Avina on Division
Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.
based on 9 Google reviews
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Quality Concerns Identified
Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.
Above average in WI · Below recommended RN staffing · Low staff turnover (stable workforce) · No penalties on record
What this means for your family
While the physical environment and therapy services are well-regarded, the recent surge in reports regarding neglect and slow response times is concerning. Families should conduct an unannounced visit during off-peak hours to observe staff responsiveness and ask management specifically how they handle call light wait times and resident hygiene needs.
Google Reviews
Google Reviews
9 reviews on Google“Avina on Division, formerly known as The Manor of Fond du Lac, receives highly polarized feedback. While some families praise the spacious, bright rooms and the therapy department, recent reviews from late 2025 highlight severe concerns regarding neglect, slow response times to call lights, and poor food quality.”
Quality Themes
Tap a score for detailsStrengths
- Spacious and bright resident rooms
- Effective therapy department
- Friendly and caring staff interactions
Concerns
- Excessively slow response times to call lights (mentioned by 3 reviewers)
- Neglect and failure to assist with basic hygiene and wound care (mentioned by 2 reviewers)
- General unhappiness and distress among residents (mentioned by 3 reviewers)
Rating Trends
Tap a year to see what changed
Distribution · 9 analyzed
How They Respond to Reviews
Questions for Your Tour
- 1Given that some families have expressed concerns about call light response times, could you explain the specific system or protocol you use to ensure residents receive timely assistance?
- 2I noticed the facility has a strong therapy department; how do you integrate those therapeutic activities into the daily routine to ensure residents stay engaged and active?
- 3With recent feedback regarding hygiene and wound care, what specific oversight or training measures do you have in place to ensure consistent, high-quality personal care for every resident?
- 4Since medication management is a critical part of daily life, could you walk me through your process for ensuring accuracy and timely administration for residents?
- 5How do you approach communication with families regarding changes in a resident's health or daily status, and what is the best way for us to stay updated?
- 6What steps are you taking to improve the overall dining experience and meal quality to ensure residents are getting the nutrition and enjoyment they need?
Personalized based on this facility's data
Key Review Excerpts
“The rooms are spacious with large windows and ample closet space, the facility is clean, and the entire staff is caring and extremely friendly!”
“The CNAs take forever (literally over 45 minutes) to answer the lights. The place is dirty and depressing.”
“I get calls from my mom daily with her crying about how they are trying her, neglecting her cares and not following doctors orders.”
Staffing
Staffing Hours
per resident/day · Medicare 2026Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.
Quality Measures
Quality Measures
Resident outcomes compared with national, state, and local averages · 17 measures
10
measures
5
measures
2
measures
Residents whose walking got worse
Residents needing more daily help over time
Residents on anti-anxiety or sleep medication
Residents with depression symptoms
Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.
Residents with pressure sores (bedsores)
Residents vaccinated for pneumonia
Short-stay residents vaccinated for the flu
Short-stay residents vaccinated for pneumonia
Short-stay residents newly given antipsychotics
US average from Medicare published data
Inspection History
Medicare Inspection History
3-year lookback · Medicare 2026
Avina on Division has a concerning pattern of recurring deficiencies across fire safety systems, dietary operations, and infection control that persist across multiple surveys. Families have filed complaints resulting in findings related to improper discharges, reporting failures, and inadequate nutrition. While the facility corrects violations when cited, the repetitive nature of issues—particularly with sprinkler systems, food safety, and emergency preparedness—suggests ongoing operational challenges that warrant careful consideration.
Apr 30, 2026Complaint4
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Resident Rights Deficiencies
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.
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies
Provide for the safe, appropriate administration of IV fluids for a resident when needed.
Mar 28, 2026Complaint7
Nursing and Physician Services Deficiencies
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.
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Administration Deficiencies
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
May 21, 2025Routine12
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies
Dispose of garbage and refuse properly.
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Egress Deficiencies
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Smoke Deficiencies
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Services Deficiencies
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Miscellaneous Deficiencies
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Nov 18, 2024Complaint1
Nutrition and Dietary Deficiencies
Dispose of garbage and refuse properly.
Mar 27, 2024Routine26
Smoke Deficiencies
Install a fire alarm system that can be heard throughout the facility.
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Nutrition and Dietary Deficiencies
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.
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Smoke Deficiencies
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Gas, Vacuum, and Electrical Systems Deficiencies
Meet requirements for the installation and maintenance of electrical systems.
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Resident Rights Deficiencies
Give the resident's representative the ability to exercise the resident's rights.
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Nutrition and Dietary Deficiencies
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Egress Deficiencies
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Miscellaneous Deficiencies
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Miscellaneous Deficiencies
Have restrictions on the use of portable space heaters.
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure proper usage of power strips and extension cords.
Gas, Vacuum, and Electrical Systems Deficiencies
Have proper medical gas storage and administration areas.
Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
Mar 7, 2023Routine21
Nursing and Physician Services Deficiencies
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.
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Resident Rights Deficiencies
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Smoke Deficiencies
Construct fire resistant interior walls.
Resident Rights Deficiencies
Give the resident's representative the ability to exercise the resident's rights.
Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
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.
Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
Quality of Life and Care Deficiencies
Provide activities to meet all resident's needs.
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Quality of Life and Care Deficiencies
Provide care or services that was trauma informed and/or culturally competent.
Quality of Life and Care Deficiencies
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
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.
Egress Deficiencies
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Smoke Deficiencies
Ensure that waiting areas, nurse’s stations, gift shops, and cooking facilities, open to the corridor are properly protected.
Smoke Deficiencies
Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.
Ownership & Operations
Who Operates This Facility
Avina on Division
for profit
Chain Affiliation
Avina Healthcare
9 facilities nationwide
Chain avg rating: 2.8/5 · Rank 4 of 8
Ownership & Management
Owners
Brandman, Joseph
Owner
Rebel, Igor
Owner
Key personnel
Contact
Get in Touch
Contact this facility directly and verify the details that matter most to your family.
References & Resources
Medicare Care Compare
Official Medicare quality ratings, inspections & staffing data
Google Maps
Photos, directions & neighborhood info
Google Reviews
9 reviews from families & visitors
Official Website
Visit crossroadscarecenter.com
Medicare data downloads
Original nursing home datasets
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