Inspection Reports for Bay Harbor of Deforest

Surveyor conducted a verification visit at Bay Harbor of DeForest to verify correction of previous deficiencies.

No deficiencies were identified during the verification visit. A $200 revisit fee is being assessed under statutory provisions.

A verification visit was conducted on 05/27/2025 to determine if Bay Harbor of Deforest was in substantial compliance with Wisconsin statutes and administrative codes governing community-based residential facilities.

The Department found violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83, resulting in a Notice of Violation and an imposed forfeiture of $800.00. The licensee is ordered to comply with all requirements within 45 days and is subject to a $200 inspection fee for a revisit to verify compliance.

On 05/27/2025, a surveyor conducted a verification visit at Bay Harbor of DeForest to assess compliance with medication administration and resident care requirements, identifying two deficiencies including a repeat violation.

Two deficiencies were identified, including a repeat deficiency related to failure to administer medications as prescribed for one resident and failure to provide assistance with stockings for two residents. The provider was found not to ensure residents received appropriate care and medication administration as prescribed.

A verification visit was conducted on 01/13/2025 to determine if The Koselig House was in substantial compliance with Wisconsin statutes and administrative codes governing community-based residential facilities (CBRF). The visit was to assess compliance and resulted in issuance of a Statement of Deficiency (SOD) #YSHR13.

The Department found violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83 at The Koselig House, leading to an imposed forfeiture totaling $2,540.00. The licensee is ordered to comply with all requirements immediately and maintain substantial compliance within 45 days. A $200 inspection fee for a revisit was also assessed.

On 01/08/2025, surveyors conducted a verification visit at The Koselig House following previous deficiencies. The visit aimed to verify correction of prior medication administration and service plan deficiencies.

Four deficiencies were identified, all repeat violations related to medication administration and individualized service plan updates. The provider failed to administer medications as prescribed for several residents and did not update service plans to reflect changes in residents' needs. Additionally, dietary menus were not posted or planned properly.

The inspection was conducted to investigate three complaints and two verification visits to determine if The Koselig House was in substantial compliance with Wisconsin statutes and administrative codes governing community-based residential facilities.

The Department issued a Statement of Deficiency (SOD #YSHR12) for violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83, resulting in an order to comply with requirements, an extended order not to admit new residents, and the imposition of a forfeiture totaling $10,530. The facility must consult with a registered nurse to develop corrective measures and provide training to staff.

The visit was complaint-related, involving three complaint investigations and two verification visits concluded on 10/15/2024. The Department found violations substantiated as detailed in SOD #YSHR12.

The inspection was conducted to conclude three complaint investigations for The Koselig House to determine if the facility was in substantial compliance with Wisconsin statutes and administrative codes governing community-based residential facilities.

The Department found violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83, resulting in a Statement of Deficiency (SOD #YSHR11), imposition of a $2,500 forfeiture, and orders to comply with requirements, not admit new residents, and implement corrective measures.

The visit was complaint-related, concluding three complaint investigations. Specific substantiation status is not stated.

Surveyors conducted 3 complaint investigations at The Koselig House following concerns of abuse, neglect, injuries of unknown source, and other regulatory compliance issues.

Nine deficiencies were identified, including failure to investigate and report abuse allegations, failure to investigate injuries of unknown origin, failure to update service plans, and failure to ensure adequate staff designation and communication. Two of the three complaints were substantiated.

Three complaints were investigated; two were substantiated. Issues included abuse and neglect by caregivers, injuries of unknown origin, and failure to report and investigate incidents properly.

A standard survey and three complaint investigations were conducted on 04/02/2024 to determine if The Koselig House was in substantial compliance with Wisconsin statutes and administrative codes governing community-based residential facilities.

The Department issued Statement of Deficiency (SOD) #T56511 for violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83, resulting in a Notice of Violation, Order to Comply, Special Orders, and a Notice of Imposed Forfeiture totaling $2,510.00.

The visit included three complaint investigations alongside a standard survey to assess compliance with regulatory requirements.

Surveyors conducted a standard licensure survey and three complaint investigations at The Koselig House, identifying twelve deficiencies, including three repeat violations. Two of the three complaints were substantiated.

The facility failed to ensure admission agreements were completed before or at the time of admission for two residents. Medication administration was not consistently provided as prescribed for multiple residents, including failure to administer medications at prescribed intervals and proper documentation. Residents did not receive timely assistance with incontinence care, call light response, and personal care. The facility also failed to ensure residents could lock their bedroom doors and maintain a safe, clean, and comfortable living environment.

Two of three complaints were substantiated. Complaints included failure to provide admission agreements upon admission, failure to provide prompt care during episodes of incontinence, and failure to monitor diabetic residents' blood sugar levels. Resident representatives were responsible for ordering medications, causing delays and communication issues.

Surveyor conducted a verification visit at Koselig House, a CBRF in DeForest, to verify correction of previous deficiencies.

No deficiencies were identified during this visit. The previously cited Statement of Deficiency dated 06/01/2023 was corrected.

Surveyor completed a verification visit and complaint investigation at Koselig House, a CBRF in DeForest, based on complaints regarding resident care, narcotic counts, personal care services, cleanliness, and laundry storage.

Six deficiencies were identified including failure to assess a resident after a fall, narcotic count discrepancies, inadequate personal care services with poor call light response times and lack of supplies, failure to follow hand washing procedures, unclean environment, and improper laundry storage with clean and dirty laundry not separated.

The complaint was substantiated. The investigation included concerns about resident falls, narcotic discrepancies, personal care delays, hygiene practices, facility cleanliness, and laundry storage. A $200 revisit fee was assessed under Wis. Stat. Ch. 50.

A complaint investigation and verification visit were conducted on May 31, 2023, to determine if The Koselig House was in substantial compliance with Wisconsin statutes and administrative codes governing community-based residential facilities.

The Department found violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83, resulting in a Statement of Deficiency (SOD #2U5R12) and imposed a total forfeiture of $800.00. A $200 inspection fee was also assessed for a verification visit on June 1, 2023.

The visit was complaint-related, conducted to verify compliance with applicable statutes and administrative codes. Specific substantiation status is not stated.

A complaint investigation was conducted on February 8, 2023, to determine if The Koselig House was in substantial compliance with Wisconsin statutes and administrative codes governing community-based residential facilities.

The Department issued a Statement of Deficiency (SOD #2U5R11) for violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83, requiring the licensee to comply with standards for resident care and assessments. A forfeiture of $1000 was imposed for specific violations, with orders to develop corrective measures and provide staff training.

The visit was a complaint investigation concluded on February 8, 2023, to assess compliance with relevant statutes and codes. The Department found violations and issued a Statement of Deficiency.

Surveyor conducted 2 complaint investigations at Koselig House related to the facility's response to falls and calls for assistance.

Two deficiencies were identified and substantiated. Resident 1 did not receive prompt and adequate treatment following a fall resulting in rib fractures and pneumothorax. Resident 2's physical condition was not assessed timely after a fall, resulting in delayed treatment for a hip fracture and finger injury. Additionally, the provider failed to ensure a written summary of a grievance related to caregiver assistance and call light system was completed.

Two complaints were substantiated related to inadequate treatment following falls and failure to complete grievance documentation.

YSHR12SODS.PDF_18717.pdf