Starfile / Wisconsin

WHEATON FRANCISCAN HC - TERRACE AT ST FRANCIS

3200 S 20TH ST, MILWAUKEE, WI 53215 · CCN 525552

Inspection history vs Wisconsin & national averages

Cycle 1 is the most recent standard health inspection. Lower total deficiency counts are better.

Cycle 1 deficiencies by category

Staffing (hours per resident per day)

Fines & penalties

Total fines

$175,897

Number of fines

3

Number of penalties

5

Payment denials

2

Chain

Chain

ASCENSION LIVING

Facilities in chain

19

Chain avg overall

2.60 / 5

Inspection citations (84)1 immediate jeopardy10 actual harm

1. DF0550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.2026-01-06 · Health

   Potential for more than minimal harm

2. DF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.2026-01-06 · Health

   Potential for more than minimal harm

3. DF0686Provide appropriate pressure ulcer care and prevent new ulcers from developing.2026-01-06 · Health

   Potential for more than minimal harm

4. DF0585Honor 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.2025-10-29 · Health · corrected 2025-11-20

   Potential for more than minimal harm

5. DF0609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.2025-10-29 · Health · corrected 2025-11-20

   Potential for more than minimal harm

6. DF0610Respond appropriately to all alleged violations.2025-10-29 · Health · corrected 2025-11-20

   Potential for more than minimal harm

7. DF0677Provide care and assistance to perform activities of daily living for any resident who is unable.2025-10-29 · Health · corrected 2025-11-20

   Potential for more than minimal harm

8. DF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.2025-10-29 · Health · corrected 2025-11-20

   Potential for more than minimal harm

9. DF0686Provide appropriate pressure ulcer care and prevent new ulcers from developing.2025-10-29 · Health · corrected 2025-11-20

   Potential for more than minimal harm

10. GF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.2025-10-29 · Health · corrected 2025-11-20

    Actual harm

11. DF0690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.2025-10-29 · Health · corrected 2025-11-20

    Potential for more than minimal harm

12. DF0880Provide and implement an infection prevention and control program.2025-10-29 · Health · corrected 2025-11-20

    Potential for more than minimal harm

13. EF0552Ensure that residents are fully informed and understand their health status, care and treatments.2025-08-20 · Health · corrected 2025-09-17

    Potential for more than minimal harm

14. DF0583Keep residents' personal and medical records private and confidential.2025-08-20 · Health · corrected 2025-09-17

    Potential for more than minimal harm

15. DF0610Respond appropriately to all alleged violations.2025-08-20 · Health · corrected 2025-09-17

    Potential for more than minimal harm

16. EF0628Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.2025-08-20 · Health · corrected 2025-09-17

    Potential for more than minimal harm

17. DF0645PASARR screening for Mental disorders or Intellectual Disabilities2025-08-20 · Health · corrected 2025-09-17

    Potential for more than minimal harm

18. EF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.2025-08-20 · Health · corrected 2025-09-17

    Potential for more than minimal harm

19. DF0686Provide appropriate pressure ulcer care and prevent new ulcers from developing.2025-08-20 · Health · corrected 2025-09-17

    Potential for more than minimal harm

20. DF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.2025-08-20 · Health · corrected 2025-09-17

    Potential for more than minimal harm

21. DF0698Provide safe, appropriate dialysis care/services for a resident who requires such services.2025-08-20 · Health · corrected 2025-09-17

    Potential for more than minimal harm

22. CF0725Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.2025-08-20 · Health · corrected 2025-09-17

    Potential for minimal harm

23. FF0729Verify that a nurse aide has been trained; and if they haven't worked as a nurse aide for 2 years, receive retraining.2025-08-20 · Health · corrected 2025-09-17

    Potential for more than minimal harm

24. FF0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.2025-08-20 · Health · corrected 2025-09-17

    Potential for more than minimal harm

25. EF0756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.2025-08-20 · Health · corrected 2025-09-17

    Potential for more than minimal harm

26. DF0759Ensure medication error rates are not 5 percent or greater.2025-08-20 · Health · corrected 2025-09-17

    Potential for more than minimal harm

27. DF0600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.2025-06-11 · Health · corrected 2025-07-10

    Potential for more than minimal harm

28. DF0657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.2025-06-11 · Health · corrected 2025-07-10

    Potential for more than minimal harm

29. DF0580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.2025-04-01 · Health · corrected 2025-05-06

    Potential for more than minimal harm

30. DF0677Provide care and assistance to perform activities of daily living for any resident who is unable.2025-04-01 · Health · corrected 2025-05-06

    Potential for more than minimal harm

31. EF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.2025-04-01 · Health · corrected 2025-05-06

    Potential for more than minimal harm

32. GF0686Provide appropriate pressure ulcer care and prevent new ulcers from developing.2025-04-01 · Health · corrected 2025-05-06

    Actual harm

33. DF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.2025-04-01 · Health · corrected 2025-05-06

    Potential for more than minimal harm

34. GF0690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.2025-04-01 · Health · corrected 2025-05-06

    Actual harm

35. DF0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.2025-04-01 · Health · corrected 2025-05-06

    Potential for more than minimal harm

36. DF0760Ensure that residents are free from significant medication errors.2025-04-01 · Health · corrected 2025-05-06

    Potential for more than minimal harm

37. EF0761Ensure 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.2025-04-01 · Health · corrected 2025-05-06

    Potential for more than minimal harm

38. DF0773Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.2025-04-01 · Health · corrected 2025-05-06

    Potential for more than minimal harm

39. FF0880Provide and implement an infection prevention and control program.2025-04-01 · Health · corrected 2025-05-06

    Potential for more than minimal harm

40. DF0759Ensure medication error rates are not 5 percent or greater.2024-12-18 · Health · corrected 2025-01-16

    Potential for more than minimal harm

41. DF0697Provide safe, appropriate pain management for a resident who requires such services.2024-08-28 · Health · corrected 2024-09-20

    Potential for more than minimal harm

42. DF0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.2024-08-28 · Health · corrected 2024-09-20

    Potential for more than minimal harm

43. DF0553Allow resident to participate in the development and implementation of his or her person-centered plan of care.2024-07-22 · Health · corrected 2024-08-19

    Potential for more than minimal harm

44. DF0580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.2024-07-22 · Health · corrected 2024-08-19

    Potential for more than minimal harm

45. DF0609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.2024-07-22 · Health · corrected 2024-08-19

    Potential for more than minimal harm

46. DF0610Respond appropriately to all alleged violations.2024-07-22 · Health · corrected 2024-08-19

    Potential for more than minimal harm

47. DF0636Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.2024-07-22 · Health · corrected 2024-08-19

    Potential for more than minimal harm

48. EF0638Assure that each resident’s assessment is updated at least once every 3 months.2024-07-22 · Health · corrected 2024-08-19

    Potential for more than minimal harm

49. GF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.2024-07-22 · Health · corrected 2024-08-19

    Actual harm

50. GF0686Provide appropriate pressure ulcer care and prevent new ulcers from developing.2024-07-22 · Health · corrected 2024-08-19

    Actual harm

51. GF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.2024-07-22 · Health · corrected 2024-08-19

    Actual harm

52. DF0690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.2024-07-22 · Health · corrected 2024-08-19

    Potential for more than minimal harm

53. DF0695Provide safe and appropriate respiratory care for a resident when needed.2024-07-22 · Health · corrected 2024-08-19

    Potential for more than minimal harm

54. DF0697Provide safe, appropriate pain management for a resident who requires such services.2024-07-22 · Health · corrected 2024-09-20

    Potential for more than minimal harm

55. EF0756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.2024-07-22 · Health · corrected 2024-08-19

    Potential for more than minimal harm

56. DF0758Implement 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.2024-07-22 · Health · corrected 2024-08-19

    Potential for more than minimal harm

57. DF0791Provide or obtain dental services for each resident.2024-07-22 · Health · corrected 2024-08-19

    Potential for more than minimal harm

58. DF0810Provide special eating equipment and utensils for residents who need them and appropriate assistance.2024-07-22 · Health · corrected 2024-08-19

    Potential for more than minimal harm

59. FF0812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.2024-07-22 · Health · corrected 2024-08-19

    Potential for more than minimal harm

60. DF0849Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.2024-07-22 · Health · corrected 2024-08-19

    Potential for more than minimal harm

61. FF0880Provide and implement an infection prevention and control program.2024-07-22 · Health · corrected 2024-08-19

    Potential for more than minimal harm

62. DF0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.2024-02-28 · Health · corrected 2024-03-04

    Potential for more than minimal harm

63. GF0580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.2024-01-17 · Health · corrected 2024-02-16

    Actual harm

64. GF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.2024-01-17 · Health · corrected 2024-02-16

    Actual harm

65. GF0686Provide appropriate pressure ulcer care and prevent new ulcers from developing.2024-01-17 · Health · corrected 2024-02-16

    Actual harm

66. JF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.2024-01-17 · Health · corrected 2024-02-16

    Immediate jeopardy

67. GF0690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.2024-01-17 · Health · corrected 2024-02-16

    Actual harm

68. DF0692Provide enough food/fluids to maintain a resident's health.2024-01-17 · Health · corrected 2024-02-16

    Potential for more than minimal harm

69. DF0693Ensure 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.2024-01-17 · Health · corrected 2024-02-16

    Potential for more than minimal harm

70. DF0947Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.2024-01-17 · Health · corrected 2024-02-16

    Potential for more than minimal harm

71. DF0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.2023-10-05 · Health · corrected 2023-11-05

    Potential for more than minimal harm

72. DF0759Ensure medication error rates are not 5 percent or greater.2023-10-05 · Health · corrected 2023-11-05

    Potential for more than minimal harm

73. DF0880Provide and implement an infection prevention and control program.2023-10-05 · Health · corrected 2023-11-05

    Potential for more than minimal harm

74. DF0607Develop and implement policies and procedures to prevent abuse, neglect, and theft.2023-04-01 · Health · corrected 2023-05-18

    Potential for more than minimal harm

75. DF0610Respond appropriately to all alleged violations.2023-04-01 · Health · corrected 2023-05-18

    Potential for more than minimal harm

76. DF0636Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.2023-04-01 · Health · corrected 2023-05-18

    Potential for more than minimal harm

77. DF0637Assess the resident when there is a significant change in condition2023-04-01 · Health · corrected 2023-05-18

    Potential for more than minimal harm

78. DF0638Assure that each resident’s assessment is updated at least once every 3 months.2023-04-01 · Health · corrected 2023-05-18

    Potential for more than minimal harm

79. DF0657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.2023-04-01 · Health · corrected 2023-05-18

    Potential for more than minimal harm

80. DF0677Provide care and assistance to perform activities of daily living for any resident who is unable.2023-04-01 · Health · corrected 2023-05-18

    Potential for more than minimal harm

81. DF0686Provide appropriate pressure ulcer care and prevent new ulcers from developing.2023-04-01 · Health · corrected 2023-05-18

    Potential for more than minimal harm

82. DF0745Provide medically-related social services to help each resident achieve the highest possible quality of life.2023-04-01 · Health · corrected 2023-05-18

    Potential for more than minimal harm

83. DF0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.2023-04-01 · Health · corrected 2023-05-18

    Potential for more than minimal harm

84. DF0759Ensure medication error rates are not 5 percent or greater.2023-04-01 · Health · corrected 2023-05-18

    Potential for more than minimal harm

Ownership

Other facilities in MILWAUKEE

Source: CMS Provider Data Catalog, Nursing Home Care Compare files (processed 2026-03-01). Citations show the 3 most recent inspection cycles.