Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

Peabody Manor

Appleton, WI · 58 certified beds · Last Life Safety survey March 19, 2026

CMS Certification Number 525548 · first certified October 1994

Ownership

Independently operated (no chain recorded by CMS) · Non profit - Corporation

No change of ownership on CMS record since January 1, 2016, when the records begin.

30
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
3
Tags cited more than once
Across separate surveys
11
Inspection & testing records
Of the citations on file

Position within WI

30 citations — more than 86% of the 323 certified nursing homes in WI. Compared within WI rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated

Improvingfewer citations at the latest survey than at its earlier surveys in the window.

The latest survey found 5 citations; the earlier surveys in the window averaged 12.5. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

The window opens April 2027 — about 7 months from now. This facility’s last Life Safety survey was March 2026. Facilities in WI are typically surveyed 13–15 months after the last one (median 14), measured over 516 consecutive surveys in the last two years of CMS records.

A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured

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Which alerts

3 inspection-and-testing tags have been cited here at more than one survey. Nationally, that pattern is common: about three quarters of cited facilities have at least one repeated tag, and half of the facilities ever cited for sprinkler inspection and testing are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.

Emergency preparedness

9 of the 30 citations on file are Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index

Physical environment (health survey)

5 physical-environment citations on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 30 Life Safety citations above. The Physical Environment Index

  • F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  • F-0880 Provide and implement an infection prevention and control program.

How that compares

Citations on file over three years

Compared with the median facility in WI, and nationally. Surveyors differ markedly between states, so the WI figure is the meaningful one.

This facility30WI median17National median11
Citations on file over three years, compared
MeasureCitations
This facility30
Median facility in WI17
Median facility nationally11

Survey history

Citations at each Life Safety survey
132023-09122024-1252026-03
Citations at each Life Safety survey
Survey dateCitations
September 13, 202313
December 18, 202412
March 19, 20265

Most-cited tags

Most-cited tags at this facility
K-03532K-07122K-09232K-09141E-00241K-07611K-03241K-05111
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0353Inspect, test, and maintain automatic sprinkler systems.22026-03-19
K-0712Have simulated fire drills held at unexpected times.22026-03-19
K-0923Have proper medical gas storage and administration areas.22026-03-19
K-0914Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.12024-12-18
E-0024Establish policies and procedures for volunteers.12023-09-13
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.12024-12-18
K-0324Provide properly protected cooking facilities.12024-12-18
K-0511Have properly installed electrical wiring and gas equipment.12026-03-19

What the citations cover

Citations by CMS category
  • Emergency Preparedness Deficiencies 9
  • Miscellaneous Deficiencies 6
  • Gas, Vacuum, and Electrical Systems Deficiencies 5
  • Smoke Deficiencies 5
  • Other 5
Citations by CMS category
CategoryCitations
Emergency Preparedness Deficiencies9
Miscellaneous Deficiencies6
Gas, Vacuum, and Electrical Systems Deficiencies5
Smoke Deficiencies5
Egress Deficiencies2
Services Deficiencies2
Construction Deficiencies1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

March 19, 2026 — 5 citations

Citations issued on March 19, 2026
TagWhat the surveyor checksStatus
K-0351Install an approved automatic sprinkler system.Deficient, Provider has date of correction (March 20, 2026)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (March 20, 2026)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (March 20, 2026)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (April 10, 2026)
K-0923Have proper medical gas storage and administration areas.Deficient, Provider has date of correction (March 20, 2026)

December 18, 2024 — 12 citations

Citations issued on December 18, 2024
TagWhat the surveyor checksStatus
E-0022Establish policies and procedures for sheltering.Deficient, Provider has date of correction (January 15, 2025)
K-0161Use approved construction type or materials.Deficient, Provider has date of correction (January 13, 2025)
K-0291Install emergency lighting that can last at least 1 1/2 hours.Deficient, Provider has date of correction (January 15, 2025)
K-0293Have properly located and lighted "Exit" signs.Deficient, Provider has date of correction (January 13, 2025)
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (January 14, 2025)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (January 15, 2025)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (January 22, 2025)
K-0753Have restrictions on the use of highly flammable decorations.Deficient, Provider has date of correction (January 15, 2025)
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.Deficient, Provider has date of correction (January 15, 2025)
K-0781Have restrictions on the use of portable space heaters.Deficient, Provider has date of correction (January 15, 2025)
K-0914Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.Deficient, Provider has date of correction (January 13, 2025)
K-0923Have proper medical gas storage and administration areas.Deficient, Provider has date of correction (January 13, 2025)

September 13, 2023 — 13 citations

Citations issued on September 13, 2023
TagWhat the surveyor checksStatus
E-0001Establish an Emergency Preparedness Program (EP).Deficient, Provider has date of correction (October 5, 2023)
E-0006Conduct risk assessment and an All-Hazards approach.Deficient, Provider has date of correction (October 5, 2023)
E-0007Address patient/client population and determine types of services needed.Deficient, Provider has date of correction (October 5, 2023)
E-0020Establish policies and procedures including evacuation.Deficient, Provider has date of correction (October 6, 2023)
E-0023Establish policies and procedures for medical documentation.Deficient, Provider has date of correction (October 5, 2023)
E-0024Establish policies and procedures for volunteers.Deficient, Provider has date of correction (October 5, 2023)
E-0033Establish methods for sharing information.Deficient, Provider has date of correction (October 5, 2023)
E-0039Conduct testing and exercise requirements.Deficient, Provider has date of correction (October 5, 2023)
K-0531Have elevators that firefighters can control in the event of a fire.Deficient, Provider has date of correction (September 29, 2023)
K-0711Provide a written emergency evacuation plan.Deficient, Provider has date of correction (October 5, 2023)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (October 5, 2023)
K-0911Meet requirements for the installation and maintenance of electrical systems.Deficient, Provider has date of correction (October 31, 2023)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (October 5, 2023)

Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.