Beaver Dam Health Care Center
BEAVER DAM HEALTH CARE CENTER in BEAVER DAM, WI — inspection on November 13, 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.
Inspection Findings
On 11/13/25, at 08:00AM, Surveyor interviewed NP D (Nurse Practitioner). NP D indicated she would expect a medical provider to be notified whether it be the wound care team, physician, or NP of wound care not being completed due to refusal or not in facility or whatever the reason may be for wound care not being completed.
On 11/13/25, at 10:00AM, Surveyor interviewed DON B (Director of Nursing).
Surveyor asked DON B what blanks on TAR indicate. DON B indicated it was not completed.
Surveyor asked DON B if it is his expectation that physician orders be followed. DON B indicated yes.
Surveyor asked DON B if physician should be notified if wound care is not completed due to refusal or not being in facility or whatever the reason be for wound care not being completed. DON B indicated he would expect physician to be notified.
Surveyor informed DON B of R3's missed treatments indicated on R3's TAR. DON B indicated he would look for documentation regarding missed treatments. DON B came back later to Surveyor and indicated he was unable to find documentation regarding missed tr Example 3: The facility's policy Vital Signs, dated 3/1/19, includes: 3.
Vital signs shall be obtained at least in the following circumstances: c. At least daily for a resident receiving skilled services.
The facility's policy Charting and Documentation, dated 7/17, includes: All services provided to the resident, progress toward the care plan goals.shall be documented in the resident's medical record.
The following information is to be documented in the resident medical record: c.
Treatments or services performed; f.
Progress toward or changes in the care plan goals and objectives. 7.
Documentation of procedures and treatments will include care-specific details, including: a. the date and time the procedure/treatment was provided; c. the assessment data and/or any unusual findings obtained during the procedure/treatment; d. how the resident tolerated the procedure/treatment; R2 admitted to the facility on [DATE] with a diagnosis of sepsis (overwhelming immune response to an infection).
R2's physician orders include:Daptomycin Intravenous Solution 500 mg.
Use 950 mg intravenously one time a day for infection for 33 administrations.
Order date 10/9/25.
R2's comprehensive care plan includes Focus: Active infection.
Endocarditis r/t (Related To) Enterococcus with IV antibiotic treatment.
R2's Weights and Vitals Summary include blood pressure, pulse, and temperature was obtained on 10/9/25, 10/10/25, 10/11/25, 10/12/25, 10/22/25, and 10/24/25.
Of note: R2 did not have daily vitals while receiving antibiotic therapy.
R2's Skilled Charting Note UDA (User Defined Assessment) was completed on 11/11/25 and 11/12/25.
On 11/12/25 at 2:26 PM, Surveyor interviewed DON B (Director of Nursing) regarding assessments and skilled services. DON B indicated IV antibiotics and therapy would be considered skilled services. DON B indicated a resident on IV antibiotics and therapy should have documented daily vital signs and an assessment. DON B indicated R2 should have had daily vital signs and an assessment but did not.
R2 did not have daily assessments while receiving antibiotic therapy.
Facility ID:
IDENTIFICATION NUMBER:
A.
Building
COMPLETED
11/13/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Beaver Dam Health Care Center
410 Roedl CT Beaver Dam, WI 53916
SUMMARY STATEMENT OF DEFICIENCIES
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility did not provide pharmaceutical services (including procedures that assure the accurate acquiring, receiving, dispensing, and administering of all drugs and biologicals) to meet the needs of each resident for 1 of 3 residents (R2) reviewed for medications.R2 did not have the correct order for his Gabapentin (medication to treat nerve pain).This is evidenced by:The facility's policy Preventing and Detecting Adverse Consequences and Medication Errors, dated 10/25/14, includes: When a resident receives a new medication, the medication order is evaluated for the following: 1) The dose, rout of administration, duration, and monitoring are in agreement with the current clinical practice, clinical guidelines, and/or manufacturer's specifications for use.R2 admitted to the facility on [DATE] with a diagnosis of polyneuropathy (damage or disease affecting peripheral nerves).R2's hospital discharge paperwork, dated 10/9/25, includes an order for Gabapentin 100 mg capsule take 1 capsule by mouth every 8 hours. Of note, every 8 hours would be three times a day.R2's active physician orders, printed 11/13/25, includes Gabapentin 100 mg capsule.
Give 1 capsule by mouth two times a day for pain.
Scheduled at 8:00 AM and 4:00 PM.
Order date 10/9/25. On 11/13/25 at 8:00 AM, Surveyor interviewed NP D (Nurse Practitioner) regarding R2's Gabapentin order. NP D indicated she did not change R2's Gabapentin order and the medication should have been given three times a day.On 11/13/25 at 8:58 AM, Surveyor interviewed UM C (Unit Manager) regarding entering medication orders. UM C indicated if R2's hospital discharge paperwork included an order for every 8 hours, the medication should have been put in for 3 times a day.On 11/13/25 at 10:00 AM, Surveyor interviewed DON B (Director of Nursing) regarding medication orders. DON B indicated if the hospital discharge paperwork included an order for every 8 hours, the medication should have been put in for 3 times day. DON B indicated this was a medication error.
Facility ID: