Deficiencies per Year
4
3
2
1
0
Unclassified
Inspection Report
Routine
Census: 96
Deficiencies: 2
Jan 3, 2024
Visit Reason
Surveyor conducted a standard survey and self-report review at Fairhaven, a CBRF in Whitewater, from 01/03/2024 to 01/05/2024.
Findings
Two deficiencies were identified: failure to ensure an admission agreement was completed before or at the time of admission for one resident, and failure to ensure quarterly reassessment of scheduled psychotropic medications for one resident.
Deficiencies (2)
| Description |
|---|
| Admission agreement was not completed before or at the time of admission for 1 of 1 residents reviewed. |
| Scheduled psychotropic medications for 1 of 1 residents reviewed were not reassessed quarterly by a pharmacist, practitioner, or registered nurse. |
Report Facts
Deficiencies identified: 2
Resident census: 96
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| RN C | Registered Nurse | Interviewed regarding missing admission agreement and psychotropic medication reassessment |
| Administrator A | Interviewed regarding missing admission agreement | |
| Director of Nursing B | Director of Nursing | Interviewed regarding missing admission agreement |
Inspection Report
Enforcement
Deficiencies: 0
Jan 5, 2023
Visit Reason
A survey and self-report were conducted on January 5, 2023, to determine if Fairhaven was in substantial compliance with Wisconsin Statutes and Administrative Code requirements for community-based residential facilities.
Findings
The Department issued a Statement of Deficiency (SOD #X4HD11) for violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83, resulting in a Notice of Violation and an Order to Comply with Requirements.
Report Facts
Appeal filing timeframe: 10
Compliance timeframe: 45
Posting duration: 90
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kenneth Brotheridge | Assisted Living Director | Signed the Notice and Order letter |
| Hillary Holman | Assisted Living Regional Director | Contact person for questions about the letter |
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