01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-05-07 | 12 | 2025-05-07 | 8 |
| Cycle 2 | 2024-03-12 | 16 | 2024-03-12 | 14 |
| Cycle 3 | 2023-03-08 | 14 | 2023-03-08 | 3 |
CMS CCN 5255592026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Odd Fellow Home
1229 S Jackson St · Green Bay, WI 54301 · Brown County
Certified beds88CMS provider file
Recent citation rows67current CMS citation release
Penalty rows18current 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
67 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 13 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-02-02 · HEALTHF0755Severity D · isolated; 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 · 2026-03-02 · complaint2025-11-18 · 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 · 2025-12-15 · complaint2025-11-18 · 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 · 2025-12-15 · complaint2025-11-18 · HEALTHF0755Severity D · isolated; 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 · 2025-12-15 · complaint2025-10-08 · 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 · 2025-12-16 · complaint2025-05-07 · 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 · 2025-07-092025-05-07 · HEALTHF0645Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
Correction field: Deficient, Provider has plan of correction · 2025-06-072025-05-07 · HEALTHF0698Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Correction field: Deficient, Provider has plan of correction · 2025-06-072025-05-07 · HEALTHF0755Severity D · isolated; 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 plan of correction · 2025-06-072025-05-07 · 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 plan of correction · 2025-06-072025-05-07 · HEALTHF0880Severity E · pattern; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has plan of correction · 2025-06-072025-05-07 · HEALTHF0881Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Implement a program that monitors antibiotic use.
Correction field: Deficient, Provider has plan of correction · 2025-06-072025-05-07 · HEALTHF0882Severity F · widespread; potential for more than minimal harm
Infection Control Deficiencies
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Correction field: Deficient, Provider has plan of correction · 2025-06-072025-05-07 · FIREK0222Severity D · isolated; 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 · 2025-05-282025-05-07 · 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 · 2025-06-072025-05-07 · FIREK0353Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2025-06-072025-05-07 · FIREK0355Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Properly select, install, inspect, or maintain portable fire extinguishes.
Correction field: Deficient, Provider has date of correction · 2025-06-072025-05-07 · FIREK0511Severity E · pattern; potential for more than minimal harm
Services Deficiencies
Have properly installed electrical wiring and gas equipment.
Correction field: Deficient, Provider has date of correction · 2025-06-072025-05-07 · FIREK0521Severity F · widespread; potential for more than minimal harm
Services Deficiencies
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Correction field: Deficient, Provider has date of correction · 2025-07-092025-05-07 · 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 · 2025-06-072025-01-09 · 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 · 2025-02-09 · complaint2025-01-09 · 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 · 2025-02-09 · complaint2025-01-09 · 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 · 2025-02-09 · complaint2025-01-09 · HEALTHF0803Severity D · isolated; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Correction field: Deficient, Provider has date of correction · 2025-02-09 · complaint03 / 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 |
|---|---|---|---|
| 2024-02-20 | Fine | $4,938 | 0 |
| 2024-02-12 | Fine | $4,938 | 0 |
| 2024-01-22 | Fine | $14,814 | 0 |
| 2024-01-08 | Fine | $4,938 | 0 |
| 2024-01-02 | Fine | $4,587 | 0 |
| 2023-12-11 | Fine | $13,762 | 0 |
| 2023-11-20 | Fine | $4,587 | 0 |
| 2023-11-13 | Fine | $4,587 | 0 |
| 2023-11-06 | Fine | $4,587 | 0 |
| 2023-10-30 | Fine | $4,587 | 0 |
| 2023-10-23 | Fine | $4,545 | 0 |
| 2023-10-17 | Fine | $4,235 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- KOHN, DAN-AIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 06/15/2022
- KOHN, DAN-AIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/15/2022
- CUNNINGHAM, LORENIndividual · CORPORATE OFFICERNOT APPLICABLE · since 06/13/2016
- EVERETT, CHARLENEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 06/13/2022
- JONES, JEFFREYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 06/10/2019
- MOTT, PATRICIAIndividual · CORPORATE OFFICERNOT APPLICABLE · since 06/13/2016
- OLSEN, DENISEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 06/13/2016
- PROULX, RICHARDIndividual · CORPORATE OFFICERNOT APPLICABLE · since 08/06/2011
- TEWS, ELLENIndividual · CORPORATE OFFICERNOT APPLICABLE · since 06/13/2016
- KOHN, DAN-AIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/15/2022
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 hours3.74per resident day
RN hours0.68per resident day
Weekend nurse hours3.46per resident day
Staff turnover56.3%CMS reported field
06 / LOCAL RECORDS
Open the Green Bay ledger →Other published facilities nearby
Brown Cty Comm Treatment Ctr-Bayshore Village63 beds · CMS overall 5/537 citation rowsEdenbrook Of Green Bay90 beds · CMS overall 3/559 citation rowsGreen Bay Health Services125 beds · CMS overall 2/544 citation rowsSerenity Spring Senior Living At Green Bay64 beds · CMS overall 5/522 citation rowsWoodside Lutheran Home118 beds · CMS overall 5/521 citation rows