Inspection Reports for
Country Villa Assisted Living
1900 HUCKLEBERRY AVE, OMRO, WI, 54963
Back to Facility ProfileDeficiencies (last 4 years)
Deficiencies (over 4 years)
0.3 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
93% better than Wisconsin average
Wisconsin average: 4.6 deficiencies/yearDeficiencies per year
4
3
2
1
0
Occupancy
Latest occupancy rate
87% occupied
Based on a March 2026 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Occupancy rate over time
Inspection Report
Complaint Investigation
Census: 33
Deficiencies: 0
Date: Mar 19, 2026
Visit Reason
Surveyor conducted a complaint investigation at Country Villa Assisted Living based on a complaint received.
Complaint Details
1 of 1 complaints was unsubstantiated with no deficiencies identified.
Findings
The complaint was unsubstantiated and no deficiencies were identified during the investigation.
Inspection Report
Re-Inspection
Census: 37
Deficiencies: 0
Date: Sep 29, 2025
Visit Reason
Surveyor conducted a verification visit and standard survey to confirm correction of previous deficiencies.
Findings
The previous deficiency was corrected and no new deficiencies were identified during the visit.
Report Facts
Revisit fee: 200
Inspection Report
Complaint Investigation
Census: 27
Deficiencies: 0
Date: Jun 4, 2025
Visit Reason
An investigation into 2 complaints was conducted at Country Villa Assisted Living in Little Chute.
Complaint Details
Two complaints were investigated and both were found to be unsubstantiated.
Findings
No deficiencies were identified as a result of the investigation. Two of the two complaints were unsubstantiated.
Report Facts
Complaints investigated: 2
Complaints unsubstantiated: 2
Notice
Deficiencies: 0
Date: May 6, 2025
Visit Reason
A complaint investigation was conducted to determine if Country Villa Assisted Living was in substantial compliance with Wisconsin statutes and administrative codes governing community-based residential facilities.
Complaint Details
The visit was complaint-related and resulted in a Statement of Deficiency #MQU411. Specific substantiation status is not stated.
Findings
The Department issued a Statement of Deficiency for violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83, establishing grounds for enforcement action and requiring compliance within 45 days.
Report Facts
Inspection fee: 200
Compliance timeframe: 45
Appeal timeframe: 10
Posting duration: 90
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kenneth Brotheridge | Assisted Living Director | Signed the Notice and Order letter. |
| Vicky Wittman | Assisted Living Regional Director | Contact person for questions about the letter. |
Inspection Report
Complaint Investigation
Census: 33
Deficiencies: 1
Date: May 6, 2025
Visit Reason
A complaint investigation was conducted at Country Villa Assisted Living on 05/06/2025 due to an allegation regarding medication administration.
Complaint Details
The complaint was substantiated with one deficiency identified related to medication administration. Resident 1 missed Glipizide doses for 21 days, leading to hyperglycemia and an ER visit. The facility's Director confirmed the error and disciplinary action was taken.
Findings
The complaint was substantiated with one deficiency identified. Resident 1 did not receive the prescribed Glipizide 10 mg daily from 10/03/2024 through 10/23/2024, resulting in a high blood sugar of 384 and an emergency room visit.
Deficiencies (1)
83.32(3)(h) Rights of Residents: Receive medication. Resident 1 did not receive scheduled Glipizide 10 mg daily from 10/03/2024 through 10/23/2024 as ordered, causing a high blood sugar and ER visit.
Report Facts
Census: 33
Days medication not given: 21
Blood sugar level: 384
Employees mentioned
| Name | Title | Context |
|---|---|---|
| DIR - A | Director | Confirmed Resident 1 did not receive medication and was involved in medication administration error |
| RD - B | Regional Director | Confirmed medication error and disciplinary action |
Inspection Report
Complaint Investigation
Census: 30
Deficiencies: 0
Date: Nov 15, 2024
Visit Reason
Surveyor conducted a complaint investigation at Country Villa Assisted Living based on a complaint received.
Complaint Details
Complaint was unsubstantiated.
Findings
No deficiencies were identified during the complaint investigation. The complaint was found to be unsubstantiated.
Inspection Report
Complaint Investigation
Census: 32
Deficiencies: 0
Date: Jul 24, 2024
Visit Reason
Surveyor conducted two complaint investigations at Country Villa Assisted Living.
Complaint Details
Two complaints were investigated and both were found to be unsubstantiated.
Findings
No deficiencies were identified. Two of two complaints were unsubstantiated.
Inspection Report
Abbreviated Survey
Census: 26
Deficiencies: 0
Date: Jul 16, 2024
Visit Reason
The surveyor conducted an abbreviated licensure survey and three complaint investigations at the facility.
Complaint Details
Three complaints were investigated and all were unsubstantiated.
Findings
No deficiencies were identified during the abbreviated licensure survey. All three complaints investigated were found to be unsubstantiated.
Report Facts
Complaints investigated: 3
Census: 26
Inspection Report
Complaint Investigation
Census: 30
Deficiencies: 0
Date: Feb 29, 2024
Visit Reason
Surveyor conducted a complaint investigation at Country Villa Assisted Living, a CBRF in Little Chute.
Complaint Details
The complaint was unsubstantiated.
Findings
No deficiencies were identified. The complaint was unsubstantiated.
Inspection Report
Complaint Investigation
Census: 31
Deficiencies: 0
Date: Feb 8, 2024
Visit Reason
Surveyor conducted a complaint investigation at Country Villa Assisted Living based on information gathered through 02/12/2024.
Complaint Details
Complaint was not substantiated.
Findings
No deficiencies were identified during the complaint investigation. The complaint was not substantiated.
Inspection Report
Follow-Up
Census: 31
Deficiencies: 0
Date: Sep 14, 2023
Visit Reason
Surveyor conducted a verification visit and standard survey to confirm correction of previous deficiencies at Country Villa Assisted Living.
Findings
Previous deficiencies were corrected and no new deficiencies were identified during the visit.
Report Facts
Revisit fee: 200
Inspection Report
Complaint Investigation
Census: 59
Deficiencies: 0
Date: Mar 31, 2023
Visit Reason
The inspection was conducted as a complaint investigation at Country Villa Assisted Living.
Complaint Details
One complaint was investigated and found to be not substantiated.
Findings
No deficiencies were identified during the complaint investigation, and the one complaint was not substantiated.
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