Samaritan Nursing and Rehab
531 E Washington St, West Bend, WI 53095 · (262) 335-4500 · CMS certification number 525165
Samaritan Nursing and Rehab is a 131-bed for-profit nursing home in West Bend, Wisconsin, certified for Medicare and Medicaid since 1967. CMS rates it 1 out of 5 stars overall. Its last three inspection cycles produced 67 health citations, 4 of them at the level CMS classes as actual harm or immediate jeopardy.
CMS star ratings
| Overall | ★★★★★ |
|---|---|
| Health inspections | ★★★★★ |
| Staffing | ★★★★★ |
| Quality measures | ★★★★★ |
How it compares
| This facility | Wisconsin average | |
|---|---|---|
| Health citations, most recent inspection cycle | 39 | 9.4 |
| Nurse staffing hours per resident per day | 5.91 | 4.25 |
| Nursing staff turnover | 75.3% | 46.7% |
| Overall star rating | 1 | 3.1 |
Facility details
| Ownership | For profit - Limited Liability company |
|---|---|
| Chain | Shlomo Hoffman (10 facilities) |
| Certified beds | 131 (about 75 residents a day) |
| County | Washington |
| Last standard inspection | May 18, 2026 |
Inspection history
67 citations from 13 inspections, 47 of them from complaint inspections. Newest first; select an inspection to see its citations.
August 18, 2026 2 citations · complaint inspection Potential harm
Respond appropriately to all alleged violations.
Potential for more than minimal harm (isolated) Freedom from Abuse, Neglect, and Exploitation Complaint
Tag F0610 · severity code D · corrected Aug 31, 2026
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Potential for more than minimal harm (isolated) Freedom from Abuse, Neglect, and Exploitation Complaint
Tag F0609 · severity code D · corrected Aug 31, 2026
May 18, 2026 14 citations · standard inspection Potential harm
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Potential for more than minimal harm (widespread) Nutrition and Dietary
Tag F0812 · severity code F · corrected Jun 11, 2026
Provide and implement an infection prevention and control program.
Potential for more than minimal harm (widespread) Infection Control
Tag F0880 · severity code F · corrected Jun 11, 2026
Ensure 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.
Potential for more than minimal harm (pattern) Pharmacy Service
Tag F0761 · severity code E · corrected Jun 11, 2026
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Potential for more than minimal harm (isolated) Quality of Life and Care
Tag F0689 · severity code D · corrected Jun 11, 2026
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Potential for more than minimal harm (isolated) Freedom from Abuse, Neglect, and Exploitation
Tag F0607 · severity code D · corrected Jun 11, 2026
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Potential for more than minimal harm (isolated) Resident Assessment and Care Planning
Tag F0657 · severity code D · corrected Jun 11, 2026
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Potential for more than minimal harm (isolated) Quality of Life and Care
Tag F0690 · severity code D · corrected Jun 11, 2026
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Potential for more than minimal harm (isolated) Nursing and Physician Services
Tag F0726 · severity code D · corrected Jun 11, 2026
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Potential for more than minimal harm (isolated) Pharmacy Service
Tag F0755 · severity code D · corrected Jun 11, 2026
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Potential for more than minimal harm (isolated) Nutrition and Dietary
Tag F0804 · severity code D · corrected Jun 11, 2026
Implement a program that monitors antibiotic use.
Potential for more than minimal harm (isolated) Infection Control
Tag F0881 · severity code D · corrected Jun 11, 2026
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Potential for more than minimal harm (isolated) Infection Control
Tag F0883 · severity code D · corrected Jun 11, 2026
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
Potential for more than minimal harm (isolated) Infection Control
Tag F0887 · severity code D · corrected Jun 11, 2026
Post nurse staffing information every day.
Potential for minimal harm (widespread) Nursing and Physician Services
Tag F0732 · severity code C · corrected Jun 11, 2026
April 20, 2026 12 citations · complaint inspection Immediate jeopardy
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Immediate jeopardy to resident health or safety (isolated) Freedom from Abuse, Neglect, and Exploitation Complaint
Tag F0600 · severity code J · corrected Apr 21, 2026
Hire a qualified full-time social worker in a facility with more than 120 beds.
Potential for more than minimal harm (widespread) Administration Complaint
Tag F0850 · severity code F · corrected Apr 21, 2026
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Potential for more than minimal harm (pattern) Freedom from Abuse, Neglect, and Exploitation Complaint
Tag F0609 · severity code E · corrected Apr 21, 2026
Respond appropriately to all alleged violations.
Potential for more than minimal harm (pattern) Freedom from Abuse, Neglect, and Exploitation Complaint
Tag F0610 · severity code E · corrected Apr 21, 2026
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
Potential for more than minimal harm (isolated) Nursing and Physician Services Complaint
Tag F0947 · severity code D · corrected Apr 21, 2026
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Potential for more than minimal harm (isolated) Freedom from Abuse, Neglect, and Exploitation Complaint
Tag F0607 · severity code D · corrected Apr 21, 2026
Provide care and assistance to perform activities of daily living for any resident who is unable.
Potential for more than minimal harm (isolated) Quality of Life and Care Complaint
Tag F0677 · severity code D · corrected Apr 21, 2026
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Potential for more than minimal harm (isolated) Quality of Life and Care Complaint
Tag F0684 · severity code D · corrected Apr 21, 2026
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Potential for more than minimal harm (isolated) Quality of Life and Care Complaint
Tag F0689 · severity code D · corrected Apr 21, 2026
Ensure medication error rates are not 5 percent or greater.
Potential for more than minimal harm (isolated) Pharmacy Service Complaint
Tag F0759 · severity code D · corrected Apr 21, 2026
Ensure that residents are free from significant medication errors.
Potential for more than minimal harm (isolated) Pharmacy Service Complaint
Tag F0760 · severity code D · corrected Apr 21, 2026
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.
Potential for more than minimal harm (isolated) Nutrition and Dietary Complaint
Tag F0803 · severity code D · corrected Apr 21, 2026
March 11, 2026 1 citation · complaint inspection Potential harm
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Potential for more than minimal harm (isolated) Nutrition and Dietary Complaint
Tag F0804 · severity code D · corrected Mar 12, 2026
November 11, 2025 4 citations · complaint inspection Immediate jeopardy
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Immediate jeopardy to resident health or safety (isolated) Quality of Life and Care Complaint
Tag F0684 · severity code J · corrected Dec 17, 2025
Ensure that residents are free from significant medication errors.
Potential for more than minimal harm (isolated) Pharmacy Service Complaint
Tag F0760 · severity code D · corrected Dec 17, 2025
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Potential for more than minimal harm (isolated) Quality of Life and Care Complaint
Tag F0689 · severity code D · corrected Nov 12, 2025
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Potential for more than minimal harm (isolated) Quality of Life and Care Complaint
Tag F0686 · severity code D · corrected Dec 17, 2025
October 16, 2025 6 citations · complaint inspection Immediate jeopardy
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Immediate jeopardy to resident health or safety (isolated) Quality of Life and Care Complaint
Tag F0689 · severity code J · corrected Oct 17, 2025
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Potential for more than minimal harm (isolated) Pharmacy Service Complaint
Tag F0755 · severity code D · corrected Oct 17, 2025
Provide safe and appropriate respiratory care for a resident when needed.
Potential for more than minimal harm (isolated) Quality of Life and Care Complaint
Tag F0695 · severity code D · corrected Oct 17, 2025
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Potential for more than minimal harm (isolated) Quality of Life and Care Complaint
Tag F0684 · severity code D · corrected Oct 17, 2025
Respond appropriately to all alleged violations.
Potential for more than minimal harm (isolated) Freedom from Abuse, Neglect, and Exploitation Complaint
Tag F0610 · severity code D · corrected Oct 17, 2025
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Potential for more than minimal harm (isolated) Freedom from Abuse, Neglect, and Exploitation Complaint
Tag F0609 · severity code D · corrected Oct 17, 2025
August 26, 2025 3 citations · complaint inspection Potential harm
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Potential for more than minimal harm (pattern) Nutrition and Dietary Complaint
Tag F0804 · severity code E · corrected Sep 19, 2025
Ensure 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.
Potential for more than minimal harm (pattern) Pharmacy Service Complaint
Tag F0761 · severity code E · corrected Sep 19, 2025
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Potential for more than minimal harm (pattern) Pharmacy Service Complaint
Tag F0755 · severity code E · corrected Sep 19, 2025
July 29, 2025 2 citations · complaint inspection Potential harm
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Potential for more than minimal harm (pattern) Quality of Life and Care Complaint
Tag F0686 · severity code E · corrected Aug 29, 2025
Provide and implement an infection prevention and control program.
Potential for more than minimal harm (isolated) Infection Control Complaint
Tag F0880 · severity code D · corrected Aug 29, 2025
April 23, 2025 3 citations · complaint inspection Potential harm
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Potential for more than minimal harm (isolated) Nutrition and Dietary Complaint
Tag F0806 · severity code D · corrected May 20, 2025
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Potential for more than minimal harm (isolated) Pharmacy Service Complaint
Tag F0755 · severity code D · corrected May 20, 2025
Provide safe, appropriate pain management for a resident who requires such services.
Potential for more than minimal harm (isolated) Quality of Life and Care Complaint
Tag F0697 · severity code D · corrected May 20, 2025
January 29, 2025 11 citations · standard, complaint inspection Potential harm
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Potential for more than minimal harm (widespread) Nutrition and Dietary
Tag F0812 · severity code F · corrected Feb 18, 2025
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.
Potential for more than minimal harm (pattern) Nutrition and Dietary Complaint
Tag F0803 · severity code E · corrected Feb 24, 2025
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Potential for more than minimal harm (isolated) Quality of Life and Care
Tag F0686 · severity code D · corrected Feb 20, 2025
Give the resident's representative the ability to exercise the resident's rights.
Potential for more than minimal harm (isolated) Resident Rights
Tag F0551 · severity code D · corrected Feb 20, 2025
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Potential for more than minimal harm (isolated) Resident Rights
Tag F0582 · severity code D · corrected Feb 20, 2025
Keep residents' personal and medical records private and confidential.
Potential for more than minimal harm (isolated) Resident Rights Complaint
Tag F0583 · severity code D · corrected Feb 20, 2025
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Potential for more than minimal harm (isolated) Resident Rights Complaint
Tag F0584 · severity code D · corrected Feb 20, 2025
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Potential for more than minimal harm (isolated) Resident Rights Complaint
Tag F0585 · severity code D · corrected Feb 19, 2025
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Potential for more than minimal harm (isolated) Quality of Life and Care
Tag F0690 · severity code D · corrected Feb 20, 2025
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Potential for more than minimal harm (isolated) Pharmacy Service Complaint
Tag F0755 · severity code D · corrected Feb 20, 2025
Provide timely, quality laboratory services/tests to meet the needs of residents.
Potential for more than minimal harm (isolated) Administration Complaint
Tag F0770 · severity code D · corrected Feb 20, 2025
December 5, 2024 2 citations · complaint inspection Potential harm
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.
Potential for more than minimal harm (isolated) Nutrition and Dietary Complaint
Tag F0803 · severity code D · corrected Dec 20, 2024
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Potential for more than minimal harm (isolated) Pharmacy Service Complaint
Tag F0755 · severity code D · corrected Dec 20, 2024
October 16, 2024 1 citation · complaint inspection Immediate jeopardy
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Immediate jeopardy to resident health or safety (isolated) Freedom from Abuse, Neglect, and Exploitation Complaint
Tag F0600 · severity code J · corrected Oct 17, 2024
November 2, 2023 6 citations · standard, complaint inspection Potential harm
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Potential for more than minimal harm (widespread) Nutrition and Dietary Complaint
Tag F0812 · severity code F · corrected Jan 31, 2024
Provide and implement an infection prevention and control program.
Potential for more than minimal harm (widespread) Infection Control Complaint
Tag F0880 · severity code F · corrected Feb 1, 2024
Provide enough food/fluids to maintain a resident's health.
Potential for more than minimal harm (isolated) Quality of Life and Care
Tag F0692 · severity code D · corrected Dec 1, 2023
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Potential for more than minimal harm (isolated) Quality of Life and Care Complaint
Tag F0686 · severity code D · corrected Dec 8, 2023
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Potential for more than minimal harm (isolated) Quality of Life and Care Complaint
Tag F0684 · severity code D · corrected Dec 8, 2023
Respond appropriately to all alleged violations.
Potential for more than minimal harm (isolated) Freedom from Abuse, Neglect, and Exploitation Complaint
Tag F0610 · severity code D · corrected Dec 1, 2023
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| Nov 11, 2025 | Fine | $26,685 |
| Nov 11, 2025 | Payment Denial | 7 days of denied Medicare payment |
| Oct 16, 2025 | Fine | $134,800 |
| Oct 16, 2024 | Fine | $75,498 |
Covers roughly the last three years, as CMS publishes them.
Personal injury lawyers in West Bend
Lawbamba lists 3 personal injury lawyers with an office in West Bend, Wisconsin, the practice area that deals with the nursing home inspection records on this page. These 3 come first in that listing (how the order is set).
Matched by practice area and office location only. These lawyers are not connected to the records on this page and have not reviewed or endorsed it.
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Source: the Centers for Medicare & Medicaid Services (CMS) nursing home data published on data.cms.gov and Medicare's Care Compare, updated on Lawbamba November 12, 2026. Citations come from state health inspections, standard and complaint-driven, over each facility's last three inspection cycles. A citation describes what inspectors found on the inspection date; facilities can dispute citations, and most are corrected afterwards. Star ratings, fines and the abuse icon are CMS's own.
Lawbamba is not affiliated with CMS or any nursing home, and this page is general information, not legal advice. Report a concern about a nursing home to your state survey agency or long-term care ombudsman.