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Complaint Investigation

Rocky Knoll Health Care

July 3, 2024 · Plymouth, WI · N7135 Rocky Knoll Parkway
Citations 1
CMS Rating 3/5
Beds 149
Provider ID 525337
Healthcare Facility
Rocky Knoll Health Care
Plymouth, WI  ·  View full profile →
Source Document
Official CMS Inspection Report (Medicare.gov)  ·  7 pages
Downloaded from CMS/Medicare.gov. Reflects what state inspectors documented and does not include the facility's plan of correction, which is submitted separately. Facilities may have taken corrective actions since this report was released.
Inspection Summary

Rocky Knoll Health Care in Plymouth, WI — inspection on July 3, 2024.

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.

Inspection Findings

FF689
Minimal harm or allegation of sexual abuse to the SA because they determined the incident was not an abuse situation and Few Services Assessment for R5 and provided Surveyor with a copy of the assessment. Surveyor noted the affected

F-F689 where, under resident-to-resident altercations it notes: A resident-to-resident altercation should be reviewed as a potential situation of abuse which should be investigated under the guidance of 42 CFR 483.12.

Willful means the individual intended the action itself, regardless of whether or not the individual intended to inflict injury or harm.

Even though a resident may have cognitive impairment, he/she can still commit a willful act.

The 2nd column on the form lists Wisconsin Administrative Code Chapter DHS 13 Caregiver Misconduct Definitions.

The column provides a definition of abuse as an act or repeated acts by a caregiver or non-client resident.

The facility highlighted in the DHS Caregiver Misconduct definitions column the following: Abuse does not include an act or acts of mere .incapacity.

525337

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 525337 B.

Wing 07/03/2024

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

Rocky Knoll Health Care N7135 Rocky Knoll Parkway Plymouth, WI 53073

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 Plymouth, 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 Rocky Knoll Health Care or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


More Reports

About This Inspection Report

Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.

Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.

Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.