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

RANDOLPH HEALTH SERVICES

RANDOLPH, WI · 84 certified beds · Last Life Safety survey March 12, 2026

CMS Certification Number 525355 · first certified April 1984

Ownership

Operated by NORTH SHORE HEALTHCARE · For profit - Corporation

  • Ownership changed December 21, 2016 (change of ownership)from COMMERCIAL MANAGEMENT, INC.
23
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
6
Tags cited more than once
Across separate surveys
5
Inspection & testing records
Of the citations on file

Position within WI

23 citations — more than 67% 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

Holding steadyabout the same at the latest survey as at its earlier surveys in the window.

The latest survey found 8 citations; the earlier surveys in the window averaged 7.5. 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

2 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.

Physical environment (health survey)

2 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 23 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 facility23WI median17National median11
Citations on file over three years, compared
MeasureCitations
This facility23
Median facility in WI17
Median facility nationally11

Survey history

Citations at each Life Safety survey
82023-1172024-1282026-03
Citations at each Life Safety survey
Survey dateCitations
November 7, 20238
December 18, 20247
March 12, 20268

Most-cited tags

Most-cited tags at this facility
K-05212K-03622K-03512K-03532K-03312K-03742K-03421K-02221
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.22026-03-12
K-0362Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.22024-12-18
K-0351Install an approved automatic sprinkler system.22026-03-12
K-0353Inspect, test, and maintain automatic sprinkler systems.22026-03-12
K-0331Construct fire resistant interior walls.22024-12-18
K-0374Install smoke barrier doors that can resist smoke for at least 20 minutes.22026-03-12
K-0342Have a complete alarm system manually initiated and initiated by fire sprinkler system connection.12024-12-18
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.12023-11-07

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 13
  • Gas, Vacuum, and Electrical Systems Deficiencies 5
  • Services Deficiencies 2
  • Egress Deficiencies 2
  • Other 1
Citations by CMS category
CategoryCitations
Smoke Deficiencies13
Gas, Vacuum, and Electrical Systems Deficiencies5
Services Deficiencies2
Egress Deficiencies2
Construction Deficiencies1

Every citation on file

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

March 12, 2026 — 8 citations

Citations issued on March 12, 2026
TagWhat the surveyor checksStatus
K-0132Meet requirements for outpatient facilities located next to inpatient facilities separated by fire resistive construction.Deficient, Provider has date of correction (April 10, 2026)
K-0351Install an approved automatic sprinkler system.Deficient, Provider has date of correction (April 10, 2026)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (April 10, 2026)
K-0374Install smoke barrier doors that can resist smoke for at least 20 minutes.Deficient, Provider has date of correction (April 10, 2026)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Deficient, Provider has date of correction (April 10, 2026)
K-0911Meet requirements for the installation and maintenance of electrical systems.Deficient, Provider has date of correction (April 10, 2026)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (April 10, 2026)
K-0927Have proper fire barriers, ventilation and signs for the transfilling of oxygen.Deficient, Provider has date of correction (April 10, 2026)

December 18, 2024 — 7 citations

Citations issued on December 18, 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 (January 20, 2025)
K-0331Construct fire resistant interior walls.Deficient, Provider has date of correction (January 20, 2025)
K-0342Have a complete alarm system manually initiated and initiated by fire sprinkler system connection.Waiver has been granted (January 20, 2025)
K-0354Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.Deficient, Provider has date of correction (January 20, 2025)
K-0362Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.Deficient, Provider has date of correction (January 20, 2025)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Waiver has been granted (January 30, 2025)
K-0912Have power receptacles that are properly grounded.Deficient, Provider has date of correction (January 20, 2025)

November 7, 2023 — 8 citations

Citations issued on November 7, 2023
TagWhat the surveyor checksStatus
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 (November 22, 2023)
K-0223Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.Deficient, Provider has date of correction (November 22, 2023)
K-0331Construct fire resistant interior walls.Deficient, Provider has date of correction (November 22, 2023)
K-0351Install an approved automatic sprinkler system.Deficient, Provider has date of correction (November 22, 2023)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (November 22, 2023)
K-0362Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.Deficient, Provider has date of correction (November 22, 2023)
K-0374Install smoke barrier doors that can resist smoke for at least 20 minutes.Deficient, Provider has date of correction (November 22, 2023)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (November 22, 2023)

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