01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-08-27 | 2 | 2025-08-27 | 4 |
| Cycle 2 | 2024-06-20 | 26 | 2024-06-20 | 7 |
| Cycle 3 | 2023-04-12 | 14 | 2023-04-12 | 5 |
CMS CCN 5257022026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Lake Country Health Services
2195 North Summit Village Way · Oconomowoc, WI 53066 · Waukesha County
Certified beds100CMS provider file
Recent citation rows58current CMS citation release
Penalty rows3current 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
58 rows in the current release
4 rows carry G–L scope/severity codes; 3 carry J–L. 13 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-08-27 · 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 · 2025-09-162025-08-27 · 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 · 2025-09-162025-08-27 · FIREK0271Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Have exits that are accessible at all times.
Correction field: Deficient, Provider has date of correction · 2025-09-162025-08-27 · FIREK0353Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2025-09-162025-08-27 · FIREK0712Severity C · widespread; potential for minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2025-09-162025-08-27 · FIREK0923Severity E · pattern; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have proper medical gas storage and administration areas.
Correction field: Deficient, Provider has date of correction · 2025-09-162025-03-12 · HEALTHF0578Severity J · isolated immediate jeopardy
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 · 2025-04-02 · complaint2025-03-12 · HEALTHF0678Severity E · pattern; potential for more than minimal harm
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: Deficient, Provider has date of correction · 2025-04-02 · complaint2025-03-12 · HEALTHF0760Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2025-04-02 · complaint2024-11-04 · 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 · 2024-12-12 · complaint2024-11-04 · 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 · 2024-12-12 · complaint2024-11-04 · HEALTHF0600Severity J · isolated immediate jeopardy
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Correction field: Deficient, Provider has date of correction · 2024-12-12 · complaint2024-11-04 · HEALTHF0609Severity F · widespread; 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 · 2024-12-12 · complaint2024-11-04 · HEALTHF0610Severity F · widespread; 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 · 2024-12-12 · complaint2024-11-04 · HEALTHF0620Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Not require residents to give up Medicare or Medicaid benefits, or pay privately as a condition of admission; and must tell residents what care they do not provide.
Correction field: Deficient, Provider has date of correction · 2024-12-12 · complaint2024-11-04 · HEALTHF0657Severity D · isolated; 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 · 2024-12-12 · complaint2024-11-04 · HEALTHF0660Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Plan the resident's discharge to meet the resident's goals and needs.
Correction field: Deficient, Provider has date of correction · 2024-12-12 · complaint2024-11-04 · HEALTHF0677Severity D · isolated; 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 · 2024-12-12 · complaint2024-11-04 · HEALTHF0684Severity J · isolated immediate jeopardy
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 · 2024-12-12 · complaint2024-11-04 · 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 · 2024-12-12 · complaint2024-11-04 · 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 · 2024-12-12 · complaint2024-11-04 · HEALTHF0725Severity E · pattern; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2024-12-12 · complaint2024-11-04 · HEALTHF0825Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide or get specialized rehabilitative services as required for a resident.
Correction field: Deficient, Provider has date of correction · 2024-12-12 · complaint2024-06-20 · HEALTHF0623Severity E · pattern; 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 · 2024-07-1903 / 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 |
|---|---|---|---|
| 2025-03-12 | Fine | $16,985 | 0 |
| 2024-11-04 | Fine | $103,883 | 0 |
| 2024-11-04 | Payment Denial | $0 | 8 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- NSHF OPERATIONS LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 07/24/2017
- MILLS, DAVIDIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST20% · since 06/29/2017
- CIBC BANK USAOrganization · 5% OR GREATER SECURITY INTERESTNOT APPLICABLE · since 12/03/2025
- BAUMANN, TROYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/29/2017
- HOEHN, JEFFREYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/29/2017
- CIBC BANK USAOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/03/2025
- CLIFTONLARSONALLEN LLPOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/22/2018
- CONTINUUM THERAPY PARTNERS LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/01/2025
- NORTH SHORE HEALTHCARE LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/01/2017
- NSH REHAB LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/01/2025
- WIPFLI LLPOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2025
- BAUMANN, TROYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/01/2017
- BELONGIA, CHRISTINAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/01/2019
- GEE, DARRENIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/30/2021
- GREER, LAURENIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/29/2023
- HAMM, CARAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2026
- HOEHN, JEFFREYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/01/2017
- PATZER, COLLEENIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/14/2023
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 hours3.54per resident day
RN hours0.97per resident day
Weekend nurse hours3.24per resident day
Staff turnover51.8%CMS reported field
06 / LOCAL RECORDS
Open the Oconomowoc ledger →