Public Record
Capitol Lakes Health Center
Operated by Pacific Retirement Services
From CMS
Facility profile
- CMS overall rating
- 3 / 5
- Certified beds
- 49
- Avg. residents per day
- 24.9
*CMS Five-Star
*CMS
*CMS
Inspection record
On record from CMS
- Health citations
- 23
- Fire safety findings
- 36
- Inspections on file
- 9
- Last inspection
- 2026-03-10
*CMS
*CMS
*CMS
*CMS
Citations
23 citations on record
Each deficiency cited on a CMS health inspection of this facility, sourced from the federal record. Open a report for the raw CMS Scope and Severity grade on each finding.
What do CMS severity letters mean?
Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.
General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.
Each letter combines severity with scope: how many residents the deficiency affected.
- 0678Seriousimmediate jeopardy
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
- 0880Generalpotential for harm
Provide and implement an infection prevention and control program.
- 0688Generalpotential for harm
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
- 0698Generalpotential for harm
Provide safe, appropriate dialysis care/services for a resident who requires such services.
- 0804Generalpotential for harm
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- 0812Generalpotential for harm
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- 0684Generalpotential for harm
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- 0686Generalpotential for harm
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- 0687Generalpotential for harm
Provide appropriate foot care.
- 0758Generalpotential for harm
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
- 0759Generalpotential for harm
Ensure medication error rates are not 5 percent or greater.
- 0809Generalpotential for harm
Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.
- 0578Generalpotential for harm
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
- 0697Generalpotential for harm
Provide safe, appropriate pain management for a resident who requires such services.
- 0580Seriousactual harm
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- 0678Generalpotential for harm
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
- 0583Generalpotential for harm
Keep residents' personal and medical records private and confidential.
- 0561Generalpotential for harm
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
- 0554Generalpotential for harm
Allow residents to self-administer drugs if determined clinically appropriate.
- 0880Generalpotential for harm
Provide and implement an infection prevention and control program.
- 0755Generalpotential for harm
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- 0842Generalno actual harm
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- 0689Generalpotential for harm
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspection history
Every health inspection on record
Each CMS health inspection of this facility, and the deficiencies the surveyors cited. Where the verbatim Form 2567 statement of deficiencies is on file, it links to the full report.
- View inspection reportInspectionFire Safety10 deficiencies
- View inspection reportInspection1 deficiency
- View inspection reportInspectionFire Safety9 deficiencies
- View inspection reportInspection8 deficiencies
- View inspection reportInspection4 deficiencies
- View inspection reportInspectionFire Safety9 deficiencies
- View inspection reportInspection2 deficiencies
- View inspection reportInspection8 deficiencies
- View inspection reportInspectionFire Safety8 deficiencies
Ownership
Pacific Retirement Services
10nursing homes nationwide, in CMS records
FAQ
Questions and answers
- What is Capitol Lakes Health Center?
- Capitol Lakes Health Center is a Medicare- and Medicaid-certified nursing home in Madison, WI, tracked by the Centers for Medicare & Medicaid Services (CMS). Its CMS Certification Number (CCN) is 525305.
- What is the CMS rating for Capitol Lakes Health Center?
- Capitol Lakes Health Center has a CMS overall rating of 3 out of 5 stars. CMS rates nursing homes on health inspections, staffing, and quality measures.
- How many beds does Capitol Lakes Health Center have?
- Capitol Lakes Health Center is certified for 49 beds. It serves an average of 24.9 residents per day.
- How many citations does Capitol Lakes Health Center have?
- Capitol Lakes Health Center has 23 citations on record from CMS health inspections, each tied to a federal deficiency tag.
- When was Capitol Lakes Health Center last inspected?
- Capitol Lakes Health Center was last inspected on March 10, 2026. CMS surveys nursing homes about once a year and after complaints.
- What can I do if I have concerns about care at this facility?
- Start by raising the concern with the facility administrator or director of nursing. Every state also runs a free long-term care ombudsman program that advocates for residents and families; the federal Eldercare Locator at eldercare.acl.gov can connect you with yours. Complaints about quality of care can also be filed with your state survey agency.
*Sourced from the Centers for Medicare & Medicaid Services (CMS). See the official record on CMS Care Compare. If you believe any information is inaccurate, report it here.
/nursing-home/525305-capitol-lakes-health-center