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Complaint Investigation

Heritage Lakeside

October 7, 2025 · Rice Lake, WI · 1016 Lakeshore Dr
Citations 2
CMS Rating 1/5
Beds 50
Provider ID 525654
Healthcare Facility
Heritage Lakeside
Rice Lake, WI  ·  View full profile →
Inspection Summary

HERITAGE LAKESIDE in RICE LAKE, WI — inspection on October 7, 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

FF0656
Resident Assessment and Care Planning Deficiencies
Potential for More Than Minimal Harm

cushion.Surveyor reviewed the care plan and there was no mention of R1's preference to sit on multiple items in the wheelchair, and no mention of the lumbar back support that was used.Example 3Surveyor reviewed R1's physicians orders.

Order was received on 09/26/25 that reads, in part, Patient may bear weight on right foot in CAM boot.Surveyor reviewed R1's chart and found no mention of the use of a CAM boot in R1's care plan nor on the CNA Kardex.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

10/07/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Heritage Lakeside

1016 Lakeshore Dr Rice Lake, WI 54868

SUMMARY STATEMENT OF DEFICIENCIES

During the transport, driver applied brakes to avoid hitting a deer, which led to R1 falling off the seat of the wheelchair and onto the foot pedals. On 10/07/25 at 10:06 AM, Surveyor interviewed CNA C. CNA C stated R1 was sitting on a dycem, cushion, and bath blanket to the best of her knowledge.

When the driver applied the brakes, R1 slid under the safety belts and landed on the wheelchair foot pedals. R1's right foot got pinned between the wheelchair wheel and the seat belt device on the floor of the transportation van. CNA C and the van driver attempted to assist R1 but was unable.

Van driver called 911.

Paramedics arrived and lifted R1 up as another moved the wheelchair out from under R1 and lowered to the floor.

From there the paramedics used a sheet to place R1 on a stretcher and transported to the hospital via ambulance.Surveyor reviewed R1's hospital records, dated 09/16/25, which identified R1 acquired a right ankle fracture. R1 was treated and sent back to the facility with follow up orders.On 10/07/25, Surveyor interviewed Director of Nursing (DON) B and asked if having R1 sit on multiple items in the wheelchair during transport contributed to a hazard. DON B said it could have been a possibility, or the driver could have also strapped the belt over the top of the abdomen instead of under it.

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 RICE LAKE, 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 HERITAGE LAKESIDE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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