01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-02-09 | 27 | 2026-02-09 | 8 |
| Cycle 2 | 2024-09-23 | 14 | 2024-09-23 | 16 |
| Cycle 3 | 2023-06-22 | 16 | 2023-06-22 | 4 |
CMS CCN 5254952026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Ascension Living - Lakeshore At Siena
5643 Erie Street · Racine, WI 53402 · Racine County
Certified beds60CMS provider file
Recent citation rows85current CMS citation release
Penalty rows1current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
85 rows in the current release
4 rows carry G–L scope/severity codes; 0 carry J–L. 17 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-02-09 · HEALTHF0561Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Correction field: Deficient, Provider has date of correction · 2026-03-312026-02-09 · HEALTHF0585Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2026-03-312026-02-09 · HEALTHF0606Severity F · widespread; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Not hire anyone with a finding of abuse, neglect, exploitation, or theft.
Correction field: Deficient, Provider has date of correction · 2026-03-312026-02-09 · HEALTHF0609Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Deficient, Provider has date of correction · 2026-03-31 · complaint2026-02-09 · HEALTHF0610Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
Correction field: Deficient, Provider has date of correction · 2026-03-31 · complaint2026-02-09 · HEALTHF0628Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Correction field: Deficient, Provider has date of correction · 2026-03-312026-02-09 · HEALTHF0657Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Correction field: Deficient, Provider has date of correction · 2026-03-312026-02-09 · HEALTHF0684Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2026-03-31 · complaint2026-02-09 · HEALTHF0686Severity H · pattern of actual harm
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2026-04-272026-02-09 · HEALTHF0688Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Correction field: Deficient, Provider has date of correction · 2026-03-312026-02-09 · HEALTHF0689Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2026-04-27 · complaint2026-02-09 · HEALTHF0690Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Correction field: Deficient, Provider has date of correction · 2026-03-312026-02-09 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2026-03-312026-02-09 · HEALTHF0732Severity C · widespread; potential for minimal harm
Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
Correction field: Deficient, Provider has date of correction · 2026-03-31 · complaint2026-02-09 · HEALTHF0744Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
Correction field: Deficient, Provider has date of correction · 2026-03-312026-02-09 · HEALTHF0755Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Correction field: Deficient, Provider has date of correction · 2026-03-31 · complaint2026-02-09 · HEALTHF0756Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Correction field: Deficient, Provider has date of correction · 2026-03-312026-02-09 · HEALTHF0757Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Correction field: Deficient, Provider has date of correction · 2026-03-312026-02-09 · HEALTHF0759Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
Correction field: Deficient, Provider has date of correction · 2026-03-31 · complaint2026-02-09 · HEALTHF0761Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2026-03-312026-02-09 · HEALTHF0842Severity F · widespread; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2026-03-312026-02-09 · HEALTHF0865Severity F · widespread; potential for more than minimal harm
Administration Deficiencies
Have a plan that describes the process for conducting QAPI and QAA activities.
Correction field: Deficient, Provider has date of correction · 2026-03-312026-02-09 · HEALTHF0868Severity F · widespread; potential for more than minimal harm
Administration Deficiencies
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Correction field: Deficient, Provider has date of correction · 2026-03-312026-02-09 · HEALTHF0880Severity F · widespread; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2026-03-3103 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2024-09-23 | Payment Denial | $0 | 19 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- ASCENSION HEALTH SENIOR CAREOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 07/01/2014
- MUSGRAVE, LISAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2024
- SHADBOLT, ERINIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2024
- SMOOT, KENNETHIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2024
- SHADBOLT, ERINIndividual · CORPORATE OFFICERNOT APPLICABLE · since 10/17/2022
- AJAYI, OLUSOLAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/19/2025
- SIDHU, SARFRAZIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/01/2025
- ASCENSION HEALTH SENIOR CAREOrganization · ADP OF THE SNFNOT APPLICABLE · since 07/14/2015
- HEALTH DIMENSIONS CONSULTING INCOrganization · ADP OF THE SNFNOT APPLICABLE · since 08/02/2019
- HOUSE HEALTHCARE SOLUTIONS LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 06/10/2025
- INTELYCARE INCOrganization · ADP OF THE SNFNOT APPLICABLE · since 02/08/2022
- MEDICAL SOLUTIONS LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 06/14/2017
- METIS LTC LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 09/02/2024
- PERSONNEL SPECIALISTS LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 04/10/2025
- PROLINK HEALTHCARE LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 04/26/2023
- AJAYI, OLUSOLAIndividual · ADP OF THE SNFNOT APPLICABLE · since 05/19/2025
- MUSGRAVE, LISAIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2024
- SHADBOLT, ERINIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2024
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours4.70per resident day
RN hours0.96per resident day
Weekend nurse hours4.05per resident day
Staff turnover73.3%CMS reported field
06 / LOCAL RECORDS
Open the Racine ledger →