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

Door County Memorial Hospital SNF

Sturgeon Bay, WI · 32 certified beds · Last Life Safety survey April 28, 2026

CMS Certification Number 525377 · first certified October 1984

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.

14
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
2
Tags cited more than once
Across separate surveys
8
Inspection & testing records
Of the citations on file

Position within WI

14 citations — more than 35% 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 2 citations; the earlier surveys in the window averaged 6. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

The window opens June 2027 — about 8 months from now. This facility’s last Life Safety survey was April 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 14 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 facility14WI median17National median11
Citations on file over three years, compared
MeasureCitations
This facility14
Median facility in WI17
Median facility nationally11

Survey history

Citations at each Life Safety survey
92024-0132025-0222026-04
Citations at each Life Safety survey
Survey dateCitations
January 4, 20249
February 19, 20253
April 28, 20262

Most-cited tags

Most-cited tags at this facility
K-03532K-09182K-07121K-03621K-03461K-07531K-02811K-03631
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0353Inspect, test, and maintain automatic sprinkler systems.22025-02-19
K-0918Have generator or other power source capable of supplying service within 10 seconds.22025-02-19
K-0712Have simulated fire drills held at unexpected times.12024-01-04
K-0362Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.12024-01-04
K-0346Follow proper procedures when the fire alarm was out of service for more than 4 hours.12025-02-19
K-0753Have restrictions on the use of highly flammable decorations.12024-01-04
K-0281Install proper backup exit lighting.12024-01-04
K-0363Install corridor and hallway doors that block smoke.12024-01-04

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 7
  • Gas, Vacuum, and Electrical Systems Deficiencies 3
  • Egress Deficiencies 2
  • Miscellaneous Deficiencies 2
Citations by CMS category
CategoryCitations
Smoke Deficiencies7
Gas, Vacuum, and Electrical Systems Deficiencies3
Egress Deficiencies2
Miscellaneous Deficiencies2

Every citation on file

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

April 28, 2026 — 2 citations

Citations issued on April 28, 2026
TagWhat the surveyor checksStatus
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (June 22, 2026)
K-0916Have a battery powered remote alarm panel in a location accessible by operating personnel.Deficient, Provider has date of correction (May 8, 2026)

February 19, 2025 — 3 citations

Citations issued on February 19, 2025
TagWhat the surveyor checksStatus
K-0346Follow proper procedures when the fire alarm was out of service for more than 4 hours.Deficient, Provider has date of correction (March 11, 2025)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (March 26, 2025)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (March 6, 2025)

January 4, 2024 — 9 citations

Citations issued on January 4, 2024
TagWhat the surveyor checksStatus
K-0200Meet other general requirements.Deficient, Provider has date of correction (January 8, 2024)
K-0281Install proper backup exit lighting.Waiver has been granted (June 11, 2024)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (February 16, 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 (January 8, 2024)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (January 31, 2024)
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.Deficient, Provider has date of correction (January 8, 2024)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (January 31, 2024)
K-0753Have restrictions on the use of highly flammable decorations.Deficient, Provider has date of correction (January 8, 2024)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Waiver has been granted (June 11, 2024)

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