MEADOWBROOK AT BLOOMER
1840 PRIDDY ST
BLOOMER, WI, 54724
7155682503
CCN: 525580
4
Overall3
Health5
Staffing2
QualitySpecial FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
| Name | Role | % |
|---|---|---|
| PUKSHANSKY, ROSTISLAV | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 50% |
| MASLOVSKY, BORIS | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 50% |
| VANDER VELDEN, BARBARA | CORPORATE DIRECTOR | NOT APPLICABLE |
| LINDEMANN, MITUL | CORPORATE OFFICER | NOT APPLICABLE |
| LINDEMANN, MITUL | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| SHRADER, KAIYA | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| DICKSON, ERIK | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| SYNERGY SENIOR CARE LLC | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
Health Deficiencies (16)
2025-03-13 · Health
F
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
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.
D
F656 · Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
D
F641 · Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
D
F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
2024-08-26 · Health
E
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
2024-03-06 · Health
F
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
F
F851 · Administration Deficiencies
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
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.
2023-01-12 · Health
C
F888 · Infection Control Deficiencies
Ensure staff are vaccinated for COVID-19
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.
D
F758 · Pharmacy Service Deficiencies
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
D
F691 · Quality of Life and Care Deficiencies
Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services.
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
F656 · Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
B
F625 · Resident Rights Deficiencies
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day3.68
5.40
RN Hrs/Resident/Day0.54
1.33
LPN Hrs/Resident/Day0.81
0.94
CNA Hrs/Resident/Day2.33
3.13
PT Hrs/Resident/Day0.12
0.00
Data as of 2026-03-01