01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-06-03 | 16 | 2026-06-03 | 8 |
| Cycle 2 | 2025-05-07 | 14 | 2025-05-07 | 8 |
| Cycle 3 | 2024-04-24 | 18 | 2024-04-24 | 12 |
CMS CCN 5254942026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Serenity Spring Senior Living At Scandia Village
10560 Applewood Rd · Sister Bay, WI 54234 · Door County
Certified beds50CMS provider file
Recent citation rows76current 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
76 rows in the current release
1 rows carry G–L scope/severity codes; 0 carry J–L. 16 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-06-03 · HEALTHF0576Severity C · widespread; potential for minimal harm
Resident Rights Deficiencies
Ensure residents have reasonable access to and privacy in their use of communication methods.
Correction field: Deficient, Provider has date of correction · 2026-07-012026-06-03 · HEALTHF0578Severity D · isolated; 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 · 2026-07-012026-06-03 · 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 · 2026-07-01 · complaint2026-06-03 · 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 · 2026-07-01 · complaint2026-06-03 · 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 · 2026-07-01 · complaint2026-06-03 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2026-07-012026-06-03 · 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 · 2026-07-012026-06-03 · HEALTHF0686Severity D · isolated; potential for more than minimal 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 · 2026-07-01 · complaint2026-06-03 · 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 · 2026-07-01 · complaint2026-06-03 · 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 · 2026-07-012026-06-03 · 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 · 2026-07-012026-06-03 · 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 · 2026-07-012026-06-03 · 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 · 2026-07-012026-06-03 · FIREK0321Severity E · pattern; 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 · 2026-07-152026-06-03 · FIREK0324Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2026-07-152026-06-03 · FIREK0331Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Construct fire resistant interior walls.
Correction field: Deficient, Provider has date of correction · 2026-07-152026-06-03 · FIREK0341Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Install a fire alarm system that can be heard throughout the facility.
Correction field: Deficient, Provider has date of correction · 2026-07-152026-06-03 · 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 · 2026-07-152026-06-03 · 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 · 2026-07-152026-06-03 · 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 · 2026-07-152026-06-03 · 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 · 2026-07-152026-02-10 · 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 · 2026-03-07 · complaint2026-02-10 · HEALTHF0686Severity G · isolated 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 · 2026-07-01 · complaint2026-02-10 · HEALTHF0803Severity E · pattern; 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 · 2026-03-07 · 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 |
|---|---|---|---|
| 2026-02-10 | Payment Denial | $0 | 131 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- SCANDIA VILLAGE MEMBER LLCOrganization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 01/25/2024
- BRUCKSTEIN, DANIELIndividual · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 01/25/2024
- EISENBERG, ANDREWIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 01/25/2024
- SISTER BAY SNF REALTY LLCOrganization · 5% OR GREATER MORTGAGE INTERESTNOT APPLICABLE · since 01/25/2024
- LITMAN, WARRENIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/01/2024
- DORN, CHERYLIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/25/2024
- MANDELBAUM, DANIELIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/25/2024
- CONTINUUM HEALTHCARE I INCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/01/2023
- FASTEN HALBERSTAM LLPOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/25/2024
- WIPFLI ADVISORY LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/25/2024
- DORN, CHERYLIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/25/2024
- JOHNSON, RORYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/25/2024
- LITMAN, WARRENIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/01/2024
- MANDELBAUM, DANIELIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/25/2024
- SCHMITZ, ARTHURIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/25/2024
- CONTINUUM HEALTHCARE I INCOrganization · ADP OF THE SNFNOT APPLICABLE · since 11/06/2025
- FASTEN HALBERSTAM LLPOrganization · ADP OF THE SNFNOT APPLICABLE · since 11/17/2025
- GRAPE TREE MEDICAL STAFFING LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 06/01/2023
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 hours3.45per resident day
RN hours0.65per resident day
Weekend nurse hours2.94per resident day
Staff turnover70.4%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.