Average — CMS composite of the measures below.
The next survey window likely opens around February 2027
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at The Nichols Center during CMS and state inspections, most recent first.
Failure to update care plan for stage 2 pressure ulcer: A resident with severe cognitive impairment developed a stage 2 pressure ulcer on the right ankle, and the physician ordered daily wound care. The RN/MDS nurse and DON confirmed the comprehensive care plan was not updated after the new order and diagnosis, and the care plan contained no goals or interventions for the wound.
A resident with Alzheimer's disease and moderate cognitive impairment was receiving Seroquel, but there were no psychiatric consult or follow-up orders and no psych follow-up notes in the record. The DON confirmed the resident had not been referred to psychiatry and said behavior entries in the chart were made in error without supporting documentation, while staff reported confusion, restlessness, cursing during care, and poor oral intake.
Failure to Treat a Resident with Dignity and Respect: A cognitively intact resident admitted with difficulty in walking was treated disrespectfully by two CNAs during separate incidents. One CNA delayed incontinence care after telling the resident to use his brief and stating he should be walking because he was in rehab, while another CNA reportedly provided care without speaking, threw the covers over the resident, tossed the bed remote onto the bed, and slammed the door.
A resident sustained a lumbar compression fracture and skin abrasion after staff used an incorrect and damaged sling during a mechanical lift transfer. Despite staff training and facility policy requiring assessment and inspection of slings, the resident was not assessed for lift use, and the sling used was not appropriate or in good condition. Staff proceeded with the transfer after consulting with an RN and LPN, leading to the sling breaking and the resident falling.
Failure to Update Care Plan for Stage 2 Pressure Ulcer
Penalty
Summary
The facility failed to develop and implement a comprehensive, person-centered care plan for Resident #38’s stage 2 pressure ulcer on the right ankle. Record review showed the resident was admitted on 9/20/24 with a diagnosis of pressure ulcer of the right ankle, stage 2, with an onset date of 3/16/26. The order summary included a physician order dated 3/17/26 to clean the stage 2 pressure ulcer with wound cleanser, pat dry, apply calcium alginate to the wound bed, and cover with bordered foam every day shift. The facility’s care plan policy stated each resident is to have a person-centered plan of care and that the care plan is to be reviewed and/or revised at quarterly intervals and with changes in condition as needed. During interview, the RN/MDS nurse stated care plans are supposed to be updated when a new physician order is received and confirmed the care plan was not updated. The DON stated the area had been entered as a skin tear, but the care plan should have been updated after the physician order and diagnosis of a stage 2 pressure wound. Review of the comprehensive care plan showed no goals or interventions related to the stage 2 pressure area on the resident’s right ankle. The resident’s MDS showed a BIMS score of 6, indicating severe cognitive impairment.
Failure to Provide Psychiatric Follow-Up for Resident on Antipsychotic Medication
Penalty
Summary
The facility failed to provide psychiatric services in accordance with professional standards of practice for one resident who was receiving an antipsychotic medication. Record review showed the resident had a BIMS score of 11, indicating moderate cognitive impairment, and diagnoses included Alzheimer's disease. The order summary showed Seroquel (Quetiapine) 100 mg by mouth at bedtime, but there were no orders for psychiatric consultation or follow-up, and no psychiatric follow-up notes were available in the progress notes reviewed from 2/3/26 through 3/12/26. During interviews, the DON stated the resident was not being followed by psychiatric services despite the antipsychotic medication and confirmed the resident had not been referred to psychiatry. She also stated the facility did not have a policy specifying when psychiatric consultation should be obtained. The progress notes contained behavior entries marked yes, but the DON later confirmed there were no descriptive notes supporting those entries and said they were entered in error. Other staff reported the resident had confusion, restlessness, cursing during care, and poor oral intake, and the DON stated psychiatric follow-up is important for residents receiving antipsychotic medications to monitor for adverse effects such as changes in mental status, weight loss, mood changes, or behavioral changes.
Failure to Treat a Resident with Dignity and Respect
Penalty
Summary
The facility failed to ensure a resident was treated with dignity and respect. Facility policy stated the resident has a right to a dignified existence, self-determination, and communication with access to persons and services inside and outside the facility. During the investigation, Resident #1 reported that when he called for assistance at about 2:00 AM, CNA #1 told him to use his brief for incontinence and said she would return to change him, but he waited about an hour and a half before she returned. The resident reported that CNA #1 told him, "You are in rehab and should be walking." The facility investigation also found that CNA #1 was placed on investigative leave and later terminated. A separate facility investigation found that on another occasion, the resident's RP reported CNA #2 entered the room to assist the resident to the bathroom but did not speak to him during the interaction, threw the covers over him, and threw the bed remote onto the bed. The resident confirmed the account and described CNA #2 as rude and nasty, and the RP stated she witnessed CNA #2 not speaking to the resident, throwing the covers over him, throwing the remote onto the bed, and slamming the door. The resident was admitted with difficulty in walking and had a BIMS score of 14, indicating he was cognitively intact. The Administrator and DON verified that both CNAs did not treat the resident with dignity and respect.
Failure to Assess and Use Proper Sling During Mechanical Lift Transfer Results in Resident Fall and Injury
Penalty
Summary
The facility failed to ensure resident safety during a mechanical lift transfer by not assessing and using the appropriate sling, and by not inspecting the sling for signs of wear or damage prior to use. A resident, who was cognitively intact and recently admitted with a diagnosis including anxiety disorder, was transferred using a sling that was not approved for transfers and was in poor condition. The sling was obtained from the laundry, was not on the facility's audit list, and was not provided by the facility's lift company. During the transfer, staff used a shower sling instead of a transfer sling, despite concerns raised by a CNA. The CNA consulted with an RN and an LPN, who allowed the use of the incorrect sling for that instance. The sling appeared old, faded, and had frayed straps, but was still used. The resident fell approximately three feet to the floor when the sling's straps broke, resulting in a skin abrasion and an L1 compression fracture. Interviews with staff confirmed that the resident had not been assessed for lift use, the sling was not inspected for damage, and the correct sling size was not determined. Staff involved acknowledged that proper procedures were not followed, and the sling used was in poor condition and not intended for transfers. Documentation showed that staff had previously been trained and checked off on proper sling use, but these protocols were not followed during the incident.
What surveyors are citing around you — mapped
All 10 risk areas, ranked with evidence
Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 114 citations issued within 25 miles in the last 12 months — including the 7 immediate-jeopardy cases — and tell you exactly what happened, in plain English, matched to your record.
Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
Illustrative
A prioritized, do-first checklist
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Madison
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| The Madison Health And Rehab | 1.8 mi | ★★★★★ | 4 | 0 |
| Highland Home | 5.5 mi | ★★★★★ | 1 | 1 |
| Parkway Health & Rehab Llc | 6.7 mi | ★★★★★ | 4 | 0 |
| Community Place | 9.3 mi | ★★★★★ | 1 | 0 |
| Manhattan Community Care Center | 9.7 mi | ★★★★★ | 7 | 1 |
Every risk area ranked, a do-first checklist, and your local survey patterns
Built specifically for The Nichols Center.
100% money-back within 48 hours.
Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.