Inspection Reports for Maple Meadows Assisted Living

WI, 54935

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Deficiencies per Year

4 3 2 1 0
2024
2025
Unclassified

Census Over Time

12 15 18 21 24 27 Aug '24 Feb '25 Jul '25 Dec '25
Inspection Report Follow-Up Census: 19 Deficiencies: 0 Dec 16, 2025
Visit Reason
Surveyor conducted a verification visit to Maple Meadows Assisted Living to verify correction of a previous deficiency.
Findings
One of one previous deficiency was corrected. No new deficiencies were identified during the visit.
Report Facts
Revisit fee: 200
Inspection Report Complaint Investigation Deficiencies: 0 Jul 22, 2025
Visit Reason
A complaint investigation was conducted on July 22, 2025, to determine if Maple Meadows 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 #BC8E11) for violations related to the administration and operation of the facility, specifically requiring corrective measures to ensure proper care, fall management procedures, and staff training to protect resident health, safety, and rights.
Complaint Details
Complaint investigation concluded on July 22, 2025, resulting in issuance of Statement of Deficiency #BC8E11 for violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83.
Report Facts
Compliance timeframe: 45 Inspection fee: 200 Appeal timeframe: 10 Posting duration: 90
Employees Mentioned
NameTitleContext
Kenneth BrotheridgeAssisted Living DirectorSigned the Notice and Order letter
Vicky WittmanAssisted Living Regional DirectorContact person for questions about the letter
Inspection Report Complaint Investigation Census: 20 Deficiencies: 1 Jul 18, 2025
Visit Reason
The surveyor conducted a complaint investigation at Maple Meadows Assisted Living based on a complaint alleging that interventions were not developed and implemented to prevent falls.
Findings
The investigation substantiated the complaint, identifying one deficiency related to the failure to update the Individual Support Plan (ISP) after Resident 1 experienced multiple falls and injuries. The ISP did not reflect updates after falls on 02/24/2025 and 05/01/2025, and did not adequately address fall risk or interventions.
Complaint Details
The complaint was substantiated. The complaint alleged that interventions were not developed and implemented to prevent falls for Resident 1, who experienced multiple falls resulting in fractures and injuries.
Deficiencies (1)
Description
Provider did not ensure the Individual Support Plan (ISP) was updated upon change in Resident 1's needs, abilities, or physical condition after multiple falls.
Report Facts
Falls: 4 Census: 20
Employees Mentioned
NameTitleContext
Executive Director AExecutive DirectorInterviewed regarding Resident 1's falls and ISP updates.
Inspection Report Follow-Up Census: 18 Deficiencies: 0 Feb 6, 2025
Visit Reason
Surveyor conducted a verification visit to assess correction of previous deficiencies at Maple Meadows Assisted Living.
Findings
Four of four previous deficiencies were corrected and no new deficiencies were identified during the visit.
Report Facts
Revisit fee: 200
Inspection Report Complaint Investigation Deficiencies: 0 Aug 27, 2024
Visit Reason
A Standard Survey and Complaint Investigation were conducted to determine if Maple Meadows 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 # I4PN11) for violations of state statutes and administrative codes. The licensee was ordered to comply with requirements, develop and provide staff training on health monitoring procedures, and was assessed a forfeiture of $1,400 for the violations.
Complaint Details
The visit was triggered by a complaint investigation combined with a standard survey. Specific substantiation status is not stated.
Report Facts
Forfeiture Amount: 1400 Reduced Forfeiture Amount: 910 Forfeiture Breakdown: 400 Forfeiture Breakdown: 400 Forfeiture Breakdown: 600 Compliance Timeframe: 45 Payment Timeframe: 10
Employees Mentioned
NameTitleContext
Kenneth BrotheridgeAssisted Living DirectorSigned the Notice and Order letter.
Vicky WittmanAssisted Living Regional DirectorContact person for questions about the letter.
Inspection Report Complaint Investigation Census: 19 Deficiencies: 4 Aug 27, 2024
Visit Reason
Surveyor conducted 3 complaint investigations and a standard survey at Maple Meadows Assisted Living from 08/16/2024 to 08/27/2024.
Findings
Four deficiencies were identified including lack of complete orientation training for employees, failure to provide prompt and adequate treatment to residents, incomplete involvement of residents or their legal representatives in service plan development, and inadequate health monitoring with failure to notify physician of critical blood sugar levels.
Complaint Details
Three complaint investigations were conducted; one complaint was substantiated and two were unsubstantiated.
Deficiencies (4)
Description
Two employees did not receive orientation training covering required topics before performing job duties.
Residents did not receive prompt treatment appropriate to their needs, evidenced by Resident 1's extended call light wait times and missed showers.
Three individual service plans were not developed with involvement or signatures from residents or their legal representatives.
Provider failed to notify Resident 3's physician on 33 occasions when blood sugar levels were within notification parameters.
Report Facts
Call light wait times exceeding 20 minutes: 180 Total call pendant uses: 1070 Individual service plans reviewed: 3 Blood sugar notification failures: 33
Employees Mentioned
NameTitleContext
Administrator AInterviewed regarding concerns about orientation training, call light wait times, service plan development, and health monitoring.
Wellness Director BInterviewed regarding orientation training deficiencies, call light wait times, service plan development, and failure to notify physician of blood sugar levels.
Market Leader FInterviewed regarding call light wait times and service plan development.
Supervisor GInterviewed regarding call light wait times and service plan development.
Nurse HInterviewed regarding call light wait times and service plan development.
Wellness Coordinator IReported on Resident 3's diabetes management and communication practices with physician.

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