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

Edenbrook Sheboygan

Sheboygan, WI · 121 certified beds · Last Life Safety survey April 30, 2025

CMS Certification Number 525568 · first certified July 1995

Ownership

Operated by EDEN SENIOR CARE · For profit - Corporation

  • New ownershipOwnership changed April 24, 2025 (change of ownership)from SUNNY RIDGE OPERATIONS LLC
35
Citations on file
Rolling three-year window
4
Life Safety surveys
In the same window
8
Tags cited more than once
Across separate surveys
15
Inspection & testing records
Of the citations on file

Position within WI

35 citations — more than 94% 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 10 citations; the earlier surveys in the window averaged 8.3. 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 (June 2026 to August 2026), and past the point by which nine in ten WI facilities have been surveyed. This facility’s last Life Safety survey was April 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

6 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)

8 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 35 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.
  • F-0919 Make sure that a working call system is available in each resident's bathroom and bathing area.
  • 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.

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 facility35WI median17National median11
Citations on file over three years, compared
MeasureCitations
This facility35
Median facility in WI17
Median facility nationally11

Survey history

Citations at each Life Safety survey
102023-0112024-01142024-02102025-04
Citations at each Life Safety survey
Survey dateCitations
January 25, 202310
January 17, 20241
February 28, 202414
April 30, 202510

Most-cited tags

Most-cited tags at this facility
K-03213K-09183K-03532K-07122K-05212K-09112K-09232K-03632
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.32025-04-30
K-0918Have generator or other power source capable of supplying service within 10 seconds.32025-04-30
K-0353Inspect, test, and maintain automatic sprinkler systems.22025-04-30
K-0712Have simulated fire drills held at unexpected times.22025-04-30
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.22024-02-28
K-0911Meet requirements for the installation and maintenance of electrical systems.22024-02-28
K-0923Have proper medical gas storage and administration areas.22024-02-28
K-0363Install corridor and hallway doors that block smoke.22025-04-30

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 11
  • Gas, Vacuum, and Electrical Systems Deficiencies 11
  • Miscellaneous Deficiencies 5
  • Egress Deficiencies 4
  • Other 4
Citations by CMS category
CategoryCitations
Smoke Deficiencies11
Gas, Vacuum, and Electrical Systems Deficiencies11
Miscellaneous Deficiencies5
Egress Deficiencies4
Services Deficiencies3
Construction Deficiencies1

Every citation on file

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

April 30, 2025 — 10 citations

Citations issued on April 30, 2025
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 (May 30, 2025)
K-0291Install emergency lighting that can last at least 1 1/2 hours.Deficient, Provider has date of correction (May 30, 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 (July 29, 2025)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (April 14, 2026)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (May 30, 2025)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (May 30, 2025)
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.Deficient, Provider has date of correction (May 30, 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 (May 30, 2025)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (May 30, 2025)
K-0927Have proper fire barriers, ventilation and signs for the transfilling of oxygen.Deficient, Provider has date of correction (May 30, 2025)

February 28, 2024 — 14 citations

Citations issued on February 28, 2024
TagWhat the surveyor checksStatus
K-0161Use approved construction type or materials.Deficient, Provider has date of correction (March 27, 2024)
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-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (March 27, 2024)
K-0362Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.Deficient, Provider has date of correction (March 27, 2024)
K-0374Install smoke barrier doors that can resist smoke for at least 20 minutes.Deficient, Provider has date of correction (March 27, 2024)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Waiver has been granted (April 5, 2024)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (March 27, 2024)
K-0741Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.Deficient, Provider has date of correction (March 27, 2024)
K-0781Have restrictions on the use of portable space heaters.Deficient, Provider has date of correction (March 27, 2024)
K-0911Meet requirements for the installation and maintenance of electrical systems.Deficient, Provider has date of correction (March 27, 2024)
K-0912Have power receptacles that are properly grounded.Deficient, Provider has date of correction (March 27, 2024)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (March 27, 2024)
K-0923Have proper medical gas storage and administration areas.Deficient, Provider has date of correction (March 27, 2024)
K-0925Ensure that sources of ignition are removed from patients receiving respiratory therapy.Deficient, Provider has date of correction (March 27, 2024)

January 17, 2024 — 1 citation

Citations issued on January 17, 2024
TagWhat the surveyor checksStatus
K-0500Meet other general requirements that are deficient.Deficient, Provider has date of correction (February 7, 2024)

January 25, 2023 — 10 citations

Citations issued on January 25, 2023
TagWhat the surveyor checksStatus
K-0200Meet other general requirements.Deficient, Provider has date of correction (February 23, 2023)
K-0211Keep aisles, corridors, and exits free of obstruction in case of emergency.Deficient, Provider has date of correction (February 23, 2023)
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 (February 23, 2023)
K-0351Install an approved automatic sprinkler system.Waiver has been granted (March 24, 2023)
K-0352Properly install and monitor supervisory attachments on automatic sprinkler systems.Waiver has been granted (March 24, 2023)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (February 23, 2023)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Deficient, Provider has date of correction (March 9, 2023)
K-0911Meet requirements for the installation and maintenance of electrical systems.Deficient, Provider has date of correction (February 23, 2023)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Waiver has been granted (November 19, 2024)
K-0923Have proper medical gas storage and administration areas.Deficient, Provider has date of correction (February 23, 2023)

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