Shell Lake Health Care Center
SHELL LAKE HEALTH CARE CENTER in SHELL LAKE, WI — inspection on June 20, 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
F-F686 for details.
48793
Example 3
R2 was admitted to the facility on [DATE].
Diagnoses included Alzheimer's disease, dementia, heart failure, anemia, and hypertension.
Minimum Data Set (MDS) assessment dated [DATE] confirmed R2 scored 03/15 during Brief Interview for Mental Status (BIMS), indicating severely impaired cognition. R2's MDS assessment reported R2 is frequently incontinent of urine and always incontinent of bowel. R2 required substantial assistance with toileting, showering, and dressing, and was dependent on staff for transfers.
The follow occurred on 06/19/24 during a continuous observation from 1:05 PM-2:14 PM, for 1 hour and 9 minutes.
Surveyor observed four facility staff members (Director of Nursing, two licensed nursing staff, and Activities Director) walk by R2's call light.
On 06/19/24 at 1:05 PM, Surveyor observed R2's call light on when ambulating down the hallway.
Surveyor observed CNA G walk past R2's call light and enter another resident room.
On 06/19/24 at 1:06 PM, Surveyor entered into R2's room and asked how R2 was. R2 indicated that R2 had to use the bathroom badly and wanted to get into bed as R2 was tired.
On 06/19/24 at 1:25 PM, Surveyor observed R2's call light still on.
Surveyor observed CNA J walk by R2's room.
On 06/19/24 at 1:41 PM, Surveyor observed R2's call light still on.
Surveyor observed Activities Director E walk by R2's room.
On 06/19/24 at 1:59 PM, Surveyor observed R2's call light still on.
Surveyor observed DON B enter R2's room and ask R2 what R2's needs were. R2 indicated that R2 had to use the bathroom and get into bed. DON B turned the call light off and indicated that DON B would let a staff member know that R2 needed assistance in R2's room.
Surveyor observed DON B exit R2's room and walk down the hallway.
On 06/19/24 at 2:02 PM, Surveyor observed R2's call light go on again.
525553
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 525553 B.
Wing 06/20/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Shell Lake Health Care Center 802 E Cty Hwy B Shell Lake, WI 54871