Kewaunee Health Services

Inspection findings

1. Apr 8, 2025 Fire Safety · 8 findings
   • Not serious Scope/severity E

     K0345 Smoke Deficiencies

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

     Corrected May 2, 2025 · CMS fire safety

   • Not serious Scope/severity F

     K0353 Smoke Deficiencies

     Inspect, test, and maintain automatic sprinkler systems.

     Corrected Apr 15, 2025 · CMS fire safety

   • Not serious Scope/severity E

     K0521 Services Deficiencies

     Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

     Corrected Apr 21, 2025 · CMS fire safety

   • Not serious Scope/severity F

     K0712 Miscellaneous Deficiencies

     Have simulated fire drills held at unexpected times.

     Corrected Apr 29, 2025 · CMS fire safety

   • Not serious Scope/severity F

     K0761 Miscellaneous Deficiencies

     To conduct inspection, testing and maintenance of fire doors by qualified individuals.

     Corrected Apr 19, 2025 · CMS fire safety

   • Not serious Scope/severity F

     K0781 Miscellaneous Deficiencies

     Have restrictions on the use of portable space heaters.

     Corrected May 15, 2025 · CMS fire safety

   • Not serious Scope/severity F

     K0918 Gas, Vacuum, and Electrical Systems Deficiencies

     Have generator or other power source capable of supplying service within 10 seconds.

     Corrected May 15, 2025 · CMS fire safety

   • Not serious Scope/severity D

     K0923 Gas, Vacuum, and Electrical Systems Deficiencies

     Have proper medical gas storage and administration areas.

     Corrected Apr 30, 2025 · CMS fire safety

2. Mar 6, 2024 Fire Safety · 11 findings
   • Not serious Scope/severity F

     E0039 Emergency Preparedness Deficiencies

     Conduct testing and exercise requirements.

     Corrected Apr 4, 2024 · CMS fire safety

   • Not serious Scope/severity D

     F0684 Quality of Life and Care Deficiencies

     Provide appropriate treatment and care according to orders, resident’s preferences and goals.

     Corrected Apr 4, 2024 · CMS health inspection

   • Not serious Scope/severity F

     F0851 Administration Deficiencies

     Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.

     Corrected Apr 4, 2024 · CMS health inspection

   • Not serious Scope/severity F

     K0291 Egress Deficiencies

     Install emergency lighting that can last at least 1 1/2 hours.

     Corrected Apr 4, 2024 · CMS fire safety

   • Not serious Scope/severity E

     K0311 Smoke Deficiencies

     Have an enclosure around a vertical opening shaft.

     Corrected Apr 4, 2024 · CMS fire safety

   • Not serious Scope/severity E

     K0324 Smoke Deficiencies

     Provide properly protected cooking facilities.

     Corrected Apr 4, 2024 · CMS fire safety

   • Not serious Scope/severity E

     K0353 Smoke Deficiencies

     Inspect, test, and maintain automatic sprinkler systems.

     Corrected Apr 4, 2024 · CMS fire safety

   • Not serious Scope/severity F

     K0521 Services Deficiencies

     Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

     Corrected Apr 4, 2024 · CMS fire safety

   • Not serious Scope/severity E

     K0781 Miscellaneous Deficiencies

     Have restrictions on the use of portable space heaters.

     Corrected Apr 4, 2024 · CMS fire safety

   • Not serious Scope/severity F

     K0918 Gas, Vacuum, and Electrical Systems Deficiencies

     Have generator or other power source capable of supplying service within 10 seconds.

     Corrected Apr 4, 2024 · CMS fire safety

   • Not serious Scope/severity D

     K0923 Gas, Vacuum, and Electrical Systems Deficiencies

     Have proper medical gas storage and administration areas.

     Corrected Apr 4, 2024 · CMS fire safety

3. Jan 12, 2023 Health · 7 findings
   • Not serious Scope/severity C

     F0623 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.

     Corrected Feb 10, 2023 · CMS health inspection

   • Not serious Scope/severity C

     F0625 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.

     Corrected Feb 10, 2023 · CMS health inspection

   • Not serious Scope/severity D

     F0755 Pharmacy Service Deficiencies

     Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

     Corrected Feb 10, 2023 · CMS health inspection

   • Not serious Scope/severity D

     F0805 Nutrition and Dietary Deficiencies

     Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.

     Corrected Feb 10, 2023 · CMS health inspection

   • Not serious Scope/severity F

     F0812 Nutrition and Dietary Deficiencies

     Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

     Corrected Feb 10, 2023 · CMS health inspection

   • Not serious Scope/severity E

     F0880 Infection Control Deficiencies

     Provide and implement an infection prevention and control program.

     Corrected Feb 10, 2023 · CMS health inspection

   • Not serious Scope/severity E

     K0353 Smoke Deficiencies

     Inspect, test, and maintain automatic sprinkler systems.

     Corrected Feb 6, 2023 · CMS fire safety

Owners and managers (as published by CMS)

• BAUMANN, TROY — adp of the snf, NOT APPLICABLE, since 12/01/2019
• BAUMANN, TROY — corporate director, NOT APPLICABLE, since 10/01/2019
• BAUMANN, TROY — operational/managerial control, NOT APPLICABLE, since 12/01/2019
• BELONGIA, CHRISTINA — adp of the snf, NOT APPLICABLE, since 12/01/2019
• BELONGIA, CHRISTINA — operational/managerial control, NOT APPLICABLE, since 12/01/2019
• DUFRESNE, CASSANDRA — adp of the snf, NOT APPLICABLE, since 12/01/2019
• DUFRESNE, CASSANDRA — operational/managerial control, NOT APPLICABLE, since 12/01/2019
• GEE, DARREN — adp of the snf, NOT APPLICABLE, since 11/30/2021
• GEE, DARREN — operational/managerial control, NOT APPLICABLE, since 11/30/2021
• GREER, LAUREN — operational/managerial control, NOT APPLICABLE, since 11/29/2023
• GREER, LAUREN — adp of the snf, NOT APPLICABLE, since 11/29/2023
• HOEHN, JEFFREY — adp of the snf, NOT APPLICABLE, since 12/01/2019
• HOEHN, JEFFREY — operational/managerial control, NOT APPLICABLE, since 12/01/2019
• HOEHN, JEFFREY — corporate director, NOT APPLICABLE, since 10/01/2019
• LEMKE, BLAKE — adp of the snf, NOT APPLICABLE, since 02/01/2023
• LEMKE, BLAKE — operational/managerial control, NOT APPLICABLE, since 02/01/2023
• MILLS, DAVID — 5% or greater indirect ownership interest, 18%, since 10/01/2019
• PATZER, COLLEEN — adp of the snf, NOT APPLICABLE, since 02/14/2023
• PATZER, COLLEEN — operational/managerial control, NOT APPLICABLE, since 02/14/2023
• PURTELL, BRIAN — operational/managerial control, NOT APPLICABLE, since 12/01/2019
• PURTELL, BRIAN — adp of the snf, NOT APPLICABLE, since 12/01/2019
• ARROWHEAD 123 LLC — 5% or greater indirect ownership interest, 10%, since 10/01/2019
• ARROWHEAD 123 LLC — adp of the snf, NOT APPLICABLE, since 12/01/2019
• CIBC BANK USA — 5% or greater mortgage interest, NOT APPLICABLE, since 12/31/2024
• CIBC BANK USA — 5% or greater security interest, NOT APPLICABLE, since 12/31/2024
• CIBC BANK USA — operational/managerial control, NOT APPLICABLE, since 12/31/2024
• CLIFTONLARSONALLEN LLP — operational/managerial control, NOT APPLICABLE, since 12/01/2019
• CLIFTONLARSONALLEN LLP — adp of the snf, NOT APPLICABLE, since 06/06/2025
• CONTINUUM THERAPY PARTNERS LLC — operational/managerial control, NOT APPLICABLE, since 03/01/2025
• CONTINUUM THERAPY PARTNERS LLC — adp of the snf, NOT APPLICABLE, since 06/06/2025
• NORTH SHORE HEALTHCARE LLC — adp of the snf, NOT APPLICABLE, since 06/06/2025
• NORTH SHORE HEALTHCARE LLC — operational/managerial control, NOT APPLICABLE, since 12/01/2019
• NSH 1308 LINCOLN STREET LLC — adp of the snf, NOT APPLICABLE, since 12/01/2019
• NSH REHAB LLC — operational/managerial control, NOT APPLICABLE, since 03/01/2025
• NSH REHAB LLC — adp of the snf, NOT APPLICABLE, since 06/06/2025
• NSHR OPERATIONS LLC — 5% or greater direct ownership interest, 100%, since 10/01/2019
• THE LANE MORRELL BOWEN TRUST — adp of the snf, NOT APPLICABLE, since 12/01/2019
• THE LANE MORRELL BOWEN TRUST — 5% or greater indirect ownership interest, 10%, since 10/01/2019
• WIPFLI LLP — operational/managerial control, NOT APPLICABLE, since 02/01/2025
• WIPFLI LLP — adp of the snf, NOT APPLICABLE, since 06/06/2025