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

WI Veterans Hm Ainsworth Hall

King, WI · 198 certified beds · Last Life Safety survey March 19, 2025

CMS Certification Number 525719 · first certified March 2015

Ownership

Independently operated (no chain recorded by CMS) · Government - State

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

28
Citations on file
Rolling three-year window
4
Life Safety surveys
In the same window
5
Tags cited more than once
Across separate surveys
9
Inspection & testing records
Of the citations on file

Position within WI

28 citations — more than 80% 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

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

The latest survey found 16 citations; the earlier surveys in the window averaged 6.3. With 4 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

Well past the typical window (April 2026 to June 2026), and past the point by which nine in ten WI facilities have been surveyed. This facility’s last Life Safety survey was March 2025. 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

5 of the 28 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 28 Life Safety citations above. The Physical Environment Index

  • F-0584 Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
  • 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.
  • F-0921 Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.

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 facility28WI median17National median11
Citations on file over three years, compared
MeasureCitations
This facility28
Median facility in WI17
Median facility nationally11

Survey history

Citations at each Life Safety survey
52022-1272024-0172024-01162025-03
Citations at each Life Safety survey
Survey dateCitations
December 7, 20225
January 31, 20247
January 31, 20247
March 19, 202516

Most-cited tags

Most-cited tags at this facility
K-07122K-02932E-00362K-03722K-03532K-09191K-09161K-05411
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0712Have simulated fire drills held at unexpected times.22025-03-19
K-0293Have properly located and lighted "Exit" signs.22024-01-31
E-0036Establish emergency prep training and testing.22025-03-19
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.22025-03-19
K-0353Inspect, test, and maintain automatic sprinkler systems.22025-03-19
K-0919Meet requirements for the use of electrical equipment.12024-01-31
K-0916Have a battery powered remote alarm panel in a location accessible by operating personnel.12025-03-19
K-0541Install properly constructed and protected linen or trash chutes.12024-01-31

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 8
  • Miscellaneous Deficiencies 5
  • Emergency Preparedness Deficiencies 5
  • Gas, Vacuum, and Electrical Systems Deficiencies 4
  • Other 6
Citations by CMS category
CategoryCitations
Smoke Deficiencies8
Miscellaneous Deficiencies5
Emergency Preparedness Deficiencies5
Gas, Vacuum, and Electrical Systems Deficiencies4
Egress Deficiencies3
Services Deficiencies2
Construction Deficiencies1

Every citation on file

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

March 19, 2025 — 16 citations

Citations issued on March 19, 2025
TagWhat the surveyor checksStatus
E-0013Develop Emergency Preparedness policies and procedures.Deficient, Provider has date of correction (April 18, 2025)
E-0022Establish policies and procedures for sheltering.Deficient, Provider has date of correction (April 18, 2025)
E-0032Provide primary/alternate means for communication.Deficient, Provider has date of correction (April 18, 2025)
E-0036Establish emergency prep training and testing.Deficient, Provider has date of correction (June 16, 2025)
K-0133Install a two-hour-resistant firewall separation.Deficient, Provider has date of correction (March 25, 2025)
K-0222Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.Deficient, Provider has date of correction (March 27, 2025)
K-0311Have an enclosure around a vertical opening shaft.Deficient, Provider has date of correction (April 10, 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 (April 14, 2025)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (May 22, 2025)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (March 27, 2025)
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.Deficient, Provider has date of correction (April 18, 2025)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Deficient, Provider has date of correction (March 27, 2025)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (March 20, 2025)
K-0753Have restrictions on the use of highly flammable decorations.Deficient, Provider has date of correction (April 15, 2025)
K-0908Ensure gas and vacuum systems are inspected and tested as part of a maintenance program.Deficient, Provider has date of correction (April 15, 2025)
K-0916Have a battery powered remote alarm panel in a location accessible by operating personnel.Deficient, Provider has date of correction (April 18, 2025)

January 31, 2024 — 7 citations

Citations issued on January 31, 2024
TagWhat the surveyor checksStatus
K-0293Have properly located and lighted "Exit" signs.Deficient, Provider has date of correction (February 26, 2024)
K-0341Install a fire alarm system that can be heard throughout the facility.Waiver has been granted (June 30, 2024)
K-0541Install properly constructed and protected linen or trash chutes.Deficient, Provider has date of correction (February 1, 2024)
K-0711Provide a written emergency evacuation plan.Deficient, Provider has date of correction (March 22, 2024)
K-0712Have simulated fire drills held at unexpected times.Waiver has been granted (June 30, 2024)
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.Waiver has been granted (May 3, 2024)
K-0919Meet requirements for the use of electrical equipment.Deficient, Provider has date of correction (February 26, 2024)

December 7, 2022 — 5 citations

Citations issued on December 7, 2022
TagWhat the surveyor checksStatus
E-0036Establish emergency prep training and testing.Deficient, Provider has date of correction (January 6, 2023)
K-0293Have properly located and lighted "Exit" signs.Deficient, Provider has date of correction (January 6, 2023)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (January 6, 2023)
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.Deficient, Provider has date of correction (January 6, 2023)
K-0911Meet requirements for the installation and maintenance of electrical systems.Deficient, Provider has date of correction (January 6, 2023)

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