Rivers Edge Nursing and Rehab: Abuse Report Withheld - WI
That last decision is what brought inspectors to Rivers Edge on August 25, 2025.
The resident, identified in inspection records only as R10, was admitted to the facility with a Parkinson's diagnosis and has a legal guardian. Parkinson's disease causes involuntary muscle movements, tremors, and the kind of uncontrolled motion that one nurse on staff described as "very spastic-like." On the evening of August 12, CNA O brought R10 to the nurse's station and began recording him on her phone.
LPN G, a licensed practical nurse who was present, told inspectors that R10 does like to dance. She also said that when she saw CNA O recording him, she thought it was "inappropriate and demeaning to R10." She said nothing to CNA O at the time. She and two other staff members, CNA C and LPN U, later reported what they had seen to the nursing home administrator and wrote formal statements at the administrator's request.
CNA C's written statement was the most direct. She described CNA O telling R10 to "work it" and "dance baby dance" while recording him.
LPN U told inspectors she had watched CNA O record R10 for five minutes. She also showed inspectors a photograph she had taken herself, on her own phone, of CNA O taking a selfie with R10. LPN U said she had not shared the photograph with the facility's administration because she "did not want to get in trouble." She believed CNA O was posting the recordings to Snapchat.
CNA O denied recording R10 when inspectors interviewed her on August 25.
Inspectors tried to reach CNA C and CNA T for interviews. Neither was available.
R10 declined to speak with inspectors.
What happened next, or rather what did not happen, is the core of what inspectors cited. The administrator, identified in the report as NHA A, acknowledged to inspectors that she had received the staff statements and conducted her own review of the incident. She said she was unable to substantiate the allegation. On that basis, she decided not to file an initial abuse report with the State Survey Agency.
When the inspector asked NHA A directly whether an allegation that a staff member had been recording a resident would constitute potential abuse, the administrator said yes.
The inspector then asked why she had not reported it.
NHA A said she had investigated and could not prove it happened, so she did not report.
That reasoning is precisely what the reporting requirement is designed to prevent. The obligation to report an allegation to the state is not contingent on whether a facility can prove the allegation internally. It is triggered by the allegation itself. Four staff members had made statements. One had photographic evidence she had not disclosed. An anonymous complaint had already reached the state agency directly, which is what prompted the inspection in the first place.
The facility's own written abuse policy states that all alleged violations must be reported to the administrator, the state agency, adult protective services, and other required agencies within specified timeframes. The policy lists mental abuse explicitly, alongside verbal, physical, and sexual abuse, and includes abuse "facilitated or enabled through the use of technology."
No report was ever submitted.
The inspection cited the facility under the federal requirement that nursing homes report all alleged violations involving abuse, neglect, exploitation, or mistreatment immediately to the administrator and to outside officials, including the State Survey Agency. The harm level was classified as minimal harm or potential for actual harm, and the violation affected a small number of residents reviewed.
That classification does not capture what LPN G described when she watched the recording happen and said nothing, or what LPN U said when she explained why she hid her photograph from the people running the building. It does not account for a man with a degenerative neurological disease whose involuntary movements were being filmed at a nurse's station while a staff member told him to perform, and whose guardian was not in the building that evening.
What the classification does capture is what the state found provable on the day inspectors arrived: not that abuse occurred, but that the facility never told anyone with authority outside its own walls that four employees had said it did.
The anonymous complaint that triggered the inspection was received by the state agency before inspectors arrived. Without it, the incident of August 12 would exist only in a set of staff statements sitting in a folder inside the facility, and in a photograph on LPN U's personal phone that she had decided, on her own, not to share.
CNA O still denied everything on August 25.
R10's guardian was not mentioned in the inspection report as having been notified of the allegation.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Rivers Edge Nursing and Rehab from 2025-08-25 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: October 5, 2026 · Our methodology
Rivers Edge Nursing and Rehab in Muscoda, WI was cited for abuse-related violations during a health inspection on August 25, 2025.
That last decision is what brought inspectors to Rivers Edge on August 25, 2025.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.