01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-10-13 | 34 | 2025-10-13 | 18 |
| Cycle 2 | 2024-07-11 | 30 | 2024-07-11 | 11 |
| Cycle 3 | 2023-03-30 | 10 | 2023-03-30 | 11 |
CMS CCN 5253312026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Ingleside Manor
407 N Eighth St · Mount Horeb, WI 53572 · Dane County
Certified beds80CMS provider file
Recent citation rows114current CMS citation release
Penalty rows7current 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
114 rows in the current release
6 rows carry G–L scope/severity codes; 3 carry J–L. 28 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-10-13 · FIREE0013Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Develop Emergency Preparedness policies and procedures.
Correction field: Deficient, Provider has date of correction · 2025-11-102025-10-13 · FIREE0039Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Correction field: Deficient, Provider has date of correction · 2025-11-102025-10-13 · HEALTHF0565Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to organize and participate in resident/family groups in the facility.
Correction field: Deficient, Provider has date of correction · 2025-11-102025-10-13 · HEALTHF0578Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2025-11-102025-10-13 · HEALTHF0584Severity E · pattern; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2025-11-102025-10-13 · 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 · 2025-11-102025-10-13 · 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 · 2025-11-102025-10-13 · HEALTHF0686Severity J · isolated immediate jeopardy
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 · 2025-12-162025-10-13 · 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 · 2025-11-102025-10-13 · HEALTHF0692Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Correction field: Deficient, Provider has date of correction · 2025-11-102025-10-13 · 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 · 2025-11-102025-10-13 · HEALTHF0761Severity D · isolated; 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 · 2025-11-102025-10-13 · HEALTHF0806Severity D · isolated; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2025-11-102025-10-13 · HEALTHF0849Severity D · isolated; potential for more than minimal harm
Administration Deficiencies
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
Correction field: Deficient, Provider has date of correction · 2025-11-102025-10-13 · HEALTHF0867Severity D · isolated; potential for more than minimal harm
Administration Deficiencies
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Correction field: Deficient, Provider has date of correction · 2025-11-102025-10-13 · 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 · 2025-11-102025-10-13 · HEALTHF0883Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Correction field: Deficient, Provider has date of correction · 2025-11-102025-10-13 · FIREK0223Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
Correction field: Deficient, Provider has date of correction · 2025-11-102025-10-13 · 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 · 2025-11-102025-10-13 · FIREK0331Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Construct fire resistant interior walls.
Correction field: Deficient, Provider has date of correction · 2025-11-102025-10-13 · FIREK0345Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2025-11-102025-10-13 · 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 · 2025-11-102025-10-13 · FIREK0374Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Correction field: Deficient, Provider has date of correction · 2025-11-102025-10-13 · FIREK0511Severity D · isolated; potential for more than minimal harm
Services Deficiencies
Have properly installed electrical wiring and gas equipment.
Correction field: Deficient, Provider has date of correction · 2025-11-1003 / 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 |
|---|---|---|---|
| 2025-10-13 | Fine | $83,597 | 0 |
| 2025-10-13 | Payment Denial | $0 | 35 |
| 2025-06-10 | Fine | $20,420 | 0 |
| 2025-06-10 | Fine | $128,700 | 0 |
| 2025-06-10 | Payment Denial | $0 | 68 |
| 2024-07-11 | Fine | $36,946 | 0 |
| 2023-11-01 | Fine | $13,397 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- DUPONT, LORIIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/25/2016
- GEHLER, MIRIAMIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2017
- KERWIN, ANDREWIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/26/2009
- KUMAR, RAJEEV SHIVAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/24/2012
- LACKE (CARRIG), KARENIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2016
- LYNN, NICHOLASIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 03/14/2011
- CARRIAGE HEALTHCARE COMPANIES INCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/09/2012
- PASZCZAK, MATTHEWIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/05/2023
- SHERMAN, STEPHANIEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/12/2012
- CARRIAGE HEALTHCARE COMPANIES INCOrganization · ADP OF THE SNFNOT APPLICABLE · since 10/06/2025
- HBT IT LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 07/01/2024
- JT AND ASSOCIATES LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 01/01/2010
- PARTNERS IN WEALTH MANAGEMENT, INCOrganization · ADP OF THE SNFNOT APPLICABLE · since 01/01/2024
- PINION, LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 01/01/1995
- REHAB SOLUTIONS GROUP, LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 01/01/2024
- TWOMAGNETS LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 01/01/2022
- PASZCZAK, MATTHEWIndividual · ADP OF THE SNFNOT APPLICABLE · since 03/05/2023
- SHERMAN, STEPHANIEIndividual · ADP OF THE SNFNOT APPLICABLE · since 08/12/2012
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 hours4.15per resident day
RN hours1.06per resident day
Weekend nurse hours3.59per resident day
Staff turnover80.6%CMS reported field
06 / LOCAL RECORDS
Open the Wisconsin ledger →Other published facilities nearby
No second facility in the same city met the directory rule.