Nursing homeActive
The Pines Post Acute and Memory Care
1625 E Main St, Clintonville, WI 54929715823313550 certified beds · 45 residentsFor profit - CorporationMedicare and Medicaid
Surveys on file
5
since 2023
Deficiencies
18
● 0● 16● 2
Penalties · 3 yrs
$11,960
1 fine
Last survey
2025-07-17
Standard
CMS overall
4 / 5
stars as published by CMS
CMS overall 4/5
Health 3
Staffing 2
Quality 5
Star ratings as published by CMS · CMS’s caveats
Survey history
Source: CMS · Wisconsin Division of Quality Assurance · data as of 2026-08-01| Date | Kind | Deficiencies | Official record | Archived PDF |
|---|---|---|---|---|
| 2025-07-17 | Standard | 060 | CMS-2567 (Care Compare) | — |
| 2025-06-19 | Complaint | 011 | CMS-2567 (Care Compare) | — |
| 2025-05-01 | Complaint | 011 | CMS-2567 (Care Compare) | — |
| 2024-05-15 | Standard | 050 | CMS-2567 (Care Compare) | — |
| 2023-05-10 | Standard | 030 | CMS-2567 (Care Compare) | — |
Counts by class: paperwork · standard · harm.
Deficiencies
CMS · Wisconsin Division of Quality Assurance publishes each citation’s tag, official description and scope/severity letter. The surveyor’s written findings are in the Statement of Deficiencies (CMS-2567) for each survey, linked above.
F558Reasonably accommodate the needs and preferences of each resident.Scope/severity DStandard
Dignity & rights
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-08-08Record 525497-20250717-F558
F628Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.Scope/severity DStandard
Dignity & rights
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-08-08Record 525497-20250717-F628
F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Scope/severity DStandard
Care planningFalls
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-08-08Record 525497-20250717-F689
F692Provide enough food/fluids to maintain a resident's health.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-08-08Record 525497-20250717-F692
F761Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.Scope/severity EStandard
Medication
Pattern; no actual harm, potential for more than minimal harm.Corrected 2025-08-08Record 525497-20250717-F761
F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Scope/severity EStandard
Food & nutrition
Pattern; no actual harm, potential for more than minimal harm.Corrected 2025-08-08Record 525497-20250717-F812
F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Scope/severity GHarm
Care planningFalls
Isolated; actual harm that is not immediate jeopardy.Corrected 2025-07-04Record 525497-20250619-F689
F607Develop and implement policies and procedures to prevent abuse, neglect, and theft.Scope/severity DStandard
Abuse & neglect
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-07-04Record 525497-20250619-F607
F604Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.Scope/severity JHarm
Abuse & neglect
Isolated; immediate jeopardy to resident health or safety.Corrected 2025-04-02Record 525497-20250501-F604
F607Develop and implement policies and procedures to prevent abuse, neglect, and theft.Scope/severity DStandard
Abuse & neglect
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-05-28Record 525497-20250501-F607
F690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-06-10Record 525497-20240515-F690
F755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.Scope/severity DStandard
Medication
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-06-10Record 525497-20240515-F755
F761Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.Scope/severity EStandard
Medication
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-06-10Record 525497-20240515-F761
F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Scope/severity EStandard
Food & nutrition
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-06-10Record 525497-20240515-F812
F880Provide and implement an infection prevention and control program.Scope/severity DStandard
Infection control
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-06-10Record 525497-20240515-F880
F610Respond appropriately to all alleged violations.Scope/severity DStandard
Abuse & neglect
Isolated; no actual harm, potential for more than minimal harm.Corrected 2023-06-09Record 525497-20230510-F610
F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Scope/severity DStandard
Care planningFalls
Isolated; no actual harm, potential for more than minimal harm.Corrected 2023-06-09Record 525497-20230510-F689
F805Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.Scope/severity DStandard
Food & nutrition
Isolated; no actual harm, potential for more than minimal harm.Corrected 2023-06-09Record 525497-20230510-F805
Penalties & enforcement
| Date | Action | Amount | Source |
|---|---|---|---|
| 2025-06-19 | Civil money penalty | $11,960 | CMS · Penalties |
Staffing
CMS Payroll-Based Journal · PBJ, as published Aug 2026 · explainerRN hours per resident day0.46
Facility
Wisconsin
National
Wisconsin 0.99 · National 0.69
Total nurse hours per resident day3.40
Facility
Wisconsin
National
Wisconsin 4.21 · National 3.86
Weekend total nurse hours3.01
Facility
Wisconsin
National
Wisconsin 3.77 · National 3.42
Total nursing staff turnover53%
Facility
Wisconsin
National
Wisconsin 47% · National 46%
Registered nurse turnover43%
Facility
Wisconsin
National
Wisconsin 40% · National 43%
Quality measures
CMS MDS quality measures · 2025Q2-2026Q1 · definitions| Measure | Facility | Wisconsin | National |
|---|---|---|---|
| Percentage of long-stay residents with pressure ulcers lower is better | 0.9% | 5.0% | 4.6% |
| Percentage of long-stay residents experiencing one or more falls with major injury lower is better | 5.1% | 3.3% | 3.2% |
| Percentage of long-stay residents who received an antipsychotic medication lower is better | 25.0% | 15.8% | 15.4% |
| Percentage of long-stay residents with a urinary tract infection lower is better | 4.5% | 2.7% | 1.6% |
| Percentage of long-stay residents who were physically restrained lower is better | 0.0% | 0.1% | 0.1% |
| Percentage of long-stay residents whose need for help with daily activities has increased lower is better | 12.4% | 16.1% | 13.9% |
| Percentage of long-stay residents who lose too much weight lower is better | 7.3% | 5.1% | 5.2% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication lower is better | 19.2% | 16.9% | 19.5% |
Figures verbatim from CMS, with the state and national figures from the same release. The direction that counts as better is CMS’s own and is stated on every row.
Ownership
As reported to CMS (Provider Enrollment)| Entity | Role | Interest | Since | Registry |
|---|---|---|---|---|
| Bell, Cody Individual | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE | — | — |
| J Thompson Staffing Inc Organization | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE | — | — |
| Kamin, Shayna Individual | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE | — | — |
| Kelstar LLC Organization | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE | — | — |
| Prn Health Services, Inc. Organization | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE | — | — |
| Bell, Cody Individual | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Bell, Cody Individual | MANAGING CONTROL - GOVERNING BODY | NOT APPLICABLE | — | — |
| Burnam, Soon Individual | CORPORATE OFFICER | NOT APPLICABLE | — | — |
| Ensign Services Inc Organization | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Gateway Healthcare LLC Organization | DIRECT OWNERSHIP INTEREST | NOT APPLICABLE | — | — |
| Jorgensen, David Individual | CORPORATE OFFICER | NOT APPLICABLE | — | — |
| Kamin, Shayna Individual | MANAGING CONTROL - GOVERNING BODY | NOT APPLICABLE | — | — |
| Kamin, Shayna Individual | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Keetch, Chad Individual | CORPORATE OFFICER | NOT APPLICABLE | — | — |
| Legend Lake Health Holdings LLC Organization | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Port, Barry Individual | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | NOT APPLICABLE | — | — |
| Standard Bearer Healthcare Op, LP Organization | ADP OF THE SNF | NOT APPLICABLE | — | — |
| The Ensign Group Inc Organization | ADP OF THE SNF | NOT APPLICABLE | — | — |
| The Ensign Group Inc Organization | INDIRECT OWNERSHIP INTEREST | NOT APPLICABLE | — | — |
Part of a chain
The Ensign Group — 342 facilities
Ownership as reported to CMS/state. CMS ownership data has known gaps; merges between entities are published only after human review.
Cost context
County figures from public surveys. Not this facility’s price. Nursing-home rates are not published by CMS or Wisconsin.
No county cost figures on file for Waupaca.
Nearby nursing homes
| Facility | Distance | Last survey | Deficiencies · 3 yrs |
|---|---|---|---|
| Greentree Health and Rehabilitation Center Clintonville | 4.7 mi | 2025-10-09 | 0161 |
| Shawano Health Services Shawano | 7.1 mi | 2026-02-17 | 0120 |
| Evergreen Health Services Shawano | 7.4 mi | 2025-09-16 | 0162 |
| Birch Hill Health Services Shawano | 7.7 mi | 2026-07-01 | 0200 |
| St Joseph Residence New London | 21.1 mi | 2025-10-01 | 090 |
Watch this facility
One email when a new survey, harm-class deficiency, penalty, Special Focus change or ownership change is recorded. Nothing else, ever.
Sources & provenance
| Section | Agency · dataset | Retrieved |
|---|---|---|
| Facility, ratings | CMS Provider Data · Nursing Home Provider Information | 2026-08-01 |
| Surveys | CMS · Survey Summary | 2026-08-01 |
| Deficiencies | CMS · Health Deficiencies (CMS-2567 findings via Care Compare) | 2026-08-01 |
| Penalties | CMS · Penalties | 2026-08-01 |
| Staffing | CMS · Payroll-Based Journal (PBJ, as published Aug 2026) | 2026-08-01 |
| Quality measures | CMS · MDS Quality Measures | 2026-08-01 |
| Ownership | CMS · Ownership | 2026-08-01 |