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Complaint Investigation

Masonic Center For Health & Rehab Inc

January 29, 2026 · Dousman, WI · 410 N Main St
Citations 1
CMS Rating 5/5
Beds 50
Provider ID 525572
Healthcare Facility
Masonic Center For Health & Rehab Inc
Dousman, WI  ·  View full profile →
Inspection Summary

MASONIC CENTER FOR HEALTH & REHAB INC in DOUSMAN, WI — inspection on January 29, 2026.

Found 1 citation. 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

FF0610
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Potential for More Than Minimal Harm

interviews from staff or other residents who may have had knowledge of or also witnessed the incident.

The facility did not interview other individuals (residents or staff) to determine if they had ever witnessed R2 touching other peers inappropriately before this incident, if there were any other behaviors or statements of a sexual nature demonstrated by R2, or if there was a pattern of behavior or interactions to help determine the extent of the interaction between R2 and R1 and how long it may have been going on.

The facility also did not determine if any other residents may have been effected by R2's behavior as part of their investigation.On 1/29/26 at 12:38 PM, Surveyor interviewed Administrator- A and Director of Nursing- B regarding the investigation of the 1/4/26 incident involving R2 and R1.

Surveyor asked if the facility had interviewed any other potential witnesses to the incident on 1/4/26.

Administrator- A stated they got a statement from the Activities Director who witnessed the incident and separated R2 and R1.

Surveyor asked Administrator- A if she was aware if any other staff had witnessed the incident, as they were found in a common living area.

Administrator- A was unable to answer.

Surveyor asked Administrator- A if there were any other residents in the living area at the time of the incident.

Administrator- A was unable to provide an answer.

Surveyor asked if R2 had ever been inappropriate with any other peers.

Director of Nursing - B stated that this was the first time and that they monitor all the residents for changes in their behavior so they would know if something happened to them.

After Surveyor and Administrator- A and Director of Nursing - B spoke with Surveyor, Administrator- A did conduct interviews with staff who were working on 1/29/26.

Staff were asked have you ever seen (sic) any residents inappropriately touch one another, if so, what would you do and who would you report to if you did?As of the time of exit on 1/29/26, the facility was not able to provide any additional evidence that they had conducted a thorough investigation by interviewing additional staff and residents regarding the incident that took place on 1/4/26 between R1 and R2.On 2/3/26 the facility submitted additional documentation to review regarding the 1/4/26 incident regarding R2 and R1.

The facility information confirms any interviews with facility residents and staff occurred on 1/29/26, during or after the survey regarding the incident.

The facility provided details of staff training regarding abuse, reporting, and investigating incidents on 2/2/26, following the survey.

Facility ID:

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 DOUSMAN, 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 MASONIC CENTER FOR HEALTH & REHAB INC or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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