01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-06-11 | 5 | 2025-06-11 | 2 |
| Cycle 2 | 2024-02-22 | 1 | 2024-02-22 | 4 |
| Cycle 3 | 2022-11-14 | 4 | 2022-11-14 | 2 |
CMS CCN 5255602026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Shorehaven Hlth & Rehab Ctr
1305 W Wisconsin Ave · Oconomowoc, WI 53066 · Waukesha County
Certified beds88CMS provider file
Recent citation rows18current 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
18 rows in the current release
2 rows carry G–L scope/severity codes; 0 carry J–L. 2 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-03-05 · 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 · 2026-03-17 · complaint2026-03-05 · 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 · 2026-03-06 · complaint2025-06-11 · 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 · 2025-07-082025-06-11 · 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 · 2025-07-082025-06-11 · 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 · 2025-07-082025-06-11 · FIREK0324Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2025-06-262025-06-11 · FIREK0712Severity D · isolated; potential for more than minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2025-06-262024-06-25 · 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 · 2024-08-09 · complaint2024-02-22 · HEALTHF0812Severity E · pattern; 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 · 2024-03-142024-02-22 · 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 · 2024-03-122024-02-22 · FIREK0362Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.
Correction field: Deficient, Provider has date of correction · 2024-02-232024-02-22 · FIREK0711Severity C · widespread; potential for minimal harm
Miscellaneous Deficiencies
Provide a written emergency evacuation plan.
Correction field: Deficient, Provider has date of correction · 2024-03-202024-02-22 · FIREK0791Severity E · pattern; potential for more than minimal harm
Miscellaneous Deficiencies
Ensure that any exit in an area undergoing construction, repair, or improvements shall be inspected daily to ensure its ability to be used instantly in case of emergency.
Correction field: Deficient, Provider has date of correction · 2024-03-112022-11-14 · HEALTHF0644Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Correction field: Deficient, Provider has date of correction · 2023-01-042022-11-14 · 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 · 2023-01-312022-11-14 · HEALTHF0758Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Correction field: Deficient, Provider has date of correction · 2023-01-042022-11-14 · FIREK0293Severity D · isolated; potential for more than minimal harm
Egress Deficiencies
Have properly located and lighted "Exit" signs.
Correction field: Deficient, Provider has date of correction · 2022-12-032022-11-14 · FIREK0324Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Waiver has been granted · 2022-12-0303 / 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 |
|---|---|---|---|
| 2024-06-25 | Payment Denial | $0 | 13 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- BERGIN, SCOTTIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 06/10/2024
- BORAY, JOHATHANIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/20/2022
- BOYER-RUAN, BETHIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/19/2023
- BUSCEMI, ALFONSOIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/17/2024
- LAMMERS, JOELIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/24/2021
- LENTZ, WILLIAMIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/21/2021
- MAYER, ROGERIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/20/2022
- MILLER, MARYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/21/2021
- O'MALLEY, MARYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/24/2019
- RATZEL, MARY LEEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/01/2015
- SOKOP, MARYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/24/2018
- BERGIN, SCOTTIndividual · CORPORATE OFFICERNOT APPLICABLE · since 06/10/2024
- HOLLAND, PHILIPIndividual · CORPORATE OFFICERNOT APPLICABLE · since 10/21/2021
- COOPER, WILLIAMIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/27/2024
- DAHLKE, DALEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/08/2018
- KARLS, EMILYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/26/2024
- POLINSKE, BRYANIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/30/2018
- COOPER, WILLIAMIndividual · ADP OF THE SNFNOT APPLICABLE · since 12/05/2024
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 hours5.41per resident day
RN hours1.33per resident day
Weekend nurse hours4.87per resident day
Staff turnover38.8%CMS reported field
06 / LOCAL RECORDS
Open the Oconomowoc ledger →