Deficiency Index

Cornell Health Services

Cornell, Wisconsin · CCN 525637

17 surveys since 2010, 3 of them producing a finding at harm level or worse.

Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.

Citations on record
48
Surveys
17
Harm or worse
3
Immediate jeopardy
1
The record, 2010–2026
’10’15’20’25’26
No harm recordedHarm or worseNot surveyed
Immediate jeopardy1

Findings at the most serious level CMS records.

Beyond CMS’s monthly file13/17

Older surveys no longer in CMS’s monthly file or on Care Compare. They are shown here.

The facility

Certified beds
50
Ownership
For profit - Corporation
Chain
NORTH SHORE HEALTHCARE
County
Chippewa
Medicare-certified since
1997

CMS ratings

Overall
5
Health inspection
4
Staffing
4
Quality measures
5

CMS’s own Five-Star ratings.

Compared with similar facilities

Not shown for this facility: too few citations in window (n=10, floor 20).

Last survey on record

Jul 14, 2026

118 days ago.

Counts surveys with at least one finding. A clean survey leaves no record here, so the real gap may be shorter.

Staffing

MeasureThis facilityPeer median
Nurse hours per resident day3.313.73
Registered-nurse hours per resident day0.74—
Annual nurse turnover33.3%45.7%

As reported by the facility to CMS, beside the peer-group median.

Enforcement

No fines, payment denials or special-focus designation on the current CMS record.

Severity of recent findings

Citations by CMS scope and severity. Rows are harm level, columns are how widespread the finding was.
SeverityIsolatedPatternWidespread
Immediate jeopardyJ—K—L—
Actual harmG—H—I—
No harm, potential for more than minimalD350.0%E116.7%F233.3%
No harm, potential for minimalA—B—C—
CMS’s current file: 6 of the 48 citations on record.

Most frequently cited here

In CMS’s current monthly file.

  • F8122×

    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

  • F8802×

    Provide and implement an infection prevention and control program.

  • F5831×

    Keep residents' personal and medical records private and confidential.

  • F7601×

    Ensure that residents are free from significant medication errors.

In the surveyor’s words

From the most serious findings on record at Cornell Health Services, in the surveyor’s own words.

  • No harm, potential for more than minimal, widespreadF812Jul 14, 2026

    Based on observation and interview, the facility did not store and follow proper sanitation and food handling practices to prevent foodborne illnesses for 41 residents who consume food out of 41 residents who reside at facility. The facility:-Did not ensure food in dry storage was properly stored in containers after opened and exposed to air and was not dated when opened.-Did not ensure all foods in resident refrigerator in common area was labeled and dated when opened for a possible 5 residents (R3, R17, R18, R19, R27).-Did not ensure juices and milk were dated when opened in resident dining room refrigerator.-Did not ensure food was a minimum of 6 inches off the floor in walk in freezer.-Did not ensure dietary staff properly contained hair within hair nets.-Did not ensure dietary staff… […]

  • No harm, potential for more than minimal, widespreadF812May 7, 2025

    Based on observation, interview and record review, the facility did not ensure that food was prepared, distributed, and served in accordance with professional standards for food service safety. Kitchen staff had beard hair exposed and uncovered while preparing food. This had the potential to affect all 39 of 39 residents residing in the facility. Findings include: The facility policy, titled Personal Hygiene states, Hair must be kept clean and kept restrained with a hair net or cap covering all hair. Beards must be restrained using a beard net. On 05/05/25 at 8:20 AM, Surveyor conducted initial tour of kitchen and observed [NAME] C standing at breakfast steam table with beard net on that did not cover facial hair along both sides of face or mustache. […]

  • No harm, potential for more than minimal, patternF880Sep 4, 2024

    Based on observation, interview and record review, the facility did not establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections. This had the potential to affect 17 residents (R) on the 200 Hall. The facility did not ensure the standards of practice for applying and removing Personal Protective Equipment (PPE) to prevent the spread of infection while providing high contact care for COVID-19 positive R4. Housekeeper observed not sanitizing hands between resident rooms when delivering clean linens. […]

  • No harm, potential for more than minimal, patternF880Jan 20, 2022

    Based on observation and interview, the facility did not maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment, and to help prevent the development and transmission of communicable diseases and infections. The facility staff did not perform hand hygiene during personal cares for 1 Resident (R) 6 of 1 care observation. The facility staff did not clean or sanitize the mechanical lift between 3 Residents (R6, R15, and R20) of 3 observations, or use appropriate infection control practices for catheter care for R31. Facility staff provided personal cares for R6 and did not wash or sanitize hands after removing contaminated gloves. […]

  • No harm, potential for more than minimal, patternF679Dec 7, 2021

    Based on observation, interview and record review, the facility did not provide an ongoing program to support resident's choice of activities, designed to meet the interests of and support the physical, mental and psychosocial well-being of each resident. This affects 10 of 29 residents (R). (R1, 2, 3, 4, 5, 6, 7, 8, 9, and 10) Residents were not offered or provided a variety of engaging activities based on their individual preferences since the activity director position was unfilled for the past month. Findings include: Example 1: On 12/07/21 at 9:50 AM, Surveyor observed R1 sitting in the recliner in the resident's room. There was a half-eaten breakfast tray on the over bed table in front of R1. The TV was on, but R1's eyes were closed and R1 appeared to be sleeping. […]

Read 22 findings in full →The most serious and the most recent: 22 of 48 on record.

Every survey on record

FindingsAt actual harm or above

  • Jul 14, 2026Standard2 findings
  • May 7, 2025Standard1 finding
  • Sep 4, 2024Complaint1 finding
  • Apr 10, 2024Standard2 findings
  • Jan 20, 2022Standard1 finding
  • Dec 7, 2021Complaint1 finding
  • Nov 22, 2021Complaint1 finding
  • Sep 21, 2021Complaint1 finding
Show the 9 earlier surveys
  • Jun 9, 2020Complaint2 findings
  • Feb 11, 2020Standard6 findings
  • Mar 20, 2019Standard1 finding
  • Jan 5, 2017Standard1 finding · 1 harm
  • Jan 14, 2016Standard3 findings
  • Mar 26, 2014Standard7 findings
  • Mar 19, 2013—7 findings
  • Jan 11, 2012—5 findings · 1 harm
  • Oct 26, 2010—6 findings · 1 harm

Surveys that found no deficiencies are not in CMS’s files and do not appear here.

Comparable facilities

The nearest facilities to this one in the same peer group, by weighted findings.

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