Not rated by CMS — ratings are suppressed for new or low-volume facilities.
A standard survey is most likely before around October 2026
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Dove Healthcare - Spooner during CMS and state inspections, most recent first.
A hospice resident with severe cognitive impairment and total dependence on staff developed a pressure ulcer due to the facility's failure to provide appropriate support surfaces and timely interventions. Despite being at high risk for skin breakdown, the resident did not receive an alternating air mattress or Roho cushion until after a pressure injury developed. Interviews revealed a lack of communication and coordination among staff regarding the resident's care needs.
The facility's steam heated hot water system was not maintained properly, leading to fluctuating water temperatures that were often inadequate for resident use. Observations showed temperatures ranging from 80 to 100 degrees Fahrenheit, below the required levels. Residents and staff reported inconsistent water temperatures, and the Director of Maintenance acknowledged ongoing issues with the system, which was installed in the 1960s. Despite regular checks and adjustments, the system's performance remained inconsistent.
A resident with type 1 diabetes experienced unmanaged hypoglycemia and hyperglycemia due to the facility's failure to follow diabetic protocols. Staff did not administer glucagon or recheck blood glucose levels as required, nor did they notify the physician of these episodes. Interviews revealed that staff based insulin administration on the resident's preferences rather than medical guidelines, despite previous education on protocols.
A resident with type 1 diabetes experienced significant medication errors due to facility staff not following diabetic protocols. Staff administered glucagon outside prescribed parameters and allowed the resident to dictate insulin dosages, leading to incorrect administration. Interviews revealed staff prioritized resident preferences over physician orders, compromising the resident's health.
The facility did not maintain the required RN coverage of at least 8 consecutive hours a day, 7 days a week, affecting all 50 residents. On certain weekends, RN coverage was less than 8 hours, with specific dates showing only 4.5 hours of coverage and one day with no coverage at all. The DON and NHA confirmed the deficiency, acknowledging the lack of full coverage on these dates.
The facility failed to follow food safety standards, affecting 48 residents. Opened milk containers were not labeled with opening dates, and staff did not perform hand hygiene between glove changes while handling food. A staff member used contaminated gloves to handle various surfaces and ready-to-eat foods, contrary to facility policy and the Wisconsin Food Code. The DON confirmed that hand hygiene should be performed between glove changes.
The facility failed to maintain an effective infection prevention and control program, lacking a comprehensive water management plan to prevent Legionella transmission. Staff did not adhere to Enhanced Barrier Precautions, failing to wear appropriate PPE during high-contact care. Infection surveillance was inadequate, with poor tracking of symptoms and insufficient testing for influenza or RSV. The Infection Preventionist's limited presence led to communication gaps, contributing to the deficiencies.
The facility failed to implement its policies and procedures for screening employees for a history of abuse, neglect, or exploitation. Background checks for five out of eight staff members were either delayed or incomplete, potentially affecting all residents. The HR representative was unaware of the reasons for these deficiencies, and the Nursing Home Administrator acknowledged ongoing efforts to achieve compliance.
A resident, who is dependent on staff for care following a stroke, was repeatedly observed lying in bed uncovered and visible from the hallway, with the room door open and privacy curtain not pulled. Despite the presence of staff, no actions were taken to cover the resident or ensure privacy. The resident indicated discomfort with the situation, and the Director of Nursing acknowledged the dignity concern.
A resident with Alzheimer's and dementia had a stop sign barrier intervention to prevent other residents from entering her room. However, surveyors observed that the barrier was not consistently in place, and staff interviews revealed a lack of awareness and consistency in maintaining it. The DON confirmed the intervention was still active but acknowledged it might not have been moved during a room change.
A resident with multiple diagnoses, including hemiplegia and osteoarthritis, had a care plan that failed to reflect their preferred toileting method, which was less painful than other options. The CNA and DON were aware of the resident's preference, but it was not documented in the care plan.
A resident with multiple diagnoses requiring assistance with ADLs was left unattended for extended periods, resulting in unmet needs for meal assistance, repositioning, and incontinence care. Despite the care plan indicating the need for supervision during meals and regular repositioning, staff failed to provide the necessary support, as observed by surveyors. Interviews with staff confirmed a lack of adherence to care expectations.
A resident at high risk for falls did not have a pressure alarm on their wheelchair, despite it being a part of their care plan. Observations showed the resident without the alarm, and staff interviews revealed confusion about its necessity. The lack of consistent use of the pressure alarm indicates a failure to follow the care plan to prevent falls.
Two residents with indwelling Foley catheters received inadequate care, leading to potential complications and UTIs. One resident was hospitalized for a UTI and sepsis, with staff failing to follow proper infection control practices during catheter care. Another resident's catheter was changed monthly without clinical indications, contrary to CDC guidelines. The facility's policies on perineal care, hand hygiene, and catheter care were not followed, indicating a need for improved training and adherence to standards.
Two residents with gastrostomy tubes experienced deficiencies in their care, including improper management of feeding supplies and failure to check tube placement. Feeding bags were left open to air, and supplies were stored improperly, increasing contamination risk. An LPN did not use PPE as required, and the Director of Nursing confirmed these practices were against facility protocols.
The facility failed to provide written notifications to residents or their representatives regarding hospital transfers, including reasons for the transfers. This deficiency was identified for several residents with complex medical conditions, who were transferred without receiving the required written notices. The Nursing Home Administrator acknowledged the lack of compliance with this requirement.
Failure to Prevent Pressure Ulcers in Hospice Resident
Penalty
Summary
The facility failed to provide appropriate pressure ulcer care and prevent new ulcers from developing for a resident who was on hospice and nearing the end of life. The resident, who had severe cognitive impairment and was totally dependent on staff for transfers, toileting, repositioning, and personal hygiene, was admitted without skin issues but was at risk for skin breakdown. Despite this risk, the facility did not provide alternate support surfaces when skin issues were noted, and no new interventions were put into place when the resident's condition declined. The resident's care plan included interventions such as conducting weekly full-body skin inspections, providing a pressure reduction mattress and wheelchair cushion, and repositioning the resident. However, the facility did not implement these interventions effectively. The resident developed an open area on the left buttock, which was initially treated but later progressed to an unstageable pressure injury with black eschar and drainage. The facility's failure to provide an alternating air mattress or a Roho cushion earlier contributed to the development of the pressure injury. Interviews with facility staff revealed a lack of communication and coordination regarding the resident's care needs. The Director of Nursing and the wound nurse were unaware of the resident's need for an alternating air mattress and a Roho cushion until after the pressure injury developed. The facility's inaction and lack of timely interventions led to the resident developing a pressure injury that was not adequately addressed, contributing to the deficiency identified by the surveyor.
Inconsistent Hot Water Temperatures in Facility
Penalty
Summary
The facility failed to maintain its steam heated hot water system in a safe operating condition, resulting in fluctuating water temperatures that were often inadequate for resident use. The facility's Water Management Program Policy and Procedure requires that hot water temperatures be maintained between 140 to 150 degrees Fahrenheit in holding tanks, with safe bathing temperatures at 100 degrees Fahrenheit. However, observations and interviews revealed that the water temperatures in resident rooms and showers were frequently below the required levels, with temperatures ranging from 80 to 100 degrees Fahrenheit during the surveyor's checks. Interviews with residents and staff confirmed the inconsistency in water temperatures. Residents reported that the water was sometimes not hot enough for bathing, and staff noted that it often took a long time for the water to reach a warm temperature. The Director of Maintenance acknowledged that the facility's hot water system, installed in the 1960s, had ongoing issues, including a sticking steam valve and a mixing valve that required frequent adjustments. Despite these known issues, there had been no attempts to repair the system. The Director of Maintenance indicated that the system was checked regularly, and adjustments were made as needed. However, the water temperatures did not remain consistent throughout the day, as evidenced by the surveyor's findings. The Nursing Home Administrator was informed of the issues, and it was noted that the water temperature problems would be reported to the corporate office for further action.
Failure to Follow Diabetic Protocols in Resident Care
Penalty
Summary
The facility failed to provide appropriate diabetic care and treatment for a resident with type 1 diabetes, resulting in multiple instances of unmanaged hypoglycemia and hyperglycemia. The staff did not adhere to the established diabetic protocol, which required administering glucagon for blood glucose levels below 54 mg/dL and rechecking blood glucose within 15 minutes after intervention. Additionally, the staff failed to notify the resident's physician of these episodes, which is a critical step in managing the resident's condition. The resident, who has a complex medical history including type 1 diabetes, chronic kidney disease, and vascular dementia, experienced numerous episodes of low blood glucose levels. Despite the facility's policy outlining specific steps for managing hypoglycemia, the staff repeatedly did not administer glucagon when necessary, did not recheck blood glucose levels in a timely manner, and failed to monitor and document vital signs and symptoms. These omissions were observed over several months, indicating a pattern of non-compliance with the facility's diabetic management protocol. Interviews with the resident and staff revealed further issues in the management of the resident's diabetes. The resident expressed concerns about receiving too much insulin and experiencing frequent low blood sugar episodes. The LPN interviewed admitted to not following the diabetic protocol strictly and based insulin administration on the resident's preferences rather than medical guidelines. The DON acknowledged that despite previous education on diabetic protocols, staff continued to deviate from the expected procedures. The endocrinologist emphasized the importance of following the protocol and being notified of blood glucose levels below 70 mg/dL, highlighting the critical nature of these deficiencies.
Significant Medication Errors in Diabetic Management
Penalty
Summary
The facility failed to ensure that a resident with type 1 diabetes mellitus was free from significant medication errors. The resident, who also has multiple health complications including chronic kidney disease and vascular dementia, experienced numerous instances where the facility staff did not follow the diabetic protocol for hypoglycemic episodes. The staff administered glucagon outside of the prescribed blood glucose parameters and failed to administer it when the resident's blood glucose levels were critically low. Additionally, the staff did not document the reasoning for these actions or notify the physician as required by the facility's policy. The resident's medical records revealed multiple instances where insulin was administered based on the resident's request rather than following physician orders. The staff allowed the resident to dictate the amount of insulin administered, despite the absence of a physician order permitting this. This led to incorrect dosages being given, which were not aligned with the prescribed treatment plan. The facility's staff also failed to document the number of insulin units administered and did not follow the protocol for treating low blood glucose levels, such as administering glucagon or notifying the physician. Interviews with the facility's staff, including the Director of Nursing and nursing staff, indicated a lack of adherence to the diabetic protocol. The staff admitted to administering insulin based on the resident's preferences rather than following the physician's orders. The endocrinologist confirmed that the facility staff should adhere to the diabetic protocol and expressed concerns about the resident making their own decisions regarding insulin usage. The failure to follow the protocol and physician orders resulted in significant medication errors, compromising the resident's health and safety.
Insufficient RN Coverage in Facility
Penalty
Summary
The facility failed to ensure that a registered nurse (RN) was on duty for at least 8 consecutive hours a day, 7 days a week, which has the potential to affect all 50 residents residing in the facility. This deficiency was identified through a record review conducted by the surveyor on May 22, 2024, which revealed that on certain weekends in May, specifically on the 4th, 5th, 18th, and 19th, RN coverage was less than the required 8 hours. On May 4th, 5th, and 18th, only 4.5 hours were covered by an RN, and on May 19th, there was no RN coverage at all. During an interview with the Director of Nursing (DON) and the Nursing Home Administrator (NHA), it was confirmed that the procedure for covering RN shifts involves calling available RNs, and if no one is available, the DON or the Infection Preventionist would cover the hours. However, on the specified dates, the DON acknowledged that they did come in but did not work the full 8 hours, and the NHA confirmed the lack of coverage on May 19th and insufficient hours on the other dates.
Food Safety and Hand Hygiene Deficiencies
Penalty
Summary
The facility failed to adhere to professional standards for food service safety, which had the potential to affect 48 of 50 residents who received nourishment from the kitchen. During an inspection, it was observed that opened milk containers in the refrigerator were not labeled with the date they were opened, contrary to the facility's policy requiring all commercial products to be labeled with the date of initial opening. The Dietary Manager was unable to provide the opening dates for the milk containers when questioned by the surveyor. Additionally, there were multiple instances of improper hand hygiene practices during food service. A staff member, identified as [NAME] M, was observed using single-use gloves to handle various surfaces and ready-to-eat foods without performing hand hygiene between glove changes. This included touching ladles, food covers, and bread with contaminated gloves, and then serving food to residents. Despite the facility's policy and the Wisconsin Food Code requiring hand hygiene between glove changes, both [NAME] M and the Dietary Manager incorrectly believed that hand hygiene was not necessary if the staff remained in the hot service area. The Director of Nursing later confirmed that hand hygiene should be performed between glove changes.
Inadequate Infection Control and Water Management in LTC Facility
Penalty
Summary
The facility failed to establish and maintain an effective infection prevention and control program, which had the potential to affect all 49 residents. The facility lacked a comprehensive water management plan to prevent the transmission of Legionella, as evidenced by the absence of a detailed flow system diagram, audits, and documentation of hot spots, stagnation, and dead-leg areas. The Maintenance Director admitted to not documenting audits or flushing procedures, indicating a significant gap in the facility's water management practices. Staff members did not adhere to Enhanced Barrier Precautions (EBP) protocols, as observed in multiple instances. Certified Nursing Assistants (CNAs) and a Licensed Practical Nurse (LPN) failed to wear appropriate Personal Protective Equipment (PPE) while providing high-contact care to residents on EBP. In one case, CNAs entered a resident's room without gowns or gloves, despite a sign indicating EBP requirements. Similarly, an LPN did not wear full PPE while performing tube feeding for a resident on EBP, acknowledging the oversight only after being questioned by the surveyor. The facility's infection surveillance was inadequate, as it did not track the type and onset of symptoms for staff and resident infections. During a COVID-19 outbreak, the Infection Preventionist (IP) did not document symptom onset or provide alternative testing for influenza or RSV when COVID-19 tests were negative. The IP was only present at the facility three times a week, leading to communication gaps and instances where staff returned to work prematurely after illness. The lack of proper documentation and communication regarding infection control measures further contributed to the facility's deficiencies.
Failure to Implement Employee Background Check Policies
Penalty
Summary
The facility did not implement its policies and procedures related to screening employees for a prior history of abuse, neglect, exploitation of residents, or misappropriation of resident property. This deficiency was identified for five out of eight staff members reviewed. The facility's policy required background checks to be completed before employment and repeated every four years. However, several staff members had delayed or incomplete background checks. For instance, a Dietary Aide was hired before the background check was completed, and a Housekeeper who had resided in Minnesota did not have a background check from that state. Additionally, an Environmental Services Director and two Certified Nursing Assistants had delayed background checks, with one CNA's check being overdue by several months. The Human Resources representative, HR N, who was interviewed, stated that these employees were hired before they started working in their position and did not know the reasons for the delays or omissions. The Nursing Home Administrator confirmed that the facility was aware of the non-compliance issue and had been working on achieving 100% compliance since HR N was hired. This lack of adherence to the facility's own policies and procedures had the potential to affect all residents by not ensuring that staff members were properly vetted for any history of abuse, neglect, or exploitation.
Resident Privacy and Dignity Not Maintained
Penalty
Summary
The facility failed to uphold the dignity and privacy of a resident, identified as R43, who was observed multiple times lying in bed uncovered, wearing only an incontinent brief, and visible from the hallway. R43, who was admitted following a stroke and is dependent on staff for care, was observed by the surveyor on several occasions with the room door open and the privacy curtain not pulled, exposing the resident to passersby. Despite the presence of staff members, including a Licensed Practical Nurse (LPN) and a Certified Nursing Assistant (CNA), no actions were taken to cover the resident or close the privacy curtain. The surveyor noted that R43 was unable to speak but could communicate by nodding. When asked if they were comfortable with the lack of privacy, R43 indicated no by shaking their head. The Director of Nursing (DON) acknowledged the dignity concern when informed of the observations. The facility's inaction in ensuring the resident's privacy and dignity, despite clear indications of discomfort from the resident, constitutes a deficiency in care.
Failure to Implement Safety Care Plan for Resident
Penalty
Summary
The facility failed to implement a comprehensive individualized safety care plan for a resident diagnosed with Alzheimer's disease, dementia, and cognitive communication deficit. The resident, identified as R34, experienced an incident where another male resident entered her room and urinated. As a result, a stop sign barrier was introduced as an intervention to prevent other residents from wandering into her room. However, observations by the surveyor on multiple occasions revealed that the stop sign barrier was not consistently in place across the doorway as intended. This lack of implementation was noted despite the care plan specifying the use of the stop sign barrier when the resident was in her room, particularly at night. Interviews with facility staff, including CNAs and LPNs, indicated a lack of awareness and consistency in maintaining the stop sign barrier. Some staff members were unsure of the barrier's location, while others noted that the resident had been known to remove it. The Director of Nursing confirmed that the intervention was still active but acknowledged that the barrier might not have been moved during a room change. This inconsistency in following the care plan led to the deficiency identified by the surveyor.
Failure to Update Toileting Care Plan for Resident
Penalty
Summary
The facility failed to review and revise the comprehensive toileting care plan for a resident, identified as R7, who was always incontinent of bowel and bladder. R7 was admitted with multiple diagnoses, including hemiplegia and hemiparesis following a cerebral infarction, osteoarthritis, anxiety disorder, hip pain, and constipation. The care plan, dated March 27, 2024, did not reflect R7's preferred method of toileting, which was to use Depends briefs while lying on their left side, as other methods like the commode or bedpan were too painful. This preference was not documented in the care plan, despite being known to the staff through experience. The surveyor observed that the CNA was aware of R7's toileting preference from experience rather than documented instructions. Interviews with the CNA, R7, and the Director of Nursing confirmed that the current toileting method was the least painful for R7 and had been in place for some time. The Director of Nursing acknowledged that the care plan should have been updated to reflect R7's preferences. Additionally, therapy services confirmed that R7 had attempted therapy for other toileting methods but chose to stop all therapies and pursue palliative care.
Failure to Provide Required ADL Assistance
Penalty
Summary
The facility failed to ensure that activities of daily living (ADLs) such as meal set-up, repositioning, and incontinence care were provided for a resident, identified as R21. R21 was admitted with multiple diagnoses, including alcohol-induced persisting dementia and aphasia following cerebral infarction, and was assessed to require assistance with various ADLs. The care plan specified that R21 needed supervision for eating, assistance with personal hygiene, dressing, and was dependent on staff for transferring and toileting. Despite these needs, observations revealed that R21 was left unattended for extended periods without receiving necessary assistance. On the morning of the survey, a CNA delivered R21's breakfast tray but did not assist with eating or repositioning. The resident was observed lying in bed, unable to reach the food, and the tray remained untouched for several hours. Throughout the morning and early afternoon, surveyors noted that staff did not enter R21's room to provide assistance, despite the resident's apparent inability to eat independently. When staff did enter the room, they focused on R21's roommate and did not check on R21 or provide the required assistance. Interviews with staff, including a CNA and the Director of Nursing (DON), revealed a lack of adherence to the care plan and facility expectations. The DON confirmed that R21 should have been repositioned and provided incontinence care every two hours and required supervision during meals to prevent aspiration. However, the surveyor's observations indicated that these care needs were not met, as staff failed to provide the necessary assistance and supervision for R21's meals and other ADLs.
Failure to Implement Fall Prevention Measures for Resident
Penalty
Summary
The facility failed to ensure adequate supervision and assistance to prevent falls and injury for a resident identified as R40. R40 was admitted with multiple diagnoses, including unspecified mood disorder, cognitive communication deficit, and major depressive disorder, and was assessed as a high fall risk. The care plan for R40 included the use of a pressure alarm on the wheelchair to prevent falls. However, during multiple observations by the surveyor, R40 was seen sitting in a wheelchair without the pressure alarm in place, which was a critical intervention to alert staff if R40 attempted to rise from the wheelchair. Interviews with facility staff, including a CNA, LPN, DON, and OT, revealed a lack of clarity and communication regarding the implementation of the pressure alarm intervention. The CNA was unsure if the alarm was necessary, while the LPN and DON confirmed that the alarm should have been in place. The OT explained that the alarm was added due to R40's impulsiveness and risk of falls, especially in open areas. Despite these acknowledgments, the pressure alarm was not consistently used, indicating a failure in following the established care plan to prevent falls for R40.
Deficient Catheter Care and Infection Control Practices
Penalty
Summary
The facility failed to provide appropriate catheter care for residents with indwelling Foley catheters, leading to potential complications and urinary tract infections (UTIs). For Resident 43, the staff did not follow proper infection control practices during catheter care. The surveyor observed a Certified Nursing Assistant (CNA) using the same washcloth for different areas of the perineal region and catheter, which is against the facility's policy. Additionally, the CNA did not perform hand hygiene between glove changes, which is a critical step in preventing infections. Resident 43 had a history of UTIs and was recently hospitalized for a UTI and sepsis, indicating a serious lapse in care. Resident 29's care also did not align with professional standards. The facility had an open-ended order to change the resident's Foley catheter on a routine monthly basis without clinical indications, contrary to the Centers for Disease Control and Prevention (CDC) guidelines. The Director of Nursing (DON) was unaware that the standard of practice had changed and believed that regular changes were still required. This misunderstanding led to unnecessary catheter changes, which could increase the risk of infection and other complications. The facility's policies on perineal care, hand hygiene, and catheter care were not adequately followed, contributing to the deficiencies observed. The staff's lack of adherence to these policies, particularly in hand hygiene and the sequence of perineal care, highlights a significant gap in training and awareness. The DON acknowledged the errors and the need to update practices to align with current standards, but the deficiencies observed indicate a need for immediate attention to prevent further harm to residents.
Deficiencies in Feeding Tube Management and Infection Control
Penalty
Summary
The facility failed to ensure proper treatment and services for residents with feeding tubes, as observed in two cases. Resident R32, who has multiple medical conditions including type 1 diabetes, chronic kidney disease, and dysphagia, was found to have a gastrostomy tube feeding setup that was not properly managed. The feeding bag was left open to air, and the tubing was not labeled with the date it was opened. Additionally, the LPN did not check the placement of the G-tube before administering feedings, which is against the facility's protocol. In the case of R32, the LPN was observed not using personal protective equipment (PPE) as required, and the feeding supplies were improperly stored on the bathroom counter, increasing the risk of contamination. The Director of Nursing confirmed that the supplies should be stored outside the bathroom and that the LPN should have used PPE. The LPN also failed to recap the tubing end properly, leaving it exposed to air, which was not in line with the facility's infection control practices. For resident R43, who also has a gastrostomy tube due to conditions like cerebral infarction and dysphagia, similar issues were noted. The feeding supplies were left uncovered on the bathroom counter, and the feeding bag was left open to air. Although the LPN administered medications and feedings correctly, the improper storage of supplies and open feeding bag were consistent with the deficiencies observed in R32's care.
Failure to Provide Written Transfer Notices
Penalty
Summary
The facility failed to provide timely written notification to residents or their representatives regarding transfers to the hospital, including the reasons for such transfers, as required by regulations. This deficiency was identified during a survey that reviewed the cases of five residents who were hospitalized. For instance, one resident with spastic hemiplegia and aphasia following a stroke was transferred to the hospital multiple times without their legal guardian receiving written notice of the transfers. Similarly, another resident with cerebral infarction and related conditions was hospitalized, and their representative was only informed verbally, not in writing. The survey also revealed that a resident with multiple complex medical conditions, including an amputation and chronic kidney disease, was hospitalized several times without receiving written explanations for the transfers. Additionally, a resident with congestive heart failure was transferred to the hospital without a written notice that included the reason for the transfer. The facility's Nursing Home Administrator acknowledged that they had not been providing written notices of discharge or transfer, which is a requirement. This oversight had the potential to affect all 50 residents in the facility.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Spooner
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Shell Lake Health Care Center | 10.9 mi | — | 9 | 0 |
| Care And Rehab - Cumberland | 21.3 mi | — | 14 | 0 |
| Dove Healthcare - Rice Lake | 22.7 mi | — | 1 | 0 |
| Heritage Lakeside | 23 mi | — | 15 | 1 |
| Hayward Health Services | 24 mi | — | 12 | 0 |
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