CMS PUBLIC RECORD · AUGUST 2026 RELEASERECORDS ARE ONE INPUT—NOT A PLACEMENT RECOMMENDATION
NURSING HOMELEDGERINSPECTIONS · OWNERSHIP · PENALTIES
CMS CCN 5254972026-08-01 PROCESSING DATE

NURSING HOME PUBLIC RECORD

The Pines Post Acute And Memory Care

CMS lists this provider in Clintonville, WI, with 50 certified beds, an overall rating of 4/5, and 32 citation rows in the current August 2026 release.

1625 E Main St · Clintonville, WI 54929 · Waupaca County

CMS OVERALL RATING★★★★☆4/5CMS field—not our score or recommendation
Certified beds50CMS provider file
Recent citation rows32current 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.

01 / INSPECTION LEDGER

The Pines Post Acute And Memory Care survey cycles in this release

CMS supplies 3 survey-cycle rows for The Pines Post Acute And Memory Care in this release; health and fire inspection dates remain separate.

CycleHealth dateHealth deficienciesFire dateFire deficiencies
Cycle 12025-07-1762025-07-175
Cycle 22024-05-1592024-05-157
Cycle 32023-05-1032023-05-102
02 / CITATION DETAIL

The Pines Post Acute And Memory Care citations in the current release

CMS reports 32 citation rows, including 2 with G–L codes and 1 with J–L codes.

2 rows carry G–L scope/severity codes; 1 carry J–L. 6 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.

2025-07-17 · HEALTHF0558Severity D · isolated; potential for more than minimal harm

Resident Rights Deficiencies

Reasonably accommodate the needs and preferences of each resident.

Correction field: Deficient, Provider has date of correction · 2025-08-08
2025-07-17 · 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 · 2025-08-08
2025-07-17 · 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 · 2025-08-08
2025-07-17 · 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 · 2025-08-08
2025-07-17 · 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 date of correction · 2025-08-08
2025-07-17 · 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 · 2025-08-08
2025-07-17 · 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 · 2025-08-21
2025-07-17 · FIREK0324Severity E · pattern; potential for more than minimal harm

Smoke Deficiencies

Provide properly protected cooking facilities.

Correction field: Deficient, Provider has date of correction · 2025-08-08
2025-07-17 · FIREK0345Severity F · widespread; potential for more than minimal harm

Smoke Deficiencies

Have approved installation, maintenance and testing program for fire alarm systems.

Correction field: Deficient, Provider has date of correction · 2025-08-08
2025-07-17 · FIREK0355Severity E · pattern; 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 · 2025-08-08
2025-07-17 · 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 · 2025-08-08
2025-06-19 · HEALTHF0607Severity D · isolated; potential for more than minimal harm

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Develop and implement policies and procedures to prevent abuse, neglect, and theft.

Correction field: Deficient, Provider has date of correction · 2025-07-04 · complaint
2025-06-19 · 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 · 2025-07-04 · complaint
2025-05-01 · HEALTHF0604Severity J · isolated immediate jeopardy

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.

Correction field: Past Non-Compliance · 2025-04-02 · complaint
2025-05-01 · HEALTHF0607Severity D · isolated; potential for more than minimal harm

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Develop and implement policies and procedures to prevent abuse, neglect, and theft.

Correction field: Deficient, Provider has date of correction · 2025-05-28 · complaint
2024-05-15 · FIREE0025Severity F · widespread; potential for more than minimal harm

Emergency Preparedness Deficiencies

Create arrangements with other facilities to receive patients.

Correction field: Deficient, Provider has date of correction · 2024-06-07
2024-05-15 · 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 · 2024-06-10
2024-05-15 · 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 · 2024-06-10
2024-05-15 · 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 date of correction · 2024-06-10
2024-05-15 · 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 · 2024-06-10
2024-05-15 · 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 · 2024-06-10
2024-05-15 · FIREK0211Severity D · isolated; potential for more than minimal harm

Egress Deficiencies

Keep aisles, corridors, and exits free of obstruction in case of emergency.

Correction field: Deficient, Provider has date of correction · 2024-06-10
2024-05-15 · FIREK0311Severity E · pattern; potential for more than minimal harm

Smoke Deficiencies

Have an enclosure around a vertical opening shaft.

Correction field: Deficient, Provider has date of correction · 2024-06-07
2024-05-15 · 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 · 2024-06-07
03 / ENFORCEMENT FILE

CMS penalties reported for The Pines Post Acute And Memory Care

The August 2026 file contains 1 penalty row and $11,960 in listed fines for this provider record.

Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.

DateTypeFine amountPayment-denial days
2025-06-19Fine$11,9600
04 / OWNERSHIP DISCLOSURES

Ownership disclosures for The Pines Post Acute And Memory Care

CMS matched 19 ownership disclosure rows to The Pines Post Acute And Memory Care; names and roles are reported fields, not independently verified identities.

  • GATEWAY HEALTHCARE LLCOrganization · DIRECT OWNERSHIP INTEREST
    NOT APPLICABLE · since 02/01/2014
  • THE ENSIGN GROUP INCOrganization · INDIRECT OWNERSHIP INTEREST
    NOT APPLICABLE · since 05/23/2011
  • BELL, CODYIndividual · MANAGING CONTROL - GOVERNING BODY
    NOT APPLICABLE · since 06/01/2014
  • KAMIN, SHAYNAIndividual · MANAGING CONTROL - GOVERNING BODY
    NOT APPLICABLE · since 11/01/2024
  • BURNAM, SOONIndividual · CORPORATE OFFICER
    NOT APPLICABLE · since 12/20/2013
  • JORGENSEN, DAVIDIndividual · CORPORATE OFFICER
    NOT APPLICABLE · since 09/09/2024
  • KEETCH, CHADIndividual · CORPORATE OFFICER
    NOT APPLICABLE · since 03/01/2011
  • J THOMPSON STAFFING INCOrganization · OPERATIONAL/MANAGERIAL CONTROL
    NOT APPLICABLE · since 06/01/2014
  • KELSTAR LLCOrganization · OPERATIONAL/MANAGERIAL CONTROL
    NOT APPLICABLE · since 06/01/2014
  • PRN HEALTH SERVICES, INC.Organization · OPERATIONAL/MANAGERIAL CONTROL
    NOT APPLICABLE · since 06/01/2014
  • BELL, CODYIndividual · OPERATIONAL/MANAGERIAL CONTROL
    NOT APPLICABLE · since 06/01/2014
  • KAMIN, SHAYNAIndividual · OPERATIONAL/MANAGERIAL CONTROL
    NOT APPLICABLE · since 11/01/2024
  • PORT, BARRYIndividual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
    NOT APPLICABLE · since 10/15/2025
  • ENSIGN SERVICES INCOrganization · ADP OF THE SNF
    NOT APPLICABLE · since 12/20/2013
  • LEGEND LAKE HEALTH HOLDINGS LLCOrganization · ADP OF THE SNF
    NOT APPLICABLE · since 06/01/2014
  • STANDARD BEARER HEALTHCARE OP, LPOrganization · ADP OF THE SNF
    NOT APPLICABLE · since 06/01/2014
  • THE ENSIGN GROUP INCOrganization · ADP OF THE SNF
    NOT APPLICABLE · since 06/01/2014
  • BELL, CODYIndividual · ADP OF THE SNF
    NOT APPLICABLE · since 06/01/2014

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

Staffing hours and turnover for The Pines Post Acute And Memory Care

CMS reports 3.40 total nurse hours and 0.46 RN hours per resident day for this provider.

Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.

Total nurse hours3.40per resident day
RN hours0.46per resident day
Weekend nurse hours3.01per resident day
Staff turnover52.7%CMS reported field
06 / LOCAL RECORDS

Facilities published near The Pines Post Acute And Memory Care

The local peer set contains 1 other published facility record near Clintonville, WI, with separate bed, rating, and citation-row fields.

Open the Clintonville ledger →
BEFORE A CARE DECISION

Verify the current record and visit in person.

Use this ledger to frame questions—not to choose care on its own. Recheck Medicare Care Compare, contact the state survey agency and long-term care ombudsman, and ask the facility about anything you find.