Federal inspection record · CMS data as of October 1, 2026
Bethany Home
1226 Berlin Street, Waupaca, WI · (715) 258-5521
- Certified beds
- 100
- Residents per day
- 87
- Ownership
- For-Profit
- Chain
- No chain reported
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- July 1, 1994
1
How this home got 4 stars
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Wisconsin.
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Staffing
★★★★★−1 star
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
-
Quality measures
★★★★★+1 star
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
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Overall
★★★★★4 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Wisconsin homes
Bethany Home carries 35 inspection points. That is fewer than 68% of Wisconsin's 321 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Wisconsin: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–11 pts
- 4★ 11–37 pts
- 3★ 37–76 pts
- 2★ 76–130.75 pts
- 1★ over 130.75 pts
Bars show every rated home in Wisconsin by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
10 health citations on record since 2024. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
Harm and immediate-jeopardy citations (1)
-
G
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Everything else, by area of care
Quality of Life and Care3D
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Provide enough food/fluids to maintain a resident's health.
- D
Provide safe and appropriate respiratory care for a resident when needed.
Pharmacy Service2D
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Freedom from Abuse, Neglect, and Exploitation1D
- D
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Infection Control1E
- E
Provide and implement an infection prevention and control program.
Resident Rights1D
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Resident Assessment and Care Planning1D
- D
PASARR screening for Mental disorders or Intellectual Disabilities
Inspection history
2025-05-21
5 health deficiencies · 5 fire-safety deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (1 deficiency)
2024-04-17
4 health deficiencies · 13 fire-safety deficiencies
Top issue: Pharmacy Service (2 deficiencies)
2023-03-15
1 health deficiencies · 2 fire-safety deficiencies
Top issue: Quality of Life and Care (1 deficiency)
4
Nursing time per resident, per day
Each resident here gets about 2 min of nursing staff time a day, 1 min of it from a registered nurse.
This home
2 min
Wisconsin average
4 h 15 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 100% of nursing staff and 100% of registered nurses left in the past year.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.7 pts better | 0.9 | 1.6 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.2 pts better | 2.0 | 2.2 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine4 pts better | 100.0% | 96.0% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine4.4 pts better | 100.0% | 95.6% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury1.4 pts better | 1.9% | 3.3% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms0.2 pts worse | 6.2% | 6.0% | 13.5% |
| Percentage of long-stay residents who lose too much weight1.6 pts better | 3.3% | 4.9% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication5.7 pts worse | 22.5% | 16.8% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication1.6 pts better | 14.3% | 15.9% | 15.4% |
| Percentage of long-stay residents who were physically restrained0.1 pts better | 0.0% | 0.1% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened6.2 pts worse | 23.2% | 17.0% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased4.2 pts better | 11.6% | 15.8% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.9 pts better | 1.0% | 1.9% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection1.9 pts better | 0.8% | 2.7% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence0.7 pts better | 22.9% | 23.6% | 18.3% |
| Percentage of long-stay residents with pressure ulcers3 pts better | 1.9% | 4.9% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine10.7 pts better | 97.6% | 86.9% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit4.2 pts better | 11.4% | 15.6% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication1.2 pts better | 0.0% | 1.2% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine16.5 pts better | 98.7% | 82.2% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission14.2 pts better | 8.3% | 22.5% | 23.4% |
·
Who owns and runs it
10 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Abrahamson, Sue | Corporate Director · Individual | 0% | 1 facilities |
| Conradt, Barbara | Corporate Director · Individual | 0% | 1 facilities |
| Gutho, Hannah | Corporate Director · Individual | 0% | 1 facilities |
| Jacquart, Mike | Corporate Director · Individual | 0% | 1 facilities |
| Mazemke, Michele | Corporate Director · Individual | 0% | 1 facilities |
| Mazemke, Michele | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Mazemke, Michele | Adp Of The SNF · Individual | 0% | 1 facilities |
| Reichenbach, Gregory | Corporate Officer · Individual | 0% | 2 facilities |
| Reichenbach, Gregory | Operational/Managerial Control · Individual | 0% | 2 facilities |
| Reichenbach, Gregory | Adp Of The SNF · Individual | 0% | 2 facilities |
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Fire safety
20 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke7F
- F
Have approved installation, maintenance and testing program for fire alarm systems.
- E
Provide properly protected cooking facilities.
- F
Follow proper procedures when the fire alarm was out of service for more than 4 hours.
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- E
Have approved installation, maintenance and testing program for fire alarm systems.
- E
Inspect, test, and maintain automatic sprinkler systems.
- D
Inspect, test, and maintain automatic sprinkler systems.
Gas, Vacuum, and Electrical Systems4F
- E
Have generator or other power source capable of supplying service within 10 seconds.
- F
Have generator or other power source capable of supplying service within 10 seconds.
- D
Meet requirements for the installation and maintenance of electrical systems.
- D
Meet requirements for the installation and maintenance of electrical systems.
Egress3D
- D
Install emergency lighting that can last at least 1 1/2 hours.
- D
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.
- D
Install emergency lighting that can last at least 1 1/2 hours.
Services2E
- E
Install properly constructed and protected linen or trash chutes.
- E
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Emergency Preparedness2F
- F
Provide primary/alternate means for communication.
- F
Provide family notifications of emergency plan.
Miscellaneous2F
- F
Provide a written emergency evacuation plan.
- D
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
·
Other homes nearby
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WI Veterans Hm Ainsworth Hall
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★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
- 5 h 53 min
- Fines
- $0
-
WI Veterans Home Moses Hall
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★★★★★- Worst citation, 3 yrs
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- Nursing / resident / day
- 5 h 14 min
- Fines
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-
Avina of Weyauwega
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★★★★★- Worst citation, 3 yrs
- K
- Nursing / resident / day
- 4 h 20 min
- Fines
- $116,356