Deficiencies per Year
4
3
2
1
0
Unclassified
Census Over Time
Census
Capacity
Inspection Report
Routine
Deficiencies: 0
Sep 12, 2025
Visit Reason
A standard survey was conducted on September 12, 2025, for Cottonwood Manor Assisted Living to determine if the facility was in substantial compliance with Wisconsin statutes and administrative codes governing community-based residential facilities.
Findings
The Department issued a Statement of Deficiency (SOD # FZS611) for violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83, establishing grounds for enforcement action and requiring the licensee to comply with all applicable requirements to protect resident health, safety, and welfare.
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
Routine
Census: 29
Capacity: 35
Deficiencies: 3
Sep 9, 2025
Visit Reason
Surveyor conducted a standard survey at Cottonwood Manor Assisted Living to assess compliance with regulatory requirements and identify any deficiencies.
Findings
Three deficiencies were identified: failure to assess a resident for choking risk related to loose-fitting dentures and diet refusal; improper disposal of expired medications; and failure to maintain a safe, clean, comfortable, and homelike living environment with multiple cleanliness and maintenance issues observed throughout the facility.
Deficiencies (3)
| Description |
|---|
| Provider did not ensure Resident 5 was assessed for all risks including choking related to loose-fitting dentures and refusal of soft diet. |
| Provider did not ensure 4 of 4 resident medications reviewed were disposed of after 30 days past expiration date. |
| Provider did not ensure a living environment that was safe, clean, comfortable, and homelike; multiple issues including mold, odors, stains, dust, and maintenance problems were observed. |
Report Facts
Deficiencies identified: 3
Resident census: 29
Total licensed capacity: 35
Expired medications observed: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| ED B | Executive Director | Interviewed regarding Resident 5's assessment and medication disposal issues; acknowledged deficiencies and cleaning concerns. |
| Nurse C | Nurse | Interviewed about Resident 5's condition and refusal of soft diet. |
| OM A | Office Manager | Accompanied surveyor during tour and medication cart observations. |
Inspection Report
Re-Inspection
Census: 27
Deficiencies: 0
Sep 20, 2023
Visit Reason
A verification visit and review of a self-report was conducted at Cottonwood Manor Assisted Living to assess correction of a previous deficiency.
Findings
The previous deficiency was corrected and there were no deficiencies found with the self-report during this survey.
Report Facts
Re-visit fee: 200
Inspection Report
Complaint Investigation
Deficiencies: 0
Apr 27, 2023
Visit Reason
A complaint investigation and self-report review were conducted to determine if Cottonwood Manor Assisted Living was in substantial compliance with Wisconsin statutes and administrative codes governing community-based residential facilities.
Findings
The Department issued a Statement of Deficiency (SOD #6WDT11) for violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83, establishing grounds for enforcement action and requiring the licensee to comply with all applicable requirements within 45 days.
Complaint Details
The visit was complaint-related, involving a complaint investigation and self-report review to assess compliance with regulatory requirements. The Department issued a Statement of Deficiency based on findings.
Report Facts
Compliance timeframe: 45
Inspection fee: 200
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: 26
Deficiencies: 1
Apr 27, 2023
Visit Reason
An investigation of 3 complaints and 2 self-reports was conducted at Cottonwood Manor Assisted Living to determine compliance with health monitoring regulations.
Findings
The investigation substantiated 1 complaint with one deficiency identified related to failure to monitor a resident's health following a medication error. Two complaints were unsubstantiated and no deficiencies were found related to the self-reports.
Complaint Details
The complaint investigation involved 3 complaints and 2 self-reports. Two complaints were unsubstantiated, one was substantiated with one deficiency identified. No deficiencies were found with the self-reports.
Deficiencies (1)
| Description |
|---|
| The provider did not monitor the health of 1 resident following a medication error where the wrong insulin was administered and physician-ordered blood sugar checks were not completed. |
Report Facts
Complaints investigated: 3
Self-reports investigated: 2
Residents involved in deficiency: 1
Insulin units administered incorrectly: 36
Blood sugar checks ordered: 12
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Wellness Director | Confirmed no evidence of hourly blood sugar checks after medication error |
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