Country Terrace Black River Falls II

Last survey

May 13, 2026 complaint, verification visit

Surveys

8

Deficiencies cited

35

Enforcement letters

5

Forfeitures imposed

$9,230 4 notices

Complaints substantiated

6 of 11 as stated in the reports

Enforcement

• March 20, 2026: notice of violation, order to comply
• February 4, 2026: notice of violation, order to comply, special orders, forfeiture, forfeiture $1,300 (reduced to $845 if paid within ten days)
• May 13, 2025: notice of violation, order to comply, special orders, forfeiture, forfeiture $3,500 (reduced to $2,275 if paid within ten days)
• December 10, 2024: notice of violation, order to comply, special orders, forfeiture, forfeiture $850 (reduced to $552.50 if paid within ten days)
• May 7, 2024: notice of violation, order to comply, special orders, forfeiture, forfeiture $3,580 (reduced to $2,327 if paid within ten days)

May 13, 2026, complaint, verification visit · statement of deficiency

• No deficiencies listed in the statement

March 3, 2026, complaint 1 of 1 complaints substantiated · statement of deficiency

• Medication administration (DHS 83.38(1)(h)) Program services
  From the report: Based on record review and interview, the provider did not ensure Resident 1 received adequate medication administration services to meet his/her needs.

December 1, 2025, complaint, verification visit 1 of 1 complaints substantiated · statement of deficiency

• Notification: incident, injury, changes (DHS 83.12(5)(a)) Investigation, notification, and reporting requirements
  From the report: Based on record review and interview the provider did not immediately notify Resident 4's physician when Resident 4 exhibited changes in his/her mental and physical condition.
• Medication error or adverse reaction (DHS 83.37(1)(k)) Medications
  From the report: Based on record review and interview, the provider did not document in the resident's record a medication error and adverse reaction when Resident 4 developed lithium toxicity.
• Documentation of medication administration (DHS 83.37(2)(d)) Medications
  From the report: Based on record review and interview, the provider did not ensure there was accurate documentation of Resident 4's lithium carbonate dosage, date, and time.
• Leisure time activities (DHS 83.38(1)(c)) Program services
  From the report: Based on interview and record review, the provider did not provide a daily activity program to meet the interests and capabilities of the residents.

March 3, 2025, standard survey, complaint, verification visit 1 of 2 complaints substantiated · statement of deficiency

• Administrator shall supervise daily operation (DHS 83.15(3)(a)) Administrator
  From the report: Based on record review and interview, the administrator did not supervise the daily operations, including supervision to ensure proper care and services, that the residents' health and safety were protected and promoted, and that residents' rights were respected.
• Continuing education (DHS 83.25) Continuing education
  From the report: Based on record review and interview, the provider did not ensure Caregiver D completed continuing education requirements in 2023 or 2024.
• Admission agreement include services, charges (DHS 83.29(2)) Admission agreement
  From the report: Based on record review and interview, the provider did not obtain a signed and dated admission agreement for 1 of 4 resident records reviewed.
• Explanation of rights, grievance procedure (DHS 83.32(2)(a)) Rights of residents
  From the report: Based on record review and interview, the provider did not obtain a signed statement acknowledging the provider explained resident rights, grievance procedures, and house rules to residents, for 1 of 4 resident records reviewed.
• Pre-admission and ongoing assessments (DHS 83.35(1)(a)) Assessment, individual service plan and evaluations
  From the report: Based on record review and interview, the provider did not assess each resident's needs, abilities, and physical and mental condition, prior to admission.

Read the survey history on DQA’s Provider Search →

DQA posts surveys from the last three years. DHS says posting may be delayed and Provider Search is updated weekly. This community is licensed for 25 residents; larger communities are surveyed and reported on more often, so read counts with size in mind. Source: Wisconsin Department of Health Services, Division of Quality Assurance, data as of October 15, 2026. Always visit in person and ask the community about anything listed here.