who developed fluid-filled blisters on both feet, which later became infected with Methicillin Resistant Staphylococcus Aureus (MRSA). Despite the presence of these non-pressure injuries, the resident's comprehensive care plan was not updated to include interventions and treatment for the blisters. The facility's policy required the development of interventions based on individual risk factors, but this was not adhered to in the resident's case. The resident had pertinent diagnoses of diabetes mellitus type 2 and peripheral vascular disease, which were not adequately considered in the care planning process. Additionally, the facility did not follow through with the antibiotic order for the MRSA infection. The wound clinic notified the facility of the positive MRSA culture and called in an antibiotic prescription to the pharmacy. However, the facility failed to enter the prescription into the resident's chart, resulting in the medication not being administered. This oversight was acknowledged by the Director of Nursing, who confirmed that the prescription remained with the pharmacy and was never sent for administration, potentially delaying healing or causing harm to the resident.
Failure to Provide Trauma-Informed Care for Resident with PTSD
Penalty
Summary
The facility failed to provide culturally competent trauma-informed care for a resident diagnosed with post-traumatic stress disorder (PTSD). The resident, who had a history of military service and combat experience, was admitted with moderately impaired cognition and a diagnosis of PTSD. Despite the facility's policy on trauma-informed care, which includes identifying triggers and collaborating with healthcare professionals to develop individualized care plans, the resident's care plan lacked specific interventions to address potential triggers and mitigate re-traumatization. During the survey, it was observed that the resident had experienced several traumatic events, including combat and witnessing physical assaults. The resident expressed that these events continued to bother him emotionally, and he became tearful during assessments. However, the facility did not have a trauma-informed care plan in place until the day of the survey, indicating a lack of proactive measures to address the resident's PTSD. Interviews with staff revealed a lack of awareness regarding the resident's specific triggers. A Certified Nursing Assistant (CNA) mentioned that the resident cried occasionally, but there was no clear understanding of how to manage or avoid potential triggers. The absence of a trauma-informed care plan prior to the survey highlights the facility's failure to adhere to its own policy and provide appropriate care for the resident's PTSD.
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 2 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 Rib Lake
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Aspirus Care & Rehab-medford | 14.5 mi | ★★★★★ | 2 | 0 |
| Riverview Health Services | 25.7 mi | ★★★★★ | 8 | 0 |
| Abbotsford Health Care Center | 26.4 mi | ★★★★★ | 7 | 0 |
| Pine Crest Health And Memory Care | 27.5 mi | ★★★★★ | 1 | 0 |
| Tomahawk Health Services | 27.5 mi | ★★★★★ | 15 | 1 |
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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.