Bayshore Nursing & Rehab
Bayshore Nursing & Rehab operates 112 certified beds in GLENDALE, Wisconsin. Its Medicare and Medicaid certification dates to 1984-10-01. It averages 79.5 residents a day.
What harm was found in the violations cited at Bayshore Nursing & Rehab?
CMS lists 128 health-inspection deficiencies for Bayshore Nursing & Rehab since 2023-03-21, 106 of them in the three years to 2026-08-01: the highest scope-and-severity letter on record is L; the most recent health inspection was 2026-04-30.
| Survey date | Tag | Deficiency | Severity |
|---|---|---|---|
| 2026-04-30 | F0600, F0657, F0658, F0689 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. / Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. / Ensure services provided by the nursing facility meet professional standards of quality. / Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D |
| 2025-09-30 | F0835, F0841 | Administer the facility in a manner that enables it to use its resources effectively and efficiently. / Designate a physician to serve as medical director responsible for implementation of resident care policies and coordination of medical care in the facility. | L |
| 2025-09-30 | F0684, F0686 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. / Provide appropriate pressure ulcer care and prevent new ulcers from developing. | J |
| 2025-09-30 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G |
| 2025-09-30 | F0727, F0812, F0851, F0867, F0880, F0881, F0887, F0925, F0946, F0949 | Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. / Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. / Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data. / Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. / Provide and implement an infection prevention and control program. / Implement a program that monitors antibiotic use. / Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. / Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. / Provide training in compliance and ethics. / Provide behavior health training consistent with the requirements and as determined by a facility assessment. | F |
| 2025-09-30 | F0582, F0585, F0641, F0656, F0679, F0730, F0756, F0761, F0883 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. / Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. / Ensure each resident receives an accurate assessment. / Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. / Provide activities to meet all resident's needs. / Observe each nurse aide's job performance and give regular training. / Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. / 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. / Develop and implement policies and procedures for flu and pneumonia vaccinations. | E |
| 2025-09-30 | F0552, F0576, F0584, F0605, F0609, F0610, F0628, F0645, F0677, F0699, F0700, F0790, F0842, F0947 | Ensure that residents are fully informed and understand their health status, care and treatments. / Ensure residents have reasonable access to and privacy in their use of communication methods. / Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. / Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. / Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. / Respond appropriately to all alleged violations. / Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. / PASARR screening for Mental disorders or Intellectual Disabilities / Provide care and assistance to perform activities of daily living for any resident who is unable. / Provide care or services that was trauma informed and/or culturally competent. / 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. / Provide routine and 24-hour emergency dental care for each resident. / Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. / Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention. | D |
| 2025-09-30 | F0577 | Allow residents to easily view the nursing home's survey results and communicate with advocate agencies. | C |
| 2025-07-30 | F0558 | Reasonably accommodate the needs and preferences of each resident. | D |
| 2025-07-28 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J |
| 2025-07-28 | F0600, F0609 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. / Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D |
| 2025-07-28 | F0732 | Post nurse staffing information every day. | C |
| 2025-07-03 | F0692 | Provide enough food/fluids to maintain a resident's health. | J |
| 2025-07-03 | F0801, F0940, F0941, F0942, F0943, F0944, F0945, F0946, F0947 | Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. / Develop, implement, and/or maintain an effective training program for all new and existing staff members. / Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members. / Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents. / Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation. / Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program. / Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program. / Provide training in compliance and ethics. / Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention. | F |
| 2025-07-03 | F0609, F0610, F0684, F0697, F0755 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. / Respond appropriately to all alleged violations. / Provide appropriate treatment and care according to orders, resident’s preferences and goals. / Provide safe, appropriate pain management for a resident who requires such services. / Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D |
| 2025-05-29 | F0880 | Provide and implement an infection prevention and control program. | E |
| 2025-05-29 | F0561, F0584, F0641, F0655, F0657, F0684, F0690, F0695 | Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. / Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. / Ensure each resident receives an accurate assessment. / Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted / Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. / Provide appropriate treatment and care according to orders, resident’s preferences and goals. / Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. / Provide safe and appropriate respiratory care for a resident when needed. | D |
| 2025-01-29 | F0584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | F |
| 2025-01-29 | F0554, F0580, F0585, F0755, F0759 | Allow residents to self-administer drugs if determined clinically appropriate. / Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. / Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. / Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. / Ensure medication error rates are not 5 percent or greater. | D |
| 2024-10-30 | F0584, F0814, F0925 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. / Dispose of garbage and refuse properly. / Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | F |
| 2024-10-30 | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D |
| 2024-07-24 | F0837 | Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility. | F |
| 2024-06-20 | F0814, F0880, F0908 | Dispose of garbage and refuse properly. / Provide and implement an infection prevention and control program. / Keep all essential equipment working safely. | F |
| 2024-06-20 | F0584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | E |
| 2024-06-20 | F0558, F0578, F0607, F0656, F0689, F0692, F0761, F0919 | Reasonably accommodate the needs and preferences of each resident. / Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. / Develop and implement policies and procedures to prevent abuse, neglect, and theft. / Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. / Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. / Provide enough food/fluids to maintain a resident's health. / 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. / Make sure that a working call system is available in each resident's bathroom and bathing area. | D |
| 2024-05-30 | F0584, F0655, F0880 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. / Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted / Provide and implement an infection prevention and control program. | E |
| 2023-10-10 | F0801, F0925 | Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. / Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | F |
| 2023-10-10 | F0584, F0585, F0609, F0689, F0805, F0806 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. / Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. / Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. / Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. / Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. / Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | D |
| 2023-03-21 | F0882 | Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | L |
| 2023-03-21 | F0689, F0760 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. / Ensure that residents are free from significant medication errors. | G |
| 2023-03-21 | F0584, F0623, F0625, F0800, F0812 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. / Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. / 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. / Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs. / Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E |
| 2023-03-21 | F0656, F0677, F0684, F0692, F0695, F0698, F0755, F0756, F0757, F0758, F0759, F0761, F0804 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. / Provide care and assistance to perform activities of daily living for any resident who is unable. / Provide appropriate treatment and care according to orders, resident’s preferences and goals. / Provide enough food/fluids to maintain a resident's health. / Provide safe and appropriate respiratory care for a resident when needed. / Provide safe, appropriate dialysis care/services for a resident who requires such services. / Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. / Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. / Ensure each resident’s drug regimen must be free from unnecessary drugs. / 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. / Ensure medication error rates are not 5 percent or greater. / 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. / Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | D |
| 2023-03-21 | F0814 | Dispose of garbage and refuse properly. | C |
Has Bayshore Nursing & Rehab had payment denied by Medicare?
| Payment denial start | Length in days |
|---|---|
| 2025-01-22 | 36 |
How is Bayshore Nursing & Rehab staffed relative to the WI average?
| Measure | This facility | WI average |
|---|---|---|
| Total nurse staffing hours per resident per day | 3.96071 | 4.21234 |
| Total nursing staff turnover (%) | 56.4 | 46.9 |
| Average number of residents per day | 79.5 | 54.8 |
Who owns Bayshore Nursing & Rehab, and what chain is it in?
Bayshore Nursing & Rehab is registered with CMS as For profit - Limited Liability company, operates under the legal business name BEDROCK HCS AT GLENDALE LLC and belongs to the BEDROCK HEALTHCARE chain.
| Role | Owner | Association date |
|---|---|---|
| 5% OR GREATER INDIRECT OWNERSHIP INTEREST | CHOPP, LYNN, CHOPP, MARTIN, CHOPP, PNINA, CHOPP, RACHEL, CHOPP, SARAH, CHOPP, SOLOMON, PRAGER, AVROHOM, PRAGER, SHULAMIT | since 10/01/2019 |
| CONTRACTED MANAGING EMPLOYEE | NICHOLS, KENNETH | since 10/01/2019 |
| CORPORATE OFFICER | NICHOLS, KENNETH | since 10/01/2019 |
| OPERATIONAL/MANAGERIAL CONTROL | OPAL HEALTHCARE NJ LLC, NICHOLS, KENNETH | since 10/01/2019 |
Were you or a family member harmed at Bayshore Nursing & Rehab?