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PINE VALLEY COMMUNITY VILLAGE Inspection Report, Violations & Safety Grade (RICHLAND CENTER, Wisconsin)

25951 CIRCLE VIEW LANE, RICHLAND CENTER, Wisconsin 53581

Phone: 6086472138

CMS Overall:3/5

Overview & Bed Count

Certified Beds
80
Avg Residents/Day
64.3
Ownership
Government - County
Provider Type
Medicare and Medicaid
County
Richland
Sprinkler Systems
Yes
Special Focus
None
Abuse Icon
No

CMS Star Ratings

Overall3/5
Health2/5
Staffing5/5
Quality3/5

Nurse Staffing Check

MetricThis FacilityWisconsin AvgDifference
RN Hours per Resident per Day1.170.98+0.18
Total Nurse Hours per Resident per Day4.774.25+0.52
CMS Staffing Rating5/53.7/5-
Nursing Staff Turnover43.4%46.7%-

Health Citation History

22 health citations on record

DateCategoryDescriptionSeverity
2026-07-01Nutrition and Dietary DeficienciesEmploy sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.F – Moderate Harm Potential
2026-07-01Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.F – Moderate Harm Potential
2026-01-14Pharmacy Service DeficienciesProvide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.D – Moderate Harm Potential
2025-07-22Quality of Life and Care DeficienciesProvide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.J – Immediate Jeopardy
2025-07-22Nursing and Physician Services DeficienciesObserve each nurse aide's job performance and give regular training.F – Moderate Harm Potential
2025-07-22Administration DeficienciesDevelop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.F – Moderate Harm Potential
2025-07-22Administration DeficienciesConduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.F – Moderate Harm Potential
2025-07-22Infection Control DeficienciesInclude as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program.F – Moderate Harm Potential
2025-07-22Administration DeficienciesProvide training in compliance and ethics.F – Moderate Harm Potential
2025-06-30Pharmacy Service DeficienciesEnsure that residents are free from significant medication errors.G – Actual Harm
2025-05-22Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.F – Moderate Harm Potential
2025-05-22Resident Rights DeficienciesAllow residents to self-administer drugs if determined clinically appropriate.D – Moderate Harm Potential
2025-05-22Freedom from Abuse, Neglect, and Exploitation DeficienciesDevelop and implement policies and procedures to prevent abuse, neglect, and theft.D – Moderate Harm Potential
2025-05-22Pharmacy Service DeficienciesEnsure medication error rates are not 5 percent or greater.D – Moderate Harm Potential
2025-05-22Pharmacy Service DeficienciesEnsure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.D – Moderate Harm Potential
2025-05-22Infection Control DeficienciesProvide and implement an infection prevention and control program.D – Moderate Harm Potential
2025-03-31Quality of Life and Care DeficienciesProvide appropriate treatment and care according to orders, resident’s preferences and goals.J – Immediate Jeopardy
2025-03-31Freedom from Abuse, Neglect, and Exploitation DeficienciesRespond appropriately to all alleged violations.D – Moderate Harm Potential
2025-03-31Nursing and Physician Services DeficienciesVerify that a nurse aide has been trained; and if they haven't worked as a nurse aide for 2 years, receive retraining.D – Moderate Harm Potential
2025-03-31Nursing and Physician Services DeficienciesObserve each nurse aide's job performance and give regular training.D – Moderate Harm Potential
2024-04-03Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.F – Moderate Harm Potential
2024-04-03Freedom from Abuse, Neglect, and Exploitation DeficienciesTimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.D – Moderate Harm Potential

Fire Safety Citation History

18 fire safety citations on record

DateCategoryDescriptionSeverity
2026-07-01Smoke DeficienciesInspect, test, and maintain automatic sprinkler systems.F – Moderate Harm Potential
2026-07-01Gas, Vacuum, and Electrical Systems DeficienciesEnsure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.F – Moderate Harm Potential
2026-07-01Gas, Vacuum, and Electrical Systems DeficienciesHave generator or other power source capable of supplying service within 10 seconds.F – Moderate Harm Potential
2026-07-01Smoke DeficienciesEnsure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.E – Moderate Harm Potential
2026-07-01Smoke DeficienciesEnsure that corridors are separated from use areas by walls constructed to limit the passage of smoke.E – Moderate Harm Potential
2026-07-01Smoke DeficienciesInstall corridor and hallway doors that block smoke.D – Moderate Harm Potential
2025-05-22Emergency Preparedness DeficienciesDevelop Emergency Preparedness policies and procedures.F – Moderate Harm Potential
2025-05-22Emergency Preparedness DeficienciesEstablish methods for sharing information.F – Moderate Harm Potential
2025-05-22Egress DeficienciesInstall emergency lighting that can last at least 1 1/2 hours.F – Moderate Harm Potential
2025-05-22Miscellaneous DeficienciesTo conduct inspection, testing and maintenance of fire doors by qualified individuals.F – Moderate Harm Potential
2025-05-22Smoke DeficienciesHave approved installation, maintenance and testing program for fire alarm systems.E – Moderate Harm Potential
2025-05-22Gas, Vacuum, and Electrical Systems DeficienciesHave power receptacles that are properly grounded.E – Moderate Harm Potential
2025-05-22Egress DeficienciesProvide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.D – Moderate Harm Potential
2025-05-22Smoke DeficienciesInspect, test, and maintain automatic sprinkler systems.D – Moderate Harm Potential
2024-04-03Gas, Vacuum, and Electrical Systems DeficienciesEnsure proper usage of power strips and extension cords.E – Moderate Harm Potential
2024-04-03Smoke DeficienciesInstall an approved automatic sprinkler system.D – Moderate Harm Potential
2024-04-03Smoke DeficienciesEnsure that corridors are separated from use areas by walls constructed to limit the passage of smoke.D – Moderate Harm Potential
2024-04-03Smoke DeficienciesEnsure smoke barriers are constructed to a 1 hour fire resistance rating.D – Moderate Harm Potential

Total Penalties & Fines

$89,287
Total Fine Amount (CMS)
2
Number of Fines
2
Total Penalties
DateTypeFine AmountPayment Denial
2025-07-22Fine$14,901-
2025-03-31Fine$74,386-

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