Deficiencies (last 2 years)
Deficiencies (over 2 years)
2 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
57% better than Wisconsin average
Wisconsin average: 4.6 deficiencies/yearDeficiencies per year
4
3
2
1
0
Census
Latest occupancy rate
20 residents
Based on a November 2024 inspection.
Census over time
Inspection Report
Enforcement
Deficiencies: 0
Date: Nov 13, 2024
Visit Reason
A standard survey and verification visit were conducted on November 13, 2024, to determine if Fairway Knoll was in substantial compliance with Wisconsin statutes and administrative codes governing community-based residential facilities. A subsequent verification visit was conducted to determine if prior violations were corrected.
Findings
The Department issued a Statement of Deficiency (SOD #2W0F12) for violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83. The licensee was ordered to comply with requirements immediately and achieve substantial compliance within 45 days. An inspection fee of $200 was assessed for the verification visit confirming correction of prior violations.
Report Facts
Inspection fee: 200
Days to achieve compliance: 45
Appeal filing period: 10
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Kenneth Brotheridge | Assisted Living Director | Signed the enforcement notice letter |
| Vicky Wittman | Assisted Living Regional Director | Contact person for questions about the letter |
Inspection Report
Routine
Census: 20
Deficiencies: 1
Date: Nov 11, 2024
Visit Reason
A standard survey and verification visit was conducted at Fairway Knoll to assess compliance with regulatory requirements and verify correction of previous deficiencies.
Findings
The survey found that previous deficiencies had been corrected, but identified one new deficiency related to the failure to ensure quarterly reassessment of scheduled psychotropic medications for one resident.
Deficiencies (1)
The provider did not ensure 1 of 2 residents were reassessed by a pharmacist, practitioner, or registered nurse at least quarterly for the desired response and possible side effects of scheduled psychotropic medications.
Report Facts
Revisit fee: 200
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Administrator A | Acknowledged RN responsibility for quarterly psychotropic medication reviews and confirmed findings during exit conference |
Inspection Report
Complaint Investigation
Deficiencies: 1
Date: Feb 2, 2024
Visit Reason
A complaint investigation was conducted on February 2, 2024, to determine if Fairway Knoll was in substantial compliance with Wisconsin statutes and administrative codes governing community-based residential facilities.
Complaint Details
The complaint investigation was concluded on February 2, 2024, and violations were substantiated as indicated by the issuance of the Statement of Deficiency and imposed forfeiture.
Findings
The Department found violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83, resulting in a Statement of Deficiency #2W0F11 and an imposed forfeiture of $700.00 for noncompliance with regulatory requirements.
Deficiencies (1)
Violation of Wis. Admin. Code 83.35(3)(d)
Report Facts
Forfeiture amount: 700
Reduced forfeiture amount: 455
Days to achieve compliance: 45
Days to request extension: 10
Inspection fee: 200
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: 20
Deficiencies: 2
Date: Feb 2, 2024
Visit Reason
Surveyor conducted a complaint investigation at Fairway Knoll on 02/02/2024 following a substantiated complaint regarding residents' rights and service plan updates.
Complaint Details
Complaint was substantiated. The investigation found that Resident 1's behaviors led to locking of other residents' doors, and individual service plans were not updated to reflect changes such as fall history and behavioral issues.
Findings
Two deficiencies were identified: the provider locked resident doors to prevent Resident 1 from entering other residents' rooms, limiting residents' self-determination; and the provider failed to update individual service plans for Residents 1, 2, and 3 to reflect changes in their needs, including fall histories and behavioral interventions.
Deficiencies (2)
Provider did not ensure all residents had the right to self-determination; resident doors were locked to prevent Resident 1's behaviors.
Provider did not update individual service plans for Residents 1, 2, and 3 when there were changes in their needs, including fall history and behavioral interventions.
Report Facts
Census: 20
Resident 2 fall date: Aug 29, 2023
Resident 2 admission date: Dec 13, 2022
Resident 1 admission date: Jul 1, 2020
Resident 1 individual service plan date: Mar 27, 2023
Resident 2 individual service plan date: Jun 29, 2023
Resident 3 individual service plan date: Mar 21, 2023
Resident 3 fall date: Oct 8, 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Administrator A | Administrator | Interviewed regarding locking of resident doors and individual service plan updates |
| Caregiver B | Interviewed about Resident 1's behaviors and locking of resident doors | |
| Caregiver C | Interviewed about Resident 1 wandering into other residents' rooms | |
| Caregiver D | Interviewed about monitoring Resident 1's behaviors and incident causing Resident 2's fall |
Inspection Report
Complaint Investigation
Census: 21
Deficiencies: 0
Date: Sep 19, 2023
Visit Reason
Surveyor conducted a complaint investigation at Fairway Knoll, a CBRF in Germantown.
Complaint Details
The complaint was unsubstantiated.
Findings
No deficiencies were identified. The complaint was unsubstantiated.
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