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

WAUNAKEE VALLEY SENIOR LIVING

WAUNAKEE, WI · 84 certified beds · Last Life Safety survey April 9, 2026

CMS Certification Number 525098 · first certified January 1967

Ownership

Operated by TRILOGY HEALTH SERVICES · For profit - Corporation

  • Ownership changed March 1, 2023 (change of ownership)from WAUNAKEE OPERATIONS LLC
32
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
10
Tags cited more than once
Across separate surveys
9
Inspection & testing records
Of the citations on file

Position within WI

32 citations — more than 88% 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 10 citations; the earlier surveys in the window averaged 11. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

The window opens May 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.

Emergency preparedness

1 of the 32 citations on file is 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)

4 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 32 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 facility32WI median17National median11
Citations on file over three years, compared
MeasureCitations
This facility32
Median facility in WI17
Median facility nationally11

Survey history

Citations at each Life Safety survey
92024-01132025-01102026-04
Citations at each Life Safety survey
Survey dateCitations
January 8, 20249
January 23, 202513
April 9, 202610

Most-cited tags

Most-cited tags at this facility
K-09123K-03313K-09203K-03533K-05212K-03212K-03512K-01322
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0912Have power receptacles that are properly grounded.32026-04-09
K-0331Construct fire resistant interior walls.32026-04-09
K-0920Ensure proper usage of power strips and extension cords.32026-04-09
K-0353Inspect, test, and maintain automatic sprinkler systems.32026-04-09
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.22026-04-09
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.22025-01-23
K-0351Install an approved automatic sprinkler system.22026-04-09
K-0132Meet requirements for outpatient facilities located next to inpatient facilities separated by fire resistive construction.22025-01-23

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 18
  • Gas, Vacuum, and Electrical Systems Deficiencies 7
  • Services Deficiencies 3
  • Construction Deficiencies 2
  • Other 2
Citations by CMS category
CategoryCitations
Smoke Deficiencies18
Gas, Vacuum, and Electrical Systems Deficiencies7
Services Deficiencies3
Construction Deficiencies2
Egress Deficiencies1
Emergency Preparedness Deficiencies1

Every citation on file

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

April 9, 2026 — 10 citations

Citations issued on April 9, 2026
TagWhat the surveyor checksStatus
K-0211Keep aisles, corridors, and exits free of obstruction in case of emergency.Deficient, Provider has date of correction (May 1, 2026)
K-0331Construct fire resistant interior walls.Deficient, Provider has date of correction (May 1, 2026)
K-0351Install an approved automatic sprinkler system.Deficient, Provider has date of correction (May 1, 2026)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (May 1, 2026)
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.Deficient, Provider has date of correction (May 1, 2026)
K-0362Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.Deficient, Provider has date of correction (May 1, 2026)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Deficient, Provider has date of correction (May 1, 2026)
K-0912Have power receptacles that are properly grounded.Deficient, Provider has date of correction (May 1, 2026)
K-0919Meet requirements for the use of electrical equipment.Deficient, Provider has date of correction (May 1, 2026)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (May 1, 2026)

January 23, 2025 — 13 citations

Citations issued on January 23, 2025
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 (February 17, 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 (February 17, 2025)
K-0331Construct fire resistant interior walls.Deficient, Provider has date of correction (February 17, 2025)
K-0343Have a fire alarm with audible and visual signals that transmits the alarm automatically to notify emergency forces in event of fire.Deficient, Provider has date of correction (February 17, 2025)
K-0351Install an approved automatic sprinkler system.Deficient, Provider has date of correction (February 17, 2025)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (February 17, 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 (February 17, 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 (February 17, 2025)
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.Deficient, Provider has date of correction (February 17, 2025)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (February 17, 2025)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Deficient, Provider has date of correction (February 17, 2025)
K-0912Have power receptacles that are properly grounded.Deficient, Provider has date of correction (February 17, 2025)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (February 17, 2025)

January 8, 2024 — 9 citations

Citations issued on January 8, 2024
TagWhat the surveyor checksStatus
E-0006Conduct risk assessment and an All-Hazards approach.Deficient, Provider has date of correction (February 1, 2024)
K-0132Meet requirements for outpatient facilities located next to inpatient facilities separated by fire resistive construction.Deficient, Provider has date of correction (February 1, 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 (February 15, 2024)
K-0331Construct fire resistant interior walls.Deficient, Provider has date of correction (February 15, 2024)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (February 1, 2024)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (February 1, 2024)
K-0354Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.Deficient, Provider has date of correction (February 1, 2024)
K-0912Have power receptacles that are properly grounded.Deficient, Provider has date of correction (February 1, 2024)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (February 1, 2024)

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