01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-04-30 | 14 | 2025-04-30 | 10 |
| Cycle 2 | 2024-02-28 | 12 | 2024-02-28 | 14 |
| Cycle 3 | 2023-01-25 | 12 | 2023-01-25 | 11 |
CMS CCN 5255682026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Edenbrook Sheboygan
3014 Erie Ave · Sheboygan, WI 53081 · Sheboygan County
Certified beds121CMS provider file
Recent citation rows73current CMS citation release
Penalty rows4current 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
73 rows in the current release
5 rows carry G–L scope/severity codes; 4 carry J–L. 19 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-07-01 · HEALTHF0678Severity J · isolated immediate jeopardy
Quality of Life and Care Deficiencies
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
Correction field: Past Non-Compliance · 2026-06-16 · complaint2026-02-04 · HEALTHF0553Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
Correction field: Deficient, Provider has date of correction · 2026-02-23 · complaint2026-02-04 · HEALTHF0689Severity E · pattern; potential for more than minimal 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 · 2026-02-23 · complaint2025-12-17 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2026-01-12 · complaint2025-12-17 · HEALTHF0684Severity D · isolated; 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 · 2026-01-12 · complaint2025-12-17 · HEALTHF0689Severity J · isolated immediate jeopardy
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 · 2026-01-12 · complaint2025-12-17 · HEALTHF0812Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2026-01-12 · complaint2025-09-03 · HEALTHF0605Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Correction field: Deficient, Provider has date of correction · 2025-10-02 · complaint2025-07-09 · HEALTHF0677Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Correction field: Deficient, Provider has date of correction · 2025-07-29 · complaint2025-04-30 · HEALTHF0551Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Give the resident's representative the ability to exercise the resident's rights.
Correction field: Deficient, Provider has date of correction · 2025-05-302025-04-30 · HEALTHF0623Severity D · isolated; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2025-05-302025-04-30 · HEALTHF0644Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Correction field: Deficient, Provider has date of correction · 2025-05-302025-04-30 · HEALTHF0689Severity D · isolated; potential for more than minimal 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 · 2025-05-302025-04-30 · HEALTHF0812Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2025-05-302025-04-30 · HEALTHF0880Severity D · isolated; 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 · 2025-05-302025-04-30 · FIREK0222Severity F · widespread; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2025-05-302025-04-30 · FIREK0291Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Install emergency lighting that can last at least 1 1/2 hours.
Correction field: Deficient, Provider has date of correction · 2025-05-302025-04-30 · FIREK0321Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Correction field: Deficient, Provider has date of correction · 2025-07-292025-04-30 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2026-04-142025-04-30 · FIREK0363Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2025-05-302025-04-30 · FIREK0712Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2025-05-302025-04-30 · FIREK0761Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Correction field: Deficient, Provider has date of correction · 2025-05-302025-04-30 · FIREK0914Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Correction field: Deficient, Provider has date of correction · 2025-05-302025-04-30 · FIREK0918Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Correction field: Deficient, Provider has date of correction · 2025-05-3003 / 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 |
|---|---|---|---|
| 2025-12-17 | Fine | $142,630 | 0 |
| 2025-02-26 | Fine | $161,788 | 0 |
| 2024-07-11 | Fine | $14,053 | 0 |
| 2024-02-28 | Fine | $27,105 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- SR OPCO LLCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTEREST40% · since 01/01/2025
- SUNNY RIDGE INVESTORS LLCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTEREST60% · since 01/01/2025
- LIFSICS, CHANNIEIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 01/01/2025
- MAUER, DOVIEIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 01/01/2025
- POLSTEIN, MORDECHAIIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 01/01/2025
- STESEL, MAXIMIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 01/01/2025
- ZAHLER, CHARLESIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 01/01/2025
- SHEBOYGAN SNF REALTY LLCOrganization · 5% OR GREATER MORTGAGE INTERESTNOT APPLICABLE · since 01/01/2025
- LIFSICS, CHANNIEIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2025
- MAUER, DOVIEIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2025
- POLSTEIN, MORDECHAIIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2025
- STESEL, MAXIMIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2025
- ZARKH, GLEBIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2025
- EDEN SENIOR CARE LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2025
- LIFSICS, CHANNIEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2025
- MAUER, DOVIEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2025
- POLSTEIN, MORDECHAIIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2025
- RADEMACHER, EMILYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2025
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 hours3.26per resident day
RN hours0.64per resident day
Weekend nurse hours2.86per resident day
Staff turnover55.1%CMS reported field
06 / LOCAL RECORDS
Open the Sheboygan ledger →Other published facilities nearby
Meadow View Health Services50 beds · CMS overall 4/527 citation rowsMorningside Health Services50 beds · CMS overall 3/527 citation rowsSheboygan Health Services64 beds · CMS overall 3/530 citation rowsSheboygan Progressive Health Services50 beds · CMS overall 1/533 citation rowsSheboygan Senior Community Inc60 beds · CMS overall 1/550 citation rows