01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-08-28 | 1 | 2025-08-28 | 1 |
| Cycle 2 | 2024-07-10 | 4 | 2024-07-10 | 1 |
| Cycle 3 | 2023-08-03 | 2 | 2023-08-03 | 5 |
CMS CCN 2354002026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Wellspring Lutheran Services
1390 Maple Drive · Fairview, MI 48621 · Oscoda County
Certified beds39CMS provider file
Recent citation rows14current 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
14 rows in the current release
1 rows carry G–L scope/severity codes; 0 carry J–L. 1 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-08-28 · HEALTHF0921Severity F · widespread; potential for more than minimal harm
Environmental Deficiencies
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Correction field: Deficient, Provider has date of correction · 2025-09-222025-08-28 · FIREK0271Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Have exits that are accessible at all times.
Correction field: Deficient, Provider has date of correction · 2025-10-092025-02-06 · 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 · 2025-03-12 · complaint2024-07-10 · 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 · 2024-08-092024-07-10 · 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 · 2024-08-092024-07-10 · HEALTHF0759Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
Correction field: Deficient, Provider has date of correction · 2024-08-092024-07-10 · 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 · 2024-08-142024-05-30 · 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 · 2024-07-01 · complaint2023-08-03 · HEALTHF0880Severity C · widespread; potential for minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has plan of correction · 2023-09-182023-08-03 · 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 · 2023-09-142023-08-03 · FIREK0324Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2023-09-142023-08-03 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2023-09-142023-08-03 · FIREK0363Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2023-09-142023-08-03 · 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 · 2023-09-1403 / 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 |
|---|---|---|---|
| 2025-02-06 | Payment Denial | $0 | 7 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- LUTHERAN HOMES OF MICHIGAN, INCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 01/01/2011
- BENDER, PETERIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/01/2012
- BENKO, AMYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/04/2016
- CUSHWAY, RITCHIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/09/2013
- LOGAN, ANDREAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/18/2012
- NYQUIST, PAULIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/27/2014
- SCHOENOW, CARLIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 11/24/2014
- GEHM, DAVIDIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2011
- KALBFLEISCH, TIMOTHYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 09/01/2019
- DARGIS, DAVIDIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2020
- GEHM, DAVIDIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2011
- NAFFIEN, FAWNIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/01/2022
- LUTHERAN HOMES OF MICHIGAN, INCOrganization · ADP OF THE SNFNOT APPLICABLE · since 01/01/2011
- DARGIS, DAVIDIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2020
- GEHM, DAVIDIndividual · ADP OF THE SNFNOT APPLICABLE · since 11/14/2011
- KALBFLEISCH, TIMOTHYIndividual · ADP OF THE SNFNOT APPLICABLE · since 09/01/2019
- NAFFIEN, FAWNIndividual · ADP OF THE SNFNOT APPLICABLE · since 05/01/2022
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 hours4.03per resident day
RN hours0.94per resident day
Weekend nurse hours3.42per resident day
Staff turnover38.1%CMS reported field
06 / LOCAL RECORDS
Open the Michigan ledger →Other published facilities nearby
No second facility in the same city met the directory rule.