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Complaint Investigation

Beaver Dam Health Care Center

March 20, 2025 · Beaver Dam, WI · 410 Roedl Ct
Citations 2
CMS Rating 1/5
Beds 90
Provider ID 525338
Healthcare Facility
Beaver Dam Health Care Center
Beaver Dam, WI  ·  View full profile →
Inspection Summary

BEAVER DAM HEALTH CARE CENTER in BEAVER DAM, WI — inspection on March 20, 2025.

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.

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Inspection Findings

FF600
Minimal harm or Few Based on observation, interview and record review the facility did not ensure that a resident who is fed by affected

The facility failed to obtain R6's pain medication, and failed to offer R6 any non-pharmacological interventions to treat her pain, resulting in R6 having continued pain.

Evidenced by:

The facility policy titled Pain Management, dated 10/1/22, states in part, The facility must ensure that pain management is provided to residents who require such services, consistent with professional standards of practice, the comprehensive person-centered care plan, and the residents goals and preferences .

Recognition: .

Facility staff will observe for nonverbal indicators which may indicate the presence of pain.

These indicators include but are not limited to . b.

Loss of function or inability to perform activities of daily living (ADLs) . e.

Behaviors such as: . depressed mood or decreased participation in usually physical and/or social activities . h.

Difficulty sleeping (insomnia) . i.

Negative vocalizations (e.g. groaning, crying .), j.

Decline in activity level .

Pain Assessment: . 2.

Based on professional standards of practice, an assessment or evaluation of pain by the appropriate members of the interdisciplinary team (e.g. nurses, practitioner, pharmacists and anyone else with direct contact with the resident) may necessitate gathering the following information, as applicable to the resident . g.

Identifying activities, resident care or treatment that precipitate or exacerbate pain and those that reduce or eliminate pain. h.

Impact of pain on quality of life (e.g. sleeping, functioning, appetite and mood) . j.

The resident's goals for pain management and his/her satisfaction with the current level of pain control .

Pain Management and Treatment: . 6.

Non-pharmacological interventions will include but are not limited to . a.

Environmental comfort measures . d.

Physical modalities . e.

Exercises to address stiffness . as well as restorative programs to maintain joint mobility . f.

Cognitive/behavioral interventions . 7.

Pharmacological interventions .

The interdisciplinary team is responsible for developing a pain management regimen that is specific to each resident who has pain or who has the potential for pain . i.

Facility staff will notify the practitioner, if the resident's pain is not controlled by the current treatment regimen .

R6 was admitted to the facility on [DATE] with diagnoses that include Morbid obesity, Type 2 Diabetes Mellitus, Chronic Obstructive Pulmonary Disease (COPD), Insomnia, Essential Hypertension, Major Depressive Disorder, and Rhabdomyolysis. R6's Brief Interview for Mental Status (BIMS) dated 1/30/25 was 15 out of 15, indicating that R6 is cognitively intact.

525338

Form Approved OMB

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.

Building 525338 B.

Wing 03/20/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Beaver Dam Health Care Center 410 Roedl CT Beaver Dam, WI 53916

F-F609.

525338

Form Approved OMB

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.

Building 525338 B.

Wing 03/20/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Beaver Dam Health Care Center 410 Roedl CT Beaver Dam, WI 53916

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in BEAVER DAM, WI, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from BEAVER DAM HEALTH CARE CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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