Complete Care at Jefferson Meadows LLC

1414 Jefferson St.
Baraboo, WI, 53913
6083564838
CCN: 525317
3
Overall
2
Health
4
Staffing
5
Quality
ChainCOMPLETE CARE
Special FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
NameRole%
PC WCM OPCO HOLDCO LLC5% OR GREATER DIRECT OWNERSHIP INTEREST100%
PC WCM TOPCO LLC5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED
PEACE CAPITAL HOLDINGS II LLC5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED
SMS 2021 TRUST5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED
STEIN, SHALOMCORPORATE OFFICERNOT APPLICABLE
GREENWOOD, EMILYOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
HELMAN, YOSEFOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
PENDLETON, JULIEOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
STERNBUCH, DANIELOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
FLYGT, THOMASOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Penalties (2)
DateTypeAmount
2025-05-13Fine$19K
2025-01-31Fine$54K
Health Deficiencies (22)
2025-05-13 · Health
E
F881 · Infection Control Deficiencies
Implement a program that monitors antibiotic use.
C
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
F849 · Administration Deficiencies
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
E
F842 · Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
F
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
F761 · Pharmacy Service Deficiencies
Ensure 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
F760 · Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
D
F740 · Quality of Life and Care Deficiencies
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
D
F693 · Quality of Life and Care Deficiencies
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
G
F692 · Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
D
F679 · Quality of Life and Care Deficiencies
Provide activities to meet all resident's needs.
D
F645 · Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
D
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
D
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
2025-01-31 · Health
K
F700 · Quality of Life and Care Deficiencies
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
2023-02-27 · Health
D
F757 · Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
D
F688 · Quality of Life and Care Deficiencies
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
J
F686 · Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
E
F604 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
D
F583 · Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
D
F580 · Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
D
F561 · Resident Rights Deficiencies
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day
4.20
3.68
RN Hrs/Resident/Day
1.06
0.54
LPN Hrs/Resident/Day
0.42
0.81
CNA Hrs/Resident/Day
2.71
2.33
PT Hrs/Resident/Day
0.09
0.12
Data as of 2026-03-01