MEADOWBROOK AT BLOOMER

1840 PRIDDY ST
BLOOMER, WI, 54724
7155682503
CCN: 525580
4
Overall
3
Health
5
Staffing
2
Quality
ChainSYNERGY SENIOR CARE
Special FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
NameRole%
PUKSHANSKY, ROSTISLAV5% OR GREATER DIRECT OWNERSHIP INTEREST50%
MASLOVSKY, BORIS5% OR GREATER DIRECT OWNERSHIP INTEREST50%
VANDER VELDEN, BARBARACORPORATE DIRECTORNOT APPLICABLE
LINDEMANN, MITULCORPORATE OFFICERNOT APPLICABLE
LINDEMANN, MITULOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
SHRADER, KAIYAOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
DICKSON, ERIKOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
SYNERGY SENIOR CARE LLCOPERATIONAL/MANAGERIAL CONTROLNOT 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/Day
5.40
3.68
RN Hrs/Resident/Day
1.33
0.54
LPN Hrs/Resident/Day
0.94
0.81
CNA Hrs/Resident/Day
3.13
2.33
PT Hrs/Resident/Day
0.00
0.12
Data as of 2026-03-01