01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-01-20 | 9 | 2026-01-20 | 7 |
| Cycle 2 | 2024-09-25 | 17 | 2024-09-25 | 8 |
| Cycle 3 | 2023-07-19 | 2 | 2023-07-19 | 7 |
CMS CCN 5255982026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Sheboygan Senior Community Inc
3505 County Road Y · Sheboygan, WI 53083 · Sheboygan County
Certified beds60CMS provider file
Recent citation rows50current CMS citation release
Penalty rows0current 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
50 rows in the current release
1 rows carry G–L scope/severity codes; 0 carry J–L. 8 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-01-20 · 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 · 2026-02-162026-01-20 · HEALTHF0552Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Ensure that residents are fully informed and understand their health status, care and treatments.
Correction field: Deficient, Provider has date of correction · 2026-02-182026-01-20 · 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 · 2026-02-182026-01-20 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2026-02-182026-01-20 · HEALTHF0684Severity G · isolated actual 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 · 2026-03-10 · complaint2026-01-20 · 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 · 2026-03-102026-01-20 · 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 · 2026-02-182026-01-20 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2026-02-182026-01-20 · 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 date of correction · 2026-02-182026-01-20 · 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 · 2026-02-182026-01-20 · FIREK0132Severity E · pattern; potential for more than minimal harm
Construction Deficiencies
Meet requirements for outpatient facilities located next to inpatient facilities separated by fire resistive construction.
Correction field: Deficient, Provider has plan of correction2026-01-20 · FIREK0324Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2026-02-162026-01-20 · FIREK0345Severity C · widespread; potential for minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2026-02-162026-01-20 · FIREK0511Severity F · widespread; potential for more than minimal harm
Services Deficiencies
Have properly installed electrical wiring and gas equipment.
Correction field: Deficient, Provider has date of correction · 2026-02-162026-01-20 · FIREK0541Severity D · isolated; potential for more than minimal harm
Services Deficiencies
Install properly constructed and protected linen or trash chutes.
Correction field: Deficient, Provider has date of correction · 2026-02-162026-01-20 · 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 · 2026-02-162025-02-27 · 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 · 2025-03-26 · complaint2025-02-27 · 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 · 2025-03-26 · complaint2024-09-25 · 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 · 2024-10-112024-09-25 · HEALTHF0550Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Correction field: Deficient, Provider has date of correction · 2024-11-082024-09-25 · 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 · 2024-11-082024-09-25 · HEALTHF0582Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Correction field: Deficient, Provider has date of correction · 2024-11-082024-09-25 · 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 · 2024-11-082024-09-25 · HEALTHF0625Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Correction field: Deficient, Provider has date of correction · 2024-11-0803 / 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 |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- BANK FIRST NATIONALOrganization · 5% OR GREATER MORTGAGE INTERESTNOT APPLICABLE · since 02/26/2010
- UNITED STATES DEPARTMENT OF AGRICULTURE - RURAL DEVELOPMENTOrganization · 5% OR GREATER MORTGAGE INTERESTNOT APPLICABLE · since 12/01/2016
- HOLZEM, TARAIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 05/24/2014
- CLAPP, ROGERIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2011
- FRITZ, PERRYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2014
- GENSCH, BRIANIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/01/2017
- HAMER, STEPHENIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2011
- HOUWERS, JAMESIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2011
- ISKEN, KEITHIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/01/2017
- KERPE, MARSHAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2011
- PRICE, JAMESIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2011
- THEUNE, DORISIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2011
- THOMPSON, CYNTHIAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2015
- TRAGER, MARGARETIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/01/2017
- VANDEWATER, DAVIDIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2014
- HOUWERS, JAMESIndividual · CORPORATE OFFICERNOT APPLICABLE · since 07/01/2011
- THEUNE, DORISIndividual · CORPORATE OFFICERNOT APPLICABLE · since 07/01/2011
- VANDEWATER, DAVIDIndividual · CORPORATE OFFICERNOT APPLICABLE · since 07/01/2014
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 hours4.26per resident day
RN hours0.29per resident day
Weekend nurse hours4.04per resident day
Staff turnover36.8%CMS reported field
06 / LOCAL RECORDS
Open the Sheboygan ledger →Other published facilities nearby
Edenbrook Sheboygan121 beds · CMS overall 1/573 citation rowsMeadow 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 rows