Above average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
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 Bethel Home during CMS and state inspections, most recent first.
A deficiency was cited when a facility area was not kept free from accident hazards and supervision was inadequate to prevent accidents. The environment and oversight did not meet required standards to minimize accident risks.
A resident with orthostatic hypotension and unresponsive episodes did not have their care plan updated to include an APNP's recommendations for slow transfers and hydration. Despite the resident's intact cognition and multiple diagnoses, the facility failed to incorporate these critical interventions, as confirmed by the DON and NHA during a surveyor's review.
A resident experienced an unresponsive episode and shoulder pain, leading to X-rays that revealed a clavicle fracture. The facility failed to ensure the physician received and reviewed the clavicle X-ray results, resulting in a delay in appropriate management. The physician only became aware of the fracture during an orthopedic appointment, highlighting a communication lapse in the facility's process.
The facility failed to provide adequate transfer notices to three residents who were hospitalized, lacking essential information such as the date, reason, and location of transfer, appeal rights, and ombudsman contact details. This deficiency was partly due to inconsistent practices for Medicaid residents, as acknowledged by the DON and NHA.
The facility failed to provide bed hold notifications to three residents during hospital transfers. One resident with intact cognition did not receive notifications for two transfers, and attempts were made to backdate forms. Two other residents, one with moderately impaired cognition and another with severe cognitive impairment, also did not receive notifications. The DON and NHA confirmed that Medicaid residents were not always given notices due to an automatic 15-day bed hold policy.
Failure to Maintain Accident-Free Environment and Provide Adequate Supervision
Penalty
Summary
A deficiency was identified due to the failure to ensure that a specific area within the facility was free from accident hazards and that adequate supervision was provided to prevent accidents. The report notes that the environment was not maintained in a manner that would minimize the risk of accidents, and supervision protocols were insufficient to prevent such incidents from occurring. No additional details regarding the specific individuals involved, their medical history, or their condition at the time of the deficiency are provided in the report.
Care Plan Revision Deficiency for Resident with Orthostatic Hypotension
Penalty
Summary
The facility failed to revise the care plan for a resident who experienced unresponsive episodes and orthostatic hypotension. The resident, who had intact cognition and was their own decision maker, was admitted with multiple diagnoses including surgical aftercare, cervical spine issues, and hypertension. An Advanced Practice Nurse Prescriber (APNP) recommended monitoring the resident for orthostatic hypotension, assisting with slow position changes, and ensuring adequate hydration. However, these recommendations were not incorporated into the resident's care plan. The deficiency was identified when the surveyor reviewed the resident's medical record and noted that the care plan did not include the APNP's recommendations. The Director of Nursing and Nursing Home Administrator confirmed that the care plan lacked these interventions. The care plan only addressed potential unresponsive episodes with interventions such as acknowledging the resident's feelings and assessing unmet needs, but did not include specific instructions for slow transfers or hydration as advised by the APNP.
Failure to Communicate X-ray Results to Physician
Penalty
Summary
The facility failed to ensure that a physician saw and responded to the radiological records for a resident who had X-rays of the shoulder and clavicle after experiencing an unresponsive episode and complaining of pain. The X-rays were completed, and the results for the shoulder showed no acute fracture, which was signed by the physician. However, the clavicle X-ray indicated a fracture, but the results were not signed or acknowledged by the physician, indicating that the physician did not receive or review these results. The resident, who had intact cognition and was their own decision-maker, was admitted for rehabilitation following surgery on the nervous system and had multiple diagnoses, including a right clavicle fracture. Despite the facility receiving the clavicle X-ray results, the registered nurse who documented the shoulder X-ray results did not recall receiving the clavicle X-ray results. Consequently, the physician was not informed of the fracture, and the resident continued to experience pain and instability in the shoulder area. Interviews with the occupational therapist and the director of nursing revealed that the clavicle fracture was only discovered when preparing for an orthopedic appointment. The physician confirmed that they had not seen the clavicle X-ray results and indicated that the treatment would not have changed significantly. However, the lack of communication and oversight resulted in a delay in the appropriate acknowledgment and management of the resident's clavicle fracture.
Failure to Provide Adequate Transfer Notices for Hospitalized Residents
Penalty
Summary
The facility failed to provide timely and adequate transfer notices to three residents (R50, R65, and R27) who were hospitalized. These notices should have included the date of transfer, reason for transfer, location of transfer, appeal rights, and contact information for the State Long-Term Care Ombudsman. R50, who had intact cognition and was their own decision maker, was transferred to the hospital on three occasions without receiving a written transfer notice. Similarly, R65, who had moderately impaired cognition and an activated Power of Attorney for Healthcare (POAHC), was transferred without a written notice. R27, with severe cognitive impairment and an activated POAHC, was also transferred without receiving the necessary documentation. The surveyor's review revealed that the facility's practice was inconsistent, particularly for Medicaid residents, due to an automatic 15-day bed hold policy. The Director of Nursing acknowledged that staff did not always issue the required forms for Medicaid residents, and the Nursing Home Administrator confirmed the lack of a comprehensive written transfer notice. The forms provided at the time of transfer did not contain all necessary information, contributing to the deficiency in communication and documentation for these residents.
Failure to Provide Bed Hold Notifications
Penalty
Summary
The facility failed to provide proper bed hold notifications to three residents during their transfers to the hospital. Resident 50, who had intact cognition and was their own decision-maker, was transferred to the hospital on two occasions without receiving a bed hold notification. The Director of Nursing and Nurse Manager confirmed that a bed hold form was not completed at the time of the transfer, and an attempt was made to backdate a form, which was acknowledged as inappropriate by the Nursing Home Administrator. Resident 65, who had moderately impaired cognition and an activated Power of Attorney for Healthcare (POAHC), was also transferred without a bed hold notification being provided to either the resident or their POAHC. Similarly, Resident 27, with severe cognitive impairment and an activated POAHC, was transferred without a bed hold notice. The Director of Nursing stated that Medicaid residents were not always given a bed hold notice due to an automatic 15-day bed hold policy, which was confirmed by the Nursing Home Administrator.
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 143 citations issued within 25 miles in the last 12 months — including the 4 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 Oshkosh
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Evergreen Health Center | 0.8 mi | ★★★★★ | 0 | 0 |
| Eden Rehab Suites And Green House Homes | 2.2 mi | ★★★★★ | 5 | 0 |
| Edenbrook Of Oshkosh | 2.6 mi | ★★★★★ | 3 | 0 |
| Park View Health Center | 4.5 mi | ★★★★★ | 0 | 0 |
| Edenbrook Omro | 9 mi | ★★★★★ | 35 | 0 |
Every risk area ranked, a do-first checklist, and your local survey patterns
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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.