With a score of 12/100, Bayshore Nursing & Rehab ranks in the bottom tier of Wisconsin nursing facilities, earning an F grade. CMS data highlights significant concerns that prospective residents and families should thoroughly evaluate.
Staffing levels are a potential concern at Bayshore Nursing & Rehab, with 3.42 total nursing hours per resident per day — below the national average of 3.8 hours. Lower staffing can impact care quality and staff responsiveness.
Recent CMS inspections identified 143 deficiencies at Bayshore Nursing & Rehab, including 9 classified as serious — among the most concerning citation levels. The most notable finding involved: administer the facility in a manner that enables it to use its resources effectively and efficiently..
Score Breakdown
🏥 Staffing Details
| Staff Type | Hours/Resident/Day | National Avg | Comparison |
|---|---|---|---|
| Total Nursing | 3.42 | 3.8 | Below Average |
| Registered Nurses (RN) | 0.34 | 0.7 | Below Average |
| Licensed Practical Nurses (LPN) | 0.82 | 0.7 | Above Average |
| Certified Nursing Assistants (CNA) | 2.25 | 2.4 | Average |
| Weekend Total Nursing | 3.08 | 3.8 | Below Average |
| Weekend RN Hours | 0.25 | 0.7 | Below Average |
🔍 Inspection & Deficiency History
View recent deficiencies (5 shown)
- Tag 0835 Severity LAdminister the facility in a manner that enables it to use its resources effectively and efficiently.Sep 29, 2025 · Administration Deficiencies
- Tag 0841 Severity LDesignate a physician to serve as medical director responsible for implementation of resident care policies and coordination of medical care in the faSep 29, 2025 · Nursing and Physician Services Deficiencies
- Tag 0684 Severity JProvide appropriate treatment and care according to orders, resident’s preferences and goals.Sep 29, 2025 · Quality of Life and Care Deficiencies
- Tag 0686 Severity JProvide appropriate pressure ulcer care and prevent new ulcers from developing.Sep 29, 2025 · Quality of Life and Care Deficiencies
- Tag 0689 Severity GEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Sep 29, 2025 · Quality of Life and Care Deficiencies
📊 Resident Outcome Measures
Based on CMS quality measure data. Lower percentages are better for most metrics.
| Measure | This Facility | Nat'l Avg | |
|---|---|---|---|
| Residents with pressure ulcers | 7.5% | 4.5% | Worse |
| Falls with major injury | 5.0% | 3.0% | Worse |
| On antipsychotic medication | 25.3% | 14.5% | Worse |
| Urinary tract infections | 1.2% | 2.5% | Better |
| ADL decline (daily activities) | 15.4% | 14.0% | Worse |
| Excessive weight loss | 6.8% | 7.5% | Average |
| New/worsened incontinence | 21.8% | 45.0% | Better |
⚠️ Penalties & Fines
1 penalty recorded by CMS
Total fines: $178,395
How This Grade Was Calculated
This facility's grade of F is based on a score of 12 out of 100, calculated from official CMS Nursing Home Compare data:
- Overall CMS Rating: 1★ → 8 pts (max 40)
- Health Inspection Rating: 1★ → 5 pts (max 25)
- Staffing Rating: 2★ → 8 pts (max 20)
- Quality Measures Rating: 2★ → 6 pts (max 15)
- Penalty deductions: -5 pts
- Fine deductions: -10 pts
Grades: A=85+, B=70–84, C=55–69, D=40–54, F=below 40
Facility Details
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