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Avina of Weyauwega: THC Complaint Mishandled - WI

Healthcare Facility
Avina Of Weyauwega
Weyauwega, WI  ·  1/5 stars

The resident, identified in inspection records only as R7, had a documented history of Wernicke's encephalopathy, a serious neurological condition caused by thiamine deficiency that can produce confusion, vision problems, and loss of muscle coordination. R7's guardian, identified as GD-F, had specifically warned the facility that R7 could not be exposed to alcohol, CBD, THC, or any illegal drugs because of that history.

The warning did not produce a system to monitor whether R7 was actually receiving those substances. According to GD-F, the facility did not put any monitoring in place.

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On July 5, 2025, during an emergency room visit, R7's urine drug screen came back presumptive positive for cannabinoids. GD-F had already found the gummy wrapper in R7's pants when taking them home to wash. A vape had also been found in R7's room. Staff gave the vape to the facility's former nursing home administrator, identified as FNHA-E. FNHA-E later gave it back to R7. GD-F did not know whether the vape contained THC or tobacco.

GD-F reported all of this to FNHA-E. What happened next is largely a blank.

FNHA-E did not file a grievance. On July 7, two days after the positive drug screen, FNHA-E wrote a note indicating there had been a discussion with GD-F. A follow-up appointment with R7's medical provider took place on July 9, but the positive drug test was not mentioned. There is no record of what nursing staff did after learning the results.

When the Social Services Director, identified as SSD-G, learned that GD-F had raised concerns about R7's exposure to drugs and alcohol, FNHA-E's response was that FNHA-E would handle it. SSD-G did not follow up further.

The Regional Director of Operations, identified as RDO-C, was interviewed by the surveyor on August 27 alongside the Assistant Director of Nursing and the current nursing home administrator. None of them knew about GD-F's concerns. None of them knew about the positive drug screen. They had not been at the facility when the concerns were reported, and no one had briefed them.

RDO-C could not say whether the positive result might have been caused by R7's medications rather than external THC exposure. RDO-C also confirmed that FNHA-E should have filed a formal grievance in response to GD-F's concerns. No grievance had been filed.

No evidence of illegal drugs was found in R7's room at the time of the inspection.

The deficiency was cited at a level of minimal harm or potential for actual harm, a designation that reflects what inspectors could document, not necessarily what the resident experienced in the weeks between the positive test and the August inspection. For a resident whose neurological condition makes THC exposure a specific documented risk, the gap between the July 5 drug screen and any formal institutional response stretched across the rest of the summer without a grievance filed, without a provider informed, and without anyone in current leadership who knew it had happened at all.

GD-F never learned what steps, if any, the facility took.

Full Inspection Report

The details above represent a summary of key findings. View the complete inspection report for Avina of Weyauwega from 2025-08-27 including all violations, facility responses, and corrective action plans.

Additional Resources


Editorial Standards

Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).

Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.

Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.

Last verified: July 2, 2026  ·  Our methodology

Quick Answer

Avina of Weyauwega in Weyauwega, WI was cited for violations during a health inspection on August 27, 2025.

The warning did not produce a system to monitor whether R7 was actually receiving those substances.

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.

Frequently Asked Questions

What happened at Avina of Weyauwega?
The warning did not produce a system to monitor whether R7 was actually receiving those substances.
How serious are these violations?
Violation severity varies from minor documentation issues to serious safety concerns. Review the inspection report for specific deficiency codes and scope. All violations must be corrected within required timeframes and are subject to follow-up verification inspections.
What should families do?
Families should: (1) Ask facility administration about specific corrective actions taken, (2) Request to see the follow-up inspection report verifying corrections, (3) Check if this represents a pattern by reviewing prior inspection reports, (4) Compare this facility's ratings with other nursing homes in Weyauwega, WI, (5) Report any new concerns directly to state authorities.
Where can I see the full inspection report?
The complete inspection report is available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request a copy directly from Avina of Weyauwega or from the state Department of Health. The report includes specific deficiency codes, facility responses, and correction timelines. This facility's federal provider number is 525315.
Has this facility had violations before?
To check Avina of Weyauwega's history, visit Medicare.gov's Care Compare and review their inspection history, quality ratings, and staffing levels. Look for patterns of repeated violations, especially in critical areas like abuse prevention, medication management, infection control, and resident safety.


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