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

Shady Lane Nursing Care Center

Manitowoc, WI · 50 certified beds · Last Life Safety survey June 24, 2026

CMS Certification Number 525575 · first certified October 1995

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.

12
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
1
Tags cited more than once
Across separate surveys
5
Inspection & testing records
Of the citations on file

Position within WI

12 citations — more than 25% 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 3 citations; the earlier surveys in the window averaged 4.5. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

The window opens August 2027 — about 10 months from now. This facility’s last Life Safety survey was June 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

Emergency preparedness

2 of the 12 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)

3 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 12 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 facility12WI median17National median11
Citations on file over three years, compared
MeasureCitations
This facility12
Median facility in WI17
Median facility nationally11

Survey history

Citations at each Life Safety survey
22024-0272025-0432026-06
Citations at each Life Safety survey
Survey dateCitations
February 28, 20242
April 16, 20257
June 24, 20263

Most-cited tags

Most-cited tags at this facility
K-03212K-07121K-03721K-03631K-09181E-00361E-00061K-07001
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.22026-06-24
K-0712Have simulated fire drills held at unexpected times.12025-04-16
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.12024-02-28
K-0363Install corridor and hallway doors that block smoke.12025-04-16
K-0918Have generator or other power source capable of supplying service within 10 seconds.12026-06-24
E-0036Establish emergency prep training and testing.12025-04-16
E-0006Conduct risk assessment and an All-Hazards approach.12026-06-24
K-0700Meet requirements for operating features, such as evacuation plans, fire drills, smoking regulations, draperies, decorations and the inspection, testing and maintenance of fire doors.12025-04-16

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 5
  • Miscellaneous Deficiencies 3
  • Emergency Preparedness Deficiencies 2
  • Gas, Vacuum, and Electrical Systems Deficiencies 1
  • Other 1
Citations by CMS category
CategoryCitations
Smoke Deficiencies5
Miscellaneous Deficiencies3
Emergency Preparedness Deficiencies2
Gas, Vacuum, and Electrical Systems Deficiencies1
Construction Deficiencies1

Every citation on file

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

June 24, 2026 — 3 citations

Citations issued on June 24, 2026
TagWhat the surveyor checksStatus
E-0006Conduct risk assessment and an All-Hazards approach.Deficient, Provider has date of correction (July 20, 2026)
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 (July 20, 2026)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (July 20, 2026)

April 16, 2025 — 7 citations

Citations issued on April 16, 2025
TagWhat the surveyor checksStatus
E-0036Establish emergency prep training and testing.Deficient, Provider has date of correction (May 7, 2025)
K-0132Meet requirements for outpatient facilities located next to inpatient facilities separated by fire resistive construction.Deficient, Provider has date of correction (April 17, 2025)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (April 17, 2025)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (April 17, 2025)
K-0700Meet requirements for operating features, such as evacuation plans, fire drills, smoking regulations, draperies, decorations and the inspection, testing and maintenance of fire doors.Deficient, Provider has date of correction (May 8, 2025)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (April 17, 2025)
K-0753Have restrictions on the use of highly flammable decorations.Deficient, Provider has date of correction (April 17, 2025)

February 28, 2024 — 2 citations

Citations issued on February 28, 2024
TagWhat the surveyor checksStatus
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 (March 27, 2024)
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.Deficient, Provider has date of correction (March 27, 2024)

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