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Public Record

Bethel Home

Nursing HomeOshkosh, WICMS 525554
39 citations on record

From CMS

Facility profile

CMS overall rating
4 / 5

*CMS Five-Star

Certified beds
100

*CMS

Avg. residents per day
66.9

*CMS

Inspection record

On record from CMS

Citations on record
39

*CMS

Inspections on file
10

*CMS

Last inspection
2025-08-13

*CMS

Citations

39 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.

  • 0689Seriousimmediate jeopardy

    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

  • 0657Generalpotential for harm

    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

  • 0777Generalpotential for harm

    Provide or obtain x-rays/tests when ordered and promptly tell the ordering practitioner of the results.

  • 0223Generalpotential for harm

    Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.

  • 0623Generalpotential for harm

    Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

  • 0625Generalpotential for harm

    Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.

  • 0018Generalpotential for harm

    Establish procedures for tracking staff and patients during an emergency.

  • 0039Generalpotential for harm

    Conduct testing and exercise requirements.

  • 0222Generalpotential for harm

    Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.

  • 0311Generalpotential for harm

    Have an enclosure around a vertical opening shaft.

  • 0321Generalpotential for harm

    Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

  • 0324Generalpotential for harm

    Provide properly protected cooking facilities.

  • 0331Generalpotential for harm

    Construct fire resistant interior walls.

  • 0353Generalpotential for harm

    Inspect, test, and maintain automatic sprinkler systems.

  • 0355Generalpotential for harm

    Properly select, install, inspect, or maintain portable fire extinguishes.

  • 0363Generalpotential for harm

    Install corridor and hallway doors that block smoke.

  • 0521Generalpotential for harm

    Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

  • 0751Generalpotential for harm

    Have restrictions on the use of flammable curtains.

  • 0753Generalpotential for harm

    Have restrictions on the use of highly flammable decorations.

  • 0912Generalpotential for harm

    Have power receptacles that are properly grounded.

  • 0918Generalpotential for harm

    Have generator or other power source capable of supplying service within 10 seconds.

  • 0925Generalpotential for harm

    Ensure that sources of ignition are removed from patients receiving respiratory therapy.

  • 0353Generalpotential for harm

    Inspect, test, and maintain automatic sprinkler systems.

  • 0689Generalpotential for harm

    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

  • 0755Generalpotential for harm

    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

  • 0521Generalpotential for harm

    Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

  • 0911Generalpotential for harm

    Meet requirements for the installation and maintenance of electrical systems.

  • 0640Generalno actual harm

    Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.

  • 0321Generalpotential for harm

    Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

  • 0657Generalpotential for harm

    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

  • 0610Generalpotential for harm

    Respond appropriately to all alleged violations.

  • 0353Generalpotential for harm

    Inspect, test, and maintain automatic sprinkler systems.

  • 0374Generalpotential for harm

    Install smoke barrier doors that can resist smoke for at least 20 minutes.

  • 0553Generalpotential for harm

    Allow resident to participate in the development and implementation of his or her person-centered plan of care.

  • 0610Generalpotential for harm

    Respond appropriately to all alleged violations.

  • 0645Generalpotential for harm

    PASARR screening for Mental disorders or Intellectual Disabilities

  • 0698Generalpotential for harm

    Provide safe, appropriate dialysis care/services for a resident who requires such services.

  • 0686Generalpotential for harm

    Provide appropriate pressure ulcer care and prevent new ulcers from developing.

  • 0886Generalpotential for harm

    Perform COVID19 testing on residents and staff.

FAQ

Questions and answers

What is Bethel Home?
Bethel Home is a Medicare- and Medicaid-certified nursing home in Oshkosh, WI, tracked by the Centers for Medicare & Medicaid Services (CMS). Its CMS Certification Number (CCN) is 525554.
What is the CMS rating for Bethel Home?
Bethel Home has a CMS overall rating of 4 out of 5 stars. CMS rates nursing homes on health inspections, staffing, and quality measures.
How many beds does Bethel Home have?
Bethel Home is certified for 100 beds. It serves an average of 66.9 residents per day.
How many citations does Bethel Home have?
Bethel Home has 39 citations on record from CMS health inspections, each tied to a federal deficiency tag.
When was Bethel Home last inspected?
Bethel Home was last inspected on August 13, 2025. 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.

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