Golden Age Manor
GOLDEN AGE MANOR in AMERY, WI — inspection on March 30, 2026.
Found 2 citations. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
condition.
interview and record review the facility did not complete a Minimum Data Set (MDS) assessment for
significant change was not completed within 14 days.Findings include:Facility Policy titled, Comprehensive Assessments, last revised [DATE], states: Comprehensive assessments are conducted in accordance with criteria and timeframes established in the Resident Assessment Instrument (RAI) User Manual.The RAI User Manual states the Significant Change in Status Assessment (SCSA) must be completed by the end of the 14th calendar day following determination that a significant change has occurred.Surveyor reviewed R1's electronic health record.
Last completed MDS assessment was completed on [DATE].R1 was admitted to hospice on [DATE]. A SCSA was started on [DATE] but was incomplete and never submitted. R1 expired on [DATE].On [DATE] at 2:50 PM, Surveyor interviewed Director of Nursing (DON) B. DON B stated the MDS assessments are completed upon admission, annually, quarterly, with a significant change, and as needed. DON B stated the facility follows the guidelines in the RAI. DON B stated a significant change would be a decline or improvement of 2 or more areas of care, or when a resident admits to or is removed from hospice. DON B stated the timeframe was 14 or 15 days after recognizing the change for completion of the assessment. DON B acknowledged R1's significant change MDS had not been completed and was past the 14 days.
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided.
For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE
525507 03/30/2026
Golden Age Manor 220 Scholl CT Amery, WI 54001
R4 uses a sit-to-stand lift and requires 2 staff for transfers.On 03/30/26 at 2:37 PM, Surveyor
lifts require 2 staff assist and sit-to-stand lifts can be 1 or 2 depending on what the care plan says.
while at times for someone to assist. CNA D stated R4 uses a sit-to-stand lift and requires 2 staff for transfers.On 03/30/26 at 2:41 PM, Surveyor interviewed RN F in relation to what RN F would do if a resident had a fall. RN F stated in the event of a fall, RN F would assess immediately, obtain vitals, and call 911 if needed. RN F stated RN F would start an event assessment and try to find out what happened. RN F stated if the fall is unwitnessed or if the resident hits their head, RN F would initiate neurological checks. RN F stated RN F would initially talk to the CNAs and give re-education.On 03/30/26 at 2:50 PM, Surveyor interviewed DON B about what DON B's expectations of the nurse would be in the event of a fall. DON B stated DON B's expectation in the event of a fall is for the nurse on duty to assess resident for injury. DON B stated the nurse should then start an event assessment and find out the cause of the fall. DON B stated interviews should be done with resident and staff as able. DON B stated the nurse should implement immediate intervention until the Interdisciplinary Team (IDT) can further investigate. DON B stated if a fall occurs as a result of staff not following a care plan re-education should be completed. If there is severe injury, DON B stated the staff member may get sent home or the workload would be adjusted if it would cause a staffing concern and would have the staff in question work with a partner. DON B acknowledged CNA H was working alone when R4's fall occurred, and CNA H was not following the care plan.