Maryhill Manor
501 Madison Ave, Niagara, WI 54151
Maryhill Manor is a nursing home in Niagara, Wisconsin. This page lists the citations, fines and star ratings that CMS publishes for it. Each one has a date and a link to CMS.
CMS star ratings
- 5 of 5CMS overall star rating
- 3 of 5CMS health inspection star rating
- 5 of 5CMS staffing star rating
- 5 of 5CMS quality measures star rating
Facts from CMS
- Phone
- (715) 251-3172
- Last standard health inspection
- March 25, 2026 (7 months ago)
- Certified beds
- 50
- Residents per day, on average
- 44.9
- Ownership type
- Non profit - Church related
- Legal business name
- Maryhill Manor INC
- Chain
- Not listed by CMS
- Takes part in
- Medicare and Medicaid
Fewer health citations than the Wisconsin average (18 vs 28).
Inspections, fines and changes
This list shows every citation and fine in CMS's current data, which covers about the last three years. It also shows changes CMS made to this home's ratings and records.
CMS update of October 28, 2026
Star rating
The CMS overall star rating changed from 4 of 5 to 5 of 5.
Star rating
The CMS staffing star rating changed from 4 of 5 to 5 of 5.
1 citation
Health inspection on June 16, 2026
CMS lists this as a complaint inspection.
Citation F0609. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
CMS lists it as corrected on July 7, 2026.
CMS has cited this home for F0609 2 times since 2024.
CMS update of April 29, 2026
Star rating
The CMS overall star rating changed from 5 of 5 to 4 of 5.
Star rating
The CMS staffing star rating changed from 5 of 5 to 4 of 5.
3 citations
Health inspection on March 25, 2026
CMS lists this as a standard inspection.
Citation F0812. Severity F: potential for more than minimal harm, widespread.
The rule CMS cited:
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
CMS lists it as corrected on April 8, 2026.
CMS has cited this home for F0812 3 times since 2023.
Citation F0640. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
CMS lists it as corrected on April 8, 2026.
Citation F0641. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Ensure each resident receives an accurate assessment.
CMS lists it as corrected on April 8, 2026.
2 citations
Fire safety inspection on March 25, 2026
CMS lists this as a standard inspection.
Citation K0374. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Install smoke barrier doors that can resist smoke for at least 20 minutes.
CMS lists it as corrected on April 8, 2026.
CMS has cited this home for K0374 2 times since 2023.
Citation K0911. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Meet requirements for the installation and maintenance of electrical systems.
CMS lists it as corrected on April 8, 2026.
CMS update of February 25, 2026
Star rating
The CMS overall star rating changed from 4 of 5 to 5 of 5.
Star rating
The CMS quality measures star rating changed from 4 of 5 to 5 of 5.
2 citations
Health inspection on February 4, 2026
CMS lists this as a complaint inspection.
Citation F0686. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
CMS lists it as corrected on February 26, 2026.
Citation F0880. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Provide and implement an infection prevention and control program.
CMS lists it as corrected on February 26, 2026.
CMS has cited this home for F0880 2 times since 2023.
CMS update of November 20, 2025
Star rating
The CMS overall star rating changed from 5 of 5 to 4 of 5. CMS changed how it scores this rating for many homes at once.
Star rating
The CMS quality measures star rating changed from 5 of 5 to 4 of 5.
CMS update of July 30, 2025
Star rating
The CMS overall star rating changed from 4 of 5 to 5 of 5. CMS changed how it scores this rating for many homes at once.
Star rating
The CMS health inspection star rating changed from 2 of 5 to 3 of 5. CMS changed how it scores this rating for many homes at once.
CMS abuse icon
CMS removed its abuse icon from this home.
2 citations
Health inspection on March 10, 2025
CMS lists this as a complaint inspection.
Citation F0580. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
CMS lists it as corrected on March 24, 2025.
CMS has cited this home for F0580 2 times since 2023.
Citation F0657. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
CMS lists it as corrected on March 24, 2025.
CMS update of December 20, 2024
Fine
CMS changed the fine from June 25, 2024 from $77,855 to $50,606.
1 citation
Health inspection on December 18, 2024
CMS lists this as a complaint inspection.
Citation F0583. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Keep residents' personal and medical records private and confidential.
CMS lists it as corrected on January 7, 2025.
2 citations
Health inspection on November 6, 2024
CMS lists this as a standard inspection.
Citation F0812. Severity F: potential for more than minimal harm, widespread.
The rule CMS cited:
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
CMS lists it as corrected on November 18, 2024.
Citation F0883. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Develop and implement policies and procedures for flu and pneumonia vaccinations.
CMS lists it as corrected on November 18, 2024.
8 citations
Fire safety inspection on November 6, 2024
CMS lists this as a standard inspection.
Citation K0511. Severity F: potential for more than minimal harm, widespread.
The rule CMS cited:
Have properly installed electrical wiring and gas equipment.
CMS lists it as corrected on November 18, 2024.
Citation K0918. Severity F: potential for more than minimal harm, widespread.
The rule CMS cited:
Have generator or other power source capable of supplying service within 10 seconds.
CMS lists it as corrected on March 25, 2025.
Citation E0020. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Establish policies and procedures including evacuation.
CMS lists it as corrected on December 18, 2024.
Citation K0321. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
CMS lists it as corrected on November 18, 2024.
Citation K0363. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Install corridor and hallway doors that block smoke.
CMS lists it as corrected on November 18, 2024.
Citation K0751. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Have restrictions on the use of flammable curtains.
CMS lists it as corrected on November 18, 2024.
Citation K0753. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Have restrictions on the use of highly flammable decorations.
CMS lists it as corrected on November 18, 2024.
Citation K0914. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
CMS lists it as corrected on November 18, 2024.
CMS update of August 29, 2024
Star rating
The CMS overall star rating changed from 5 of 5 to 4 of 5.
Star rating
The CMS health inspection star rating changed from 3 of 5 to 2 of 5.
CMS abuse icon
CMS added its abuse icon to this home.
CMS update of July 31, 2024
Star rating
The CMS overall star rating changed from 4 of 5 to 5 of 5.
Star rating
The CMS staffing star rating changed from 4 of 5 to 5 of 5. CMS changed how it scores this rating for many homes at once.
3 citations
Health inspection on June 25, 2024
CMS lists this as a complaint inspection.
Severity J is the highest of CMS's four levels. CMS uses it when residents' health or safety is at serious risk right away.
64 of 323 Wisconsin homes (20%) got a citation at the immediate jeopardy level in 2024.
Citation F0600. Severity J: immediate jeopardy, isolated.
The rule CMS cited:
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
CMS lists it as corrected on July 10, 2024.
Citation F0609. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
CMS lists it as corrected on July 10, 2024.
Citation F0610. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Respond appropriately to all alleged violations.
CMS lists it as corrected on July 10, 2024.
Fine
June 25, 2024 (2 years ago)
CMS fine of $50,606 on June 25, 2024.
CMS update of January 31, 2024
Star rating
The CMS overall star rating changed from 5 of 5 to 4 of 5.
Star rating
The CMS health inspection star rating changed from 4 of 5 to 3 of 5.
4 citations
Health inspection on September 27, 2023
CMS lists this as a standard inspection.
Citation F0803. Severity F: potential for more than minimal harm, widespread.
The rule CMS cited:
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
CMS lists it as corrected on October 20, 2023.
Citation F0812. Severity F: potential for more than minimal harm, widespread.
The rule CMS cited:
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
CMS lists it as corrected on October 20, 2023.
Citation F0580. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
CMS lists it as corrected on October 20, 2023.
Citation F0880. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Provide and implement an infection prevention and control program.
CMS lists it as corrected on October 11, 2023.
3 citations
Fire safety inspection on September 27, 2023
CMS lists this as a standard inspection.
Citation K0374. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Install smoke barrier doors that can resist smoke for at least 20 minutes.
CMS lists it as corrected on October 11, 2023.
Citation K0712. Severity C: potential for minimal harm, widespread.
The rule CMS cited:
Have simulated fire drills held at unexpected times.
CMS lists it as corrected on October 11, 2023.
Citation K0761. Severity C: potential for minimal harm, widespread.
The rule CMS cited:
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
CMS lists it as corrected on October 11, 2023.
Owners and managers
CMS lists these owners and managers for this home. Names are as CMS writes them.
- HEALTHDIRECT INSTITUTIONAL PHARMACY SERVICES INCOperational/managerial control · not applicable · since 06/01/2018
- PRIME TIME HEALTHCARE LLCOperational/managerial control · not applicable · since 11/01/2019
- UP REHAB SERVICES LLCOperational/managerial control · not applicable · since 06/01/2018
- WIPFLI LLPOperational/managerial control · not applicable · since 01/01/1999
- BAIER, PATRICIAOperational/managerial control · not applicable · since 01/01/2016
- BRASURE, ANNOperational/managerial control · not applicable · since 01/01/2024
- CROCKFORD, LYNNEOperational/managerial control · not applicable · since 01/01/2020
- DECKER, DANOperational/managerial control · not applicable · since 01/01/2024
- EBLI, JIMOperational/managerial control · not applicable · since 01/01/2024
- FRANTZ, LANAOperational/managerial control · not applicable · since 01/01/2016
- FREDRICK, AUDREYOperational/managerial control · not applicable · since 01/01/2024
- HAYES, PAULOperational/managerial control · not applicable · since 01/01/2021
- HERRIGES, ROSEMARYOperational/managerial control · not applicable · since 01/01/2021
- KALDOR, CARRIEOperational/managerial control · not applicable · since 01/01/1999
- MATTSON, ANNOperational/managerial control · not applicable · since 01/01/2024
- PULTZ, ROBERTOperational/managerial control · not applicable · since 01/01/2016
- SIKORA, CHRISTYOperational/managerial control · not applicable · since 05/18/2021
Questions
When was Maryhill Manor last inspected?
CMS lists March 25, 2026 as the date of its most recent standard health inspection.
How many citations (violations) does Maryhill Manor have?
CMS lists 18 health citations since September 27, 2023. CMS also calls these deficiencies.
Has Maryhill Manor been fined?
CMS lists 1 fine in the past three years, $50,606 in total.
What is the CMS star rating of Maryhill Manor?
Its CMS overall star rating is 5 of 5.
Is Maryhill Manor a Special Focus Facility?
No. CMS does not list it as a Special Focus Facility or a candidate.